RESUMEN
Background: Pregnant women may present with obstetric cholestasis
Objective: To determine the frequency of common maternal complications like gestational hypertension, pre-eclampsia and gestational diabetes in obstetric cholestasis
Methodology: Study Design: Cross sectional study. Setting: Department of Obstetrics and Gynecology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Duration: Six months from 30th September 2014 to 29th March 2015. Seventy eight women admitted in the inpatient Department of Obstetrics and Gynecology ward, meeting the inclusion criteria were included. They were enrolled for study after taking informed consent. Women with obstetric cholestasis were followed till delivery and noted for any complications like gestational hypertension, preeclampsia or gestational diabetes mellitus. The outcome variables noted were; gestational hypertension, preeclampsia or gestational diabetes mellitus on specifically designed proforma along with demographic features of the patients. Data was analyzed by using SPSS version 17
Results: Mean age of the patients was 26+/-3 years, mean gestational age was 33+/-2 weeks, mean AST was 103+/-31 U/L, Mean ALT was 110.71+/-35.74 U/L and mean GGT was 84.81+/-17.59 U/L. Gestational hypertension was the most common complication 29 [65.9%] in patients presented with intrahepatic cholestasis of pregnancy. Gestational diabetes was present in 7[15.39%] patients while pre-eclampsia was noted in 8 [18.2%] patients having intrahepatic cholestasis of pregnancy
Conclusion: Gestational hypertension was the most common complication in patients presented with intrahepatic cholestasis of pregnancy, followed by pre eclampsia and gestational diabetes
RESUMEN
To compare the effectiveness of Misoprostol with syntocinon in the prophylaxis of primary post partum haemorrhage during the management of 3rd stage of labour. Experimental study. Department of Obstetrics and Gynaecology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Pregnant patient with term pregnancy in labour were admitted in labour room. After confirmation that the patient is in labour, they were randomly divided in two groups A and B with 50 patients in each group. 600 ug oral Misoprostol was given to patients in group A and 10 units I/V Syntocinon were given to patients in group B at the time of delivery of anterior shoulder of the baby. Amount of blood loss was observed and all the information were recorded and entered in predesigned proforma. Amongst the 100 pregnant patients the mean age was 28.86 + 2.94 and mean parity of patients was 3.94.57% of patients were presented with labour pains only and 27% presented with both labour pain and leaking liquor. In 59 patients duration of labour was between 2-12 hours. Total 9 patients develop PPH in both groups, three patients from Misoprostol group and six patients from syntocinon group. PPH was mild to moderate and settled down with other uterotonic drugs none of the patient required surgical intervention. Development of minor side effect was relatively high in Misoprostol group i.e. 10% such as nausea, vomiting while 4% in syntocinon group. Shivering and mild pyrexia was 12% in Misoprostol group while 5% in syntocinon group. In this study effectiveness of both syntocinon and Misoprostol has been found comparable Misoprostol being slightly more effective than syntocinon in managing 3rd stage of labour also prophylacticaly and it also has fewer minor side effects with no serious danger to life. It does not need skilled personnel for its use