In a randomised control study, we evaluated the efficacy of intravenous low-dose magnesium sulphate for the management of eclampsia. A total of 144 women with eclampsia were divided into a study group and a control group of 72 women each. The study group received 0.75 g/h of magnesium sulphate intravenously after a loading intravenous dose of 4 g and the control group was given the standard intramuscular regimen as advocated by Pritchard. The primary outcome measure was recurrence rate of the seizures. The secondary outcome measures were development of magnesium toxicity if any, and maternal and perinatal outcomes. The difference in the incidence of fit recurrence was statistically insignificant when both groups were compared (7.46% vs 8.57%, p = 0.939). The total dose of magnesium sulphate was significantly lower in the intravenous group (p < 0.0001), in which no patient developed magnesium toxicity. Low-dose intravenous magnesium sulphate was found to be as effective as the standard intramuscular regimen, while maintaining a high safety margin.
Administration of prophylactic antibiotic at 30-60 min before skin incision resulted in better maternal outcome when infectious morbidity and postoperative hospital stay were concerned, without influencing the neonatal outcome.
Background: Hysterectomy is the most common performed major gynaecological surgery and the decision depends on indications for operation, surgeon’s training and preference, uterine size, adnexal pathologies and patient choice. To avoid laparotomy either total laparoscopic hysterectomy (TLH) or non-descent vaginal hysterectomy (NDVH) is the recently practised option. Objectives of the present study are to compare duration of operation, blood loss, ambulation time, post-operative pain and complications between TLH and NDVH.Methods: Patients undergoing above operation during January 2014 to December 2014 at N.R.S. Medical College, Kolkata, were included under the study. All patients were thoroughly examined and investigated and malignancies were excluded by Pap smear and or D&C. All patients were observed minutely during pre-operative, intra operative and post-operative period for any complications.Results: NDVH requires less operative time than TLH but intra operative blood loss, post-operative pain and ambulation time are slightly more.Conclusions: TLH requires infrastructural set up, greater surgical expertise, longer operative time and major intraopertive complications as compared to NDVH. In our low resource government hospital NDVH is better choice for removal of uterus in uncomplicated benign conditions.
Moistening misoprostol tablets with 5% acetic acid before vaginal application creates no difference in outcomes when compared with those after the vaginal application of dry tablets for the termination of second-trimester pregnancy.
In a prospective comparative study we screened 112 women with a past history either of pre-eclampsia, eclampsia, recurrent abortion, IUGR, IUFD or abruptio placentae, with no apparent aetiology and a demographically matched cohort of 106 women having a past history of uncomplicated pregnancy outcome for the presence of antiphospholipid antibodies (aPL) and their significance. In the former group, the prevalence of aPL ranged from 10-46.87% compared with 8.49% in the later group. In women with the presence of aPL, the incidence of pre-eclampsia, early onset pre-eclampsia and abruptio placentae were 25%, 14.58% and 18.75%, respectively. In the same group, the abortion rate was 25% and live-birth rate was 64.58% with IUFD rate of 10.42%. Fetal morbidity rates were also higher in the mothers with aPL positivity, the incidence of IUGR was 27.08% and oligohydramnios was 33.33% in them. All these complications were statistically significant when compared with those of aPL negative mothers.
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