ePrints@TNMGRM (Tamil Nadu Dr. M.G.R. Medical University)
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Comparing Outcomes of Bicolumnar Parallel and Orthogonal Plating in Distal Humerus Extra Articular Fracture
No full textA Prospective study of Epidemiology, Etiology, Incidence, Management and Preventive Strategies for Burst Abdomen
No full textA Clinical study of Comparison between Efficacy of Topical Sucralfate and Conventional Dressing in Management of Diabetic Ulcers in GMKMCH, Salem
No full textPredictors of Psychosocial Outcomes in Patients with Chronic Schizophrenia: A Cross Sectional study
No full textA Prospective study of Functional and Radiological Outcome of Hoffa Fractures Fixation in Distal Femur
No full textProspective Analysis of the Effect on Tear Film Before and After Manual SICS and Phacoemulsification
No full textUterine Fibroid: Treatment Patterns and Patient Preference in Tertiary Care Center
No full textBACKGROUND:
Uterine leiomyomas are slow growing, benign tumours that arises from smooth muscle cell of the uterus. In India about 25% of reproductive age group women have symptomatic fibroids. To date there is no Indian study to look at the Uterine fibroid treatment patterns and patient preference in tertiary care centre. Hence this study was conducted to know Treatment patterns in patients following diagnosis of uterine fibroids and to know their pattern of treatment preference, the clinical features and FIGO stage of uterine fibroid on ultrasound imaging was studied and correlated with their symptoms and the epidemiological risk factors associated with uterine fibroids in our population were also studied.
METHODS:
It is a prospective study conducted among reproductive age group women who were earlier or newly diagnosed with uterine fibroids. The women who met the eligibility criteria, after consenting for the study are administered questionnaire regarding the epidemiological factors, clinical symptoms, duration, various treatments patient underwent with duration and their preferred treatment. Ultrasound was done as part of work up earlier prior to recruitment into study and those ultrasound findings are noted. All the information is computerised and each participant was allotted a study number and information was analysed without exposing the identity of the participant. Data was entered in Epidata v4.6.0 and was analysed using SPSS v16.0.
RESULTS:
The mean age group of women was in perimenopausal range with a mean of 41.9 years (5th decade). The mean BMI was 24.5+/- 6.6 which is within overweight category. 62.2% women with fibroids had menstrual complaints which include increased flow during cycles, prolonged duration of cycle, frequent menstrual cycles. Out of 100 women with symptomatic submucous fibroids 92% (92) had heavy menstrual bleeding. 55.1 % patients received treatment for fibroids prior to recruitment into the study out which 39 % of them received only symptomatic treatment, 14 % of them only hormonal treatment, 47 % of patients both symptomatic and hormonal treatment. Patients who were offered surgical management were 41.7 % (419), out of which 329 women preferred surgical treatment.
CONCLUSION:
Majority of women with fibroids are between 4th and 5th decade and very few women are in other decades. 20 % of women with heavy menstrual bleeding required blood transfusion. More than 50 % of women with heavy menstrual bleeding have submucosal fibroids. WaLIDD score is good tool for assessment of severity of dysmenorrhoea. Among women with Uterine fibroids who had dysmenorrhoea, about 80 % of them have mild dysmenorrhoea. Fibroids are infrequent cause for infertility. In our study carried out in tertiary care centre medical and surgical management was equally offered. Surgical treatment was offered only when it is indicated or if women were symptomatic following medical management. Among patients who were offered surgical treatment only 64 % prefer the same, the remaining opt for medical management and the main reason was cost of surgical treatment
A Prospective Cohort study to assess Delivery and Perinatal Outcomes in Women Induced for Small for Gestational Age After 36 Weeks of Gestation
Full text linkOBJECTIVES:
The primary objective of this study was to compare the proportion of mode of deliveries in those suspected to have small for gestation foetuses to those with normal pregnancy, induced at the same gestational age. The secondary objective was to compare perinatal outcomes in women induced for SGA compared to normal pregnancies induced at term.
METHODS:
This was a prospective cohort study done in a tertiary care teaching hospital in South India over a period of two years. Women who were prenatally diagnosed to have SGA foetuses and were induced at term were followed up. Delivery and perinatal outcomes were compared with gestational age matched controls.
RESULTS:
A total of 190 patients were recruited (95 in each arm). In the SGA arm 75 out of 95 (78.9%) had vaginal deliveries while 74 out of 95 (77.9%) in the control arm had vaginal deliveries (p = 0.86). This proved that there was no difference in delivery outcomes between women suspected to have SGA and controls, when induced at term gestation. With regards to perinatal outcomes, NICU admissions (38.9% vs 11.6, p < 0.001) and neonatal hyperbilirubinemia (18.9% vs 7.4%, p = 0.018) were significantly higher in the SGA group.
CONCLUSION:
There is no difference in the mode of delivery in those induced for suspected SGA at term when compared to normal pregnancies of the same gestational age
Maternal and Foetal Outcome in Pregnancies < 21 Years: A Prospective Observational study
No full textINTRODUCTION:
A pregnancy is categorized as high risk when the chances of an unfavorable outcome for the mother or child is increased beyond the baseline risk due to one or more ascertainable variables. Pregnancy less than 21 years is a high risk pregnancy since it is associated with increased incidence of complications during pregnancy and childbirth to both the mother and baby. About 8-14% of total pregnancies in India is a teenage pregnancy. This impacts as an increased incidence of school dropouts. Inadequate antenatal, perinatal care and poor diet all contributes to the increased adverse effects. Our study aims to focus on the health problems of mothers < 21 years during their pregnancy, labour and puerperium. It also aims to study the foetal outcome of these pregnancies.
OBJECTIVES OF THE STUDY:
➢ To find out strategies for prevention of problems of pregnancies < 21 years.
➢ To find out strategies to reduce perinatal mortality and morbidity.
➢ To promote multidisciplinary approach involving obstetricians, primary health workers, educationalists and psychiatrists to improve adolescent and reproductive health care.
MATERIALS AND METHODS:
It is a hospital-based Prospective Observational Study conducted in the Villupuram Medical College and Hospital. Using Epi Info, a sample size of 150 was calculated, and patients were recruited as per inclusion criteria. After informed consent, pre-structured questionnaire in which relevant history, examination findings, laboratory investigations were taken for each participant and the foetal outcome measured with the same type of questionnaire.
RESULTS:
Among the study population, the mean maternal age was 19.47 years and the mean gestational age was 37.97 weeks. At the time of birth, nearly 23% of babies were underweight. Furthermore 57.33% of the babies were born weighing between 2.5 and 3 kilograms, 15.33% were born weighing between 3.1 and 3.5 kilograms and 4% were born weighing more than 3.5 kilograms.In our study 38.67% mothers were anemic,20% had gestational hypertension, 6.67% had severe preeclampsia, 1.3%, had AP eclampsia and 3.3% had abruptio placentae. The incidence of GDM was 1.33% and 4% of the study population had seizure complicating pregnancy. On studying the foetal outcome16.67% had preterm delivery and nearly 25.1% had NICU admission. Nearly 18% of the mothers had PROM. The percentage of LSCS among the study population was 42% and all were primary sections owing to their young age, and impaired development. The predominant indications for LSCS were foetal distress 12% and CPD-9%.
CONCLUSION:
Identifying these mothers < 21 years as high risk women and early screening of these women for BMI, maternal nutrition and anemia can significantly reduce more common maternal complications. Increased awareness about regular AN follow-up, screening for GDM, gestational hypertension and for other undiagnosed comorbidities have to be made. Routine USG follow up and plotting the foetal growth can curtain many
foetal comorbidities by calculation of accurate gestational age and early diagnosis of IUGR. The findings of this study do not rule out the possibility of a combined effect of low maternal nutritional status, low BMI, and anemia along with their young age as a cause of many of the adverse outcomes. As a result, the study recommends that, in addition to maternal education about pregnancy and related prenatal, antenatal and postnatal child health care, effective public health interventions and programmes have to be implemented in improving basic knowledge and education to these women
Heart Disease Complicating Pregnancy and Its Outcome in Semi-Urban Population in Villupuram: A Prospective Study
No full textBACKGROUND: Heart disease complicates more than 1% of all pregnancies and is now the indirect leading cause of maternal deaths. The increasing prevalence of cardiovascular disease complicating pregnancy is due to number of causes like obesity, hypertension, diabetes. In India Rheumatic valvular disease still contributes to majority. Hence this study is designed with a goal to study the outcome in heart disease complicating pregnancy.
OBJECTIVE: To find out the strategies to prevent maternal mortality and morbidity and to analyse the possible prognostic factors which facilitate formulation of guidelines for safe motherhood.
METHODS: This is a prospective observational study over a period of One year. The study groups consists of antenatal mothers with heart disease admitted in labour ward in GVMCH, Villupuram. The type of heart disease, presentation during admission, maternal outcome and associated comorbidities were studied.
RESULTS AND DISCUSSION : In this study, majority of the heart disease is found to be acquired. The overall mortality was found to be 3.2% and the major cause was pulmonary edema associated with other comorbidities like pre eclampsia. Heart disease found to be an indirect cause of mortality in those patients. Study also showed that there was statistical significance in poor socioeconomic status and anemia.
CONCLUSION: Knowledge about the profile and predictors of outcome of heart disease in pregnant women is required for rapid assessment and to plan prompt treatment by directing limited resources for maximal benefit and reduce further sequale in mother