A retrospective study: twin gestation at tertiary care, maternal and fetal outcome

Background: The objective of our study was to study the maternal and neonatal outcome in twin gestation in a tertiary care center.Methods: A retrospective analysis of 197 twin pregnancies admitted and managed at M S Ramaiah medical college. Parameters in the mother and fetus were studied for any adverse antenatal complications, mode of delivery.Results: Prim gravid patients with twin pregnancy constituted (45.6%). 4.5% of patients had an IVF conception. 45.1% patients were unbooked to our institute, 82% of the unbooked patients presented with preterm labour and preterm premature rupture of membrane. PIH was noted in 32.9% of the patients, premature rupture of membranes (32.9%), Intra- Uterine Death of one fetus (6.09%) and intra uterine growth retardation (2.03%) was the antenatal complications observed. Out of the 197 patients 63 (31.97%) delivered by vaginal route whereas 134 (68.02%) had to undergo cesarean section. Section for the second twin was done in 4(2.03%). The 197 women of twin pregnancy gave birth to 378 live-born babies, 16(9.5%) stillborn and 32 (16.2%) died by the end of seven days due to complications related to prematurity: hyaline membrane disease, hyperbilirubinemia.Conclusions: Early active intervention in twin gestation can reduce the maternal and fetal mortality and morbidity

A rare case of a ruptured ovarian pregnancy

Ovarian pregnancy is a rare type of extrauterine pregnancy accounting for 1 to 3% of all extrauterine pregnancies. We report a rare case of a ruptured ovarian pregnancy. A 22 year old, gravida 2 para 1 living 1 was admitted with amenorrhea of 4 weeks and 6 days with chief complaints of severe acute lower abdomen pain. Urine pregnancy test was positive. Ultrasonogram pelvis revealed left sided ruptured adnexal mass with moderated hemoperitoneum. Laparotomy was performed and a diagnosis of ruptured ovarian pregnancy was made. Biopsy of the mass was taken which confirmed the diagnosis. Although ovarian pregnancy is rare, in any case of a ruptured ectopic pregnancy where the tubes are found to be normal on laparotomy, an ovarian pregnancy must be ruled out. Early detection and prompt diagnosis can preserve the future fertility of the woman

Preterm birth: associated risk factors and outcome in tertiary care center

Background: The major cause of infant mortality and morbidity is preterm birth. WHO has defined it as any birth before 37 completed weeks of gestation or fewer than 259 days since the last day of menstrual period. Objective of present study was to identify major etiological factors associated with preterm birth, and their effects on mode of delivery and neonatal mortality and morbidity.Methods: Retrospective cohorts study, which was conducted in M. S. Ramaiah Medical College, over period of 12 months (January 2015 to December 2015). The study included 343 women who delivered preterm they were followed from admission to discharge. Various parameters were analyzed like maternal characteristics, gestational age, associated risk factors, tocolysis, administration of steroids, and neonatal outcome.Results: The incidence of preterm birth among the total deliveries was approximately 18.01%. Although the risk factors included many, the most common occurring were hypertensive disorders during pregnancy approximately 32.9%, followed by preterm rupture of membranes (18.1%), idiopathic 14.9%, and previous LSCS at 12.2%. Neonatal mortality was 6.9% (24 neonates), and stillborn were 0.5% (2 neonates).Conclusions: Various risk factors for preterm labour are modifiable hence early detection and treatment prevents maternal morbidity and neonatal morbidity and mortality. Specific emphasis on regular antenatal checkups

Recurrent pregnancy loss: challenge to obstetricians

Background: Recurrent pregnancies loss (RPL) is physically and emotionally devastating situation for the parents, along with difficult situation for obstetrician to handle. Present study aimed at investigation of the significance of various etiology in relation to pregnancy outcome in cases of recurrent pregnancy loss.Methods: It is a retrospective analysis of patients who presented to M. S. Ramaiah Medical college with recurrent miscarriage between April 2014 and August 2015. ANA was done on the basis of clinical and laboratory data which was obtained and eventually diagnosis was made. The study results were analysed in terms of term live births, maternal and fetal complications.Results: Out of the RPL cases that were studied, 78 patients came with recurrent pregnancy loss. Out of these cases, endocrine abnormalities, like diabetes mellitus and hypothyroidism were the maximum 26.92% and 12.82% respectively. Followed by unexplained causes were 37.3%. Thrombophila and APLA positive cases constituted for 16.66% and 3.4% respectively. ANA positive and cervical incompetence were 6.4% each.Conclusions: Recurrent pregnancy loss is very difficult situation to handle. Various etiology need various specialists, and requirements, and management mainly depends on the cause for recurrent pregnancy loss

A retrospective study: twin gestation at tertiary care, maternal and fetal outcome

Background: The objective of our study was to study the maternal and neonatal outcome in twin gestation in a tertiary care center.Methods: A retrospective analysis of 197 twin pregnancies admitted and managed at M S Ramaiah medical college. Parameters in the mother and fetus were studied for any adverse antenatal complications, mode of delivery.Results: Prim gravid patients with twin pregnancy constituted (45.6%). 4.5% of patients had an IVF conception. 45.1% patients were unbooked to our institute, 82% of the unbooked patients presented with preterm labour and preterm premature rupture of membrane. PIH was noted in 32.9% of the patients, premature rupture of membranes (32.9%), Intra- Uterine Death of one fetus (6.09%) and intra uterine growth retardation (2.03%) was the antenatal complications observed. Out of the 197 patients 63 (31.97%) delivered by vaginal route whereas 134 (68.02%) had to undergo cesarean section. Section for the second twin was done in 4(2.03%). The 197 women of twin pregnancy gave birth to 378 live-born babies, 16(9.5%) stillborn and 32 (16.2%) died by the end of seven days due to complications related to prematurity: hyaline membrane disease, hyperbilirubinemia.Conclusions: Early active intervention in twin gestation can reduce the maternal and fetal mortality and morbidity