International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (7), pp. 158-162, December, 2016. © International Scholars Journals

Full Length Research Paper

Safety of vaginal birth after caesarean section

Naushaba Rizwan, Saira Dars and Erum Sumreen Siddiqui

Department of Gynaecology & Obstetrics LUMHS Jamshoro / Hyderabad.

Received  08 June, 2016; Revised 01 October, 2016;  Accepted 02 October, 2016 and Published 13 December, 2016

Corresponding author. E-mail: [email protected]

Abstract

Vaginal birth after caesarean section is one of the strategies developed to control the rising rate of caesarean section. The objective of this study was to determine the frequency and fetomaternal outcome of vaginal birth in cases of previous caesarean section. The descriptive study was carried out in the department of Gynaecology and Obstetrics for the period of one year from January 2014 to December 2014. Selection criteria were women with normal pregnancy, adequate pelvis, vertex presentation and spontaneous onset of labour with previous uncomplicated caesarean section. Exclusion criteria were women with classical caesarean section, medical complications, multiple pregnancy, IUGR, placenta previa and extensive myomectomy.   All data collected was analyzed through SPSS 17.0 version. Frequencies and percentages were calculated for qualitative data. Results were presented by frequency distribution tables. Among 866 women admitted in labour ward  fifty women were selected for VBAC. Majority of women (56%) belonged to age group 25-29 years. Regarding parity 74% were multigravida. The gestational age range between 38-40 weeks in 60% of women and only 10% had gestational age more than 40 weeks. VBAC was successful in 70% of women. Emergency caesarean deliveries  were performed in 14(30%) of women due to fetal distress and prolonged labour. The cause of previous caesarean section was fetal distress in 34% of cases, malpresentation 24% prematurity 14% APH 10% and hypertensive disorder 12%. The Maternal complication included purepural infection 4%, prolonged hospital stay 4%, wound infection 4%, UTI 2%, pulmonary infection 2% and anemia 10%, fetal morbidities included Apgar score more than 7 in 74% and less than 7 in 24%, early neonatal death in 2%. Vaginal birth in patients with previous caesarean section is safe and open successful and should be offered to reduce the rising rate of caesarean section.

Key words: Caesarean section, VBAC, Fetomaternal outcome.         

Al-Sabah Azziman¹, Hamdan Habib¹ and Abdulaziz Omar²

¹College of Pharmacy, Jazan University, Gizan, Kingdom of Saudi Arabia. ²Department of Pharmacy, Jazan General Hospital, Gizan, Kingdom of Saudi Arabia. 

Received 12 March, 2014; Revised 02 April, 2015; Accepted 18 January, 2016 and Published 12 September, 2016

Abstract

Inappropriate drug prescribing is a global problem affecting the healthcare system. This study was performed to assess the drug prescribing pattern in geriatric, paediatric and obstetrics and gynaecology department. Patient's chances of exposure to poly pharmacy are more, therefore, this study was carried out to find out the rational use of prescribed drugs in Jazan general hospital. A prospective cross sectional (descriptive) study was carried out and a total of 3070 prescriptions were collected for the study during November, 2012 to October, 2013. 1034, 1024, and 1012 prescriptions from geriatric, pediatric and obstetrics and gynaecology department respectively were collected. The average numbers of drugs used per patient were 3.1, 7.4 and 3.3 for geriatric, pediatric and obstetrics and gynaecology department patients respectively. Prescription pattern of the drugs for pediatric patients consists of antibiotics, analgesics and antipyretics mainly. For geriatric patients among systemic route, commonly prescribed therapeutic class of medications were antibacterials (70.5%), and among oral route, pantoprazole was the most commonly prescribed medication (61.2%) . For obstetrics and gynaecology department patients the most frequently prescribed drugs were oral iron, folic acid preparations, antibiotics and analgesics. There is a high level of exposure to medication in paediatric and geriatric population. In obstetrics and gynaecology department, the average numbers of drugs per prescription were slightly higher compared to the standard set by World Health Organisation (WHO) but majority of the drugs were prescribed as per United State Food and Drugs Administration (USFDA) category A (the safest category during pregnancy).

Key words: Drug prescription pattern, Jazan General Hospital.

International Journal of Obstetrics and Gynaecology ISSN 2326-7234 Vol. 4 (5), pp. 145-150, August, 2016. © International Scholars Journals

Full Length Research Paper

Hysterectomy for benign gynaecological conditions at a Tertiary Hospital, South-south, Nigeria

J.O. Alegbeleye¹  and C.O. John²

Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital (UPTH), Rivers State, Nigeria.

Corresponding author. Email: [email protected].Tel: +2348034549202

Received 27 May, 2016; Accepted 03 July, 2016; Publish August 06, 2016

Abstract

Objectives: To determine the indications, type and outcome of hysterectomy performed for benign gynaecological conditions over a 5-year period. Materials and Methods: A retrospective study of 152 women who had hysterectomy for benign conditions at the gynaecology unit of the University of Port Harcourt Teaching Hospital, (UPTH) Nigeria, between January 1, 2011 and December 31, 2015 was conducted.  Data was obtained from the theatre records and case notes of patients and entered into a proforma. This was analysed using the statistical package SPSS 20. Results: Hysterectomy for benign gynaecological conditions accounted for 15.4% of all major gynaecological operations. The leading indication for hysterectomy was uterine fibroid 75 (49.3%). The mean age and parity were 49.9 + 11.3years and 4.2 + 2.4 respectively. Abdominal hysterectomy with either unilateral or bilateral salpingo-oophorectomy accounted for 105 (69.1%). Majority of the patients 104 (68.4%) were transfused and the mean number of blood units transfused was 2.08 ± 1.24.  The crude morbidity rate was 22 (14.5%) with anaemia occurring in 15 (68.2%) of the women. There was one death from hypovolaemic shock during this period. Total abdominal hysterectomy had a statistically significant higher rate of blood transfusion (P= 0.03). Conclusion: Hysterectomy for benign gynaecological conditions is a relatively common and safe procedure. The trend in the indications and pattern of morbidity has remained largely unchanged.                                                                                                                              

Keywords: Hysterectomy, benign conditions, indications, south-south, outcome.                                                         

International Journal of Obstetrics and Gynaecology ISSN: 2326-7234 Vol. 4 (4), pp. 134-144, April, 2016. © International Scholars Journals

Full Length Research Paper

HPV and Papanicolaou (Pap) smear: Compliance, knowledge and barriers for young women in Bathurst

Dean MR, Castro A, Huang M, Kemp U, Aladdin

AWestern Sydney University, Australia.

Corresponding author. E-mail: [email protected]. 

Accepted 22 April, 2016

Abstract

Introduction: Cervical cancer is the third most commonly diagnosed cancer worldwide. Pap smears and HPV vaccinations allow for prevention, diagnosis and improved treatment for cervical cancer. Concerns have been raised about decreased Pap smear compliance due to misconceptions about the role of HPV vaccinations. This study aimed to assess the compliance of, the knowledge about and the barriers to receiving HPV vaccinations and Pap smears amongst the 18-30 year old females in Bathurst. Study Design: This descriptive study was conducted using an anonymous questionnaire that was distributed at various locations inthe Bathurst region. Results: 166 participants completed the survey. Of the92% (153) who were sexually active,59%had received ≥1 HPV vaccination and 58%were compliant with the Pap smear recommendations.  No relationship was established between vaccination status and Pap smear compliance (p=0.22).  Unemployment was the only factor negatively associated with HPV vaccination status. Greater knowledge scores were noted in the HPV vaccinated group compared with the non-vaccinated group (p<0.001). The most common barriers for Pap smears were patient discomfort and embarrassment (40%). Conclusion: This study demonstrated that women in the Bathurst region have a poor HPV vaccination rate. Although good Pap smear compliance was noted, identified barriers to Pap smears need to be addressed to further increase compliance. Further research needs to be conducted amongst HPV vaccinated females to continue to evaluate Pap smear compliance.

Key words: Cervix, cancer, cervical cancer, HPV, pap smear, women’s health.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (3), pp. 131-132, March, 2016. © International Scholars Journals

Short Communication     

Training for providing abortions in Kerala, India: Evidence from a recent survey of obstetric and gynecology professionals

Sunita Chowdhury

Independent Consultant, Public Health, Raj Villa Apartment, Flat no.: 301, 3rd floor, Plot no: 125, Sector: 18A, Nerul- West, Navi Mumbai- 400706, Maharashtra, India. Tel: +91 8879335645. E-mail: [email protected].

Accepted 18 December, 2015

Abstract

This brief emphasises that the law on abortion in India will have to specify required skills instead of professional qualifications as it currently does to ensure better access to abortion for women.  It was based on a cross sectional survey among 106 randomly selected obstetrics and gynaecology professionals (OGPs) in two southern districts of Kerala state, India.  Abortion in India has been legalised under certain conditions specified in the Medical Termination of Pregnancy (MTP) Act 2003.  This survey found that four out of the 106 OGPs had not undergone specific training to perform MTPs as part of their graduate training.  However, the act permits professionals with graduate training to provide MTPs.  This raises a concern regarding providers’ ability to offer abortion services to women. 

Key words: Legal, abortion, induced, dilatation, evacuation, providers, training, India. 

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (2), pp. 123-130, February, 2016. © International Scholars Journals

Full Length Research Paper

Comparative outcome of medical and surgical Management of urodynamically-proven mixed urinary incontinence

Tamer F Borg*, Hazem M Sammour**, Mohamed M Shahin***

*Associate Professor in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

**Professor in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

***Lecturer in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

*Corresponding author.E-mail:[email protected]

Received 04 February, 2016; Accepted 21 February, 2016

Abstract

This double armed clinical trial aimed to compare the outcome of medical versus surgical management of patients with urodynamically-proven mixed incontinence and to identify risk factors for success of each. 138 patients with mixed urinary incontinence (MUI) were studied. 78 patients with urge predominant were allocated medical treatment, 60 patients were classified as stress predominant and allocated surgical treatment. The primary outcome (Patient Global Impression Index of Improvement (PGI-I)) was analyzed in 129 (93.4%) patients. 63.3% of patients in the surgical group showed improvement of their stress component with 43.3% showing improvement in both stress and urgency components. 51.2% of patients in the medical group showed improvement in their urgency component with 33.3% showing improvement in both stress and urgency components. Maximal detrusor pressure and maximal urethral closure pressure were the only independent predictors of failure of medical treatment while the Valsalva leak point pressure was the only independent predictor of failure of surgical treatment. A prediction regression model can predict the outcome of the medical or surgical route.

Keywords: Incontinence surgery, Mixed urinary incontinence (MUI), Medical management of MUI, Predictors of failure, Prediction regression model, Urodynamic studies.