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A comparative study of carbetocin 100 mcg iv and oxytocin 10 iu iv in the prevention of postpartum hemorrhage following emergency cesarean delivery

2022-01-01T00:00:00Z

Title: A comparative study of carbetocin 100 mcg iv and oxytocin 10 iu iv in the prevention of postpartum hemorrhage following emergency cesarean delivery Authors: Vadlamudi keerthi chowdary Abstract: BACKGROUND: Obstetrical bleeding is bleeding in pregnancy that occurs before, during, or after childbirth.Between 2003 and 2009, bleeding accounted for 27% of maternal deaths globally. AIMS AND OBJECTIVES : Comparison of carbetocin 100mcg iv and oxytocin 10iu iv in the prevention of postpartum hemorrhage following emergency caesarean section. MATERIAL AND METHODS: A prospective interventional study with patients admitted for delivery in the Department of Obstetrics and Gynaecology in B.L.D.E. Shri B.M. Patil's Medical College, Hospital and Research Centre, Vijayapura from march 2023 to march 2025 with the singleton pregnancy with the period of gestation of 34 weeks and above undergoing emergency caesarean delivery were recruited. RESULTS: Carbetocin group (8.6%) compared to the Oxytocin group (18.9%) (p = 0.02),and a greater proportion of patients in the Carbetocin group (162 out of 175, 92.5%) had blood loss between 750-1000 ml, compared to 142 out of 175 (81.1%) in the Oxytocin group. This reduction in blood loss translated into a lower need for blood transfusions (1.1% vs. 4.6%, p = 0.03) and additional uterotonic agents (2.9% vs. 8.6%, p = 0.04) in the Carbetocin group. CONCLUSION : The findings of this study demonstrate that Carbetocin 100 mcg IV is significantly More effective than Oxytocin 10 IU IV in preventing postpartum hemorrhage (PPH) Following emergency caesarean section

Comparative study of vaginal misoprostol tablet versus dinoprostone insert in induction of labor

2022-01-01T00:00:00Z

Title: Comparative study of vaginal misoprostol tablet versus dinoprostone insert in induction of labor Authors: Vaishnavi Mahesh Unni Abstract: Introduction: Induction of labor (IOL) is an essential obstetric procedure for maternal and fetal safety when continuing pregnancy is risky. Prostaglandin analogues like Misoprostol (PGE1) and Dinoprostone (PGE2) are commonly used for cervical ripening and labor induction. This study compares the efficacy and safety of vaginal tablet Misoprostol versus Dinoprostone insert in IOL. Aims and objectives : To compare efficacy and safety of the vaginal Tablet Misoprostol with Dinoprostone insert in induction of labour and to compare fetal and maternal outcomes. Materials and Methods: This prospective, interventional study was conducted at BLDE University, Vijayapura, from April 2023 to February 2025, involving 106 pregnant women at term. Participants were divided into two groups: Group 1 received a 10 mg Dinoprostone vaginal insert, while Group 2 received 25 mcg vaginal Misoprostol every four hours. Key outcomes included vaginal delivery rates, cesarean section rates, and maternal and neonatal complications. Data were analyzed using SPSS (Version 20). Results: Vaginal delivery occurred in 73.58% of the Dinoprostone group compared to 50.94% in the Misoprostol group (p=0.02). The mean induction-to-delivery interval was significantly shorter in the Misoprostol group (15.2 ± 4.9 hours vs. 18.3 ± 4.29 hours, p<0.001). Maternal complications, including postpartum hemorrhage (PPH), were more common in the Misoprostol group (24.5%). Neonatal complications, such as NICU admissions and lower Apgar scores, were also significantly higher in the Misoprostol group. Conclusion: Both Misoprostol and Dinoprostone are effective for labor induction, but Misoprostol shortens the induction-to-delivery interval at the cost of increased cesarean rates and fetal complications. Dinoprostone, while slower, shows better fetal outcomes and fewer complications, making it a preferable option for high-risk pregnancies. Tailoring the choice of induction agent based on patient-specific factors is essential.

Chlorhexidine -alcohol versus povidone -iodine + Alcohol as pre-operative antiseptic for Prevention of surgical site infection in cesarean Section : a randomised control trial

2022-01-01T00:00:00Z

Title: Chlorhexidine -alcohol versus povidone -iodine + Alcohol as pre-operative antiseptic for Prevention of surgical site infection in cesarean Section : a randomised control trial Authors: Shravanthi Swamy Abstract: Introduction : Caesarean Section (CS) is the most common procedure performed and its rate is on the rise. Surgical site infection (SSI) is a dreaded post-operative complication. The most commonest disinfectants studied are PI and chlorhexidine alcohol(3).So we want to know the efficacy of chlorhexidine- based antiseptic protocol versus PI protocol as a pre-operative skin preparation in reducing SSI for patients undergoing CS Aim and objectives of the study : Primary objective was to establish the efficacy of chlorhexidine-based antiseptic protocol versus povidone-iodine protocol in reducing SSI for patients undergoing caesarean deliveries. and the organism growth on swabs taken Materials and methods : This is a randomized prospective study conducted from April 2017 to September 2017 at a tertiary care center in India. Women who underwent caesarean sections were allocated into either group. Enrolled patients were randomly assigned to have the surgical site painted with chlorhexidine- alcohol preparation or painted with a solution of 10% povidone-iodine and then with surgical spirit. The outcomes were notes. The study lasted for 18months with 208 participants. The surgical sites will be inspected on post-op day 2 and cleaned with surgical spirit and will be covered with sterile dressing sterizone (transparent filament with a silver lining in the center). The wound was inspected on day 5/day 7, or at the time of discharge, whichever was later. In case of wound discharge, the wound swabs were taken and sent for culture and sensitivity. Statistical analysis was performed using JMP-SAS Software, with results presented as mean ± S.D., counts and percentages, and diagrams. Comparisons were made using independent t-tests, Mann-Whitney U tests, Chi- square test/Fisher's Exact tests. Results : A total of 208 subjects (104 in the chlorhexidine group and 104 in the iodine group) qualified for the study.The number of surgical-site infection was significantly lower in the chlorhexidine group than in the iodine group (2.90% vs. 11.50%; P=0.02). Chlorhexidine–alcohol was significantly more protective than PI against both superficial infections (1.00% vs. 8.70%,P=0.018) and deep infections (1.90% vs. 2.90%,P=0.018). There was no significant differences in the frequency of isolating organisms. Staphylococcus aureus was the commonest bacteria isolated. Conclusion - This study highlighted that Chlorhexidine-alcohol providedsuperior skin antisepsis in comparison to PI.

Prospective case-control study on maternal ophthalmic artery doppler velocimetry in evaluation of pre-eclampsia

2022-01-01T00:00:00Z

Title: Prospective case-control study on maternal ophthalmic artery doppler velocimetry in evaluation of pre-eclampsia Authors: Sharanabasava S Kulkarni Abstract: BACKGROUND AND OBJECTIVE Preeclampsia (PE) is a lethal hypertensive disorder that significantly contributes to maternal as well as fetal morbidity besides mortality, especially in low-resource settings like in India. Early diagnosis and management are crucial in preventing adverse maternal and fetal outcomes. Preeclampsia causes cerebrovascular endothelial dysfunction and impairs cerebral autoregulation due to systemic hypertension. So, monitoring cerebrovascular alterations is crucial for preventing severe neurological complications. In this study, we have used maternal ophthalmic artery Doppler (OAD) as a key tool for monitoring hemodynamic parameters and severity of the disease in preeclampsia and normotensive pregnant women METHODOLOGY A prospective observational case-control study took place in a medical facility that provided tertiary care from April 2023 to March 2025, including 170 pregnant women (85 preeclampsia cases and 85 normotensive controls). OAD metrics, such as pulsatility index (PI), resistivity index (RI), peak systolic velocity (PSV), and end-diastolic velocity (EDV), were measured using high- resolution ultrasound with a 7-10MHz transducer. Data were analysed using SPSS version 20, and cutoff values for determining preeclampsia severity were determined using ROC curve analysis. RESULTS Preeclampsia patients demonstrated significantly higher RI and PI values compared to controls(p=0.001). ROC analysis identified RI >0.72 and a strong predictor of preeclampsia severity (sensitivity 82.3%, Specificity 79.4%). Increased ophthalmic artery Doppler indices correlated with adverse maternal and fetal consequences, including intrauterine growth restriction (IUGR) as well as preterm birth. CONCLUSION This prospective observational case-control study demonstrates the maternal ophthalmic artery doppler velocimetry as a valuable tool in evaluating and predicting preeclampsia in pregnancy. Increased resistance in the right ophthalmic artery and lower pulsatility suggest cerebrovascular dysfunction and impaired autoregulation in pre-eclampsia. As it serves as a promising surrogate marker for cerebrovascular dysfunction, its integration into routine obstetric evaluation may aid in early detection and risk stratification.