Retrospective study of post term pregnancy and its outcome

Background: Post Term Pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks (259 to 294 days) from the last menstrual period. If the pregnancy exceeds this period (above 42 completed weeks) it is classified as post term pregnancy. The overall incidence of post term pregnancy is 10.0% of all pregnancies. We estimate the recent incidence of post-date in Obstetrics and Gynecology Department, P. D. U. medical college, Rajkot (Gujarat).Methods: We are taking 500 cases of Post-date pregnancy (Retrospective cases) at P. D. U. Medical College, Rajkot (Gujarat) to know the method of induction, pregnancy outcome, maternal and Fetal complications.Results: In present study, out of 500 patients, induction was done in 366 patients and number of normal delivery was 377 (75.4%), LSCS was 113 (22.6%) and 10 (2%) was instrumental delivery.Conclusions: Post term pregnancies require early identification, effective and proper planned management. Rate of vaginal deliveries has increased due to effective Prostaglandins (PGs) and their easy availability

A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation

Background: Over the last few decades, the incidence of ectopic pregnancy has increased almost to the extent of an epidemic disease. Ectopic pregnancy is one of the commonest acute abdominal emergencies. Ectopic pregnancy remains the leading cause of maternal deaths in early pregnancy. The aim of the study was the clinical presentations, ultra sound features and diagnostic difficulties of all cases of ectopic pregnancy.Methods: This is a retrospective study conducted at Government Medical College and Hospital, Rajkot from January 2013 to June 2016, in the three and half year study period, there were a total of 100 ectopic pregnancies.Results: Most common symptom in our study was lower abdominal pain, in 90% cases. Amenorrhea was present in 100 cases, whereas vaginal bleeding in 48 cases. Nausea, vomiting observed in 26% of patients, cervical tenderness in 48%, and adnexal tenderness in 40% while shock was observed in 10% of patients.Conclusions: Ampullary part of the fallopian tube is the most common site of ectopic pregnancy observed during our study. Complex adnexal mass was the most common finding on ultrasound. Surgical management by laparotomy and salpingectomy continues to be the preferred mode of management of ectopic pregnancy in our institution

A cross sectional study of 1000 lower segment cesarean section in obstetrics and gynecology department of P. D. U Medical College, Rajkot, Gujarat, India

Background: Though WHO recommends a rate of 10-15% caesarean section for a given hospital, there has been a rising trend worldwide. We estimated the recent incidence of caesarean section in Obstetrics and Gynecology Department, P.D.U. Medical College, Rajkot (Gujarat and correlated these rates with the socioeconomic, demographic, and health variables.Methods: We have studied 1000 cases of lower segment caesarean section (cross sectional study) at Obstetrics and Gynecology Department, P.D.U Medical College, Rajkot (Gujarat) to find out rate of caesarean section, common maternal and fetal indication and complications of lower segment caesarean section.Results: Caesarean section rate of the present study is 19.9%. Most common indication of LSCS was scarred uterus 39.9%.followed by fetal distress 19.1%, malpresentation 18.6%, and failed induction 7.3%. Maternal morbidities and mortalities in emergency LSCS in compare to elective LSCS. Analysis based on Robson’s ten-group showed that group 5 (Previous CS, single cephalic,>37 weeks) made the greatest contribution to total CS rate.Conclusions: Scientific advances, social and cultural changes, and medico legal considerations seem to be the main reasons for the increased acceptability of caesarean sections. The decision to perform a C-section delivery must be chosen carefully and should not be profit oriented. There is a possibility of keeping the rate to minimum by reducing number of primary caesarean sections, by proper counseling of the patients, proper monitoring and patience

A retrospective study of 100 cases of Eclampsia: perinatal outcomes

Background: Eclampsia is associated with devastating maternal and foetal complications. Eclampsia is a major cause of maternal morbidity and mortality in developing countries. Evaluation of factors contributing to occurrence of eclampsia and death of eclamptic mother is of paramount importance. The aim of the study was to determine the perinatal mortality rate in eclamptic women. To assess the perinatal outcome with respect to time between first convulsion and delivery, time of treatment and delivery .To assess the perinatal outcome and mode of delivery. In this study we have tried to know the relationship between maternal blood group and eclampsia. Methods: A retrospective study of 100 cases of eclampsia was done in P.D.U. Medical College, Rajkot. Pregnant woman diagnosed as eclampsia during this period were included. The events and outcome of mother and fetus were recorded and analyzed.Results: Around 60% of patients were primipara and 70% patients were from rural area. On evaluation of background characteristics, 65 patients were not booked, 48% patients were hypertensive and 40% were normotensive. Out of 14 maternal deaths, five had cerebral haemorrhage, 3 had pulmonary edema, 3 had renal failure and 2 developed PPH.Conclusions: Majority of the patients were unbooked and young and primigravida. Fifteen percent of eclamptic women required cesarean delivery. Most common cause for neonatal death was prematurity and its attendant complications

A five years retrospective analytic study of maternal deaths at tertiary care centre, Gujarat, India

Background: Maternal mortality is one of the major challenges which face the developing countries throughout the world. The aim of the study is to assess the causes of maternal mortality at P.D.U. Medical College, and to identify the avoidable ones.Methods: Data were collected from records of patients who presented to and/or delivered at P.D.U. Medical College between 2011 and 2015. Only cases of maternal mortality were included in this study. In our study, we found 120 maternal deaths at our hospital between 2011 and 2015.Results: We found that the indirect causes of maternal mortality accounted for 29.3% of all mortalities. The leading cause of death in the 5 years was uncontrollable postpartum haemorrhage (23.3%), preeclampsia with its complications (15.8%), Anemia (14.1%), Abruption placentae 12.5% and Septicaemia 5% .Direct maternal deaths accounted for 70.7%.Conclusions: Preeclampsia and PPH, as well as their complications are the leading causes of death in one of the biggest tertiary care university hospitals in Egypt. However, there are other important avoidable predisposing factors that should be dealt with including lack of patient education, delayed transfer from other hospitals, and substandard practice

A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation

Background: Over the last few decades, the incidence of ectopic pregnancy has increased almost to the extent of an epidemic disease. Ectopic pregnancy is one of the commonest acute abdominal emergencies. Ectopic pregnancy remains the leading cause of maternal deaths in early pregnancy. The aim of the study was the clinical presentations, ultra sound features and diagnostic difficulties of all cases of ectopic pregnancy.Methods: This is a retrospective study conducted at Government Medical College and Hospital, Rajkot from January 2013 to June 2016, in the three and half year study period, there were a total of 100 ectopic pregnancies.Results: Most common symptom in our study was lower abdominal pain, in 90% cases. Amenorrhea was present in 100 cases, whereas vaginal bleeding in 48 cases. Nausea, vomiting observed in 26% of patients, cervical tenderness in 48%, and adnexal tenderness in 40% while shock was observed in 10% of patients.Conclusions: Ampullary part of the fallopian tube is the most common site of ectopic pregnancy observed during our study. Complex adnexal mass was the most common finding on ultrasound. Surgical management by laparotomy and salpingectomy continues to be the preferred mode of management of ectopic pregnancy in our institution

A retrospective study of 100 cases of Eclampsia: perinatal outcomes

Background: Eclampsia is associated with devastating maternal and foetal complications. Eclampsia is a major cause of maternal morbidity and mortality in developing countries. Evaluation of factors contributing to occurrence of eclampsia and death of eclamptic mother is of paramount importance. The aim of the study was to determine the perinatal mortality rate in eclamptic women. To assess the perinatal outcome with respect to time between first convulsion and delivery, time of treatment and delivery .To assess the perinatal outcome and mode of delivery. In this study we have tried to know the relationship between maternal blood group and eclampsia. Methods: A retrospective study of 100 cases of eclampsia was done in P.D.U. Medical College, Rajkot. Pregnant woman diagnosed as eclampsia during this period were included. The events and outcome of mother and fetus were recorded and analyzed.Results: Around 60% of patients were primipara and 70% patients were from rural area. On evaluation of background characteristics, 65 patients were not booked, 48% patients were hypertensive and 40% were normotensive. Out of 14 maternal deaths, five had cerebral haemorrhage, 3 had pulmonary edema, 3 had renal failure and 2 developed PPH.Conclusions: Majority of the patients were unbooked and young and primigravida. Fifteen percent of eclamptic women required cesarean delivery. Most common cause for neonatal death was prematurity and its attendant complications