Placental abruption: a persisting killer

Background: Placental abruption, common disorder in obstetric practice, enigma too, is uniquely fraught with dangers to mother baby. Objectives of study were to study trends of placental abruption, risk factors, management strategies to learn more for reduction in morbidity-mortality of mother-baby, even with low resources, also get insight for future research.  Methods: Records of cases of placental abruption managed over 27 years (between 1985 to 2011) were divided into three yearly blocks, A to I and analysed. Details  including operative procedures like dilatation-curettage, Caesarean Section (CS) or Ante-Partum Haemorrhage (APH) in past, disorders like chronic hypertension, threatened abortion, pregnancy specific hypertension, diabetes, anaemia in index pregnancy, management done maternal-neonatal outcome were analysed using stata 6 software.Results: There were 66,459 births during analysis period with 667 cases of placental abruption, 1% births, increasing trends from, 0.73% between 1985-1987 to, 1.11% in 2009-2011. In these 667 cases of placental abruption, 211 (32.5%) perinatal deaths occurred. Ratio of perinatal deaths due to placental abruption to overall perinatal deaths increased from 2.12% (8 cases) between 1985-1987 (Block A) to 5.12% (37 cases) between 2009-2011 (Block I). Case fatality in cases of placental abruption has been fluctuating between 3 to 5% till 2004, contributing to around 12-15%, maternal mortality, with no fatality in last 7 years.Conclusions: Cases of placental abruption have been increasing with no obvious reason. In recent past maternal deaths could be prevented but perinatal deaths, have been persisting actually more in last decade

Health hazards among health care personnel

While providing health services, (preventive, curative, rehabilitative), health care personnel (HCP) face hazards. Developments in medical science provide some safety, still modern technology has made health care very complex with many hazards. Biological (viruses, bacteria, and parasites) and chemical (disinfectants, drugs, and diagnostics) therapeutic modalities in health delivery are leading to many disorders in HCP. Needle prick injuries, radiation exposure, violence, psychiatric disorders, stalking by patients, and suicides are common. HCP are at high risk for musculoskeletal disorders, due to patient handling, compounded by increasing number of obese patients. With increase in workload because of human immunodeficiency virus, hardships have increased. Despite potential for exposure to hazards, many HCP lack awareness about prevention. Also the system is not conducive, policies of prevention not clear, inaccessibile, or there is attitude problem. Hence, HCP continue to suffer, more in developing countries. Health managers need to ensure that health care is geared toward assessment of hazards suffered by HCP, there reasons, and do everything possible for prevention