Asymptomatic bacteriuria in antenatal cases and its effects on obstetrical outcome

Background: Urinary tract infection is the second most common bacterial infection seen during pregnancy and is due to the morphological and physiological changes that take place in the genitourinary tract. The pregnant women are two times more commonly affected than age matched non pregnant females and it may lead to less favorable pregnancy outcomes and complications such as premature birth, low birth weight, pyelonephritis, preeclampsia and anemia.Methods: This hospital based cross sectional study was conducted on 350 pregnant women, falling into the inclusion criteria of the study, who attended the antenatal clinic in the Department of Obstetrics and Gynecology at PCMS and RC, Bhopal, irrespective of the gestational age of the cases. The cases found to have asymptomatic bacteriuria were followed till delivery and any adverse antenatal or perinatal outcome was noted.Results: The study was conducted with the aim to know the prevalence of asymptomatic bacteriuria and the obstetrical outcome in pregnant women. The prevalence of asymptomatic bacteriuria was 13% and it was common in the age group of 21-25 years, in primigravidas and with period of gestation less than 12 weeks. E. coli was found to be the commonest causative organism. Asymptomatic bacteriuria was found significantly associated with the presence of anemia. Maternal morbidity in terms of pre term labour was higher in cases with asymptomatic bacteriuria.Conclusions: Urine culture and sensitivity should be done as a routine investigation to screen the patients for asymptomatic bacteriuria and to prevent adverse maternal and fetal outcomes

Factors affecting post-operative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries

Background: Postoperative wound gaping is a very traumatic event both for patient and treating doctor as it adds economical and psychological burden to the patient and the family. This study was conducted with the aim to find out the various factors affecting postoperative wound gaping and their outcome in obstetrical and gynecological abdominal surgeries.Methods: This Retrospective observational study was carried out in the Department of Obstetrics and Gynecology at Peoples College of medical sciences and research Centre, Bhopal, India from 1st May 2014 to 31st October 2015.Results: A total of 1310 patients underwent major obstetrical and gynecological abdominal surgeries, out of which 29 cases developed postoperative wound gaping with the percentage being 2.2%. The rate was found to be higher among the emergency obstetric case (51.7%). Associated risk factors being anemia (72%), obesity (65%), hypoproteinemia (62%) and diabetes (52%) among gynecological surgeries and prolonged rupture of membranes (53%), emergency LSCS and previous LSCS (47%) among the obstetric cases. The common causative organism was found to be E. coli (28.5%) followed by acinetobacter and pseudomonas.Conclusions: Anemia, obesity, hypoproteinemia, diabetes, history of previous surgeries, emergency operations are the high risk factors for wound gaping in both obstetrics and gynecology surgeries. Correction of anemia, diabetes preoperatively, high protein diet and prevention of other risk factors like avoiding prolonged labor, use potent antibiotics in cases of rupture of membrane, timely intervention, provide well equipped wards with clean environment would be rewarding for better outcome of the surgery

Gravid uterus in an incisional hernia with uterine scar dehiscence: a case report

Full term pregnancy in an incisional hernia of the anterior abdominal wall is rare and a serious condition. Initially the hernia is reducible, but as pregnancy advances, it may be complicated by skin ulcerations, incarceration and subsequent strangulation within the hernia sac. Potentially grave obstetric complications such as preterm labour, accidental hemorrhage, intrauterine growth restriction, intrauterine fetal death, scar dehiscence and rupture of the lower uterine scar can occur. We report a case of full term pregnancy in an incisional hernia with uterine scar dehiscence, its clinical course, management and review of literature