Browsing by Author "Kumari, Maya"

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    Case series on placenta accreta spectrum disorder and its management
    (Medip Academy, 2024-07) Kumari, Maya; Patel, Amrita D.; Mashruwala, Vishrut
    Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The main complication of PAS is due to it抯 massive obstetric haemorrhage which leads to maternal morbidity and mortality. The incidence of placenta accreta spectrum increases day by day due to an alarming increase in caesarean section rates. Depending on the range of invasiveness, The Placenta accreta spectrum is classified as placenta accreta, placenta increta and placenta percreta. We report here a series of 5 cases of placenta accreta spectrum and their management at our centre. With all due pre-op preparedness and anticipation of complications. All 5 cases had good maternal and fetal outcome. In 3 cases hysterectomy was required and 2 cases uterus could be preserved.
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    Operative difficulties in second stage caesarean section: an obstetrician’s nightmare
    (Medip Academy, 2024-03) Kumari, Maya; Patel, Amrita D.
    Background: By definition second stage caesarean section are performed in advanced labour at full cervical dilatation and usually after an unsuccessful attempt at vaginal delivery. It is an undesirable situation owing to the difficulties and fetomaternal complications related to it.Methods: This was a prospective observational study conducted at department of obstetrics and gynaecology, B. J. Medical College and Civil Hospital Ahmedabad between April 2022 to March 2023. All the second stage caesarean section performed were included in this study and were analysed in terms of indications, intra-operative difficulties and postoperative complications along with fetal outcome. During this one-year time period there were a total 7867 deliveries. Out of which 2569 were done by caesarean section. Out of total caesarean sections 51 were performed in second stage of labour. This contributes to 0.64% of total deliveries and 1.98% of all caesarean sections. The overall incidence was 0.64%.Results: During the study period there were a total 7867 deliveries. Out of which 2569 were done by caesarean section, out of this 51 were conducted in the second stage of labour. This contributes to 0.64% of total deliveries and 1.98% of all caesarean sections. Out of all indications the most common was non reassuring fetal heart sound. Intra-operative difficulties include extension of uterine incision (11.76%), blood transfusion was required in 19.60% of cases, 19.60% of cases had blood-tinged urine and there was bladder injury in one case. Baby was delivered by Patwardhan and modified Patwardhan method in 27.45% of cases. In post operative period 19.60% of cases were complicated by febrile illness and 11.76% by wound infection. There was total 10 NICU admissions and one perinatal mortality.Conclusions: Caesarean section in second stage of labour is a technically difficult associated with intraoperative maternal complications and adverse neonatal outcome.