A study of maternal outcome in patients with premature rupture of membranes with gestational age more than 28 weeks

Background: Premature rupture of membranes is rupture of membranes before the onset of labour irrespective of gestational age. PROM is associated with variety of maternal complications from chorioamnionitis, unfavourable cervix, dysfunctional labour to caesarean rates, postpartum haemorrhage and endometritis in mother. PROM is a still one of the most difficult and controversial problems in obstetrics. Methods: This was a prospective longitudinal study conducted in a tertiary care hospital from 2018 to 2020 (18 months). Total 275 patients admitted with complaints of per vaginal leaking with gestational age more than 28 weeks were studied. A multivariate analysis was used to find association between PROM and maternal outcome. Results: PROM was common in women belonging to low socio-economic status (68%). Most of the cases were unbooked (73%), primigravida (42%) belonging to age group 21-25 yrs. (46%), and had gestational age more than 37 wks. (71%). 62% of cases delivered vaginally while remaining underwent LSCS, most common indication being oligohydramnios (35%). Post partum fever (14%) was most common morbidity followed UTI (7%). Conclusions: In present study, PROM was common in unbooked cases and women belonging to low socioeconomic status. Asymptomatic bacteriuria was most common predisposing factor.  Maternal morbidity corresponds to duration between PROM and delivery. Early diagnosis and appropriate management reduces hospital stay and maternal morbidity

Sociodemographic determinants of medical termination of pregnancy along with contraceptive practices

Background: Though the most common reasons for medical termination of pregnancy (MTP) is unwanted pregnancy due to nonuse of contraceptives by the women of reproductive age group and other are pregnancy before marriage or due to rape. Several studies indicate that most abortions are sought to limit family size or space the next pregnancy. There is need to study relation of MTP with contraceptive practices.Methods: The present cross-sectional study was conducted at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, to study socio-demographic factors associated with medical termination of pregnancy and its relation with contraceptive practices. Total 1840 women seeking care for medical termination of pregnancy were interviewed after their informed consent during period of January 2015 to December 2017. A detailed history regarding age, religion, income, marital status, parity, history of previous MTP, indications for MTP, use of contraception, gestational age was taken.Results: Statistical analysis-chi square test of significance for qualitative data using SPSS software version 24.0. The proportion of women coming for MTP due to nonuse of contraceptives was 86% the other indications for MTP were medical condition (9%) and contraceptive failure (5%). The factors like age, religion, education and socioeconomic status were significantly associated with MTP.Conclusions: There is need to counsel women of reproductive age group that MTP is not a way to control unwanted birth

Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days)

Background: Preterm birth is defined as birth between the age of viability and 37 completed weeks of gestation. The aim of this study is to evaluate the safety and efficacy of nifedipine, a calcium channel blocker, as a tocolytic in prolonging duration of pregnancy in case of preterm labor.Methods: This is a retrospective analytical study conducted in Department of Obstetrics and Gynaecology, SKNMC and GH, Pune, India conducted over a period of one year from June 2014 to May 2015. All uncomplicated, singleton preterm labor cases were given Cap. Nifedipine as tocolytic and Inj. Betamethasone for enhancing fetal lung maturity. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. Neonatal parameters studied were weight at birth, APGAR score at birth, complications at birth, NICU admissions, mortality.Results: Out of total 4478 deliveries from June 2014 to May 2015, 252 women with preterm labor were treated with nifedipine. 214 out of 252 delivered at term with overall success rate of 84.92%. Out of remaining 38 cases, 36 cases delivered as preterm normal deliveries and 2 required Caesarean section. No major side effects observed in mothers receiving nifedipine. As regards neonatal outcome, 12 babies required NICU admission and mortality was of 2.Conclusions: Nifedipine is safe and effective in prolonging preterm labor and has minimal maternal and neonatal side effects. It eliminates the need for intensive maternal monitoring as required in case of betamimetics

A rare case of congenital methemoglobinemia in pregnancy

When iron in haemoglobin is replaced from Fe+2 (ferrous) to Fe+3 (ferric), it leads to formation of methemoglobin. Normal levels of methemoglobin are <1%. This is maintained by redox balance between activity of NADH methemoglobin reductase enzyme and amount of oxidised hemoglobin. When levels of methemoglobin are increased, it leads to methemoglobinemia. Methemoglobin has less affinity to bind to oxygen & results in left shift of oxygen–hemoglobin dissociation curve. As most of the cases of congenital methemoglobinemia are asymptomatic, it is often diagnosed first time during pregnancy. Here we report a case, Primigravida with 38 weeks of gestation posted for emergency LSCS i/v/o meconium-stained liquor, who had SPO2 of 84%, was clinically asymptomatic, vitally stable and with ABG, CXR, ECG and 2DECHO normal. Efforts to find out the cause of reduced oxygen saturation led to diagnosis of rare hemoglobinopathy, methemoglobinemia

Dysgerminoma: a case report on rare malignant tumor

Dysgerminoma is a malignant germ cell tumour (GCT) accounting for less than 1% of ovarian neoplasm. It is analogous to seminoma in males. It is a tumour of young age, affecting women of reproductive age group. In most of the cases, due to its clinical features of it is often, misdiagnosed as abdominal tuberculosis. It is one of the rare tumours, which have excellent response to chemotherapy and radiotherapy. It is tumour in whom, surgery followed by radiotherapy and chemotherapy gives excellent prognosis even in advanced stage. This is a rare case report of 16-year-old girl with primary amenorrhoea, abdominal mass and pleural effusion, when undergone staging laparotomy – had ovarian tumour with torsion which histopathologically came out to be, dysgerminoma

Retrospective record based study of maternal and fetal outcome in induction of labour at 40 and 41 weeks of gestation in uncomplicated primigravida women

Background: The objective of the study was to compare maternal and foetal outcome after induction in two groups: women who were induced at 40-weeks and at 41-weeks.Methods: This was a retrospective study conducted over period of one year from 1 January 2018 to 31 December 2018 in the obstetrics and gynaecology department. A total of 200 uncomplicated primigravida women were included in the study. The data was collected and comparative analysis was done between two groups: control group (group A), women with induction at 40 weeks; study group (group B), women with induction at 41 weeks. The outcome was then analysed in terms of mode of delivery, oligohydramnios, meconium-stained liquor, Apgar score, need of NICU, perinatal death. The data was collected, analysed and statistical analysis was done using the Chi square test.Results: Out of total 200 women, 104 women were of 40 weeks and 96 women had completed 41 weeks. The LSCS rate was reduced from 25.96% to 17.7%, when the labour was induced at 41 weeks, the instrumental delivery rate was low in the study group compared to the control group. Even though the meconium staining of liquor was high but NICU admission and perinatal mortality was comparatively lower in the study group.Conclusions: Induction of labour done at 41weeks is associated with reduced maternal morbidity and no adverse effect on the perinatal outcome as compare to induction at 40 weeks

Using abrasive flow finishing process to reduce noise and vibrations of cylindrical and conical gears

This paper reports on reduction of noise and vibrations of cylindrical and conical gears through simultaneous reduction in their microgeometry errors, functional parameters, and surface roughness by finishing them with abrasive flow finishing (AFF) process. Previously identified optimum values of AFF medium viscosity and finishing time were used during AFF of the chosen gears. Noise and vibrations characteristics of the unfinished gears and the AFF finished gears were studied by varying motor speed and applied load at four levels each. An indigenously developed test rig was used for spur and straight bevel gears whereas drivetrain diagnostic simulator was used for helical gears. Indigenously developed dual flank roll tester was used to evaluate functional parameters of the unfinished and the best finished gears by AFF process. It was found that AFF process simultaneously reduced microgeometry errors, functional parameters, maximum and average values of surface roughness of spur, helical, and straight bevel gears. It reduced noise and vibration by 5.2 dBA and 5.3 m/s2 for spur gears, by 3.4 dBA and 7.5 m/s2 for helical gears, and by 4.6 dBA and 4 m/s2 for straight bevel gears. This study proves that AFF is an easy-to-operate and effective process for reducing noise and vibrations of cylindrical and conical gears through simultaneous reduction in their microgeometry errors, functional parameters, and surface roughness values. Outcome of this work will be helpful for various manufactures and users of different types of gears. </jats:p

Quick, Decentralized, Energy-Efficient One-Shot Max Function Computation Using Timer-Based Selection

In several wireless sensor networks, it is of interest to determine the maximum of the sensor readings and identify the sensor responsible for it. We propose a novel, decentralized, scalable, energy-efficient, timer-based, one-shot max function computation (TMC) algorithm. In it, the sensor nodes do not transmit their readings in a centrally pre-defined sequence. Instead, the nodes are grouped into clusters, and computation occurs over two contention stages. First, the nodes in each cluster contend with each other using the timer scheme to transmit their reading to their cluster-heads. Thereafter, the cluster-heads use the timer scheme to transmit the highest sensor reading in their cluster to the fusion node. One new challenge is that the use of the timer scheme leads to collisions, which can make the algorithm fail. We optimize the algorithm to minimize the average time required to determine the maximum subject to a constraint on the probability that it fails to find the maximum. TMC significantly lowers average function computation time, average number of transmissions, and average energy consumption compared to approaches proposed in the literature