RESUMO
Objective: To determine the success rate of intrauterine balloon tamponade versus B Lynch suture in the management of severe postpartum hemorrhage
Study Design: Randomized controlled trial
Place and Duration of Study: This study was conducted in department of Obstetrics and Gynaecology, Combined Military Hospital, Bahawalpur, from Jan 2017 to Jun 2017
Materials and Methods: A total of 104 patients with severe postpartum hemorrhage, 20 to 35 years of age of gestational age 36-42 weeks were included in the study. Patients with genital tract trauma, retained products of conception, ruptured uterus and any bleeding disorderwere excluded. Then selected patients were placed randomly into group A [intrauterine balloon tamponade] and group B [B Lynch suture] by using lottery method. Outcome variables like control of bleeding within 15 minutes after procedure [success rate] was noted
Results: The mean age of women in group A was 27.69 +/- 3.68 years and in group B was 27.60 +/- 3.65 years. The mean gestational age in group A was 39.98 +/- 1.57 weeks and in group B was 40.04 +/- 1.68 weeks. Success was 67.31 percent in group A [intrauterine balloon tamponade] and 88.46 percent in group B [B Lynch suture] with p-value of 0.009, showing statistically significant difference between the two groups
Conclusion: This study concluded that success rate [stoppage of bleeding within 15 minutes] of B Lynch suture is better as compared to intrauterine balloon tamponade in the management of severe postpartum hemorrhage and should be used as first line procedure in controlling severe PPH
RESUMO
Sanger and coworkers introduced DNA sequencing in 1970s for the first time. It principally relied on termination of growing nucleotide chain when a dideoxythymidine triphosphate [ddTTP] was inserted in it. Detection of terminated sequences was done radiographically on Polyacrylamide Gel Electrophoresis [PAGE]. Improvements that have evolved over time in original Sanger sequencing include replacement of radiography with fluorescence, use of separate fluorescent markers for each nucleotide, use of capillary electrophoresis instead of polyacrylamide gel electrophoresis and then introduction of capillary array electrophoresis. However, this technique suffered from few inherent limitations like decreased sensitivity for low level mutant alleles, complexities in analyzing highly polymorphic regions like Major Histocompatibility Complex [MHC] and high DNA concentrations required. Several Next Generation Sequencing [NGS] technologies have been introduced by Roche, Illumina and other commercial manufacturers that tend to overcome Sanger sequencing limitations and have been reviewed. Introduction of NGS in clinical research and medical diagnostics is expected to change entire diagnostic approach. These include study of cancer variants, detection of minimal residual disease, exome sequencing, detection of Single Nucleotide Polymorphisms [SNPs] and their disease association, epigenetic regulation of gene expression and sequencing of microorganisms genome