PERINATAL MORTALITY.pptx of our ppt or.pdfallowed

its all about perinatal mortality

1. PERINATAL MORTALITY JAN TO MARCH 2023 DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

2. DR. MUMTAZ BEGUM POST GRADUATE TRAINEE Total no of Prenatal Death = 57 Low Birth Wt/ Pre Maturity=41 Term Births =16 NND= 08 FSP=22 MSP=26 Birth Asphysipa =07 Respiratory distress of New Born=01 Hydrocephalus=01 Other Congenitals Malformation =04 Total No of Delivery from Jan to March = 884

3. Disease Sub Group Total Male Female Total no of IUD/NND 22 05 27 DR. MUMTAZ BEGUM POST GRADUATE TRAINEE Total no of delivery in January = 358 Total no of Prenatal Death = 22

4. CASE 01 26 Yr old Sawera W/o Mohammad Mustafa PG admitted via ER with history of 35 week GA with leaking for more then 8Hrs Knows case of hypertension on admission her BP=160/110 Urine Dipstick= 3+ P/A= Soft, Non tender SFH= 32 week Lie=longitudinal P/P= CEPHALIC FHS= Positive AOL= Decreased P/V= V/V= Soacked with leaking OS=1.3cm C/X=22/30 Effaced Leaking positive CTG=Pathological Her EMLSCS done due to fetal distress outcome was alive baby girl 2.4kg with APG score 4/1, 5/5 got send Peads NICU got NND after 2Hrs due to birth asphyxia DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

5. CASE 02 30 yr old sana w/o Siraj G2P1+0 prv.1 C/S admitted via ER with 28 week prv.1C/S + IUD+Transvers lie. BP= 120/180 Pulse=82 Temp=98 F* PA SFH=22 weeks Lie= transverse FHS= Absent P/V= V/V= Normal OS=2cm Membrain Intact Plain Termination of pregnancy induce with indra cervical follyes SVD Done outcome =MSB BBG 0.5kg No risk factor identified DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

6. CASE 03 21yr old Shaheena W/O Faqeer Mohammad PG 34+6 weeks G/A with labor pain +IUD, totally unbooked . BP= 110/70 Pulse=92 Temp=98 F* PA SFH =34weeks Lie= longitudinal P/P= Cephalic 2/5 FHS= Absent P/V= V/V= Normal OS=1.2cm C/X= Soft 30/40 % Effaced Memb =Intact Plain Termination of pregnancy induce with tab Prostin E2(2 Doses) Mode of Delivery =SVD With episiotomy SVD Done outcome =MSB female 3kg Risk factor = MSL Grade 3 DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

7. CASE 04 28yr old Mehwish W/O Ali P1+0 Prv 1C/S Booked case of gynae 2 only 2 visits admitted via OPD with history of 36+6 week twin pregnancy +IUD+MCMA BP= 110/70 Pulse=96 Temp=A/F PA SFH =40 weeks Lie= longitudinal P/P= leading ceph FHS= Absent in both fetuses AOL= Adequate P/V= V/V= Normal OS=closed EMLSCS done due to MSMA outcome FSB female 2.3kg MSB female 2.4kg DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

8. CASE 05 38yr old hosakh bibi W/O Azam Khan G6P5+0 (SVD) only 3 alive issue LBB = 6yr back total unbooked admitted in via ER with history of loss of fetal movement for 16Hrs of Diagnosis =36+4 week +IUD with severe pre eclampsia in labour BP= 160/100 Pulse=92 Temp=A/F PA SFH =36 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= Absent AOL= Adequate P/V= V/V= Normal OS= M/P No leaking no bleeding DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

9. CASE 05 38yr old hosakh bibi W/O Azam Khan G6P5+0 (SVD) only 3 alive issue LBB = 6yr back total unbooked admitted in via ER with history of loss of fetal movement for 16Hrs of Diagnosis =36+4 week +IUD with severe pre eclampsia in labour BP= 160/100 Pulse=92 Temp=A/F PA SFH =36 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= Absent AOL= Adequate P/V= V/V= Normal OS= M/P No leaking no bleeding DR. MUMTAZ BEGUM POST GRADUATE TRAINEE PA SFH =36 weeks Lie= longi

10. HB:9.8g/ dn TLC:14.6 PLT: 249 INR: 0.8 Uric Acid :6.2 LDH :421 Urine Dipstick: 3+ Pedal / lower abdomen edema ++ Plan = admit in labour room stabilize the BP then induced with tablet prostin E2(2 Doses) Mode of delivery SVD outcome MSB female 2.3kg Risk factor= PIH with super imposed preclampsia Bad obstetrics history (full term NND and full term IUD) DR. MUMTAZ BEGUM POST GRADUATE TRAINEE INVESTIGATION

11. CASE 06 25 years old Rozina wo Noor Ameen G6P4+1 (SVD) LBB = 6yr back totally unbooked , admitted in via ER with Diagnosis =31+3 weeks G/A with massive abruptio placentae BP= 120/80 Pulse=92bpm Temp=A/F P/A=soft, tender SFH =36 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= Absent AOL= Adequate P/V= V/V= soaked with blood//// OS= M/P bleeding positive DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

12. Investigation HB =10.2g/dl Tlc =13.6 Plate=396 Uric acid=5.3 Ldh =461 Urine dipstick 2+ Other labs normal Previous H/o raised BP Emlscs done,outcome = fsb male 1.5kg.2pcv,4ffp,4plt.txed DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

13. CASE 07 36 years old samina w/o kamran G5P3+1 (SVD) LBB = 4yr back ,booked case of gynae unit one 1, admitted in via ER with complain of 34 weeks with pv spoting for 4 hourse Diagnosis =34 weeks G/A with massive abruption placentae BP = 160/ Pulse=92bpm Temp=A/F P/A=tense, tender SFH =36 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= Absent AOL= Adequate P/V= V/V= soaked with blood//// OS= M/P bleeding positive DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

14. Investigations; Hb =10.5 Tlc =13.6 Platelates =235 Urine dipstick=protein 3+ Uric acid=7.5 LDH=426 LFTs& UCEs & coagulation profile were normal Emlscs+jaddelle insertion d/t 34 weeks pregnancy +APH 2 to abrutio placentae Outcome = FSb male 1.9kg DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

15. CASE 08 18 years old nadia w/o rashid booked case of gynae unit 1, admitted in via ER with complain of 30+4 G/A with h/o 3 episodes of fits Diagnosis =30+4 weeks G/A with eclampsia BP= 160/110 Pulse=98bpm Temp=A/F P/A= soft,non tender SFH =30 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= positive AOL= Adequate P/V= V/V= normal//// OS= close DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

16. Investigations Hb =11.3 TLC=14.9 PLAT=453 Urine dipstick 3+ Uric acid=5.6 LDH =347 T.Billirubin =0.3 Rest of labs were normal Immediately shifted to oT,stablize the BP Emlscs done,outcome =ABG of 0.8kg got NND DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

17. CASE 09 22years old Haseena PG booked case of gynae unit 2, admitted in via ER with C/O 27+5 weeks G/A with labour pains + severe anemia + iud BP= 110/70 Pulse=108bpm Temp=A/F P/A= soft,non tender SFH =24 weeks Lie= longitudinal P/P= cephalic 2/5 FHS= absent AOL= Adequate P/V= V/V= normal//// OS= 3cm,cx=30 to 40 percent effeced,memb =intact PLAN=admit in labour room for svd Send labs + cross match 4pcv,4ffp Mode of delievery =SVD Outcome=female FSB,wt =0.9kg Investigations HB=4.2 TLC=12.4 Plt =215 Iron profile+stool DR + MP ict sent Rest of labs normal 2pint pcv txed s during labour DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

18. Investigations HB=10.5 TLC=10.9 Plat=341 Other labs normal No H/O anomalous baby in subling or family No H/o fever,rash or drug intake. DR. MUMTAZ BEGUM POST GRADUATE TRAINEE

19. 43 years old Sumaira w/0 khaliq G6P5+0(all svds ) LBB=3years back,LMP = NSOD,admitted via ER with H/O 38 weeks G/A + hydrocephalus+IUD with labour pains Vv vitals BP=120/80mmhg Pulse=80bpm Afebrile P/A= SFH=38cm Lie=long FHS=absent Liquor=adequate P/P=cephalic 5/5 P/v=V/V=normal OS=3.5cm Cx =30% effaced Memb+intact No leaking or bleeding ARM done grade 3 MSL PLAN= admit in labour room,send labs + cross match and augment with syntocinon Mode of delievery = DR. MUMTAZ BEGUM POST GRADUATE TRAINEE CASE 10