Cesarean Section Scar Ectopic Pregnancy: A Case Report and Literature Review
Soumana Diaouga H, Chaibou Yacouba M, Garba Rahamatou M, Idi N, Nayama M
Page Numbers : 357-359
DOI : 10.36348/sijog.2022.v05i08.001
Scar pregnancy is a rare but serious form of ectopic pregnancy that is life-threatening and functional. Its actual incidence remains undetermined, but the increase in published cases over the past ten years testifies to the increased vigilance of obstetrician-gynecologists on ultrasound diagnosis, which remains the first-line examination. To date, there is no consensus on a reference treatment. We report our experience of a case of pregnancy on caesarean section scar in a 36-year-old patient treated in our department. The diagnosis was suspected in the presence of metrorrhagia associated with pelvic pain in the first trimester of pregnancy. Ultrasound confirmed the diagnosis and treatment consisted of surgical cure by laparotomy. The objective was to discuss the epidemiological, physiopathological, diagnostic aspects, the therapeutic and evolutionary modalities of this rare pathology.
Original Research Article
July 30, 2022
Clinical Attributes and Socio-Demographic Characteristics of Patients Managed for Eclampsia in a Tertiary Hospital in Nigeria
Kehinde Osazee, Peter Waibode Alabrah, Valentine Chinweike Nweke
Page Numbers : 245-251
DOI : 10.36348/sijog.2022.v05i07.005
Eclampsia is a serious obstetric complication that, especially in developing countries, is linked to high rates of maternal and perinatal morbidity and mortality. The study's goal is to assess the clinical characteristics of eclampsia, the maternal and perinatal outcomes and proffer suggestions for improvement. The cases of eclampsia managed at the University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria, for over 5 years (from 2015 to 2019) were the subjects of the study. The medical records library, special care infant unit, labour ward, theatre, postnatal wards, and emergency room records were retrieved. SPSS version 23 was used to analyze the generated data. Eclampsia occurred in 16.7 out of every 1000 deliveries. The majority (66.9%) of eclampsia cases included women; between the ages of 20 and 35, who were unbooked (98.1%), and nulliparous (61.3%). 73.8 percent of the cases involved antepartum eclampsia, and 71.9 percent of deliveries were emergency caesareans. Eclampsia contributed to 31.7% of all maternal deaths, had a case fatality rate of 18.97%, and had a mother mortality ratio of 316/100,000 births. Eclamptic deliveries had a 149/1000 perinatal death rate. Pulmonary oedema, renal failure, HELLP syndrome, cerebrovascular accident, and disseminated intravascular were determinant factors in maternal mortality. Eclampsia remains a significant factor in maternal morbidity and mortality, particularly in resource-limited countries. Risk factors such as nulliparity and unbooked status were linked to increased prevalence. It also shows the need for early referral and timely management of the disease.
Original Research Article
July 30, 2022
Correlation of Gestational Age and Fetal Sacral Length: Study in a Specialized Hospital
Dr. Salma Shahnawaz Parvin, Dr. Md. Ahsan Habib, Dr. Maksuda Khatun, Dr. Md. Towrit Reza, Dr. Md. Saiful Haque
Page Numbers : 252-256
DOI : 10.36348/sijog.2022.v05i07.006
Introduction: To choose whether to end the pregnancy and how to deliver the baby, obstetricians require a precise estimation of gestational age. Other criteria can be useful when inaccurate menstrual history cannot be utilized to estimate gestational age. One such element is the fetal sacral length, which may be measured using ultrasound. Numerous criteria have been utilized in conjunction with ultrasonography to estimate gestational age. However, only the first and second trimesters of pregnancy are when all of these metrics are trustworthy. They become less accurate as the pregnancy goes on for a number of reasons, with the third trimester having the most fluctuation at around 3 to 3.5 weeks. Methods: A total of 200 pregnant women participated in this prospective observational study at the Department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders. The research was carried out between January 2001 and December 2002. Result: The participants' average age was 24.54 years. Only 3% of the participants were in the oldest age range of 36-40 years, with 38 percent of the participants being between the ages of 21 and 25. The average height of the participants was 150-154 cm in 52 percent of the cases. The mean SD height and weight were 152.40±3.44 cm and 54.80±4.45 kg, respectively. There is a strong positive relationship between fetal sacral length and gestational age, according to BPD and FL. The relationship between gestational age and fetal sacral length was demonstrated to be statistically significant. There was no statistically significant relationship between fetal sacral length and maternal height. Conclusion: Fetal sacral length and gestational age are closely connected. Sacral length can be used consistently as an extra metric during pregnancy in conjunction with other established parameters if it is assessed precisely with a high-resolution ultrasound scanner.
Original Research Article
July 27, 2022
The Causes of Post-Partum Hemorrhage in Patients Attending in a Tertiary Care Hospital
Nahar, S, Roy, J. S
Page Numbers : 238-244
DOI : 10.36348/sijog.2022.v05i07.004
Background: Post-partum hemorrhage is defined as excessive bleeding following a vaginal delivery or cesarean section of more than 500ml and 1000ml respectively. Post-partum hemorrhage is a potentially life-threatening complication of vaginal and cesarean delivery. The aim of the study was to identify the causes of PPH cases and find out modalities and maternal outcomes of PPH cases and different presentations of PPH patients, to identify the causes of primary & secondary PPH. Methods: This cross-sectional study was conducted at Dhaka Medical College & Hospital, Dhaka, Bangladesh during the period from July 2011 to December 2011. The total number of patients in the present study was 200. Patients were selected from those who developed PPH after vaginal delivery or LSCS or instrumental delivery. Patients who were admitted as cases of PPH after home or other institutional delivery. The data were entered into a computer and statistical analysis of the results was obtained by using windows-based computer software devised with Statistical Packages for Social Sciences version 24. Results: During the study period, 407 PPH cases were admitted and the incidence of PPH was 5.72% of the total obstetric cases. Out of 407 cases, 317 (77.89%) were primary PPH cases and 90 (22.11%) were secondary PPH. Among the study people, 89% of patients developed primary PPH, and only 11% developed secondary PPH, 77% of the patients developed no complications other than PPH. 0.5% of patients expired remaining 23% of the patients developed some kind of complication following PPH. Conclusion: Maternal mortality has been used traditionally as a measure of the quality of health care. Recently maternal mortality is being taken into account to assess the burden of the disease. Safe motherhood policies, systematic evaluation, aggressive and appropriate treatment, prompt resuscitation, and volume replacement minimize the potentially serious outcomes associated with PPH. Most of the patients can be managed at the upazilla level by properly trained personnel. Only one-tenth of the patients require surgical management with active management of third-stage labor. So detecting the complications as early as possible and early referred to the tertiary level hospital would be able to reduce the complications and will improve the maternal outcome.
Original Research Article
July 25, 2022
Comparison of Post-operative Complications among Patients Undergoing Cesarean Section vs Normal Vaginal Delivery
Sah, D. K, Purbey, H. N2, Jha, R
Page Numbers : 233-237
DOI : 10.36348/sijog.2022.v05i07.003
Introduction: Majority of the deaths during child birth are due to complication after delivery. C-section which is a measure to reduce death rate of the mother and fetus comes with many complications. Proper knowledge should be provided to the child bearing mother to choose the right method of delivery. Aim of the study: The aim of this study was to compare the post-operative complications among patients undergoing cesarean section vs normal vaginal delivery. Methods: This cross-sectional study was conducted in department of obstetrics & gynaecology, Janaki Medical College Teaching Hospital, Ramdaiya Bhawadi, Janakpurdham, Nepal, during the period from January 2020 to December 2022. Total 500 women who have given birth through vaginal delivery or cesarean section were included in this study. Result: Mean age of the study people in vaginal delivery group and cesarean section was 29.3 years (SD±7.5 years) and 30.9 years (SD±8.5 years) respectively. Maternal mortality was higher in cesarian section. Muscular pain was the commonest maternal complications in both vaginal delivery group and cesarean section group; 35.6% and 44.4% respectively. There was significant difference (p<0.05) between groups in muscular pain, problem in digestion, urinary trac infection, wound infection and SUI and other values were not statistically significant. In vaginal delivery group, 7.6% new born were admitted to NICU and in cesarean section group it was 11.6%. Delivery injury was commonest complication of neonatal in vaginal delivery group and RDS was commonest complication of neonatal in cesarean section group. Conclusion: For both maternal and neonatal cases, cesarean section has more complication than vaginal delivery. Muscular pain and headache were present in majority of the study people. Mortality rate in cesarean section is also slightly higher in this study.
Case Report
July 22, 2022
Ovarian Pregnancy: A Rare Case Report
Haddout, S, Jalal, M, Oubid, A, Ikouch, K, Lamrissi, A, Bouhya, S
Page Numbers : 230-232
DOI : 10.36348/sijog.2022.v05i07.002
Ovarian pregnancy is a rare entity among ectopic pregnancies where the ovary is the site of implantation. Its diagnosis requires a well codified approach. The particularities of the determining factors, histopathological and evolutionary characteristics of ovarian pregnancies led us to take an interest in this form of ectopic pregnancy. We report a case of ovarian pregnancy treated during our shift. It concerns a 42 year old woman, multiparous, with a notion of delay of menstruation of 3 weeks. She presented to the gynecological emergency room with acute pelvic pain complicated by shock. On examination, the diagnosis of ampullary ectopic pregnancy was made. The patient was resuscitated and underwent emergency surgery. The diagnosis of ovarian pregnancy was made intraoperatively, for which a salpingectomy was performed. The postoperative course was simple. Indeed, the diagnosis of ovarian pregnancy is difficult and is based on intraoperative findings. The presence of the ovarian nidation zone on histopathological examination is optimal to confirm the diagnosis. Treatment is based on surgery with the development of conservative techniques by laparoscopy when the patient's hemodynamic state allows it.
Original Research Article
July 5, 2022
Evaluation of Pelvic Organ by Laparoscopy among Patients with Adnexal Mass Attending Bangabandhu Sheikh Mujib Medical University
Introduction: Adnexal masses consist of anomalies which can be noticed in any age of women. These abnormalities determine different features during reproductive age, entail surgical treatment, and are monitored with clinical and laboratory findings. Adnexal masses may result from benign or malignant lesions of ovarian, tubal, and para tubal origin, as well as pregnancy-related causes such as ectopic pregnancy. The study intends to evaluate the adnexal masses by laparoscopy among patients admitted to Bangabandhu Sheikh Mujib Medical University from March 2016 to August 2016. Methods: This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University, Dhaka. The sample was collected by the purposive consecutive sampling method. Subjects were selected by appropriate inclusion criteria. Data were collected after appropriate verbal consent from the guardian of patients and the result was subjected to standard statistical evaluation and was analyzed by the SPSS programme. Result: This study shows the average age was 27.82 years. Regarding parity majority (31, 62.0%) were nulliparous women and the majority (31, 62.0%) were from a lower-middle-class families. The primary complaints in the study group (27, 54.0%) were dysmenorrhoea followed by infertility (21, 42%). Eighteen women (18, 36.0%) complained of dyspareunia. Twenty-six patients (26, 52.0%) had tender mass. Size of the uterus, twenty-two (22, 44%) patients had an enlarged uterus. The commonest finding was tubo-ovarian mass in thirteen (13, 26.0%) patients followed by an endometriotic cyst in twelve patients (12, 24%). The findings of diagnostic laparoscopy, maximum (22, 44.0%) were enlarged uterus followed by fourteen patients (14, 28.0%) who had ovarian cysts. Conclusion: This study observed laparoscopic findings are far way better than ultrasonography. As a result, laparoscopy is a gold standard for the estimation of patients with pelvic adnexal masses.
