TY - JOUR AU - Ambreen, Afshan AU - Khurshid, Samina AU - Khurshid, Misbah AU - Khan, Fareeha AU - Intisar, Ayesha PY - 2013/05/21 Y2 - 2024/03/29 TI - Obstetrics Outcome of Cases Referred to Tertiary Care Hospital after Trial of Labour JF - Annals of King Edward Medical University JA - Annals KEMU VL - 18 IS - 1 SE - Articles DO - 10.21649/akemu.v18i1.379 UR - https://annalskemu.org/journal/index.php/annals/article/view/379 SP - 71 AB - <p class="MsoBodyText2" style="margin-bottom: 3pt; text-align: justify;"><strong><span style="font-size: 11pt;">Introduction:</span></strong><span style="font-size: 11pt;">&nbsp;&nbsp;Labour is the physiological process with its inherent risk of complications so it requires supervision by skilled birth attendants. Delivery con-ducted by untrained birth attendants has a 4.67 times higher mortality rate as compared to the one conducted by SBAs. This study was conducted to determine feto-maternal outcome of cases referred to Fatima Memo-rial Hospital, after a trial of labour by TBA&rsquo;s.</span></p> <p class="MsoBodyText2" style="margin-bottom: 0.0001pt; text-align: justify;"><strong><span style="font-size: 11pt;">Objectives:</span></strong><span style="font-size: 11pt;">&nbsp;&nbsp;</span><span style="font-size: 11pt;">To determine feto-maternal outcome and to identify factors associated with adverse obstetric outcome.</span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Study Design:</span></strong><span style="font-size: 11pt;">&nbsp; Case series descriptive study.</span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Setting:</span></strong><span style="font-size: 11pt;">&nbsp;&nbsp;Department of Obstetrics and Gynecology Fatima Memorial Hospital, Lahore.</span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Duration with Dates:&nbsp;&nbsp;</span></strong><span style="font-size: 11pt;">Six months from 1<sup>st</sup> April 2011 to 30<sup>th</sup> September 2011.</span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Subjects and Methods:&nbsp;&nbsp;</span></strong><span style="font-size: 11pt;">One hundred patients who were admitted through emergency after a trial of labo-ur by traditional birth attendants (TBAs), lady health visitors (LHVs) or doctors at home or private clinics were managed and followed in the department of gy-necology and obstetrics Unit II. Patients were clini-cally evaluated and relevant investigations were car-ried out in all patients. Final diagnosis was made on the basis of history, clinical examination and investi-gations. Data collection too was structured proforma specifically designed for the purpose. </span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Results:</span></strong><span style="font-size: 11pt;">&nbsp;&nbsp;</span><span style="font-size: 11pt;">Mean age of the patients was 27.28 &plusmn; 5.13 years. Fever was the most common complication fou-nd in 69 (69%) patients. Antepartum hemorrhage occ-urred in 22 (22%) cases. Postpartum hemorrhage com-plicated 46 (46%) pregnancies leading to shock in 51 (51%) patients. Oligohydramnios was observed in 35 (35%) patients and uterine rupture in 5 (5%) cases. There were 3 (3%) maternal deaths.</span></p><p style="margin-top: 0cm; margin-right: 0cm; margin-bottom: 1.2pt; margin-left: 0cm; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><span style="font-size: 11pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Low Apgar score was observed in 36 (36%) ba-bies. Meconium staining was present in 34 (34%) cases and 34 (34%) babies needed hospitalization. (Fe-tal growth restriction was found in 23 (23%) patients. There were 23 (23%) fetal neonate deaths.</span></p><p style="margin: 0cm; margin-bottom: .0001pt; text-align: justify; mso-pagination: none; tab-stops: 18.0pt;"><strong><span style="font-size: 11pt;">Conclusion:&nbsp;&nbsp;</span></strong><span style="font-size: 11pt;">Postpartum hemorrhage led to maternal and fetal complications in majority of the patients whi-ch was not handled appropriately and immediately.</span></p><p class="MsoBodyText2" style="margin-bottom: 0.0001pt; text-align: justify;"><strong><span style="font-size: 11pt; font-family: 'Times New Roman', serif;">Key Words:</span></strong><span style="font-size: 11pt; font-family: 'Times New Roman', serif;">&nbsp;&nbsp;</span><span style="font-size: 11pt; font-family: 'Times New Roman', serif;">Postpartum hemorrhage (PPH), Oligo-hydramnios, shock.</span></p> ER -