Prolapse in pregnancy

Presentation of uterine prolapse is a normal event in a pregnant woman which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of uterus vary from minor cervical infection to spontaneous abortion to preterm labour, maternal and fetal mortality, acute retention of urine and urinary tract infection. Authors of this paper have studied a case of a pregnant lady who presented to the emergency department with prolapse and her line of management which was executed. This was a case report study and management were done as per standard obstetrical guidelines. Patient was counselled at the time of discharge. Implementation of conservative treatment modalities throughout pregnancy with prolapse and their application in accordance of severity of uterine prolapse and patient’s preference may be sufficient to achieve an uneventful pregnancy, normal and spontaneous vaginal delivery.

A study of maternal near miss cases at tertiary medical college of Jharkhand, India

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases.Methods: The study was conducted in the Department of Obstetrics and Gynecology at RIMS, Ranchi, Jharkhand, India, which is a tertiary care centre. For each case of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near-miss morbidity, nature of obstetric complications, presence of organ-system dysfunction/failure, ICU admission and timing of near-miss event with respect to admission.Results: During the twenty-four months of the study period, 20000 deliveries at the institution and 480 women were identified as near-miss obstetrical cases by five factor scoring system. The prevalence of near-miss case in this study was 2.4%. Near-miss per 1000 delivery was 24%. Maternal death to near miss ratio was 1:7.2. The leading causes of maternal near miss were hemorrhage (42.5%) and hypertensive disorder of pregnancy (23.5%) The morbidity was high in unbooked cases.Conclusions: Maternal near miss is good alternative indicator of health care system