its all about perinatal mortality

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

2. DR. MUMTAZ BEGUM POST
GRADUATE TRAINEE
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

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

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

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
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
DR. MUMTAZ BEGUM POST
GRADUATE TRAINEE