Nirupa, P (2021) Outcome of Pregnancy with Tablet Micronized Progesterone till 20 weeks in First Trimester Bleeding. Masters thesis, Tirunelveli Medical College, Tirunelveli.
Full text not available from this repository.Abstract
INTRODUCTION: The ‘Safe-Motherhood’, not only in relation to mother but also in relation to fetus. Vaginal bleeding during first trimester has been estimated to occur in 15-25% of all pregnant women. Threatened abortion is a clinically descriptive term that applies to women who are at less than 20 weeks of gestation with a viable pregnancy and have vaginal spotting or bleeding, a closed cervical OS and possibly mild uterine cramping. It has been shown to be associated with an increased risk of poor obstetric outcomes such as Low birth weight, preterm labour and premature rupture of membranes. In this study we are treating the patients who come to the casualty with first trimester bleeding. They are assessed clinically, confirm intrauterine pregnanacy and diagnosed as threatened abortion are treated with micronized progesterone 400mg till 20 weeks of pregnancy. They are followed up monthly till delivery. this study is to measure outcome of pregnancy. MATERIALS AND METHODS: This prospective cohort study was done in the Department of Obstetrics And Gynecology, Tirunelveli Medical College and Hospital, Tirunelveli in the year January 2019 to December 2020. The cases were selected from the inpatient department. Participants with significant vaginal bleed in the first trimester were recruited. 140 cases were selected as study group. After informed consent women were recruited into the study. INCULSION CRITERIA: • Pregnant women with maternal age group (18-36 years). • Normal BMI. • Both primi and multigravida. • Sure of dates, with regular cycles. • Absence of cervical pathology. • Patients who are willing for follow up. EXCULSION CRITERIA: • Patients with systemic diseases, thrombophilia. • h/o recurrent miscarriages, with BOH. • Cervical incompetence, uterine fibroids and cervical pathology. • Patients who are not willing for study. • Patients who are not willing for follow up. INVESTIGATION: • Urine pregnancy test,Urine albumin,sugar and deposit. • Routine blood investigations-HB%, TC, DC, ESR, RBS, Urea, Creatinine. • Coagulation profile, platelet count, BT, CT, TSH, HCV, HbSAg, HIV, VDRL, HbA1C and ANA. • Serial USG abdomen and pelvis. STUDY DESIGN AND SAMPLING: • Patients were informed about the aim of the study as well as and benefits and harms of treatment informed concerned was obtained for all patients. Such patients were registered, followed up prospectively at antenatal clinics and delivered at the same hospital RESULTS: • Among the 140 mothers with trimester bleeding treated with micronized progesterone vaginally 400mg till 20 weeks, 85 mothers were primi and 55 mothers are multigravida. • Out of 32 mothers were abortions, preterm were 44 and term were 64. • Based on the reports there was significant improvement in the outcome of pregnancy with trimester bleeding.one third of mothers went for abortions and two third of mothers increasing live birth rates. • However there is contraversy in using progesterone for threatened abortion. Many trial still going on to find out the efficacy of progesterone .so it needs further research to conclude micronized progesterone used for threatened miscarriage. CONCLUSION: • Out of 140 mothers 85 were primi and 55 mothers are multigravida, out of which 32 were abortions,44 were preterm and 64 were term delivery. • Out of drug given to 85 primi mothers 17 were abortions,28 were preterm and 40 were term which is statistically significant. • Out of drug given 55 multigravida mothers 15 were abortions ,16 were preterm and 24were term which is not statistically insignificant. • Abruption is 1.4% which were preterm. • Among PROM was 11.4% were preterm and 3.6% were term. • 31.4% were delivered baby with low birth weight which was preterm and 6.4% delivered baby was term. • There is significant improvement in live pregnancy to the women treated with micronised progestrone 400 mg vaginally.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221816354 |
| Uncontrolled Keywords: | Outcome, Pregnancy, Tablet Micronized Progesterone, 20 weeks, First Trimester Bleeding. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 24 Apr 2021 02:22 |
| Last Modified: | 03 Oct 2021 14:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14991 |
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