Résumé
Objective: to evaluate postpartum complications and their outcome in patients admitted to Fatima memorial Hospital, Lahore and to find out avoidable causes
Material and Methods: this descriptive study was conducted in the Department of Obstetrics and Gynaecology, Fatima Memorial Hospital, Lahore from December, 2012 to December, 2013. A total of 100 patients who were admitted through gynaecology outpatients department or emergency with postpartum complaints following delivery at home or hospital vaginally or through caesarean section were included in the study
Results: mean age of the patients was 26. 70+/- 4.85 years. Out of 100 patients, 50 patients had no complication. Out of remaining 50, 19 had postpartum haemorrhage while 18 had postpartum eclampsia. Seven had puerperal sepsis, 2 patients with thromboembolic disease, one with postpartum depression, 2 with urinary tract infection and one with breast disease
Conclusions: PPH is major cause of maternal morbidity and mortality followed by postpartum eclampsia. Maternal mortality and severe morbidity may be reduced by regular prenatal care
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Objective: women and children are often in great danger in the place where they should be safest: within their families. Those affected by domestic violence experiences a hidden "homelessness"
Material and Methods: a cross-sectional descriptive study from April to June 2012 at Fatima Memorial hospital, Shadman Lahore. The total population of Lahore is 10,000,000. The sample size 384 women .Inclusion criteria is married women 18-50 years old , resident of the community> 3years
Results: a total of 384 women were included in the study, 82% had different types of violence, 37% had physical violence from husband .Infertility and not giving birth to a son were two other reasons for violence found in our study
Conclusion: the levels of physical, psychological violence were high as compared to sexual violence, confirming it's a universal phenomenon existing worldwide in all communities. There should be the laws passed and implemented in the society against the domestic violence so that women can also play a healthy role in the development of the country and there family and we appear as a successful nation on the globe of the world
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The three most common visual complications of preeclampsia and eclampsia are hypertensive retinopathy, exudative retinal detachment and cortical blindness. Preeclampsia-eclampsia can have neurological squelae; cortical blindness is one of these. We report case of parturient with mild preeclampsia that subsequently developed transient blindness
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Objective: to compare the primary postpartum haemorrhage after spontaneous labour with induced and/ or augmented labour
Material and Methods: it is a comparative cross-sectional study, conducted in department of Obstetrics and Gynecology, Fatima Memorial Hospital, Lahore. This study was carried out over a period of one year from 1.7.11 to1.7.12.100 patients were included and divided into two equal groups. Group A, 50 patients having spontaneous labour and Group B, 50 patients having induced and/or augmented labour and delivered vaginally
Results: mean age of group-A was 26.4+/-3.48 and in group-B it was 26.88+/-3.64. Out of 50 patients in group B, 16 patients [42.1 %] were induced with prostaglandin E1, 22 patients [57.9%] with prostaglandin E2, and 12 patient's augmentation with syntocinon. 7 patients had PPH in group-B and prostaglandin E1 was used in 1 patient [14.2%], prostaglandin E2 used in 3 patients [42.9%] and augmentation with syntocinon was done in 3 patients [42.9%]. Duration of third stage of labour was 7 .84 minutes in group-A and in group-B it was 11. 76 minutes. Mean blood loss after delivery in group-A was 271.0+/-125.3 ml while in group-B it was 383.0+/-3 16.1 ml which are statistically significant
Conclusions: it is concluded from the study that primary postpartum haemorrhage occurs more in patients whose labour was induced and/or augmented as compared to the patients who had spontaneous onset of labour. The main aim of doing this study is to highlight the importance that all the obstetrician should wait for the spontaneous onset of labour and avoid undue inductions and its complicatios
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Preterm delivery occurs before 37 completed weeks of gestation and it is the major determinant of infant mortality in developed countries. Preterm delivery is the factor most responsible for the relatively high infant mortality in our country. Despite many trials of reduced activity, tocolytic therapy, antibiotic therapy and other strategies for prevention, no effective and reproducible method of preventing preterm delivery has been demonstrated. One treatment that showed promise in small trials was prophylactic treatment with pro-gestational compounds. The purpose of this work is to determine the effectiveness of 17 alpha hydroxyl progesterone in prevention of preterm delivery in women who had a previous preterm birth. It was a descriptive case study and was conducted in the department of Obstetrics and Gynaecology Fatima Memorial Hospital, Lahore for a period of twelve months from January 2011 to December 2011. A total of 135 cases were received by non-probability purposive sampling technique. In this study majority of the patients i.e. 46.67% [n = 63] were between 26 - 30 years, 24.44% [n = 33] were found between 22 - 25 years, whereas 28.89% [n = 39] were found between 31 - 35 years, mean age was found to be 28.24 + 3.83. Most of the patients i.e. 69.62% [n = 94] were found between 21 - 24 weeks and 30.37% [n = 41] were found between 16 - 20 weeks. Data regarding number of previous preterm deliveries showed that majority of the patients i.e. 39.25% [n = 53] were found only 1 previous preterm delivery, 27.49% [n = 29] with 3 and > 3 previous preterm births were found only in 11.86% [n = 16]. Prolongation of pregnancy beyond 36 weeks of gestation is described where 68.15% [n = 92] are shown to be delivered beyond 36 weeks and only 31.85% [n = 43] could not deliver beyond 36 weeks of gestation
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Objective: to compare the risk of Placenta Previa among women who had a pervious cesarean section with women who delivered vaginally
Material and Methods: retrospective cohort study. Study analyzed available data from department of Obstetrics and Gynecology Fatima Memorial Hospital Lahore. Two Years, July 2010 to July 2012
Results: total 56 patients with all types of Placenta Previa were included in the study. Mostly patients were between 26-30 years age. Twenty patients were after normal delivery and 36 were after lower segment caesarean section
Conclusion: there is an increased risk of Placenta Previa in the subsequent pregnancy after lower segment caesarean section as compared to a normal vaginal delivery
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Objective: multiple pregnancies still warrants special attention as it is associated with increasing risk for mother and fetus. Preterm delivery increases the risk for baby. This study was conducted to evaluate the risks of pregnancy complications and associated fetal and maternal outcome in women with twin pregnancies
Material and Methods: it was one year observational study from 1st January 2012 till 31st December, 2012 at department of obstetrics and gynecology Fatima Memorial Hospital, Lahore. All women admitted to the labour ward with twin pregnancies after 28weeks of gestation were included in the study. Main outcome measures were maternal complications [i.e., anemia, preterm labour, pregnancy induced hypertension, postpartum hemorrhage etc.] and perinatal morbidity and mortality. All data collected was analyzed using SPSS-16
Results: majority of women 78[78%] were unbooked and only 22[22%] were booked, 56[56%] women presented with preterm labor, anemia was found in 72[72%] patients and hypertension in 33[33%] patients. Majority presented between 30-35weeks gestation and 30[30%] patients delivered at 36weeks and above. The most common cause of neonatal death was very low birth weight followed by sepsis and jaundice
Conclusion: multiple pregnancies are associated with increasing risk for the mother and fetus. Preterm delivery increases the risk for baby
Résumé
To identify the main causes and associated factors contributing to maternal deaths. The medical record of all the women dying in the department of obstetrics and gynecology were reviewed. Demographic records including age, parity, socioeconomic status and antenatal care were analyzed from the patient's records. There were 16 maternal deaths during the study period with the maternal mortality ratio MMR of 52.04/100,000 live births[16/30,741]. The probable causes of deaths were ascertained on clinical assessment done jointly by gynaecologist, anesthetist and physician as postmortem examination was not done. The major causative factors were hemorrhage in 8[50%] patients, thromboembolism in 2[12.50%] septic shock in 2[12.50%] and acute pancreatitis in 1[6.25%].12/16 patients were unbooked and brought in emergency department. The ages of the women, who died ranged between 21-39 years. There were 5 primigravidas, 5 patients were Para 1-4, and 6 women had a parity more than 4. Most of the maternal deaths can be prevented by providing skilled obstetrical care at the time of delivery, by emergency department and proper management of complications. Safe motherhood requires no costly technology but only appropriate setting of resources; we also need public awareness, raising the self determination and awareness of women rights and improvement of her role in decision making