Study of duration of gestation in 500 patients with spontaneous onset of labor

Background: There have been variations in the length of gestation depending upon the ethnicity of the patient.Methods: We studied 500 patients with spontaneous onset of labor for their duration of pregnancy from First day of Last Menstrual Period (FLMP).Results: The average gestational age was 275 days, 5 days earlier than the Expected date of delivery (EDD). 70% of pregnancies ended before EDD, 4.8% on the day of EDD and 25.2% ended after EDD. 35.80% patients completed 39 weeks, 24% completed 40 weeks, 23.20% completed 38 weeks, 11% completed 37 weeks and only 6% completed 41 weeks. Average gestational age was 39.31 weeks for male baby and 39.36 weeks for female baby. Sex ratio derived was 915.7 females per 1000 males. Average birth weight was 2.705 kg.Conclusions: The implication of this study is that the length of human gestation does vary according to geographic location. This may be due to genetic influences, weather conditions, food habits or some unknown factor. The clinical significance is the decision to consider a term pregnancy and a post-term pregnancy. A majority of the parturient women went in to spontaneous labour at 39 completed weeks, 5 days earlier than ‘Expected date of delivery’ calculated by Naegele’s formula. This possibility should be kept in mind when maturity assessments are made with a view to intervene in the labour process to minimize perinatal complications

Analytical study of indications of cesarean section

Background: There has been an increase in rate of cesarean section over last few decades. There are various factors involved in the rise of rate of cesarean section. There has been an increase in primary cesarean section rate, a decrease in VBAC (Vaginal birth after cesarean section) trial, decrease in operative vaginal deliveries (Forceps/Ventouse), increase in litigations, increasing facility of electronic monitoring, and decreasing threshold of patients for bearing labor pains.Methods: A retrospective study was carried out in 500 patients in the tertiary care hospital). The data were collected in a pre-designed proforma. Data were analysed by using SPSS version 20.0 Software. We have done a retrospective study of different indications of cesarean section amongst 500 patients who underwent cesarean section from March 2015 to June 2015.Results: In our study, we found out that the most common indication was Previous cesarean section (46.2%), followed by Fetal Distress (13.4%) and malpresentations (11.4%). Non progress of labour (10.2%) and toxaemia of pregnancy (6.6%) were amongst the other indications.Conclusions: Reduction of number of primary cesarean sections and successful VBAC trials are recommended to keep the rate of cesarean sections to the possible minimum level

A comparative study between manual vacuum aspiration and electronic suction for surgical treatment of abortion

Background: Present study is done to study the safety, efficacy and complications of using manual vacuum aspiration (MVA) for surgical management of first trimester abortion in comparison to electronic suction.Methods: It is a retrospective observational study conducted in department of obstetrics and gynecology at tertiary care hospital. Out of 100 cases taken, 50 abortions were terminated by MVA and 50 were terminated by electric suction/vacuum aspiration (EVA).Results: In this study, majority of the patients were primigravida (60%). Most of the patients had period of gestation between 7 to 9 weeks (40%) followed by up to 6 weeks (33%) in both groups. Time taken for the procedure was less in MVA (5-9 min.) than electronic suction (7-11 min.). In terms of complications, blood loss ≥100 ml was more with EVA (18%) compared to MVA (6%). Uterine perforation was seen with EVA (4%) and none with MVA. As far as success rate is concerned, EVA got 98% while MVA got 90%. Post-operative hospital stay was less with MVA (≤12 hours) than EVA (up to 24 hours). Post-operative pain perception was less with MVA (18% severe pain) while with EVA, 36% with severe pain.Conclusions: Both the evacuation techniques are almost equally effective and safe, still duration; post-operative pain and hospital stay are less with MVA. Success rate is better with EVA