Introduction: The process of child bearing is a beautiful experience for a woman but unfortunately it is fraught with some unpredictable dangers. One of them is an abruptio placenta which is defined as premature separation of a normally implanted placenta, before the delivery of the fetus. It occurs in up to 1.0% of all pregnancy and can be associated with severe maternal and fetal complications. Material and Methods: The study done on antenatal patients of Sultania Zanana Hospital, Bhopal from 1 st april 2008 to 31 st march 2009. Patients clinically diagnosed as abruptio placentae were included in the study and were followed throughout their stay in the hospital. Result: The study showed the incidence of abruptio placenta to be 1.6%. It was found 1.8 times more commonly in multigravida than primigravida patients. Incidence was found much higher in patients with PIH, Pre-eclempsia and eclempsia (4.35%?). The association of maternal smoking and placental abruption has been well documented and in our study 9.6% of patients were found to be smokers. The incidence of abruptio placentae was 2.3% among multifetal gestation which is 1.43 times the incidence in general population. Preterm deliveries showed an increased incidence of abruptio placentae. Mortality rate of babies in our study was 52.05%. Conclusion: This study denoted that high parity, younger age, PIH, pre-eclempsia, eclempsia, multifetal gestation and smoking are the major risk factors for abruptio placentae. Thus proper antenatal care, proper booking, screening of high risk factors, timely referral are the various pillars need to be strengthened in our population to reduce the occurrence and the complication arising out of this catastrophe.
Introduction:We tried to evaluate the effectiveness of 2 months oral contraceptive pill (OCP) pretreatment for clomiphene citrate (CC) resistant cases followed by repeat clomiphene citrate treatment. Material and Methods: In this study of 100 patients, 30 met the criteria of clomiphen citrate resistant anovulation . Before starting OCPs day 3 hormone profile assayed. All 30patients were given 2 months of continuous OCPs for hypothalamic -pituitary-ovarian axis suppression. After withdrawal bleeding, their day 3 hormonal profile assayed and clomiphene citrate was given from day 3-day7. Follicular growth monitored by sonography from day 12 till max size (>20mm) reached. 10,000 IU Hcg given to those patients who failed to show spontaneous rupture. Ovulation was confirmed by S. Progesterone assay on day 21. Pregnancy confirmed by S. Beta hCG level and 7 weeks amenorrhoea. Result: A total number of 30 patients completed 75 treatment cycles. 23 of them achieved ovulation. There were significant changes observed in hormonal profile in response to OCP treatment. 17 beta estradiol levels decreased to 58%, 63% reduction noted in LH level, androgen decreased by 56%. FSH level also decreased but not so significantly. 23 patients ovulated out of 30 patients (76.6%) which resulted in high ovulatory cycle 55/75 (73.2%) and Cumulative pregnancy rate 60% (18/30). Conclusion: This study showed the excellent ovulation and pregnancy rate following OCP suppression. This mode of treatment is a cheaper alternative to GnRH therapy for poor anovulatory women.
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