ADMISSION

REVIEW
Presented by

Dr. Romana Parvin

DGO(on course)
Gynae Unit-1
Admission review of

 Total patients admitted-30

 Obstetric patients-25

 Gynae cases-05
 Gynae cases
 Ectopic pregnancy:Nil
• Ruptured
 With shock
 Stable :

• Tubal abortion
• Unruptured

 Abortions:01
 Threatened -
 Inevitable -
 Incomplete-01

 Missed –
 Septic -
 H. Mole : 01
 Bartholin Abscess: Nil
 Others :
 Labial abscess
 Left adnexal cyst
 Primary subfertility with right ovarian multiloculated cyst
Minor Gynecological
Surgeries
 E&C / D&C :Nil
 MVA :01
 Suction evacuation :01
 Polypectomy:Nil
 Incision & drainage :01
 Biopsy:Nil
 Major gynecological surgery
 1 in number
 VH with PFR with excisional biopsy due to 2nd degree U-V prolapse with moderate
cystocele with mild urethrocele &rectocele and fungating & ulcerative lesion in
right labia minora.
 Case variations
 Primigravida- 04
 Multigravida- 21
 Adolescent pregnancy-Nil
 Elderly primi – Nil
 Grand multipara -01
 Term pregnancy-22
 Term pregnancy with labour pain: 05
 First stage:05
 2nd stage: Nil
 Post-term pregnancy – 01
 Preterm pregnancy: 02
 Early (<34 wks) – 0
 1(20+wks of pregnancy with multiple congenital anomaly)
th
 Preterm labour-04
 Early(<34wks)-nil
 Late(≥34-36th wks)-04
Cont’d..
 PROM-02
 Early preterm PROM (up to 34 wks) : Nil
 Late preterm PROM (34-36 +6 wks):Nil
 Term PROM :02
 Malpresentation :03
 Breech - 03
 Shoulder – Nil
• Malposition :Nil
• Rh negative mother-Nil
 Fetal distress –02
• Hyperemesis gravidarum : Nil
 APH: 02 ( Placenta Accreta, Placenta Praevia type I anterior)
 Cord Prolapse: Nil
Cont’d..
 DM in pregnancy -Nil
 GDM – Nil
 Recurrent Pregnancy Loss: 01
 Twin Pregnancy:Nil
 Hypertension in pregnancy:03
 Gestational HTN - Nil
 Chronic HTN :01
 Preeclampsia :02
 Pre-eclampsia with severe disease :Nil
 Eclampsia:Nil
 Antepartum

 Intrapartum

 Postpartum
Cont’d..
 Pregnancy with other medical diseases:03
 Hypothyrodism : Nil
 HBsAg +ve :Nil
 SLE :Nil
 Moderate anemia:02
 UTI :nil
 Heart disease :Nil
 CKD with stroke:01
1. Pregnancy with previous uterine scar:12
 1 LSCS :11
 2 LSCS : 01
 3 LSCS
 4 LSCS
 Previous myomectomy :nil
Induction and Augmentation

 Augmentation-Nil
 SVD :
 LSCS :
 Induction -01(primi 20 wks of pregnancy
with multiple congenital anomaly)
 VD -
 LSCS -
Obstetric management
 SVD-NVD+ VD= 04+01=05
 With episiotomy - 03
 Intact perineum :
 Perineal laceration :01
 First degree :01
 2nd degree :
 3rd degree
 4th degree
 VD- 01
 Preterm :
 IUD :
 Malposition:
 Breech :01
 Instrumental delivery- nil
 Forceps

 Ventouse

 LSCS- 17(emergency 07 and elective 10)

 VBAC /TOLAC :Nil
 Manual removal of placenta under GA:Nil
 Peripartum hysterectomy-01
 Management of primary pph with septic
shock
Emergency Obstetric
Management
 Peripartum hysterectomy-01
 Management of primary PPH with septic
shock
Indication of LSCS
 Term pregnancy with
1 LSCS : 09
2 LSCS :01
3 LSCS
4 LSCS
 Others:
Indication of LSCS
 3rd gravida with 39wks of pregnancy with breech
presentation with BOH(1 perinatal death + 1 ab)
 4th gravida with 39wks of pregnancy with previous
history of 1 C/S with impending rupture
 Primi 39 wks of pregnancy with breech
presentation with oligo hydramnios(AFI 4cm)
 2nd gravida with 34wks of pregnancy with CKD
with H/O stroke with chronic hypertension with
P/H/O 1 C/S with severe oligo hydramnios (AFI
2cm)
 3rd gravida with 42wks of pregnancy with FD in
first stage(BPP 6/8)
 2nd gravida with 38wks of pregnancy with severe
PE with FD(fetal heart rate -188 b/min)
 4th gravida with 34wks of pregnancy with APH
(placenta praevia type 1)with shock
 Expectant management

01:Primi 20+wks of pg with multiple congenital

anomaly
-Holoprocencephaly
-Bilateral cleft lip
-Nasal bone ill defined
-fetal kidneys shows minimal fullness of the P-C system
-Sole of the right foot appears edematous
-left foot shows talipes abnormality
Referred Cases : nil

 Referred in :
 Referred out :Primary PPH following LSCS (outsided
hospital ) with septic shock with AKI
 Morbidity
 Maternal:02
 Inpatient :01{peripartum hysterectomy due to 2nd gravida with 36 wks of pregnancy with
Central placenta previa (plcenta accreta) with moderate anemia with P/H/O 1C/S}
 Referred in: 01(primary pph following LSCS (outside) with septic shock with AKI)
 SSI:Nil
 Inpatient :
 Referred in:
 Fetal:
 LBW :02
 Term : nil
 Preterm : 02
 LBW
 <2500gm:01
 <2000gm :nil
 <1500gm :01{1.4kg}
 Perinatal asphyxia-02
 Responded with stimulation : 01
 Needed bag mask resuscitation : 01
ICU / NICU Referral

 Referred to ICU : 02

 Referred to NICU :04 (2 preterm low birth weight

+2PNA)
 Admitted 01(LBW)
Blood transfusion
 Total unit of whole blood required: 09 units
 4 units PCV Placenta Percreta
 3 units for primary PPH with shock
 2 units for pregnancy with Moderate anaemia (8.5 gm/dL)

 Blood products required :nil

 FFP
 Platelet
 Cryoprecipitate
 RCC
Contraceptive

 CU-T: 04
 Implanon/Jadelle : Nil
 BLTL: 03
Mortality

 No maternal death

 No Perinatal death
Thank You