Case No.1_July Statistics Presentation.pptx

Stats presentation

1. MATERNAL MORTALITY CASE PRESENTATION JULY’ 23 (CASE NO. – I) LATE BALIRAM KASHYAP GOVT. MEDICAL COLLEGE, JAGDALPUR, CHHATTISGARH DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY By: Dr. Diksha Mani JR-II, Obs. & Gynae.

2. Patient’s Information: Name: Navina Pujari (w/o- Ravindra Pujari) Age: 24 years Sex: Female Address: Vil.- Talnar , Dist.- Bastar . Time & Date of Admission: 12:35 pm on 29.06.2023. Referred from M.H. in view of Short Stature & CPD. CHIEF COMPLAINTS: Pain abdomen since 6-7 hours .

3. Patient’s Vitals (at time of admission): General Condition: Average. Height: 130 cm BP: 110/70 mmHg PR: 96/min RR: 18/min Pallor: + Edema : + Icterus: - At the time of admission patient’s – Hb: 10.1 gm%, WBC: 9.4 k & Platelets: 2.59 lakhs

4. On P/V examination: OS- 2 finger/tight 30-40% effaced Membrane: + Station: -2 Pelvis Inadequate DIAGNOSIS ON ADMISSION: Primi with (40+2 weeks by date)/ (40 weeks BS of 22+4) with Cephalic with Short Stature in latent labour. On P/A examination: Uterus Term size, Cephalic & Relaxed. FHS: 140/ min

5. Course of Treatment: 29 th June’ 23 Decision for LSCS was taken i.v.o . CPD. At 1:34 pm, live male child of 3.5 kg weight was delivered. Post op vitals were: G/C- Average, BP- 110/80 mmHg, PR- 98/min, Urine Output- 200ml (clear) 30 th June’ 23 LFT, KFT & SE reports came in which findings were normal. 1 unit RCC was transfused as patient looked clinically pale. Starting time of Blood Transfusion was 4:00 pm and ending time was 7:00 pm.

6. 30 th June’ 23 Urine output was 700 ml since 6.5 hours. At 8:00 pm, patient had breathing difficulty and O2 saturation was 85% on RA. Patient was brought in propped up position & O2 inhalation was started immediately. Medicine and Anaesthesia call was sent. At 9:30 pm, Medicine call was attended and advice was given for: Propped-up position, O­2 inhalation, Nebulisation with Budecort 8- hourly, RBS & TPR charting 4-hourly, Anaesthesia call for ventilatory support (SOS).

7. 30 th June’ 23 At 10:00 pm, patient’s G/C became poor and was very irritable. SPO2 was 69% on O2 inhalation @ 10 l/min, BP: 130/80 mmHg, PR: 104/min, Urine output: Nil (since 7:00 pm), RBS: 129 mg/dl. Transfer call was sent to Medicine Department. Patient’s Repeat CBC reports indicated Hb: 9.8 gm%, Platelets: 20k and WBC: 1.66k. Physician on duty came and examined the patient and patient was transferred to MICU for further management. Patient was put on CPAP there; but, the patient was very irritable & uncooperative and removed the CPAP within 5 minutes.

8. At 12:30 am, Anaesthesia JR came and discussed the case with Consultant on Duty. They recommended that there is no requirement for ventilatory support, as the patient was maintaining SPO2­: 86% on RA. At 1:30 am, patient was distressed and semi- conscious; BP: NR, PR: Feeble, SPO2: 74% on RA. Injection Norad @ 5 ml/hour was started. At 1:45 am, patient had 1st episode of cardiac arrest. 3 cycles of CPR and emergency drugs were provided; but the patient couldn’t be revived. At 2:20 am, patient was declared dead. 1 st July’ 23

9. DURATION OF STAY AT THE HOSPITAL : ADMISSION TO DELIVERY INTERVAL : ADMISSION TO DEATH INTERVAL : 2 days 14 hours 1 hour 2 days 14 hours PRIMARY CAUSE OF DEATH: Antecedent CAUSES of death: Cardio- Respiratory A rrest Pulmonary Embolism Severe Anaemia

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