Comparison of medical vs surgical management of missed abortion

Objective: to compare the outcome of medical vs. surgical management of missed abortion in terms of success rate and complications

Material and Methods: all the participants were admitted in hospital gynecology ward and were divided into two groups. 55 women were randomly selected to undergo surgical management i.e. D and C and 75 women to receive medical treatment with oral misoprostol 400?gm thrice daily for 2 days. If the patient did not expel products of conception during 48 hours, her medical management was considered to be failed and surgical evacuation was done. Data collection was done on a structured Performa which was then entered on excel Data sheet and analyzed on spss20 statistical package

Results: Surgical management was successful in 100% cases. Complications were more with surgical management i.e. nausea, vomiting, postoperative fever, lower abdominal pain, excessive bleeding, need for blood transfusion and genital tract trauma. Medical management had a lower success rate, evacuation was sometimes incomplete and patient had to experience labor pains but it had lower complication rate. D and C was easier in medical management group. Patient acceptability was more for medical group

Conclusion: surgical management has a high success rate but its complications are more as compared to medical management. Surgical evacuation as first line treatment option is only suitable for a woman who does not wish to undergo labor discomfort .Medical termination is -easier to manage, more natural, associated with least complications and more acceptable by the patients but its success rate is slightly less as compared to surgical intervention. Hence each patient should be given the chance of medical termination for at least two days and if she does not expel products of conception spontaneously during this time, then only surgical evacuation should be done

Intravenous maternal hydration in third trimester oligohydramnios: effect on amniotic fluid volume

To determine the affect of acute intravenous maternal hydration on amniotic fluid volume in patients with third trimester oligohydramnios. Quasi experimental study. Department of Obstetrics and Gynaecology Unit III, Sir Ganga Ram Hospital, Lahore, from May 2001 to April 2002. Twenty-five women with third trimester oligohydramnios [API

Perinatal outcome in multifetal gestations at Lady Willingdon Hospital, Lahore

To find out the perinatal outcome in multifetal gestations in relation to gestational age and birth weights of neonates after 24 weeks of gestation at Lady Willingdon Hospital, Lahore and also to identify the factors responsible for poor perinatal outcome in such pregnancies. Cross-sectional descriptive study Lady Willingdon Hospital Lahore. 1[st] July 2004 to 31[st] December 2004. Patients having multifetal gestations at or above 24 weeks of pregnancy, presenting in outdoor or in labour rooms during labour, and their neonates after birth till first week of life. One hundred cases were included in the study. The perinatal mortality in relation to gestational age and fetal weight at birth were calculated. The perinatal mortality rate was inversely proportional to gestational age and birth weights of neonates. The results were tabulated and perinatal mortality rate [PNMR] calculated for various groups. Overall PNMR in such gestation in terms of gestational age and weight was 533.33/1000 births. PNMR at 24-28 weeks was 1000, at 29-32 weeks 888/1000, at 33-36 weeks 456/1000 and was 117.5/1000 births at>/=37 weeks of gestation. PNMR was highest with birth weights of 0.5-1Kg while it decreased as the birth weight increased i.e 91/1000 at birth weight of more than 2.5 Kg. These results were compared with those of other national and international studies. Multifetal gestations are high risk pregnancies which need special care during antenatal, intrapartum and neonatal period. In order to decrease this high PNMR in such pregnancies extra vigilance on the part of obstetricians, anaesthetists and perinatologists is required

Causes of maternal mortality in lady Willingdon hospital Lahore

Was to observe the major causes of maternal mortalities in our hospital. Settings: All 3 units of Lady Willingdon Hospital Lahore. It was an observational analytical study. The data was collected with the help of the proformas. Total no. of births during 1[st] Sept 2004 to 31[st] August 2005 were 12011 and death were 40. Maternal mortality rate was 330.5579/100.000 live births. Haemorrhage was the major killer of such unfortunate patients. Maternal Mortalities can be prevented or reduced if proper and in time decision for referral and treatment is made

Septic induced abortion maternal mortality and morbidity

A total 1932 patient were admitted in Gynae ward. Out of these 188 patients were of septic induced abortions. Incidence of septic abortion is [8.6%] of total admissions. [14.28%] were first trimester below 6 weeks, [57%] were 7-12 weeks and 29% were 2nd trimester. The reason for termination was unplanned Pregnancy in most of cases [42.85%]. Maternal mortality rate was [7.1%] due to induced abortion