An observational study of uterine rupture at a tertiary care center

Background: Uterine rupture is one of the most dangerous obstetric emergency situation carrying an increased risk of maternal and perinatal morbidity and mortality. This catastrophic complication occurs most often in women attempting a vaginal birth after a prior LSCS. Aim was to determine the incidence, etiology, management, maternal and fetal outcome. Recommend strategy for its prevention to reduce the incidence of maternal and fetal morbidity and mortality.Methods: This prospective observational study was conducted over a period of 1 year. Total 51 cases who were diagnosed with rupture were included in the study. Emergency laparotomy after pre-operative resuscitation done. Hysterectomy or repair of rupture site was done depending on the condition of the patient, parity, presence or absence of infection.Results: Maximum patients of uterine rupture belonged to 37-40 weeks of GA. Inter-delivery interval <18-24 week were more vulnerable. Patients with previous caesarean section was more than without section. Maximum cases presented with signs of shock. Maternal death rate was 11.63%, whereas perinatal death rate was 82.35%.Conclusions:Uterine rupture is a major contributor to maternal morbidity and neonatal mortality. Four major easily identifiable risk factors are: history of prior caesarean section, grand multiparity, obstructed labor, and fetal malpresentations. Identification of these high risk women, prompt diagnosis, immediate transfer, and optimal management needs to be overemphasized to avoid adverse feto-maternal complications.

An observational study to assess feto-maternal outcome in severely ill COVID-19 positive pregnant females admitted at dedicated COVID care center of southern Rajasthan

Background: COVID-19 infection is caused by corona virus SARS-COV2. the aim of the study is to assess feto-maternal outcome in severely ill covid positive pregnant females.Methods: An observational study was conducted at dedicated covid care center, RNT medical college Udaipur from Jan 2021 to May 2021 among pregnant females. In this study out of 236 total covid positive pregnant patients, 54 patients which could not maintain oxygen saturation, according to NIH criteria were included in our study.Results: Out of 54 pregnant women, 24 women delivered with 2 twin pregnancies. Out of this 67% underwent cesarean section and 33% were delivered by vaginal route. Postpartum hemorrhage seen in 29% of patients. Maternal death reported in 39% of patients. Out of 54 patients 38 patients were admitted in ICU. Invasive ventilation received by 26% of patients while oxygen received by non-invasive ventilation (15%), Bains (18%) rest by NRBM and venturi mask (41%). Remdesivir were given in 26 (48%) patients.Conclusions: Our study suggests there may be increased risk of adverse pregnancy outcome for mother and fetus. COVID-19 in pregnancy was associated with risks of pre-eclampsia, stillbirth, preterm birth, PPH. Similar to general population comorbidities do play a role in the outcome of disease in pregnancy. Further studies are needed for effective strategies to prevent adverse outcomes in pregnant females with COVID-19.