Is amnioinfusion effective enough to reduce perinatal mortality?

To assess the effects of amnioinfusion for meconium stained liquor on reducing perinatal death. This case control study was conducted in Kalsoom Maternity hospital, Peshawar on singleton pregnancies with cephalic presentation, >37 weeks gestation and meconium stained liquor at admission or during labor, randomized in two groups. Group 1 [study group] received amnioinfusion [normal saline 500mls at room temperature] over a period of 30 minutes at a rate of 10-20 mls/min. Group 2 [control group] did not receive such treatment. Fetal heart monitoring at every 10-15 minutes along with progress of labour plotted on a partogram was recorded. Out of 82 cases, 1 breech and 2 premature were excluded so 79 were left for the study. All were with cephalic presentation and gestation >37 weeks in 73.41% cases and postdates in 26.5% cases. In Group 1 [n=52], 36 [69.2%] had normal vaginal delivery [NVD], 4[7.7%] had outlet forceps delivery, 12[23.1%] had vacuum vaginal delivery and cesarean section rate was 0%. Two [3.8%] newborns were referred to nursery with 1 [1.9%] early neonatal death. In Group 2 [n=27], 6 [22.2%] had NVD, 11[40.7%] delivered with outlet forceps, 10[37.1%] had vacuum vaginal delivery and no cesarean section. Twelve [44.4%] babies were referred to nursery with 2 [7.4%] early neonatal deaths. Amnioinfusion is associated with improvements in perinatal outcome, particularly in settings where facilities for fetal surveillance are limited. The technique appears to be safe, simple and economical

Maternal and perinatal outcome in eclampsia, a one year study

To estimate the maternal and perinatal morbidity and mortality due to eclampsia. Material and This study was conducted between 1st January 2001 to 31st December 2001, in Gynae 'B' unit Khyber teaching Hospital Peshawar. The data of a total of 25 patients presenting with eclampsia during the above period were analyzed. All emergency measures and treatment were taken into account and all surgical methods used, thoroughly reviewed. The presence of complications and maternal and perinatal morbidity and mortality were taken into account and compiled. Maternal Outcome:Twenty one [84%] out of 25 survived without long term complication. Four [16%] out of 25 cases deteriorated despite all the care and finally succumbed. One had cardio vascular accident, one had acute pulmonary oedema and cardiac arrest and 2 developed DIC and irreversible shock. Two out of the 4 who died were post caesarean section. Maternal morbidity was higher in the form of chest infection and renal complication. Perinatal out come:15 out of 25 babies were delivered alive, 10 survived healthily and 5 had neonatal deaths. 2 due to prematurity, 2 IRDS and 1 due to birth asphyxia. Ten out of 25 were intrauterine deaths and still births and these also included babies with anenceph and a meningocele. All patients were from low socioeconomic class and were not booked. These figures show the seriousness of the problem and the question it poses to our existing state of maternal health care, thus guiding us to work harder and develop new approaches to achive the goal set up by safe mother hood concepts