An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Background: Labour induction is a clinical intervention that has the potential to confer major benefits to the mother and new born when continuation of pregnancy poses a risk/danger to the outcome of pregnancy. Misoprostol is an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. It is stable at room temperature, relatively inexpensive and can be given via several routes (oral, vaginal, sublingual, and buccal).Methods: It is an observational study of 100 cases conducted in the labour room of a Tertiary Care Government Hospital, Rajkot over a span from January 2016 to March 2017. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. Tablet misoprostol 25 microgram given orally every 4 hourly with maximum of 5 doses till the patient was in active stage of labour.Results: Maximum patients delivered by a single dose of Tab. Misoprostol (35%), the mean induction delivery interval was 11.44 hours. Most of the women delivered by vaginal route (88%) without any maternal complications like PPH, cervical/vaginal tear and uterine rupture. Only 4 cases out of 100 of failed induction for which LSCS was taken. Eight babies were admitted in NICU for MSL and had good prognosis. The most common side effect of the drug was nausea (15%) followed by fever and vomiting. 69% patients did not have any adverse drug reaction.Conclusions: Thus, induction of labour with oral misoprostol reduces the LSCS rates, lesser induction delivery interval and has good fetal outcome. The drug is well tolerated by the patients orally and has very few side effects

A study on thrombocytopenia in pregnancy and feto-maternal outcome conducted at tertiary care center Rajkot, Gujarat

Background: Thrombocytopenia is second only to anemia as the most common hematological abnormality encountered in pregnancy. Better antenatal care has led to increased detection. Once diagnosed, it is Important to further evaluate and to determine the cause to optimize management. The objectives were to study feto-maternal outcome in patient of thrombocytopenia in terms of maternal and neonatal complications and to study the causes of thrombocytopenia in pregnancy. Methods: The present study was a hospital-based study carried out from June 2021 to June 2022 at the department of obstetrics and gynecology, PDU medical college, Rajkot, Gujarat. During this period 100 patients in the third trimester of pregnancy with thrombocytopenia were selected randomly. Results: In this study 41% cases were mild thrombocytopenia, 39% with moderate and 20% were severe cases. 50% cases were gestational thrombocytopenia, 31% were cases associated with hypertensive disorders of pregnancy, 8% cases were associated with abruption, 13% cases were associated with IUFD, 2% cases were idiopathic thrombocytopenic purpura (ITP), 8% cases were associated with viral (dengue) and bacterial (malaria) infection, 1% cases were associated with SLE, 1% cases was thrombotic thrombocytopenic purpura (TTP). Maternal complications were encountered in form of DIC in 13% cases, jaundice in 7% of cases, 2% cases were complicated by PPH, 4% cases were complicated by acute kidney injury, 2% cases were associated with sickle cell crisis and 4% cases were maternal mortality. 12% were stillbirth and 5% cases had neonatal mortality. Conclusions: Thrombocytopenia in pregnancy induced hypertension carries a risk for both the mother and her fetus. Thrombocytopenia in pregnancy if timely diagnosed do not cause any mortality, however management of these patients require a multidisciplinary approach and close collaboration between obstetrician, physician, and neonatologist

Rupture uterus: a retrospective analytical study

Background: Over 500,000 women die each year due to complications of pregnancy and childbirth, a number that has remained relatively unchanged since 1990, when the first global estimates of the burden of maternal mortality were developed (WHO 2005). Objective of present study was to find out risk factors, management, related complications and associated maternal morbidity and mortality with rupture uterus.Methods: A retrospective analytical study was performed at Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India over a period of 3 years during 2014-2016. Evaluation of maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, causes of rupture uterus, Management, intra-op and post-operative complications, maternal morbidity and mortality was done.Results: Total 29 cases of rupture uterus were found during study period. Most of them belong to age group of 21-30 (77.17%), Primipara (41.3%), Lower socioeconomic status (86.2%) and unbooked (65.52%) cases. Most common cause of rupture uterus was prolonged obstructed labor (51.72%) while scarred uterus (41.73%), transverse lie (3.44%) and injudicious use of oxytocin (3.44%) were others. In 16 cases obstetric Hysterectomy (55.17%) was performed while in 13 cases repair (44.82%) was done. We have found 2 cases of maternal death (6.89%) while study period with rupture uterus.Conclusions: Present retrospective analytical study has concluded that rupture uterus is a life threatening complication. Proper antenatal and intrapartum care, identification of high risk factors, promotion of skilled attendance at birth and institutional delivery are key factors in reduction and early diagnosis

An observational study of 100 cases of 25μg oral misoprostol for induction of labour in term pregnancy

Background: Labour induction is a clinical intervention that has the potential to confer major benefits to the mother and new born when continuation of pregnancy poses a risk/danger to the outcome of pregnancy. Misoprostol is an ideal agent for induction of labour, particularly in settings where the use of prostaglandin E2 is not possible owing to lack of availability, facilities for storage, or financial constraints. It is stable at room temperature, relatively inexpensive and can be given via several routes (oral, vaginal, sublingual, and buccal).Methods: It is an observational study of 100 cases conducted in the labour room of a Tertiary Care Government Hospital, Rajkot over a span from January 2016 to March 2017. After patient selection as per inclusion criteria and written informed consent after evaluating patients were enrolled in the study. Tablet misoprostol 25 microgram given orally every 4 hourly with maximum of 5 doses till the patient was in active stage of labour.Results: Maximum patients delivered by a single dose of Tab. Misoprostol (35%), the mean induction delivery interval was 11.44 hours. Most of the women delivered by vaginal route (88%) without any maternal complications like PPH, cervical/vaginal tear and uterine rupture. Only 4 cases out of 100 of failed induction for which LSCS was taken. Eight babies were admitted in NICU for MSL and had good prognosis. The most common side effect of the drug was nausea (15%) followed by fever and vomiting. 69% patients did not have any adverse drug reaction.Conclusions: Thus, induction of labour with oral misoprostol reduces the LSCS rates, lesser induction delivery interval and has good fetal outcome. The drug is well tolerated by the patients orally and has very few side effects

Manual vacuum aspiration in first trimester induced abortion: A randomized comparative prospective studies of 100 cases

Background: Induced abortion is one of the safest procedures for unwanted pregnancies in medical practice. Vacuum aspiration is the preferred method for uterine evacuation before 12 weeks of pregnancy. Objectives: To study the efficacy of manual vacuum aspiration (MVA) in o8 wk versus 8–12 wk of pregnancy. Materials and Methods: A randomized comparative prospective study was performed at the Department of Obstetrics and Gynaecology, P D U Medical College, Rajkot, over a period of January 2012 to June 2013. Totally, 100 subjects were enrolled in the study, which were further divided into two groups (o8 wk and 8–12 wk of pregnancy, 50 in each). MVA was performed in both the groups, and comparison was done in view to evaluate completeness of procedure, requirement of add-on procedure, and complications. Results: Of 50 subjects in each group, perforation was found in two cases in group A and one case in group B. Requirement of oxytocics noted in only one case in group B, whereas incomplete abortion noted in two cases in group A and three in group B. All complications were found statistically insignificant (P = 1) between both the groups. Conclusion: This study focused on the efficacy of MVA in higher weeks of gestations, which was equal in both the groups. Thus, MVA is a safe and an acceptable procedure up to 12 wk of pregnancy

Rupture uterus: a retrospective analytical study

Background: Over 500,000 women die each year due to complications of pregnancy and childbirth, a number that has remained relatively unchanged since 1990, when the first global estimates of the burden of maternal mortality were developed (WHO 2005). Objective of present study was to find out risk factors, management, related complications and associated maternal morbidity and mortality with rupture uterus.Methods: A retrospective analytical study was performed at Department of Obstetrics and Gynecology, PDU Medical College, Rajkot, Gujarat, India over a period of 3 years during 2014-2016. Evaluation of maternal age, parity, SE status, booking status, obstetric risk factors, duration of hospital stay, causes of rupture uterus, Management, intra-op and post-operative complications, maternal morbidity and mortality was done.Results: Total 29 cases of rupture uterus were found during study period. Most of them belong to age group of 21-30 (77.17%), Primipara (41.3%), Lower socioeconomic status (86.2%) and unbooked (65.52%) cases. Most common cause of rupture uterus was prolonged obstructed labor (51.72%) while scarred uterus (41.73%), transverse lie (3.44%) and injudicious use of oxytocin (3.44%) were others. In 16 cases obstetric Hysterectomy (55.17%) was performed while in 13 cases repair (44.82%) was done. We have found 2 cases of maternal death (6.89%) while study period with rupture uterus.Conclusions: Present retrospective analytical study has concluded that rupture uterus is a life threatening complication. Proper antenatal and intrapartum care, identification of high risk factors, promotion of skilled attendance at birth and institutional delivery are key factors in reduction and early diagnosis