Fetal and maternal outcomes and risk factors associated with preterm prelabour rupture of membrane

Background: This study aimed to assess the fetomaternal outcome of preterm prelabour rupture of membranes (PPROM) and identify the risk factors associated with this condition. Methods: The study was conducted in the Obstetrics and Gynecology department of Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, and used a hospital-based prospective observational study design. The study duration was 12 months from September 2021 to August 2022, and the sample size was 80. Results: The study found that the majority of respondents were between the ages of 20-25, Hindu, and unemployed. The occurrence of PPROM was most frequent in women between 35-36 weeks of gestation, with 41 patients (51.25%) affected. Approximately 57.50% of the study participants presented to the medical facility within 6 hours of experiencing vaginal discharge. Conclusions: Although PPROM is a common pregnancy complication, its consequences can be avoided by using antibiotics, corticosteroids, and other medications. The majority of the mothers had no risk factors. The study's findings may help healthcare providers to better understand the risk factors associated with PPROM and develop interventions to improve maternal and fetal outcomes.

Comparison between effectiveness of sublingual misoprostol and intracervical dinoprostone gel for induction of labour in pregnant women

Background: This hospital-based, prospective, comparative interventional study aimed to compare the effectiveness of sublingual misoprostol and intracervical dinoprostone gel for induction of labor in primigravida women. Methods: A total of 100 patients were alternately assigned to induction with either Misoprostol 25mcg 6 hourly or dinoprostone Gel 0.5mg 6 hourly. Results: The induction delivery interval was significantly longer in the dinoprostone group compared to the misoprostol group. The incidence of fetal distress was slightly higher in the Dinoprostone group, but the difference was not statistically significant. There were no significant differences between the two groups in the incidence of respiratory distress, birth asphyxia, and APGAR 1 MIN <6. Conclusions: This study suggests that sublingual misoprostol (a type of prostaglandin E1, or PGE1) is more effective than intracervical dinoprostone gel (a type of prostaglandin E2, or PGE2) for cervical ripening and induction of labor

Cervical ectopic pregnancy presented with massive life threatening haemorrhage: a case report

Here we report a case of a cervical ectopic pregnancy presented with massive life threatening haemorrhage and its subsequent management. After an unsuccessful attempt to stop the bleeding with balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed, this is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding

Efficacy and safety of pre-operative single dose parenteral tranexamic acid in moderately anaemic parturients undergoing caesarean section

Background: Preoperative administration of Tranexamic acid (TXA) has been found to be effective in reducing the amount of blood loss following Caesarean section in low risk women. However, studies in high risk women such as women with anaemia, where blood loss needs to be minimised are scarce.Methods: An experimental case control study was conducted with a total of 174 patients with moderate anaemia undergoing CS in a teaching hospital. Study group consisting of 87 patients received pre-operative TXA 1g intravenously. Intra operative and up to 6hours postpartum blood loss was calculated in both the groups. Requirement of blood transfusions were noted. Data analysed using Graphpad Instat® 3 statistical software.Results: Present study showed statistically significant reduction in intraoperative and postoperative blood loss among patients who received TXA compared to control group. The blood loss from placental delivery till completion of the procedure was significantly lowered (304.02ml vs 393.36ml; p value <0.0001). Postoperative blood loss (from end of the procedure up to 6hrs postpartum) was 62.57ml in comparison to 85.40ml in control group (p value <0.0001). The total blood loss from the placental delivery up to 6 hours postpartum was significantly reduced in study group (366.59ml vs 478.76ml; p value <0.0001). There was significant reduction of blood transfusion in study group (RR: 0.20, 95% CI, 0.045-0.887), without immediate adverse effect on mothers and new-borns.Conclusions: Administration of TXA preoperatively causes significant decrease in blood loss and the need for blood transfusion in patients with moderate anaemia undergoing CS.

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Cervical ectopic pregnancy presented with massive life threatening haemorrhage: a case report

Here we report a case of a cervical ectopic pregnancy presented with massive life threatening haemorrhage and its subsequent management. After an unsuccessful attempt to stop the bleeding with balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed, this is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding

Sediment mobility as an indicator of vulnerability to climate change on a Mediterranean beach: a modelling approach with several sediment transport formulae

In a context of climate change, we will present the methodology of the modeling approach to analyze the sensitivity of a Mediterranean beach to forcing conditions changes. This paper discusses the abilities of numerical models to predict the nearshore evolution and to set-up vulnerability indicators of sandy beaches against the climate change predictions for 2030. The objectives which we want to reach during this study are multiple. First, we are going to set up a procedure of linking of three codes (the waves, the flow field and the bed evolution models (Telamac)) to be able to simulate realistic climates. This procedure is validated from the point of view of the hydrodynamics and morpho-dynamic evolution (Larroudé, 2008). This technique of simulation will then use to compare and studied the contribution of the various formulae of sedimentary transport (as in Camenen and Larroudé, 2003) on the site of Sète (Languedoc-Roussillon, France). Located in a microtidal, swell-dominated coastal environment, this beach is a linear beach of about 2.5 km length with double straight bar system. The mean significant offshore wave height is about 0.5 m increasing to 3-6 m during storms, (Certain and Barusseau, 2006). We improve this methodology to simulate the Rising-Apex-Waning of a two specific storm event (Robin et al., 2010). We also present a comparison of the velocity at these different periods of the storm. We will present simple indicator methods to analyze the vulnerability of a sandy beach based on the results of simulations for different scenarios. The first method is based on the method described in Idier et al. (2006). In the present study, we calculate the maximum grain size potentially mobilized but with a simpler approach, based on analysis in different point on several cross shore profil

Fetomaternal outcome in patients with early preterm labour following administration of magnesium sulphate - a hospital based prospective study

Objective: To assess the effectiveness of magnesium sulfate as a neuroprotective agent in early preterm labour (28 to 32 weeks). To assess any maternal or fetal adverse effects after giving magnesium sulfate. Methods: Hospital based prospective observational study. Initially 72 pregnant women with preterm labour, planned preterm birth due to maternal or fetal indication between 28 to 32 weeks of gestation were selected. Among them 37 women received MgSO4, out of which 2 women could not be followed up. So, the study was conducted between 35 women as study group (Group A), who received MgSO4 and 35 women as control group (Group B), who did not receive MgSO4. Corticosteroid was given to both groups. Results: The number of babies who developed IVH in the non-MgSO4 group was significantly greater (5/35, 14.3 %) than in the MgSO4 group (3/35, 8.6%) (p Value = 0.452). In this study 3 (8.6%) ELBW babies in nonMgSO4 group had IVH compared to 2 (5.7%) in MgSO4 group. 2 (5.7%) VLBW babies in nonMgSO4 group had IVH while 1 (2.9%) VLBW babies in MgSO4 group had IVH. According to the gestational age in nonMgSO4 group 20% (7/35) of the babies between 28 to 30 weeks required intubation compared to 11.4% (4/35) babies in MgSO4 group. 14.3% (5/35) of the babies between 30 to 32 weeks in nonMgSO4 group required intubation where only 5.7% (2/35) babies in MgSO4 group required intubation. (p Value = 0.017). 5.7% (2/35) babies between 30 to 32 weeks of gestation in nonMgSO4 group had delayed milestones, while no baby showed delayed milestones in MgSO4group. Conclusions: Antenatal MgSO4 appears to minimize the likelihood of invasive mechanical ventilation, the need for continuing respiratory support, intraventricular hemorrhage. Antenatal MgSO4 has similar effects across a range of preterm gestational ages

Three simple indicators of vulnerability to climate change on a Mediterranean beach: A modeling approach

International audienceThis study assesses three different approaches for evaluating coastal vulnerability using indicators. We began by establishing a procedure for binding three codes to simulate realistic or idealized climates. The procedure was validated in terms of hydrodynamics and beach morpho-dynamics. We then defined and studied the vulnerability of the coast on the basis of in situ observations and model results taken from a set of simulations based on different scenarios. We present three simple indicator methods developed to analyze the vulnerability of a sandy beach based on the results of simulations for different wave climate scenarios. The first method is based on the wave energy, and specifically how it differs as a function of climate change scenario. The second method consists of estimating the maximum grain size mobilized. Note that the calculation of stress at the sea bottom is routinely estimated solely on the basis of simulated velocity post-wave. Here, we calculate the maximum grain size potentially mobilized with a simpler approach, based on analysis in different points along the cross-shore profile. The third method presented is the analysis of the time-course evolution of cross-shore sea bed profiles in response to different climate change scenarios