Risk factors and complications in pregnancies associated with placenta previa among admitted cases in FMCH

Background: Placenta previa is a leading cause of antepartum haemorrhage. Placenta previa present a significant clinical problem and patients are at risk for significant haemorrhage, needing blood transfusion. The risks are increased in women with previous placenta previa, endometrial damage caused by DE and C, caesarean delivery, myomectomy, multiparity, alcohol cocaine use during pregnancy, smoking during pregnancy. Methods: Admitted patients were selected with convenience sampling type of non-probability sampling type of non-probability sampling technique. The primary end point was to determine the risk factors of placenta previa and its complications. The secondary end point was to determine maternal morbidity and mortality of placenta previa. Results: Incidence of placenta previa was 2.03% out of 2459 patients, 70% were associated with risk factors. Among them 42% had history of caesarean section, 14% had history of abortion, 10% had history of manual removal, 48% patients were more than 25% years old, 36% were more than 30 years. Placenta previa occurred in gravida 3rd or more. Forty two percent patients belonged to lower socioeconomics group. Only 12% patients had regular antenatal checkup. Malpresentations were present in 24% cases. In this study 50% patients were associated with central placenta previa. Eighty percent patients were in shock, only 2% patients were asymptomatic. Regarding management 76.34% patients were managed actively, 12% patients had expectant management. Only 2% patients delivered vaginally, 82% patients delivered by caesarean section. Maternal mortality rate was 02%. Regarding fetal outcome, 76% babies were alive and there were 20% perinatal deaths. Conclusions: Although etiology of placenta previa largely remain obscure and speculative. There is a strong association between advanced maternal age, multiparity, history of caesarean section and abortion with subsequent development of placenta previa. Women aged >30 years, grand multipara, previa and must be monitored carefully. Hence the study advocates proper antenatal care early referral to hospital and prompt management of patients after proper selection can reduce maternal morbidity and mortality

Clinical study on the relationship of scar tenderness with scar integrity at repeat caesarean section

Background: Caesarean section is an operative process whereby the fetuses after the end of 28th weeks are delivered through an incision on the abdominal and uterine wall. This excludes delivery through an abdominal incision where the fetus lying free in the abdominal cavity following uterine rupture or in secondary abdominal pregnancy. The first operation carried out on a patient is referred to as an primary caesarean section. When the operation is carried out in subsequent pregnancies, it is referred to as repeat caesarean section. Caesarean section is used in cases where vaginal delivery is not either feasible or would impose undue risks on mother or baby. The aim of the study to assess the Relationship of Scar Tenderness with Scar Integrity at repeat caesarean section. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh. The duration of the period from April 2017 to October 2017. Results: This study shows that the according to age of 50 Patients aged 20 to 35 years. Here out of 50 mothers the highest 23(46%) mothers belonged to 21-25 years age group. Subsequently, 15(30%), 9(18%), 2(4%) and 1(2%) belonged to 26-30 years, ≤20 years, 31-35 years and >35 years respectively. The mean age of the respondents was 23.16±5.79 (age range: 17-38) years. Conclusions: The scar complications are highly associated with the intensity of scar tenderness. Henceforth, it can be concluded here that scar tenderness is a vital factor responsible for scar complications.

Post caesarean section complication and its management in Dhaka medical college hospital

Background: The increase in the rate of caesarian sections globally is intimately related to the development of the women access to this procedure when required. But it is still related to the indiscriminate use without medical indication. This has fulminated in the recent efforts to reduce these rates while incorporating the obstetric preferences of women. Objective of the current study was to find out the predisposing factors for caesarian complications and to observe its management pattern. Methods: This was a cross sectional observational and descriptive study performed in the department of obstetrics and gynecology, Dhaka medical college hospital, Dhaka from January2019 to June 2019. All mothers admitted for elective and emergency cesarean section were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 100 patients were finalized. A pre-tested, observation based, peer-reviewed data collection sheet was prepared before study. Data regarding clinical, biochemical and surgical profile were recorded. Results: The mean age of the respondents was 25.96±4.43 (age range: 17-39) years. Among 100 mothers, 59% underwent elective and 41% underwent emergency cesarean section. 67% had uneventful outcome after LSCS. Rest 33% had post cesarean section complications. Among them 33% mother who had complications, 19 (57.57%), 12 (36.36%), 10 (30.30%) and 8(24.24%) had wound gap, UTI, GIT complications and haemorrhage respectively. 3 (9.09%) each suffered from thromboembolic complications and septic thrombophlebitis. Only one (3.03%) experienced DIC. Out of 33 complicated cases; 27 (81.81%) required treatment with injection oxytocin, blood transfusion, condom catheterization and 10 (30.30%) required secondary closure. Among them 4 (12.12%) underwent mass closure and received antithrombotic drug. One (3.03%) each underwent excision sinus tract and re-laparotomy. Conclusions: Caesarean section complications can result in death or morbidity. Despite advances in technology and expertise, wound infection or wound gap remains the most common post-c-section complication. It is critical to successfully manage complications after cesarean section in order to reduce morbidity and mortality among mothers

Lead content in new decorative paints in India

The paint industry in India is broadly classified into two categories: organized sector and unorganized sector. Multinational and big Indian companies form the organized sector, whereas the small- and medium-scale industries which produce paints for the local market form the unorganized sector. The present study was undertaken to determine the level of lead in decorative paints in India. A total of 148 paint samples sourced from four organized sector companies and six unorganized sector companies were analyzed for the total lead content. Results of this study reveal that 39 % of the total paints tested (n = 148) contain lead more than 300 ppm, the voluntary limit prescribed by Bureau of Indian Standards, BIS (IS 15489:2011), and 45 % of the tested paints contain lead more than 90 ppm, the US limit. Further analysis of the data indicates that only 5 % of the tested paints manufactured by organized sector companies contain lead more than 300 ppm (n = 91), whereas 93 % of the tested paints manufactured by unorganized sector companies contain lead more than 300 ppm (n = 57). Comparison with earlier reported data suggests that while organized sector companies are gradually abandoning the use of leadbased compounds in their paints, the unorganized sector companies are still adding lead based compounds intentionally in their paints despite the potential health hazards associated with it. The maximum concentration of lead obtained was 80,350 ppm in one of the paints manufactured by an unorganized sector company. The presence of high concentration of lead in yellow and green color paints indicates that color can be a predictor of lead content in decorative paints