A prospective study of fetomaternal outcome in cases of placenta previa

Background: The incidence of placenta previa ranges from 0.5-1% amongst hospital deliveries. Placenta previa is major cause of antepartum haemorrhage and is potentially devastating complication. Obstetric haemorrhage is most common cause for maternal and perinatal morbidity and mortality in India. This study aimed to determine frequency, type of placenta previa, risk factors and adverse fetomaternal outcomes of placenta previa.Methods: This was a prospective study carried out in Department of Obstetrics and Gynaecology, Government Medical College and Sir-T hospital, Bhavnagar from July 2007 to July 2009 to analyze fetomaternal outcome in cases of placenta previa. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by Ultrasound examination. All cases were carefully analyzed to find out the incidence, type of placenta previa, its clinical presentation and its outcome in relation to mode of delivery, birth weight, maternal and perinatal morbidity.Results: There was total 50 cases of placenta previa out of 5636 deliveries. The prevalence of placenta previa was 0.88% and was more commonly present among multiparous women (82%). Most common type was type IV placenta previa in 23 (46%) cases followed by type III in 11 (22%) cases. Out of 50 cases, 06 (12%) cases had atonic PPH and 02 (04%) cases underwent peripartum hysterectomy. Most common predisposing factors were age >35 years (04%), multiparity (50%), previous cesarean section (16%) and previous history of abortion (12%). All cases of perinatal mortality were between 28 to 30 weeks weighing between 1-1.5 kg. There was no maternal mortality in this study.Conclusions: Managing a case of placenta previa during pregnancy poses a great challenge to every obstetrician in present day obstetrics due to its increased risk of maternal and perinatal complications

Comparison of normal and abnormal labour by using Modified WHO Partograph

Background: Modified WHO partograph is graphical record of maternal and foetal data during progress of labour entered against time on single paper sheet. Entire labour can be interpreted in a glance on the photograph. It helps to detect abnormal progress of labour. It guides obstetrician to decide about the need for augmentation of labour or termination of pregnancy either by instrumental delivery or LSCS and avoids prolong labour before obstruction. The objectives were to study the course of normal and abnormal labour and to evaluate the maternal and perinatal outcome in normal and abnormal labour.Methods: The prospective observational hospital based study of 200 randomly selected cases coming to sir t hospital, bhavnagar for delivery during September 2016 to August 2017 was done. Progress of labour assessed by use of modified WHO partograph. Various parameters like duration of labour, mode of delivery, maternal and neonatal morbidity were studied.Results: The average duration of active first stage of labour was 4 hrs 38 mins in normal labour and 7hrs 48 mins in abnormal labour. Arrest of descent was responsible for 40% of abnormal labour. Problems like obstructed labour were avoided by timely intervention in the form of cesarean section and instrumental delivery. Maternal and perinatal outcome were satisfactory.Conclusions: Routine use of modified WHO partograph helps in early detection of abnormal course in labour. Every women in labour must be benefitted by use of modified WHO partograph for labour monitoring. It assures best maternal and perinatal outcome

Estimation of foetal birth weight clinically and sonographically and its correlation with its actual birth weight: a prospective and comparative study

Background: Knowledge of fetal weight in utero is vital for the obstetrician in deciding whether to deliver the fetus as well as in fixing the mode of delivery. Both low birth weight and excessive fetal weight at delivery are associated with increased risk of newborn complications during labor and the puerperium.  During the last decade, estimated fetal weight has been incorporated into the standard routine antepartum evaluation of high-risk pregnancies and deliveries. Objective of present study was to assess the fetal weight in term pregnancies by Clinical and Sonographic and to compare the methods after knowing the actual weight of the baby after birth.Methods: It is a prospective and comparative study of 200 women at term pregnancy at Sir T. Hospital, Bhavnagar, India from 2015 to 2016. Patients within 7 days from their Expected Date of Delivery were included in the study. The formulas used in this study are: Johnson's formula, Dare’s formula and Hadlock's formula using ultrasound.Results: Results vary in terms of accuracy with various methods employed for estimating the fetal weight. This study showed that Dare’s Formula was the best indicator among all other methods assessed followed by Hadlock's formula by ultrasonographic method.Conclusions: SFH measurement continues to be used in many countries on large scale because of its low cost, ease of use and need for little training as the setup for ultrasonographic evaluation is not readily available in rural setups

Mullerian anomalies: a cause of primary amenorrhea

Background: The objectives of this study were to determine the etiologic causes of amenorrhea, the prevalence of müllerian anomalies as a cause of primary amenorrhea and the different varieties of müllerian anomalies causing primary amenorrhea.Methods: This study included all the women presenting with primary amenorrhea who presented to the department of obstetrics and gynecology, Sir T Hospital and Government Medical College, Bhavnagar from 1st January 2010 to 30th June 2012.Results: The causes of primary amenorrhea of our study due to obstructive anomalies were 37.72(n=5) and müllerian agenesis were 57.14% (n=8) and androgen insensitivity 7.14 (n=1).Conclusions: Mullerian agenesis is the most prevalent cause of primary amenorrhea in our study

Comparison of normal and abnormal labour by using Modified WHO Partograph

Background: Modified WHO partograph is graphical record of maternal and foetal data during progress of labour entered against time on single paper sheet. Entire labour can be interpreted in a glance on the photograph. It helps to detect abnormal progress of labour. It guides obstetrician to decide about the need for augmentation of labour or termination of pregnancy either by instrumental delivery or LSCS and avoids prolong labour before obstruction. The objectives were to study the course of normal and abnormal labour and to evaluate the maternal and perinatal outcome in normal and abnormal labour.Methods: The prospective observational hospital based study of 200 randomly selected cases coming to sir t hospital, bhavnagar for delivery during September 2016 to August 2017 was done. Progress of labour assessed by use of modified WHO partograph. Various parameters like duration of labour, mode of delivery, maternal and neonatal morbidity were studied.Results: The average duration of active first stage of labour was 4 hrs 38 mins in normal labour and 7hrs 48 mins in abnormal labour. Arrest of descent was responsible for 40% of abnormal labour. Problems like obstructed labour were avoided by timely intervention in the form of cesarean section and instrumental delivery. Maternal and perinatal outcome were satisfactory.Conclusions: Routine use of modified WHO partograph helps in early detection of abnormal course in labour. Every women in labour must be benefitted by use of modified WHO partograph for labour monitoring. It assures best maternal and perinatal outcome