“Fetomaternal Outcome in Term Oligohydramnios-A Study in Rajshahi Medical College Hospital, Rajshahi, Bangladesh”
Dr. Homaira Shahreen (Simi)
Page Numbers : 227-231
DOI : 10.36348/sijog.2020.v03i11.002
Introduction: Oligohydramnios is defined as AFI <5cm (amniotic fluid index) or the maximum vertical pocket of liquor is less than 2 cm. It has been correlated with increased risk of intrauterine growth retardation, meconium aspiration, severe birth asphyxia, low APGAR score and congenital abnormalties. There is an inverse relationship between amniotic fluid volume and pregnancy outcome. Objective: To find out the fetomaternal Outcome in Term Oligohydramnios. Materials and Methods: This study was conducted in the department of Obstetrics and Gynaecology at Rajshahi Medical College Hospital, Rajshahi, Bangladesh over a period of 1 year from January 2018 to December 2018. 65 patients in third trimester of pregnancy with oligohydramnios were selected randomly after satisfying inclusion and exclusion criteria. Results: This study was performed in 65 pregnant women with amniotic fluid index <5 cm with sinleton pregnancy. In this study 38 out of the 65 patients (58%) had vaginal delivery (either induced or spontaneous) and 27 patients (42%) underwent lower segment caesarean section. Patients with amniotic fluid index 4 - 5cm on USG were 39 (60%) followed by AFI 2-4 cm was 18 (28%) and AFI <2 cm was 8 (12%). Low birth weight (<2.5 kg) was seen in 19 newborns (29%). NICU was required in 22 newborns (34%). Fetal congenital anomalies were seen in 4 cases (4%). congenital anomalies were hydronephrosis, diaphragmatic hernia, hypoplastic kidneys and multiple congenital anomalies. Conclusion: In conclusion, oligohydramnios in term pregnancies is associated with an increased risk of obstetric intervention. All cases of oligohydramnios require intensive antepartum and intrapartum care. Early detection of oligohydramnios, evaluation of the cause and severity of oligohydramnios and assessment of gestational age are essential for management. Its management may help in reduction of perinatal morbidity and mortality and decreased caesarean deliveries.
Original Research Article
Nov. 23, 2020
Management of Incomplete Abortions by the Manual Intra Uterine Suction Technique at Sylvanus Olympio Teaching Hospital of Lome-Togo
Objective: to assess the management of incomplete abortions using the manual intrauterine aspiration technique (MIUA) in the Obstetric Gynecology clinic of the SO CHU. Method: This is a retrospective, descriptive study that took place at the gynecology and obstetrics clinic of the SO University of Lomé, over a period of 12 months (January to December 2017). Results: Of the 7440 pregnancies recorded, there were 460 abortions, (6.18%). Among the abortions, there were 126 cases of incomplete abortions managed by the MIUA, a frequency of 27.39%. The average age was 27 years with extremes of 13 and 54 years. Local anesthesia coupled with verbacaine has been used in all of our patients. The use of analgesics by injection before and after aspiration was systematic. Red blood cells were prescribed in 13.5% of cases, fresh frozen plasma in 4.8% of cases and antianemics in 90.48% of cases. All of our women (100%) had fluids, antibiotics, analgesics and syntocinon. In 64.29%, our patients had not adopted a contraceptive method after counseling. In contrast, 22.22% of them opted for the pills. Conclusion: Abortions, whether spontaneous or induced, constitute a public health problem and therefore require adequate management. The availability and simplicity of the MIUA technique are definite advantages.
Original Research Article
Oct. 30, 2020
Evaluation of the Efficacy of Low-Dose Acetylsalicylic Acid (Aspirin) in Prevention of Pre-Eclampsia in High-Risk Pregnant Women
Dr. Naimisha Movva, Dr. Manjari Hota
Page Numbers : 217-221
DOI : 10.36348/sijog.2020.v03i10.001
Background: Pre-eclampsia affects up to 10% pregnancies worldwide and is one of the foremost causes of poor maternal and foetal outcome. The situation in India is even grave with high rate of maternal mortality due to pre-eclampsia. Though multiple risk factors are associated with pre-eclampsia, it is known that first pregnancy itself is a significant pre-eclamptic risk factor. Therefore, in this study we intent to gauge the effects of low dose Acetyl salicylic acid (Aspirin) among pregnant women in prevention of pre-eclampsia. Materials and Methods: This randomized controlled study was conducted in Department of Obstetrics and Gynaecology of Mamata Medical College and General Hospital. Total 100 patients were enrolled in this study. Pregnant women with and without any other pre-eclamptic risk factor consulting before the 16th week of amenorrhea were selected in the study. One group i.e. Treatment group (n=50) was given 75mg/day aspirin orally after breakfast to one week before estimated date of delivery while the other group received no aspirin. Both groups were followed for regular antenatal check-up. Results: The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 24.81±3.12 years. Maximum number of cases belonged wot age group of 26-30 years. The treatment group who received acetyl salicylic acid (aspirin), the age ranged from 20-35 years with a mean age of 25.21±4.29 years. Moreover, we found pre-eclampsia in aspirin group was of lesser severity as compared to those in control group. Further, proportion wise the risk of pregnancy induced hypertension and eclampsia were also reduced with aspirin, however, these were not found statistically significant. Conclusion: Our study highlights the beneficial effect of low-dose acetyl salicylic acid in decreasing hypertension and proteinuria. This study also confirms the efficacy of acetyl salicylic acid in decreasing caesarean section, maternal mortality and morbidity.
Original Research Article
Sept. 12, 2020
A Clinical Study of Postdated Pregnancy among Patients in Dhaka Medical College Hospital
Dr. Dorothy Shahnaz Mukul Fatema, Dr. Abdul Khaleque, Dr. Salma Rouf
Page Numbers : 212-216
DOI : 10.36348/sijog.2020.v03i09.004
Introduction: Any pregnancy that has occurred beyond the expected date of delivery (EDD) is referred to as post-dated or extended pregnancy. Objective: The main objective of this study is to assess the obstetric outcome of postdated pregnancy among patients at Dhaka Medical College Hospital. Method: This was a prospective observational type study. In this study, patients who have reached 40 weeks of gestational age were included patients who were aware of the date of the last menstrual period (LMP) along with the 1st-trimester obstetrics scan. In this study, patients who were not positive were removed from LMP. The research was carried out from January 2012 to December 2013 at Dhaka Medical College Hospital. This study was selected for 250 cases purposefully observational type study. Results: The study result indicates a fetus condition among the highest 95.5% of the 250 pregnant women were alive and 4.5 % died. Male baby and female babies were 49.5% and 50.5% respectively. After delivery, 75.33% of the baby admitted to the hospital, NICU 7.23%, and 17.44% did not admit to the hospital. The maximum of the management of pregnant women (87.5%) was a failure to cause oligo, and the rest was laparoscopy. Per patient operational analysis indicates the highest (75.59%) premature membrane rupture, 17.9% ectopic pregnancy, and 6.51% uterus rupture. Conclusion: Postdated pregnancy has a 50% recurrence risk for the next birth. The infection of the fetus in the form of fetal distress, meconium aspiration syndrome, birth trauma is at high risk of pregnancy. It also improves instrument delivery and operational delivery level.
Sept. 9, 2020
Full Term Pregnancy in A Septum Utérus: A Case Report
The septate uterus is the most common uterine malformation, accounting for 30 to 50% of cases, followed by uterine malformations such as bicornuate uterus and unicornuate uterus. We report a case of a total septate uterus suspected during the obstetric examination of a patient in labor 37 weeks of amenorrhea and during an obstetric ultrasound of the term. The interest of this case is to show the obstetrical prognosis in fertile women with this uterine malformation.
Sept. 3, 2020
Challenges and Implications Associated with Septic Abortion in India: A Review
Dr. Saeeda Wasim, Tanish Baqar, Dr. Shriya Arora, Dr. Sharique Ahmad
Page Numbers : 200-205
DOI : 10.36348/sijog.2020.v03i09.002
With a population threatening towards 133.92 crores it is important for a country like India, to make mandatory efforts, providing health benefits to all especially those who are devoid till date. A terrific amount of strain is now being placed on the available medical facilities due to the low doctor-population ratio in India, which limits the time available for doctors to communicate with patients, especially those who belong to a lower socio economic class. Thousands of deaths are reported from unsafe abortion due to the lack of trained abortion providers, lack of knowledge, availability of safe services, compounded by the social stigma surrounding abortion. To save themselves from the surrounding stigma, they then turn towards local, less experienced doctors who charge low but, due to the lack of experience and proper knowledge the condition becomes more severe causing Septic abortion. Septic abortion, whether induced or spontaneously occurs because of improper, unsafe, and inadequate removal of products of conception. Subsequently products of conception become infected, bacteria infiltrate the placental tissue and infection spreads to the uterus. A condition unequivocally related to maternal complications such as hemorrhage, trauma and sepsis. Thus to avoid such outcomes the current article attempts to focus on the major challenges faced by the woman in India, further mentioning the prevention required and solutions associated with septic abortion.
Original Research Article
Sept. 3, 2020
Reappraisal on the Management of Primary Dysmenorrhoea in Adolescents
Najimudeen M, Myo Hla Myint, Masharudin A. W
Page Numbers : 192-199
DOI : 10.36348/sijog.2020.v03i09.001
Primary dysmenorrhea is painful menstrual period without any underlying pathological cause. It is a common problem among adolescents. Despite the high prevalence, primary dysmenorrhea is often poorly treated, disregarded by health professionals, pain researchers, and the adolescents themselves. They may accept it as a normal part of the menstrual cycle. Increased levels of prostaglandins E2 and F2α cause dysrhythmic myometrial contraction, hypercontractility, increased muscle tone leads to ischaemia and pain. It affects the quality of life and performance. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment. Progesterone significantly relieves the pain in subsequent cycles. Combined oral contraceptives (COC) are invaluable in the management of dysmenorrhoea.