A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy

Development and Evaluation of a Model for Conducting a Follow-up Study of Technician Program Graduates

Occupational and Adult Educatio

Effect of previous vaginal delivery on success of trial of labor in women with one previous lower segment caesarean section: a prospective study

Background: Vaginal birth after caesarean (VBAC) has many advantages but failed trial of labor after caesarean (TOLAC) has increased morbidity and mortality. The objective of this study is to determine the influence of previous vaginal delivery on the success of TOLAC.Methods: A prospective study was conducted on 250 women with history of one previous LSCS who underwent TOLAC. They were divided into two groups: Group 1 which included 184 women with previous LSCS and no vaginal delivery, group 2 included 66 women with previous LSCS and vaginal delivery before or after LSCS. Group 2 was further subdivided into group 2A-34 women with vaginal delivery before LSCS, group 2B-32 women with vaginal delivery after LSCS. The maternal outcome in terms of success rate of VBAC, scar dehiscence and uterine rupture was compared among the study groups. Chi square test was used for statistical analysis.Results: The VBAC success rate of group 1, group 2A and group 2B was 70.7%, 70.6% and 100% respectively. The VBAC success rate of women with history of vaginal delivery after LSCS (Group 2B) was significantly higher than those with no vaginal delivery (Group 1) (p=0.001) and women with vaginal delivery before LSCS (Group 2A) (p=0.003). The VBAC success rate of women with history of vaginal delivery before LSCS was not significantly higher than that of women with previous LSCS and no vaginal delivery (p=0.99).Conclusions: History of prior VBAC is a strong positive prognostic indicator for the success of TOLAC

Pengaruh Pemberian Berbagai Bahan Zat Pengatur Tumbuh Alami Pada Pertumbuhan Bibit Cempedak (Artocarpus champeden Lour.)

The use of coconut water, green bean sprouts and onions is chosen as natural growth regulator because it is easily obtained at a fairly affordable price. The aim of the study was to determine the effect of various natural growth regulator different concentrations to the growth of cempedak (Artocarpus champeden Lour.) seedlings.The research was conducted from May to July 2018 in the garden of the Tissue Culture Laboratory Faculty of Agriculture, Mulawarman University. This study used a factorial Completely Randomized Design with five replications. The first factor was the types of growth regulator, namely: coconut water, green bean sprout extract, and onion extract. The second factor was the concentration of the natural growth regulator substances,consisted of five treatment levels, namely: 0, 25, 50, 75 and 100 mL L-1. The parameters observed were plant height, number of leaves, stem diameter, root length, fresh weight (leaves, stems and roots), dry weight (leaves, stems and roots) and leaf area. Data were analyzed by analysis of variance with F-test and continued with the Least Significant Difference (LSD) test with a level of 5%. The results showed that there was no interaction between the type and concentration level of the natural growth regulator to the growth of cempedak seedlings.The growth regulator concentrationalso had no significant effect to all growth parameters observed. However, of the type of natural growth regulators showed a significant in the fresh root weight,stem dry weight, and plant height at harvest time

Effect of previous vaginal delivery on success of trial of labor in women with one previous lower segment caesarean section: a prospective study

Background: Vaginal birth after caesarean (VBAC) has many advantages but failed trial of labor after caesarean (TOLAC) has increased morbidity and mortality. The objective of this study is to determine the influence of previous vaginal delivery on the success of TOLAC.Methods: A prospective study was conducted on 250 women with history of one previous LSCS who underwent TOLAC. They were divided into two groups: Group 1 which included 184 women with previous LSCS and no vaginal delivery, group 2 included 66 women with previous LSCS and vaginal delivery before or after LSCS. Group 2 was further subdivided into group 2A-34 women with vaginal delivery before LSCS, group 2B-32 women with vaginal delivery after LSCS. The maternal outcome in terms of success rate of VBAC, scar dehiscence and uterine rupture was compared among the study groups. Chi square test was used for statistical analysis.Results: The VBAC success rate of group 1, group 2A and group 2B was 70.7%, 70.6% and 100% respectively. The VBAC success rate of women with history of vaginal delivery after LSCS (Group 2B) was significantly higher than those with no vaginal delivery (Group 1) (p=0.001) and women with vaginal delivery before LSCS (Group 2A) (p=0.003). The VBAC success rate of women with history of vaginal delivery before LSCS was not significantly higher than that of women with previous LSCS and no vaginal delivery (p=0.99).Conclusions: History of prior VBAC is a strong positive prognostic indicator for the success of TOLAC