Prophylactic amnioinfusion in oligohydramnios

Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks

Effect of hydration therapy on oligohydramnios

Background: Oligamnios is defined as an AFI 34 weeks with AFI <5 cms were randomised into an Intervention group who receive 1 litre of ringer lactate i.v given daily for 5 days and nonintervention group who were kept under observation by serial ultrasound and antepartum fetal surveillance. All were followed-up till delivery to obtain maternal and perinatal outcomes.Results: Among the 68 who were given intervention, 61 responded and 7 were non responders. With hydration therapy, mean increase in AFI was 4 cm and minimum duration needed for improvement was one week. Hydration therapy showed significant improvement in the maternal and fetal outcomes. Intravenous route of maternal hydration has the advantage that a fixed amount of fluid can be infused at a relatively constant rate with ensured compliance.Conclusions: From the study, it was concluded that Hydration therapy is an excellent method to improve AFI in Oligohydramnios and maternal and perinatal outcome

Pregnancy and heart disease: risk and predictors of obstetric complications

Background: Although the disease is limited to only 0.5 to 1.0 percent of pregnant women, it remains an important cause of maternal morbidity and even mortality and has a significant effect on fetal outcome. Pregnancy and the peripartum period are associated with important cardiocirculatory changes that can lead to marked clinical deterioration in the woman with heart disease. Objectives of present study were to comprehend the impact of heart disease during pregnancy, to study the maternal and neonatal outcomes of pregnancies in women with heart disease, to identify predictors of pregnancy related complications in women with heart disease and to refine the risk stratification and to assess the individual risk of each pregnant woman with heart disease.Methods: It is a perspective study carried out at College Department of Obstetrics and Gynaecology, Govt. Medical, Kottayam from January 2012 to March 2014.Results: The outcomes of the pregnancies in 100 women who presented with heart disease and received their obstetrical care were evaluated. A maternal cardiac event, neonatal event, or both occurred in 37 completed pregnancies. A cardiac event complicated 8 completed pregnancies. It includes 2 maternal deaths, one on 9th postnatal day in women with hypertrophic obstructive cardiomyopathy and another in women with rheumatoid mitral stenosis who died of congestive cardiac failure. Most cardiac events (75%) occurred in the antepartum period and were either heart failure or cardiac arrhythmia.Conclusions: Strict prenatal care and early risk stratification during gestation are fundamental measures to improve the prognosis of pregnancy in women with heart disease

Materials for Fish Nets-Their Properties, Selection and Preservation

The properties of synthetic fibres vary with thc inherent physical characteristics of the basic raw materials used mode of preparation of yarns and method of construction of twines. Since the synthetic fibres as maufactured from polymers which are synthesized from simple chemical units, the qualities of man-made fibres can he influenced by the process of manufacture and certain modifications can even be introduced at the processing stage to meet any specific requirement to a certain extent. Hence, an elaborate study of the properties of fish not twines produced has been taken up with a view to determining their suitability for various types of fishing gear with particular reference to conditions prevailing in India.Cochin University of Science and TechnologyCentral Institute of Fisheries Technolog