RESUMO
Objective: Study the frequency of common factors Associated with timely initiation of breastfeeding
Study design: Descriptive Cross sectional
Duration and place of study: this study was conducted at, Jinnah postgraduate Medical center Karachi unit-I from 19 May to 18 November 2015
Material and Methods: A total of 108 mother infant pairs were selected by Non probability consecutive sampling technique, meeting our inclusion criteria. Informed consent was taken after explaining the pros and cons, purpose and procedure of the study. The common factors associated with timely initiation of breastfeeding like age of the mother, gestational age, parity, educational status, working status of the mother, mode of delivery, birth weight of the baby and gender of the baby were evaluated through face to face interview of the mothers
Results: In our study mothers found to be 26.1 years old. Mean birth interval found to be 3.1years. Mean birth weight of the babies was 2.86 kg. Mean gestational age of the Patients was 38.1weeks. Most of the babies were female 63[58%] other were male 45[42%].Out of 108 patients, 40[37%] received Primary education, 27 [25%] were graduated, 18[17%] were Illiterate, 13[12%] secondary and 10[9%] were Intermediate. Thirty eight [35.2%] belonged to middle class, 56[51.9%] to upper middle class and only 14[13%] to higher class. Fifty eight [53.7%] women were multipara and 76[70.3%] were employed; And Mostly 66 [61%] delivered through C-Section
Conclusion: According to this study the main conclusion of Common factors associated to timely initiation of breastfeeding were age of mothers[74.07%] more than 20years , parity 2 or more[ 61.1%], educational level secondary and above [50.9%], house wives [32.9%], male sex of infant [41.6%] and Vaginal mode of delivery [38.8%]
RESUMO
Objective: To determine the frequency, risk factors and, maternal and perinatal outcome in women presenting with abruptio placentae at a tertiary care hospital
Methodology: This observational, descriptive study was conducted in the Department of Obstetrics and Gynecology Unit I, Jinnah Postgraduate Medical Centre [JPMC], Karachi from January 2011 to December 2013. All pregnant women with gestational age 28 weeks or greater, having retro-placental clots on ultrasound and/or painful vaginal bleeding were included by using nonprobability purposive sampling technique
Results:There were 24,591 obstetric admissions during the study period, and 21,669 of them delivered. Of these 489 were diagnosed as abruptio placentae, making it a condition with a frequency of 1.98% of obstetric admissions and 2.25% of deliveries. 394 of the 489 cases [80.6%] were un-booked. Majority of them [252, 51.5%] were grand multipara with mean parity of 4.8 +/- 3.3. 330 [61.4%] were older than 30 years [36.1+/- 12.6 years]. 392 [80.2%] delivered vaginally and the rest 97 [19.8%] were delivered by Caesarean section. Hypertension and pre-eclampsia were collectively seen in 124 [25.2%], anaemia in 77 [15.7%], smoking in 39 [7.9%] and trauma in 8 [1.6%] patients. Noteworthy maternal complications were postpartum haemorrhage [PPH] in 70 [14.3%], postpartum anemia in 55 [11.2%], disseminated intravascular coagulation in 13 [2.65%] and renal failure in 2 [0.4%] patients. Maternal death occurred in 17 [3.5%] women. Still birth occurred in 194 [39.7%] patients. Perinatal Mortality was 68.7%
Conclusion: Abruptio placenta has a significantly increased risk of maternal and perinatal mortality. Risk factors include multiparity, hypertension, pre-eclampsia, anaemia and smoking
RESUMO
Objective: To evaluate the frequency of emergency obstetric hysterectomy, and to find out its indications and accompanying maternal and perinatal morbidity and mortality
Methodology: This cross sectional study was undertaken at Obstetrics and Gynaecology department of Unit-I, Jinnah Postgraduate Medical Centre, Karachi from 1st January 2015 to 31st December 2016. Those patients who had emergency obstetric hysterectomy at JPMC during this period were included in the study. Their parity, booking status, age, indication and, the type of surgery undertaken was recorded. Maternal and fetal morbidity and mortality were also determined. Data was analyzed using SPSS 20
Results: A total of 14,157 deliveries were carried out during the study period. Out of them, 32 hysterectomies were undertaken due to obstetric indications [0.22%]. The most common indication was ruptured uterus in 20 [62.5%]. The most common complication was infection [40.6%]. Five patients could not survive after the surgery [15.6%] and perinatal deaths were 19 [59.3%]
Conclusion: Obstetric hysterectomy needs to be done in emergency cases where life of the patient can not be saved otherwise. However, clear judgement, highly professional surgical technique and optimal time for the surgery can decrease mortality and morbidity in such cases
RESUMO
Objective: to determine the agreement between visual inspection with acetic acid test [VIT] and Pap smear in detection of cervical cancer
Study design: cross-sectional study
Place and Duration of study: department of Obstetrics and Gynaecology Unit-II, Jinnah Postgraduate Medical Centre Karachi, from March 2013 to April 2014
Methodology: attendants of the patients visiting antenatal clinic were included in this study. VIA test was performed by the application of 05% acetic acid on the cervix through cotton tipped applicator. After 5 minutes a naked-eye assessment was performed under direct illumination of a 100-watt halogen lamp. A positive visual inspection with acetic acid test was defined as opaque, acetowhite lesions with raised surface and well defined margins present on the cervix. The Pap smear sample was obtained by conventional method and fixed with 95% ethanol for 30 minutes before sending to the laboratory for reporting
Results: a total of 217 patients were selected. Positive agreement between VIA test and Pap smear was found in 158 [72.8%] cases. Agreement was also cross checked with cervical cancer risk factors like age, parity, literacy and socio-economical status. Mean age of the study participants was 34.46 year. Majority [n=89 - 41%] of the women were illiterate, belonged to the poor socioeconomic class [n=52 - 24.1%] and multipara [n=149 - 68.6%]
Conclusion: overall agreement of similar results between VIA test and Pap smear was found in majority of the patients
RESUMO
Objective: to determine the maternal and perinatal outcome of pre-eclampsia and eclampsia treated with magnesium sulphate
Study design: interventional study
Place and Duration of study: department of Obstetrics and Gynecology Unit-I, Jinnah Postgraduate Medical Centre Karachi, from May 2012 to April 2014
Methodology: all patients admitted with pre-eclampsia and eclampsia were included. After taking detailed history and clinical examination they were treated with magnesium sulphate [MgSO[4]]. Patients were monitored for recurrent fits, side effects of MgSO[4], and causes of discontinuation of treatment. Maternal outcome in terms of mode of delivery, number of maternal deaths and perinatal outcome in terms of perinatal death and APGAR scores were recorded
Results: the study was conducted on 50 pre-eclamptic patients [Group-I] and 100 eclamptic patients [Group II]. Mean age of patient in group-I was 26.94 +/- 5.5 year and in Group-II 24.32 +/- 5.8 year. High frequency of eclampsia [n=61, 61%] was found in antepartum cases. Majority of patients [n=79, 52.6%] were primigravidae in both the groups. In group-II five patients had recurrence of fits. There were seven maternal deaths due to eclampsia but none of the deaths was attributed to magnesium sulphate therapy. Overall perinatal mortality was 30.7% [n=46]
Conclusions: recurrence of seizure was seen in only 5% eclamptic women and none in those with severe pre-eclampsia. Magnesium sulphate was found effective in treatment as well prophylaxis of eclampsia