RESUMO
Background: Retained placenta is one of the causes of post-partum hemorrhage in Bangladesh as it is worldwide. If a retained placenta is left untreated, there is a high risk of maternal morbidity and mortality and it has inherent risks of infection and hemorrhage. Manual removal of placenta which is the recommended treatment of retained placenta usually requires regional or general anesthesia. Intraumbilical injection of saline solution with oxytocin might represent an important option for management of retained placenta. Objectives: The aim of this study was to assess the effect of intraumbilical vein oxytocin in the management of retained placenta and to compare it to the risk of manual removal of placenta. Materials and Methods: This experimental study was conducted in the department of Obstetrics and Gynecology in Dhaka Medical College & Hospital during July to December 2004. Total 50 patients with retained placenta were included in this study. The patients were divided purposively randomly into two groups ---- Groups A and B. Twenty patients in Group A were managed by intraumbilical vein injection of 10 units of oxytocin in 20 mL of normal saline slowly and 30 patients in Group B were managed by manual removal of placenta. Results: Among the patients of Group A, 16 (80%) delivered placenta spontaneously with expulsion time of 7--12 minutes. Remaining 4 patients (20%) required manual removal of placenta even after intraumbilical vein injection of oxytocin. Group A patients had less complications, required less blood transfusion, less antibiotics and less hospital stay compared to Group B patients. Conclusion: Intraumbilical vein administration of oxytocin is superior to manual removal in the management of retained placenta.
RESUMO
Background: Carcinoma of cervix is the most common malignancy in female and a major public health problem worldwide. It is the leading cause of death from cancer among women in low resource settings. In Bangladesh, mortality rate is high as most of the cases with cervical cancer are diagnosed in advanced stage. World Health Organization considers cervical cancer as a preventable disease as it can be identified in preinvasive stage. Considerable efforts have been given in detection and treatment of the condition all over the world. A number of cervical cancer screening tests are available. Among them, visual inspection of cervix with acetic acid is rational and can be competently performed by physicians with proper training. Objective: To find out the feasibility of the visual inspection of cervix with acetic acid for the detection of the precancerous lesions of the cervix in our country. Materials and Methods: This cross sectional, analytical study was carried out among the patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) who were VIA positive and sent for colposcopy in the colposcopy clinic in the department of Obstetrics and Gynecology in BSMMU from June to December 2004. Two hundred samples were considered for this study. Results: Out of 200 cases, colposcopically 85% had CIN and invasive lesions, 4% had inflammatory lesions while 11% had normal findings. Colposcopy directed punch biopsy revealed positive lesions in 81%, 4% had inflammatory lesions while 15% had normal findings. Conclusion: The study concluded that VIA and colposcopy are the important methods in the evaluation of cervical premalignancy. VIA may be an important tool for screening of cervical cancer in low resource settings as it is simple, easy to perform and cost-effective. After screening, VIA positive cases must be referred for colposcopic evaluation. We can screen cervical cancer by VIA all over the country and thus reduce morbidity and mortality rate.