Pub Date : 2021-06-15DOI: 10.21088/ijmfnm.2347.999x.5118.12
N. Kulkarni, Richa V Patel
Introduction: Any pregnancy which has passed beyond the expected date of delivery is called a prolonged pregnancy & which have passed 42 weeks, 294 days is called postmaturity or post term pregnany [1], these are at an increased risk for fetal postmaturity syndrome, macrosomia, fetal intolerance of labor, oligohydramnios, meconium-stained amniotic fluid, and cesarean delivery [2]. The clinical evidence of an increased potential for these poor perinatal outcomes has triggered a movement toward increased antenatal testing between 37- 42 weeks of gestation, and cervical ripening with labor inductions at or before 42 weeks of gestation. While a ripe cervix is usually suggestive of fetal maturity to find an unripe cervix does not exclude maturity. Induction of labor is one of the most common procedures in obstetrics and is carried out in approximately 20% of pregnancies [3]. Mechanical and biochemical means have been used to affect cervical ripening and to induce labor. Methods of induction include amniotomy, membrane stripping or sweeping, prostaglandins, laminaria and oxytocin. Membrane stripping or sweeping is a commonly use procedure aimed at preventing the post term pregnancy and avoid the application of formal method of induction of labour. Aims and Objectives: 1. to determine the effectiveness & safety of membrane stripping at term pregnancy as a OPD procedure weekly which can reduce the incidence of Post term pregnancy, labour induction and its complication. 2. To determine what factors occurring after digital separation of the chorionic membranes from the lower uterine segment (membrane stripping) are involved in observed clinical changes compared with patients not so treated. Material and Methods: Study Design: This was a prospective study conducted at department of Obstetrics and Gynaecology at our hospital. Study Duration: Study was conducted during the period of duration September 2014 to September 2016. Results: After documenting the confirm gestational dating criteria and obtaining inform consent 200 patients at 37 complete week of gestation were randomly selected for the study. Data were collected from findings at 1,2,3 week and during labour, which is compaired by pearson chi-square and fischer exact test. Conclusion: Stripping of membranes is a very old procedure. This causes the release of plasma prostaglandin F2, Increase in endocervical phospholipase A activity and oxytocin release have also been observed. This will initiate uterine contraction and onset of labour. It is safe, cheap, effective and even an out patient procedure. It is associated with earlier delivery and decreased incidence of posterm gestation and hence maternal and fetal complication related to post maturity.
{"title":"Study of Stripping of Membranes at Term Gestation to Reduce Post-Term Pregnancies","authors":"N. Kulkarni, Richa V Patel","doi":"10.21088/ijmfnm.2347.999x.5118.12","DOIUrl":"https://doi.org/10.21088/ijmfnm.2347.999x.5118.12","url":null,"abstract":"Introduction: Any pregnancy which has passed beyond the expected date of delivery is called a prolonged pregnancy & which have passed 42 weeks, 294 days is called postmaturity or post term pregnany [1], these are at an increased risk for fetal postmaturity syndrome, macrosomia, fetal intolerance of labor, oligohydramnios, meconium-stained amniotic fluid, and cesarean delivery [2]. The clinical evidence of an increased potential for these poor perinatal outcomes has triggered a movement toward increased antenatal testing between 37- 42 weeks of gestation, and cervical ripening with labor inductions at or before 42 weeks of gestation. While a ripe cervix is usually suggestive of fetal maturity to find an unripe cervix does not exclude maturity. Induction of labor is one of the most common procedures in obstetrics and is carried out in approximately 20% of pregnancies [3]. Mechanical and biochemical means have been used to affect cervical ripening and to induce labor. Methods of induction include amniotomy, membrane stripping or sweeping, prostaglandins, laminaria and oxytocin. Membrane stripping or sweeping is a commonly use procedure aimed at preventing the post term pregnancy and avoid the application of formal method of induction of labour. Aims and Objectives: 1. to determine the effectiveness & safety of membrane stripping at term pregnancy as a OPD procedure weekly which can reduce the incidence of Post term pregnancy, labour induction and its complication. 2. To determine what factors occurring after digital separation of the chorionic membranes from the lower uterine segment (membrane stripping) are involved in observed clinical changes compared with patients not so treated. Material and Methods: Study Design: This was a prospective study conducted at department of Obstetrics and Gynaecology at our hospital. Study Duration: Study was conducted during the period of duration September 2014 to September 2016. Results: After documenting the confirm gestational dating criteria and obtaining inform consent 200 patients at 37 complete week of gestation were randomly selected for the study. Data were collected from findings at 1,2,3 week and during labour, which is compaired by pearson chi-square and fischer exact test. Conclusion: Stripping of membranes is a very old procedure. This causes the release of plasma prostaglandin F2, Increase in endocervical phospholipase A activity and oxytocin release have also been observed. This will initiate uterine contraction and onset of labour. It is safe, cheap, effective and even an out patient procedure. It is associated with earlier delivery and decreased incidence of posterm gestation and hence maternal and fetal complication related to post maturity.","PeriodicalId":220483,"journal":{"name":"Indian Journal of Maternal-Fetal & Neonatal Medicine","volume":"28 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120995415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.21088/ijmfnm.2347.999x.5118.6
Nitin Kulkarni, P. Pawar, R. Bansal
Objectives: The present study aims at advantages of ferric carboxymaltose therapy over iron sucrose in iron deficiency anaemia of ante natal and postnatal patient. Methods: A prospective observational study was carried out at ACPM medical college during January 2017 to December 2017 for 50 antenatal and 50 postnatal women, total 100 women. Diagnosis of iron deficiency anemia done by proper history taking, examination, peripheral blood smear and blood indices. Baseline haemoglobin and serum ferritin levels were noted on first, eighth, fifteenth and thirtieth day of treatment with iron sucrose or ferric carboxymaltose for randomly selected 50 antenatal and 50 postnatal women. Results: The mean rise of haemoglobin value was 4.3 g/ L for ferric carboxymaltose and 4.0 g/L for iron sucrose in pregnant women. For postpartum women mean rise of haemoglobin was 4.9 g/L after treatment with ferric carboxymaltose and 4.4 g/L for iron sucrose. Conclusion: For the treatment of iron deficiency anaemia in pregnancy as well as postnatal women ferric carboxymaltose is safe, efficient and having many advantages over iron sucrose.
{"title":"Comparative Study of Intravenous Iron Sucrose Versus Ferric Carboxymaltose for the Treatment of Iron Deficiency Anemia during Pregnancy and Postpartum Period","authors":"Nitin Kulkarni, P. Pawar, R. Bansal","doi":"10.21088/ijmfnm.2347.999x.5118.6","DOIUrl":"https://doi.org/10.21088/ijmfnm.2347.999x.5118.6","url":null,"abstract":"Objectives: The present study aims at advantages of ferric carboxymaltose therapy over iron sucrose in iron deficiency anaemia of ante natal and postnatal patient. Methods: A prospective observational study was carried out at ACPM medical college during January 2017 to December 2017 for 50 antenatal and 50 postnatal women, total 100 women. Diagnosis of iron deficiency anemia done by proper history taking, examination, peripheral blood smear and blood indices. Baseline haemoglobin and serum ferritin levels were noted on first, eighth, fifteenth and thirtieth day of treatment with iron sucrose or ferric carboxymaltose for randomly selected 50 antenatal and 50 postnatal women. Results: The mean rise of haemoglobin value was 4.3 g/ L for ferric carboxymaltose and 4.0 g/L for iron sucrose in pregnant women. For postpartum women mean rise of haemoglobin was 4.9 g/L after treatment with ferric carboxymaltose and 4.4 g/L for iron sucrose. Conclusion: For the treatment of iron deficiency anaemia in pregnancy as well as postnatal women ferric carboxymaltose is safe, efficient and having many advantages over iron sucrose.","PeriodicalId":220483,"journal":{"name":"Indian Journal of Maternal-Fetal & Neonatal Medicine","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114159952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-15DOI: 10.21088/ijmfnm.2347.999x.4217.16
Alka Patil, Nitin Kulkarni, Richa Patel
Preconceptional, conception, antenatal period and intrapartum period are in continuum. For successful obstetric outcome, prepregnancy weight and proper antenatal care are important factors. Newborn whose birthweight exceeds 40004500gms is labled as macrosomia. Prolong labour, arrest of labour, foetal distress, shoulder dystocia, instrumental delivery and increased incidence of cesarean section are associated with macrosomic fetuses. Early detection, watchfull expectancy active interventions are key factors for safe delivery of macrosomic fetuses.
{"title":"Fetal Macrosomia","authors":"Alka Patil, Nitin Kulkarni, Richa Patel","doi":"10.21088/ijmfnm.2347.999x.4217.16","DOIUrl":"https://doi.org/10.21088/ijmfnm.2347.999x.4217.16","url":null,"abstract":"Preconceptional, conception, antenatal period and intrapartum period are in continuum. For successful obstetric outcome, prepregnancy weight and proper antenatal care are important factors. Newborn whose birthweight exceeds 40004500gms is labled as macrosomia. Prolong labour, arrest of labour, foetal distress, shoulder dystocia, instrumental delivery and increased incidence of cesarean section are associated with macrosomic fetuses. Early detection, watchfull expectancy active interventions are key factors for safe delivery of macrosomic fetuses.","PeriodicalId":220483,"journal":{"name":"Indian Journal of Maternal-Fetal & Neonatal Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126111606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-15DOI: 10.21088/ijmfnm.2347.999x.4217.2
N. Kulkarni, Richa V Patel
Introduction: Increase incidence of caesarean section is a major concern in todays era. Ceaser may be performed in one of the three way, by classic technique, by lower segment or by some form of extraperitoneal cesarean section. The earliest extraperitoneal technique used was Latzko’s as introduced by Dr Henry Burns. Extraperitoneal cesarean section is a useful method of preventing postoperative morbidity in form of infections & adhesions. Early ambulation , Start oral fluids immediately and get the patient out of bed as soon as the anesthesia worn off are supposed to be advantages of this new study of old technique. Objective: To evaluate advantages or disadvantages of extra peritoneal caesarean section over trans peritoneal caesarean section. Study Design: Single blinded Randomized prospective control triel were performed over 66 patients in our tertiary care institute. Intra operative complications morbidity and outcome compaired by scaling signs, symptoms & examination findings by single consultant. Results: Patients of ECS had better score for postoperative pain, ambulation & oral intake there were less requirement of analgesic in ECS group. Postoperative nausea, shoulder pain febril episodes peritonitis genitourinary tract infection & bowel discomfort were very minimal in ECS group compaire to TCS group. Conclusion: An extra peritoneal csection is definitely advantageous over transperitoneal approach of lower segment caesarean section. There is no need for postoperative starvation, and ileus after this method is rare. Early mobilization reduces the risk of thrombosis and shortens postoperative pain. Less pain makes early commencement of breastfeeding easier within the first hours after the operation. This will also help contraction and involution of the uterus. Early removal of stitches reduces the risk of infection and keloids.
{"title":"Randomized Control Study of Extra Peritoneal Verses Trans Peritoneal Cesarean Section in View of Operative Morbidity","authors":"N. Kulkarni, Richa V Patel","doi":"10.21088/ijmfnm.2347.999x.4217.2","DOIUrl":"https://doi.org/10.21088/ijmfnm.2347.999x.4217.2","url":null,"abstract":"Introduction: Increase incidence of caesarean section is a major concern in todays era. Ceaser may be performed in one of the three way, by classic technique, by lower segment or by some form of extraperitoneal cesarean section. The earliest extraperitoneal technique used was Latzko’s as introduced by Dr Henry Burns. Extraperitoneal cesarean section is a useful method of preventing postoperative morbidity in form of infections & adhesions. Early ambulation , Start oral fluids immediately and get the patient out of bed as soon as the anesthesia worn off are supposed to be advantages of this new study of old technique. Objective: To evaluate advantages or disadvantages of extra peritoneal caesarean section over trans peritoneal caesarean section. Study Design: Single blinded Randomized prospective control triel were performed over 66 patients in our tertiary care institute. Intra operative complications morbidity and outcome compaired by scaling signs, symptoms & examination findings by single consultant. Results: Patients of ECS had better score for postoperative pain, ambulation & oral intake there were less requirement of analgesic in ECS group. Postoperative nausea, shoulder pain febril episodes peritonitis genitourinary tract infection & bowel discomfort were very minimal in ECS group compaire to TCS group. Conclusion: An extra peritoneal csection is definitely advantageous over transperitoneal approach of lower segment caesarean section. There is no need for postoperative starvation, and ileus after this method is rare. Early mobilization reduces the risk of thrombosis and shortens postoperative pain. Less pain makes early commencement of breastfeeding easier within the first hours after the operation. This will also help contraction and involution of the uterus. Early removal of stitches reduces the risk of infection and keloids.","PeriodicalId":220483,"journal":{"name":"Indian Journal of Maternal-Fetal & Neonatal Medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126521024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-15DOI: 10.21088/ijmfnm.2347.999x.4217.18
N. Kulkarni, Richa D. Patel, A. Arun, Nilay S Patel
Introduction: Advanced abdominal pregnancy is a rare condition with high maternal & fetal morbidity as well as mortality. Inadequate placentation, unusual implantation &associated anomalies increase maternal &fetal morbidity and mortality. Diagnosis & management of advance abdominal pregnancy is always a challenge for obstetricians. Aims & Objectives: Management of rare case of advanced secondary abdominal pregnancy. Material & Methods: A 20yr young second gravida with full term gestation with history of previous L.S.C.S. with transverse lie & low lying placenta refered to our institute for emergency LSCS. Her last USG at 34wks showing single live intrauterine fetus in transverse lie with placenta previa. We avoided per vaginal examination in v/o central placenta previa. Decision of emergency L.S.C.S. was taken. After opening abdomen we got many surprises, after all obstacles we came out with successful outcome. Happily closed the abdomen with expression of victory. Results: With skillful and patient handling we were able to manage such a rare case with successful outcome in terms of mother as well as fetus even with complete removal of placenta. Conclusion: Advanced secondary abdominal pregnancy are rarely diagnosed clinically. Use of timely ultra sonography, intraoperative recognition, surgical skill, ready access to blood products, patiently taking decision about status of placenta are the cornerstone of successful management. Dreadful surprises can change in a remarkable unforgettable victory.
{"title":"Advancedsecondary Abdominal Pregnancy till Term: A Case Report","authors":"N. Kulkarni, Richa D. Patel, A. Arun, Nilay S Patel","doi":"10.21088/ijmfnm.2347.999x.4217.18","DOIUrl":"https://doi.org/10.21088/ijmfnm.2347.999x.4217.18","url":null,"abstract":"Introduction: Advanced abdominal pregnancy is a rare condition with high maternal & fetal morbidity as well as mortality. Inadequate placentation, unusual implantation &associated anomalies increase maternal &fetal morbidity and mortality. Diagnosis & management of advance abdominal pregnancy is always a challenge for obstetricians. Aims & Objectives: Management of rare case of advanced secondary abdominal pregnancy. Material & Methods: A 20yr young second gravida with full term gestation with history of previous L.S.C.S. with transverse lie & low lying placenta refered to our institute for emergency LSCS. Her last USG at 34wks showing single live intrauterine fetus in transverse lie with placenta previa. We avoided per vaginal examination in v/o central placenta previa. Decision of emergency L.S.C.S. was taken. After opening abdomen we got many surprises, after all obstacles we came out with successful outcome. Happily closed the abdomen with expression of victory. Results: With skillful and patient handling we were able to manage such a rare case with successful outcome in terms of mother as well as fetus even with complete removal of placenta. Conclusion: Advanced secondary abdominal pregnancy are rarely diagnosed clinically. Use of timely ultra sonography, intraoperative recognition, surgical skill, ready access to blood products, patiently taking decision about status of placenta are the cornerstone of successful management. Dreadful surprises can change in a remarkable unforgettable victory.","PeriodicalId":220483,"journal":{"name":"Indian Journal of Maternal-Fetal & Neonatal Medicine","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117239967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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