Clinical study of maternal complications associated with eclampsia

Background: Eclampsia is still one of the leading causes of maternal mortality and morbidity in developing countries. Though the incidence in developed nations has drastically reduced, it has remained the same over years in India, mainly due to lack of awareness, poor socio-economic status and inadequate ante natal check-ups. The objective of this study was to determine the presentation, demographic features, risk factors, management, maternal mortality and morbidity, in women presenting with eclampsia.Methods: This study was conducted in Vanivilas hospital from January to December 2014 for 12 months. Total 230 women with eclampsia were studied with respect to their age, parity, socio economic status, gestational age, details of previous antenatal check-ups, clinical features at presentation, nature and number of convulsions, treatment received before admission, management in the institution and maternal morbidity and mortality.Results: The incidence of Eclampsia was 1.4%. 30% were below 20 years of age, 45% were primigravidas, 97% were referred cases with inadequate antenatal checkups. 68% had antepartum eclampsia, 22% had intrapartum eclampsia and 10% had postpartum eclampsia. 24% had instrumental delivery, 24% underwent caesarean delivery. There were 17.4% ICU admissions, 5.7% acute kidney injury cases and 13 maternal deaths.Conclusions: Eclampsia still remains a major cause of maternal morbidity and mortality in india. Information about danger signs of pre-eclampsia/ eclampsia should be made available to antenatal clients. Importance of timely referral to the tertiary center should be emphasised to the peripheral health workers

(2E)-3-(3-Benzyl­oxyphen­yl)-1-(2-hydroxy-5-methyl­phen­yl)prop-2-en-1-one

In the mol­ecule of the title compound, C23H20O3, an intra­molecular O—H⋯O hydrogen bond generates an S(6) ring. The central benzene ring makes dihedral angles of 80.17 (8) and 16.99 (7)°, respectively, with the benz­yloxy and hy­droxy­methyl phenyl rings. In the crystal, mol­ecules are linked via inter­molecular C—H⋯O hydrogen bonds to form dimers. The dimers are connected by C—H⋯O hydrogen bonds and C—H⋯π inter­actions to form columns down the b axis

Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre

Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician

1-[5-(4-Chloro­phen­yl)-3-(4-hy­droxy­phen­yl)-4,5-dihydro-1H-pyrazol-1-yl]­ethanone

In the title compound, C17H15ClN2O2, the benzene rings form dihedral angles of 89.56 (5) and 5.87 (5)° with the mean plane of the pyrazoline ring (r.m.s. deviation = 0.084 Å). The dihedral angle between the two benzene rings is 87.57 (5)°. In the crystal, mol­ecules are linked by O—H⋯O and C—H⋯O hydrogen bonds into a helical chain along the c axis. Between the chains weak C—H⋯N and C—H⋯O inter­actions are present. The crystal studied was an inversion twin with a domain ratio of 0.72 (4):0.28 (4)

A study of uterine balloon tamponade for the management postpartum haemorrhage using Bakri balloon

Background: PPH is the most common cause of maternal morbidity and mortality around the world. Incidence of PPH is 2-4% following vaginal delivery and 6% following cesarean delivery in India. Uterine atony is the most common cause of PPH. Treatment of PPH involves medical treatment and surgical management. In between medical and surgical management of PPH comes uterine balloon tamponade which is simple, less invasive and can be managed with minimal training.Methods: A retrospective cohort study was done for 2 years at Vanivilas hospital, Bangalore medical college and research centre, Bangalore, Karnataka. Cases of atonic PPH managed using Bakri balloon were included in the study. The objective of the study was to study the effectiveness of uterine balloon tamponade using Bakri balloon in the management of atonic PPH and to study the maternal outcome.Results: In this study total of 50 cases were included. Women were in the age group of 18 to 33years. Regarding obstetric history, 22 (44%) were primigravida and 28 (56%) was multigravida. Among these 50 cases 8 (16%) women had undergone caesarean delivery and 42(84%) had vaginal delivery. All women received blood transfusion, 17 (34%) received blood and blood components (like PRBC, FFP AND platelets) and 33 (66%) cases received only PRBC transfusion. In these 50 cases, 32 (64%) required ICU admission for monitoring, remaining 18 (36%) were monitored in the labor-room. Bakri balloon was effective in 49 cases among 50. Success rate was 98%.Conclusions: Intrauterine balloon tamponade using Bakri balloon is effective for control of atonic PPH in majority of cases.

Ethyl ({5-[5′-(2-eth­oxy-2-oxoeth­oxy)-4,4′′-difluoro-1,1′:3′,1′′-terphenyl-4′-yl]-1,3,4-oxadiazol-2-yl}sulfan­yl)acetate

In the title compound, C28H24F2N2O6S, the whole mol­ecule is disordered over two sites with refined occupancies of 0.778 (3) and 0.222 (3). The central benzene ring makes dihedral angles of 56.0 (4), 34.5 (4) and 70.9 (4)°, respectively, with the two terminal benzene rings and the 1,3,4-oxadiazole ring in the major component of the disordered mol­ecule. The corresponding angles in the minor component are 59.7 (16), 25.6 (13) and 75.5 (14)°. In the crystal, mol­ecules are linked via C—H⋯F, C—H⋯N, C—H⋯O and C—H⋯S hydrogen bonds into a three-dimensional network. In addition, C—H⋯π inter­actions are observed

5-Bromo­pyrimidin-2(1H)-one

The geometric parameters of the title compound, C4H3BrN2O, are in the usual ranges. The crystal packing is characterized by N—H⋯N and C—H⋯O hydrogen bonds and short O⋯Br contacts

(E)-1-(4,4′′-Difluoro-5′-meth­oxy-1,1′:3′,1′′-terphenyl-4′-yl)-3-(6-meth­oxy­naphthalen-2-yl)prop-2-en-1-one

In the title compound, C33H24F2O3, the central benzene ring makes dihedral angles of 44.71 (10), 47.80 (10) and 63.68 (9)° with the two fluoro-substituted benzene rings and the naphthalene ring system, respectively. In the crystal, mol­ecules are connected via inter­molecular C—H⋯F and C—H⋯O hydrogen bonds. Furthermore, the crystal structure is stabilized by weak C—H⋯π and π–π inter­actions [centroid–centroid distance = 3.6816 (13) Å]

1-(4,4′′-Difluoro-5′-meth­oxy-1,1′:3′,1′′-terphenyl-4′-yl)ethanone

In the title compound, C21H16F2O2, the central benzene ring is inclined at dihedral angles of 30.91 (8) and 46.88 (7)° to the two terminal fluoro-substituted rings. The dihedral angle between the two terminal fluoro-subsituted rings is 68.34 (8)°. An intra­molecular C—H⋯O hydrogen bond generates an S(6) ring motif. The crystal structure is stabilized by weak C—H⋯π inter­actions