International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (6), pp. 184-190, June, 2017. © International Scholars Journals

Full Length Research Paper

Study of obstetric cases admitted in ICU

¹Rajendra Wakankar, ²Alka Patankar, ²Anil Humne and ³Amol Khadse

¹Assistant professor, IGGMC Nagpur,²Associate professor GMC Nagpur, ³MO DTC Nagpur.

*Corresponding author E-mail: [email protected]

Accepted 10 July, 2014

Abstract

To identify the risk factors responsible for the complication leading to ICU admission and maternal outcome in terms of morbidity and mortality in an intensive care unit at Govt. Medical College Nagpur, Maharashtra. We carried out retrospective observational study. All patients admitted to ICU during pregnancy and up to 42 days of postpartum from 1^st July 2012 to 30 June 2013 were studied. Demographic data, medical and surgical histories, all the events in obstetric patients were recorded. Data was analysed by using appropriate software. 170 obstetric patients were admitted to ICU representing 1.5% of deliveries. Mean age was 24.65±4.05. Mean gravidity were 1.73±0.95. The most common obstetric cause for admission was haemorrhage (n=52, 30.58%) followed by hypertensive disorder of pregnancy (n=48, 28.23%). The commonest Non-Obstetric cause was tropical infective cases (n=19 11.17%). The commonest intervention was mechanical ventilation (n=114, 67%) and vasoactive infusion (n=55, 32.5%). Maternal mortality was 52.9% (n=90). Amongst them 93.33% (n=84) were referred cases ours being tertiary care centre. 63.52% (n=108) were from rural area.55.29% (n=94) patients received antenatal care, of these only 16 (17.02%) were booked at our hospital. Obstetric hemorrhage, hypertensive disorders of pregnancy and tropical diseases like viral encephalitis, Dengue fever, malarial fever, viral hepatitis and swine flu. Amongst 90 cases of Non-Survivors, 62.22% (n=56) belongs to obstetric group and 35.55% (n=32) were of non-obstetric group. Amongst Non-survivors 57.7% (n=52) died within 48 hour of admission.

Keywords: Critical obstetric patients, intensive care unit (ICU), maternal death.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (5), pp. 179-183, May, 2017. © International Scholars Journals

Full Length Research Paper

Effect of viral hepatitis on maternal and fetal outcome

¹Naushaba Rizwan*, ²Syed Farhan Uddin and ¹Razia Mustafa Abbasi

¹Department of Gynecolog y& Obstetrics, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan, Postal Address: H #: 72 Block-D Unit-10 Latifabad, Hyderabad, Sindh, Pakistan,

²Department of Physiology, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan Postal Address: H #: 1 Usmanabad Hyderabad. Sindh, Pakistan.

*Corresponding author E-mail: [email protected]. Tel: +92 300 3058246

Accepted 16 April, 2013

Abstract

The outcome of Hepatitis during pregnancy has been observed to be broadly diverse by various researchers, ranging from the benign to fatal. A poor result has progressively been seen in pregnant women suffering Hepatitis in Pakistan. This study was planned to study the frequency, causative organisms and chief prognostic elements affecting the consequence of viral hepatitis in pregnant women. Sixty-eight pregnant ladies answering to the doctor's facilities with jaundice were enlisted and enrolled as cases and their hematological, biochemical and viral profiles were pondered. Sixteen non-pregnant women were chosen as controls and a comparable workup was carried out. A relationship was done between the two groups. We further separated the cases into two groups – survivors and non- survivors and attempted to discover the components anticipating mortality. The unpaired understudy t test and chi square test were utilized to figure out whether the distinctions were measurably noteworthy. All the information was entered and investigated utilizing SPSS form 20.0. Viral Hepatitis in pregnancy caused a very high maternal mortality (19.1%) and foetal wastage (42.6%). Hepatitis E virus was the commonest causative organism (77.9%) responsible for viral hepatitis during pregnancy. It also caused the highest maternal mortality due to fulminant hepatic failure. Maternal mortality was significantly higher in those women presenting with features of encephalopathy, SIRS, highbilirubin levels and prolonged prothrombin time. Vertical transmission was noted in Hepatitis B and E. Hepatitis E is the chief causative organism causing fulminant hepatic failure in pregnant women. It leads to very high rates of maternal mortality and foetal wastage.

Keywords: Viral Hepatitis, maternal outcome, fetal outcome.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (3), pp. 167-171, March, 2017. © International Scholars Journals

Case Report

Paraneoplastic  internal  jugular vein thrombosis  leading to diagnosis  of  bilateral ovarian  ependymoma

Irappa Madabhavi*, Apurva  Patel, Mukesh Choudhary and Asha Anand

Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India.

*Corresponding author E-mail: [email protected]

Accepted 22 November, 2013

Abstract

Ovarian ependymomas are extremely rare tumors of the ovary with gliomatous differentiation toward ependymal cells that usually arises in the central nervous system. De novo thrombosis of the Internal Jugular Vein is also an extremely rare entity in patients with ovarian malignancy without any previous history of chemotherapy. We present the case of a 67 year old postmenopausal woman who presented to us a swelling in the right side of the neck for 2 months followed by intermittent subacute pelvic pain, lower abdominal distention and weight loss for 1 month. Her coagulation profile, blood chemistry, lipid profile, AFP, Beta-HCG and LDH were within normal limits. Neck Doppler ultrasonography revealed thrombus in the right internal jugular vein without any atherosclerotic plaque or calcification. CT scan of the thorax also showed right sided IJV thrombosis without any evidence of lung metastasis, mediastinal lymphadenopathy or any mass lesions compressing over IJV. CT scan of abdomen showed bilateral ovarian masses. Later patient was subjected to bilateral salpingo-oophorectomy for suspected ovarian cancer. Microscopic examination revealed a highly cellular tumor composed of small cells with hyper chromatic, round-to-oval nuclei and scanty cytoplasm with perivascular pseudo rosettes and ependymal rosettes. Diagnosis was confirmed by immunophenotype showing strong positivity to glial fibrillary acidic protein(GFAP). Postoperative adjuvant chemotherapy (including cisplatin, bleomycin and etoposide) was started along with anticoagulants. After 3 cycles of chemotherapy, CT abdomen was done which didn’t show any abnormal feature. Neck Doppler revealed no thrombus in right internal jugular vein. Total 6 courses of chemotherapy were completed. Patient is under surveillance for 3 months. Ovarian cancer is usually epithelial origin in most of the geriatric patients. Thus the diagnosis of ovarian ependymoma is an unusual occurrence. Further IJVT was the first symptom that developed in this patient. After ruling out other common conditions for thrombosis in this age group, this seems to be a paraneoplastic presentation of ovarian malignancy that preceded the diagnosis of ependymoma by 2 months.  An extensive review of literature, did not reveal many cases of ovarian ependymoma. To the best of our knowledge this is the first case report in the world literature, as “paraneoplastic internal jugular vein thrombosis leading to diagnosis of bilateral ovarian ependymoma”.

Keywords: Ovarian ependymoma, paraneoplastic, IJV thrombosis, hypercoagulable states.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (4), pp. 172-178, April, 2017. © International Scholars Journals

Full Length Research Paper

Doppler  velocimetry  of  cerebral  and  middle  cerebral  artery  in  normal  and   growth  restricted  pregnancies

Mubeen ara A Qazi and Vijaya M*

Department of Obstetrics and Gynaecology, Kasturba Medical College, Mangalore, Manipal University, India.

*Corresponding author E-mail: [email protected]. Tel: 9845495910, 9964084781.   

Accepted 23 July, 2013

Abstract

To study the outcomes like incidence of Cesarean delivery, birth weight, apgar score and incidence of admission to NICU among the study group and the control group. To study correlation of Cerebro-umbilical ratio with the outcomes and to establish significance of Doppler indices. Prospective observational study in a tertiary care hospital. Total of 120 patients were studied, 60 in study group and 60 in control group. Doppler parameters were studied in both the groups using Chi square test, Kruskall Wallis test and Fisher’s exact test. The incidence of induced labour, Caesarean delivery, apgar score being low at 1 minute and NICU admissions  were comparatively higher in the study group as compared to control group. S/D ratio of the Umbilical artery showed statistical significance to predict the outcomes mentioned.

Keywords: Pulsatility index, cerebroumbilical ratio, apgar score.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (2), pp. 165-166, February, 2017. © International Scholars Journals

Case Report

Increasing rates of obstetric haemorrhage in a setting of high HIV sero-prevalence – re-analysis of data from deaths due to obstetric haemorrhage in South Africa

HM Sebitloane

Department of Obstetrics and Gynaecology, Nelson Mandela School of Medicine, College  of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.

E-mail: [email protected]

Accepted 22 November, 2014

Keywords: Obstetric haemorrhage, HIV infection, combination antiretroviral therapy.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 5 (1), pp. 163-164, January, 2017. © International Scholars Journals

Case Report

Space occupying epidural air necessitating emergent cesarean delivery

Michael W Best, Chaim Golfeiz and Manuel C Vallejo*

Magee-Women's Hospital of UPMC, 300 Halket Street, Suite 3510 Pittsburgh, PA 15213.

*Corresponding author E-mail: [email protected], Tel: 412-641-4260, Fax: 412-641-4766.