Dr.Shobha.Shiragur
@bldedu.ac.in
Associate Professor
Shri.B.M.Patil Medical College
Scopus Publications
Scopus Publications
Shobha Shiragur, Preeti Patil, Praveen Ganganahalli, Muttappa Gudadinni, Shailaja Bidri, Aruna Biradar, and Rajasri Yaliwal
International Journal of Women's Health and Reproduction Sciences
Objectives: Ectopic pregnancy (EP) is the leading cause of early pregnancy accounting for 10-15% of pregnancy-related deaths. It is life-threatening condition where the majority of them present late. This study aims to evaluate the incidence, risk factors, clinical features, diagnosis, and management of EP in the tertiary care center. Materials and Methods: This study conducted a retrospective analysis of electronic medical records from June 2015 to June 2020, focusing on participants in the age group of 18 to 45 years, to examine the occurrence of EP. The data were analysed with simple descriptive statistics and presented in frequency tables and charts of age group, parity, anemia grades, risk factors and presenting symptoms. Results: The incidence of EP in the current study was 0.38%. In the present study, 73.8% of women were of 20–30-year-old. In this study, 54.1% of women had a history of pelvic inflammatory disease (PID). Prior EP was seen in 19.7 % of cases. 16.4% of participants had a prior history of tubectomy and 19.7% had a previous history of infertility treatment, and 21.3% had a previous history of lower segment caesarean section (LSCS). In the present study, 65.5% of women presented with amenorrhea of 4-8 week, and 95% had abdominal pain. In the present study, common site was the right fallopian tube in 73.9% of cases. In this study, all cases need surgical management most common procedure carried out was salpingectomy. intensive care unit (ICU) admission was needed in 26.2% of cases, and no mortality was seen in our study. Conclusions: EP is a serious and potentially life-threatening condition. Early diagnosis and prompt management are crucial in reducing maternal mortality and morbidity rates.
Rajasri G Yaliwal, Aruna M Biradar, Prathibha S Dharmarao, Shreedevi S Kori, Subhashchandra R Mudanur, Neelamma G Patil, Shobha S Shiragur, and Sangamesh S Mathapati
Informa UK Limited
Purpose Oxytocin is the preferred choice for prophylaxis and treatment of postpartum hemorrhage. Intravenous infusion has been a widely accepted route for Oxytocin administration. However, intravenous bolus route is not a readily preferred route due to apprehensions regarding hypotension that it may cause. This trial compares low dose 3 IU intravenous (IV) bolus Oxytocin along with 7 IU Oxytocin in intravenous infusion to 10IU Oxytocin intravenous infusion during cesarean section. Patients and Methods A total of 250 term pregnant women were randomized to either 3 IU intravenous bolus with 7 IU intravenous infusion of Oxytocin or 10IU of intravenous Oxytocin infusion. The difference in pre- and post-operative hemoglobin levels, tone of the uterus, hemodynamic changes, adverse effects of the drug, need for additional uterotonics and need for blood transfusions were assessed. Results There was 6.7% less blood loss in the 3 IU IV bolus Oxytocin with 7 IU Oxytocin infusion group in comparison to the Oxytocin infusion group. The tone of the uterus was firmer in IV bolus Oxytocin with Oxytocin infusion group at 5 minutes (p<0.001) than the Oxytocin infusion group. There was no significant difference in the hemodynamic changes, adverse effects or need for blood transfusions. Conclusion Intravenous bolus of 3 IU Oxytocin along with 7 IU infusion of Oxytocin is as safe and more effective than intravenous infusion of 10 IU of Oxytocin during cesarean section in the prevention of postpartum hemorrhage.
Mariana Widmer, Gilda Piaggio, Thi M. H. Nguyen, Alfred Osoti, Olorunfemi O. Owa, Sujata Misra, Arri Coomarasamy, Hany Abdel-Aleem, Ashalata A. Mallapur, Zahida Qureshi,et al.
Ovid Technologies (Wolters Kluwer Health)
METHODS We enrolled women across 23 sites in 10 countries in a randomized, double-blind, noninferiority trial comparing intramuscular injections of heat-stable carbetocin (at a dose of 100 μg) with oxytocin (at a dose of 10 IU) administered immediately after vaginal birth. Both drugs were kept in cold storage (2 to 8°C) to maintain double-blinding. There were two primary outcomes: the proportion of women with blood loss of at least 500 ml or the use of additional uterotonic agents, and the proportion of women with blood loss of at least 1000 ml. The noninferiority margins for the relative risks of these outcomes were 1.16 and 1.23, respectively.
Mariana Widmer, Gilda Piaggio, Thi M.H. Nguyen, Alfred Osoti, Olorunfemi O. Owa, Sujata Misra, Arri Coomarasamy, Hany Abdel-Aleem, Ashalata A. Mallapur, Zahida Qureshi,et al.
Massachusetts Medical Society
BACKGROUND Postpartum hemorrhage is the most common cause of maternal death. Oxytocin is the standard therapy for the prevention of postpartum hemorrhage, but it requires cold storage, which is not available in many countries. In a large trial, we compared a novel formulation of heat‐stable carbetocin with oxytocin. METHODS We enrolled women across 23 sites in 10 countries in a randomized, double‐blind, noninferiority trial comparing intramuscular injections of heat‐stable carbetocin (at a dose of 100 &mgr;g) with oxytocin (at a dose of 10 IU) administered immediately after vaginal birth. Both drugs were kept in cold storage (2 to 8°C) to maintain double‐blinding. There were two primary outcomes: the proportion of women with blood loss of at least 500 ml or the use of additional uterotonic agents, and the proportion of women with blood loss of at least 1000 ml. The noninferiority margins for the relative risks of these outcomes were 1.16 and 1.23, respectively. RESULTS A total of 29,645 women underwent randomization. The frequency of blood loss of at least 500 ml or the use of additional uterotonic agents was 14.5% in the carbetocin group and 14.4% in the oxytocin group (relative risk, 1.01; 95% confidence interval [CI], 0.95 to 1.06), a finding that was consistent with noninferiority. The frequency of blood loss of at least 1000 ml was 1.51% in the carbetocin group and 1.45% in the oxytocin group (relative risk, 1.04; 95% CI, 0.87 to 1.25), with the confidence interval crossing the margin of noninferiority. The use of additional uterotonic agents, interventions to stop bleeding, and adverse effects did not differ significantly between the two groups. CONCLUSIONS Heat‐stable carbetocin was noninferior to oxytocin for the prevention of blood loss of at least 500 ml or the use of additional uterotonic agents. Noninferiority was not shown for the outcome of blood loss of at least 1000 ml; low event rates for this outcome reduced the power of the trial. (Funded by Merck Sharpe & Dohme; CHAMPION Australian New Zealand Clinical Trials Registry number, ACTRN12614000870651; EudraCT number, 2014‐004445‐26; and Clinical Trials Registry‐India number, CTRI/ 2016/05/006969.)
Vijaya Patil
JCDR Research and Publications
The incidence of spontaneous perforations in pyometra is rare, being 0.01-0.5% in gynaecological patients. However, they are more common in postmenopausal females and their incidence is 13.6%. Here, we are reporting a rare case of peritonitis with a pneumoperitoneum in an elderly female, which was caused by a spontaneous perforation of pyometra. A 74-years old postmenopausal female with uncontrolled diabetes mellitus was admitted to surgical emergency with signs of diffuse peritonitis and she was in shock. After resuscitation, an emergency laparotomy was performed because of suspicion of a hollow viscous perforation with peritonitis. At laparotomy, about 2000ml of purulent fluid was found to be present in peritoneal cavity, while alimentary tract was intact. A rent with a diameter of 0.8 cm was found on fundus of uterus. A total abdominal hysterectomy with a bilateral salphingo oophorectomy was performed. Patient got discharged on 12(th) post-operative day without major complications. Histopathological studies revealed endometritis and myometritis, with no evidence of malignancy.