RESUMO
Background: Objectives: To compare misoprostol 600 mcg, oral with carboprost 125 mcg, i.m., in the active management of third stage of labour. Methods: A total of 200 pregnant women of 38-42 weeks of gestation delivering vaginally in the Shivamogga institute of medical sciences, Shivamogga, Karnataka, India were selected for study. 100 women received misoprostol 600 mcg, orally and 100 women received carboprost 125 mcg, i.m. immediately after delivery of baby and cord clamping by the method of randomisation. Results: In the misoprostol group, mean blood loss is 134.9 ml, mean duration of the third stage of labour is 4.07 min and mean fall in hemoglobin is 0.34 g/dl. In the carboprost group, mean blood loss is 123.7 ml, mean duration of the third stage of labour is 3.73 min and mean fall in hemoglobin is 0.28 g/dl. There was no significant difference between the two groups with regard to the above mentioned factors. There were 5 cases of PPH in the misoprostol group and 3 cases in the carboprost group. 21 cases in the misoprostol group and 14 cases in the carboprost group required additional oxytocics. Unpleasant side effects like diarrhoea and vomiting were more in carboprost group. Conclusion: Oral misoprostol is as effective as carboprost in AMTSL and can be used safely in vaginal deliveries for prevention of PPH, especially in non-institutional deliveries and in places of low resource settings.
RESUMO
To study the maternal mortality and common complication leading to maternal death over a period of 10yrs from Jan 1999 to Dec. 2009.A retrospective study of hospital records and death summaries of all maternal deaths over 10 yr periods was carried out. MMR of 270.33/1,00,000 live births was observed over a period of 10 yrs. post partum hemorrhage was the leading direct cause and anemia the leading indirect cause. Most women died within 24 hrs of admission. The age group of 20-30 yrs was crucial. Most deaths were in unbooked cases transferred from outside. Hemorrhage and PIH are major causes of death. Most maternal deaths are one preventable by quality health education of women & adequate care to the mothers at all levels district health system.
RESUMO
The study was conducted to determine the maternal mortality rate (MMR), various factors affecting it and possible prevention of maternal deaths in Christian Medical College & Hospital, a tertiary care institute during the past five years (2001- 2005). The individual record of maternal deaths was studied regarding their socio-demographic features, causes, modes of management and ultimate outcome. The Maternal Mortality rate was 1470 per lac live births. The major obstetrical complications accounted for more than three fourth of maternal deaths with hemorrhage (33%), sepsis (21.7%) and eclampsia (7.5%) playing an important role. Anemia (44.3%) and jaundice (16.0%) were two important indirect causes of maternal deaths. Un-booked cases accounted for majority of maternal deaths. Only two maternal mortality patients were showing regularly in our institute, rest all of the patients either had no antenatal check-up or were having ANC in private clinics and were referred as an emergency in critical condition. More than 90% of maternal deaths hailed from rural and urban slum areas. 61 (57.8%) cases received primary care from untrained birth attendants and 11 (10.4%) did not receive primary care in any form. There was delayed referral by the untrained personnel, 49 (46.2%) patients were referred after more than 48 hours of acute emergency, 51 (48.1%) died between 24 to 48 hours and 25 (23.6%) died within 24 hours of admission in spite of all resuscitative measures. It is concluded that providing good antenatal care, finding appropriate ways of preventing and dealing with the consequences of unwanted pregnancies, and improving the way society looks after pregnant women are three most important ways to reduce maternal mortality.