Search

Background: Primary caesarean section in multipara refers to first time caesarean section in multiparous women who have had previous one or more vaginal delivery. Aim and Objectives: The present study focuses on the frequency, indications and obstetric outcome of primary caesarean sections in multiparous women with previous vaginal deliveries. Material and Methods: This was a cross sectional observational study, carried out during a period of 1st December 2014 to 30th November 2016 at a tertiary care centre after obtaining clearance from Institutional Ethics Committee. All the consecutive subjects fulfilling the selection criteria were included in study with sample size of 200. Results: Total number of deliveries during the study period were 3485, out of which 1649 (47.32%) were vaginal and 1836 (52.68%) were caesarean sections. Frequency of primary caesarean section in multiparous women was 5.73% of all deliveries and 10.89% of all caesarean section. The most common indications for caesarean section were non reassuring fetal status (47%), mal-presentation (13%) and thick meconium stained liquor (13%). Conclusion: Though responsible for least number of overall caesarean sections, multiparous women undergoing primary caesarean section fall under high risk pregnancy with possibility of adverse obstetric outcome in significant number of subjects. [ABSTRACT FROM AUTHOR]

Aim: This study was undertaken to evaluate the impact of grandmultiparity on obstetric outcome in a low resource setting. Material & Methods: Two hundred and eighty-two antenatal grandmultiparous women (parity ≥ 4) were compared with consecutive 564 antenatal women with parity 1-3. Results: There were 13 403 deliveries over the study period from Jan 2006-December 2008 at CSMMU, Lucknow. The prevalence of grandmultipara was 2.3%. Grandmultipara were older ( P < 0.001) and more commonly from rural areas ( P < 0.001) as compared to the control group. The percentage of Muslims among grandmultipara (23.8%) was higher than among controls (16.5%), P < 0.01. Grandmultipara had significantly higher prevalence of anemia ( P < 0.001), malpresentation ( P = 0.01) and rupture uterus ( P < 0.001). Abruptio placenta, placenta previa and obstructed labor were seen more often in grandmultipara, and the difference was statistically significant ( P < 0.01 in each group). There was no difference in terms of mode of delivery, sex of newborn or the prevalence of low birthweight (<2.5 kg) babies. Stillbirths were more common in grandmultiparas ( P < 0.001). There was one maternal death in the study group. Conclusion: Grandmultiparity continues to be of grave concern with an adverse impact on obstetric and perinatal outcome. [ABSTRACT FROM AUTHOR]

Background: Understanding the effect of maternal parameters on obstetric outcome has public health importance because these indicators are associated with infant health and survival and influence development and health in later life. Aim: To determine the effects of various maternal indicators on pregnancy outcome in north-Indian women. Settings and Design: A prospective study of all consecutive women with singleton pregnancy, who were registered in the first two months of pregnancy and delivered in the hospital. Materials and Methods: Maternal indicators such as age, height, prepregnancy weight, body mass index (BMI), hemoglobin and parity were correlated with pregnancy outcome. The women with a medical disorder or complication that developed during the course of pregnancy were excluded. Results: A total of 2027 women were analyzed. Maternal height, weight, BMI and parity had a positive significant correlation with birth weight of the newborn (r=0.081, P value < 0.001, r=0.148, P value <0.001, r = 0.121, P value < 0.001 and r = 0.099, P value < 0.001, respectively). Maternal height, weight and period of gestation were significant indicators for low birth weight on multivariate logistic regression. The rate of preterm delivery was significantly higher in women with hemoglobin < 7 g% and women with parity >3. The chances of caesarian section increased significantly with increase in maternal height, weight and BMI. Conclusions: A prepregnancy weight of more than 40 kg, BMI of more than 19.8 and hemoglobin of at least 7g% or more favor good obstetric outcome. [ABSTRACT FROM AUTHOR]

Abstract: To better understand the magnitude of arsenic contamination in groundwater and its effects on human beings, a detailed study was carried out in Jalangi, one of the 85 arsenic affected blocks in West Bengal, India. Jalangi block is approximately 122 km2 in size and has a population of 215538. Of the 1916 water samples analyzed (about 31% of the total hand tubewells) from the Jalangi block, 77.8% were found to have arsenic above 10 μg l−1 [the World Health Organization (WHO)-recommended level of arsenic in drinking water], 51% had arsenic above 50 μg l−1 (the Indian standard of permissible limit of arsenic in drinking water) and 17% had arsenic at above 300 μg l−1 (the concentration predicting overt arsenical skin lesions). From our preliminary medical screening, 1488 of the 7221 people examined in the 44 villages of Jalangi block exhibit definite arsenical skin lesions. An estimation of probable population that may suffer from arsenical skin lesions and cancer in the Jalangi block has been evaluated comparing along with international data. A total of 1600 biologic samples including hair, nail and urine have been analyzed from the affected villages of Jalangi block and on an average 88% of the biologic samples contain arsenic above the normal level. Thus, a vast population of the block may have arsenic body burden. Cases of Bowen''s disease and cancer have been identified among adults who also show arsenical skin lesions and children in this block are also seriously affected. Obstetric examinations were also carried out in this block. [Copyright &y& Elsevier]

Healthy body weight on conception and adequate weight gain during pregnancy is important to ensure that the mother and baby remain well. About 30% of women living in South Asia enter pregnancy with severe or moderately severe underweight and do not gain sufficient weight during gestation to allow the fetal growth to proceed unimpeded. In India, out of twenty million babies born every year, about seven million are low birth weight.1 The aim of the present study was to determine the effects of first trimester BMI on pregnancy, labour and fetal outcomes, which will help to identify how significant is the BMI monitoring in antenatal period for preventing complications. Antenatal and intranatal records of 250 primi gravid women were studied over a period of one month for knowing the complications which had occurred to mother and her fetus during antenatal and intranatal period. Statistical analysis was done by using SPSS 11.5 package and relation was found using logistic regression. Complications like gestational diabetes mellitus, gestational hypertension, preterm delivery, meconium stained liquor, low birth weight, small for gestational age and IUGR were found to be more in abnormal first trimester BMI categories. Abnormal first trimester BMI revealed to be associated with severe maternal and neonatal complications. Therefore pregnant women should maintain a normal BMI to achieve a healthy pregnancy outcome. [ABSTRACT FROM AUTHOR]