From, Date: 26/11/09

Place: Bellary

DR.INDRA.N

POST GRADUATE IN MS (OBSTRETRICS & GYNAECOLOGY)

DEPARTMENT OF OBG,

vijayanagara institute of medical sciences,

BELLARY

To,

The Principal,

vijayanagara institute of medical sciences,

bellary

Through proper channel

Respected sir,

SUBJECT: submission and forwarding of synopsis for registration of dissertation topic.

In accordance with the below sited topic, I , the undersigned studying in PG course in MS (OBSTRETRICS & GYNAECOLOGY) has been allotted the dissertation topic “STUDY OF MATERNAL & PERINATAL OUTCOME IN OBSTRUCTED LABOUR” under the guidance of Dr.Mumtaz Bendigeri, department of OBG, VIMS, Bellary.

I am requesting you to forward the dissertation topic in the prescribed form to the Registrar, Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka for approval.

Thanking you,

Yours faithfully,

(DR.INDRA.N)

Signature of the Guide, Signature of the HOD,

Dr.Mumtaz Bendigeri, Dr. A.A.Khazi

Professor, Professor and HOD

Department of OBG, Department of OBG,

VIMS, Bellary VIMS, Bellary

From, Date: 26/11/09

Place: Bellary

The Professor and HOD

DEPARTMENT OF OBG,

vijayanagara institute of medical sciences,

BELLARY

To,

The REGISTRAR,

RAJIV GANDHI UNIVERSITY of HEALTH sciences,

bANGALORE

Through proper channel

Respected sir,

SUBJECT: submission and forwarding of synopsis for registration of dissertation topic.

As per the regulations of the University for the Registration of dissertation topic the following post graduate student in MS (OBSTRETRICS & GYNAECOLOGY) has been allotted the dissertation topic “STUDY OF MATERNAL & PERINATAL OUTCOME IN OBSTRUCTED LABOUR” as follows by the official registration committee of all qualified and eligible guides of the department of OBG.

Name / Topic / Guide
DR.INDRA N
POST GRADUATE IN MS (OBSTRETRICS & GYNAECOLOGY)
DEPARTMENT OF OBG,
vijayanagara institute of medical sciences,
BELLARY / “STUDY OF MATERNAL & PERINATAL OUTCOME IN OBSTRUCTED LABOUR” / Dr. MUMTAZ BENDIGERI,
PROFESSOR ,
DEPARTMENT OF OBG,
VIMS, BELLARY.

Therefore I kindly request you to communicate the acceptance of the dissertation topic allotted to the PG student at an early date.

Thanking you,

Yours faithfully,

Dr. A.A.Khazi

Professor and HOD

Department of OBG,

VIMS, Bellary

RAJIV GANDHI UNIVRERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA

ANNEXURE – II

PERFORMA FOR REGISTRATION OF TOPICS FOR DISSERTATION

(To be submitted in duplicate)

1 / Name of the candidate
and address / DR.INDRA. N
POST GRADUATE IN MS(OBSTRETRICS & GYNAECOLOGY)
DEPARTMENT OF OBG,VIMS,
BELLARY – 583104
2 / Name of THE Institution / VIJAYANAGAR INSTITUTE OF MEDICAL SCIENCES, BELLARY.
3 / Course of
the study
and subject / MS IN (OBSTRETRICS & GYNAECOLOGY)
4 / Date of admission to
the course / JUNE 4th 2009
5 / TITLE OF THE TOPIC / “ STUDY OF MATERNAL & PERINATAL OUTCOME IN OBSTRUCTED LABOUR ”

6 BRIEF RESUME OF THE INTENTED WORK

6.1 NEED FOR THE STUDY

Obstructed Labour is an important clinical problem seen in the developing Countries results from neglected Labour where vaginal delivery has not been possible. In spite of passage of a reasonably long time in good strong Labour, due to some mechanical obstruction to the passage of the fetus through the birth canal leading to severe maternal stress in the process. This also often distresses or kills the fetus.

Obstructed Labour accounts for 8% of maternal mortality in developing Countries. Incidence varies from 2-5% depending on the availability of MCH Services. Even at present as many as 4 mothers per 100. Survey of Indian literature reveals as many as 23-76% of mothers with obstructed laborer suffer with perinatal death. Even though there is progressive improvement over the last two decades. Still in rural settings incidence is higher due to lack of health facilities, transport, and poverty.

6.2 REVIEW OF LITERATURE

Incidence is seen between 0.56% (Adhikary et al 2005 – Kolkata) to 1.89% (Jena et al 2002 – Orissa) of all deliveries in the referral hospitals of India.

Account for 8% of maternal mortality & 23-76% perinatal mortality.

In the year 1978, a Conducted study in Kolkata Shows that the incidence was 11.4%

Jayaram K in the year 1993 studied incidence & perinatal death in obstructed labour conducted at Guntur revealed 4.7% Incidence & 76.6% perinatal death.

Adhikary S, Dalgupta M, Sanghmita M conducted a Bendy at Kolkatta in the year 2005 4 found 2.04% Incidence & 43.27% PNM.

Bhattacharya S, Maru L conducted a study at Indore in 2007 fond that incidence of obstructed labor 3.4% & 23.21% PNM.

6.3 OBJECTIVES OF THE STUDY

·  To Study Incidence of obstructed Labour

·  To study Maternal outcome

·  To study Perinatal outcome

7. MATERIAL AND METHODS

7.1 (a) Source of data

It is a prospective study conducted on patients with obstructed Labour admitted to department of OBG at VIMS, Bellary.

The Study duration: 1 year & 6 months.

The pregnant women with h/o longer duration of laborer pain Subjected to thorough Examination & detailed history & relevant investigations

CBC, Blood grouping & Rh typing,

Blood urea, Serum creatinine,

Urine for protein, Sugar & ketone,

High vaginal Swab for Culture & sensitivity,

& if Sign & symptoms suggest of Septicemia Blood Culture & sensitivity,

& planned urgent delivery either by Caesarean or vaginal delivery & these cases will be followed until discharge from the hospital for fetal & maternal outcome.

7.1 (b) study subjects

All patients who fulfill inclusion criteria

Inclusion criteria;

·  Longer duration of Labour pain >18 hours

·  Neglected labor

·  Clinical features of prolonged Labour like Maternal exhaustion, dehydration, keto acidosis Bandl’s ring, Fetal distress

7.1 (c) EXCLUSION Criteria

18 hours

No Signs & symptoms of obstructed Labour

7.1 (d) duration of study: one & half years

7.2 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS? IF SO DESCRIBE BRIEFLY.

YES, our Study requires investigations like CBC, Blood grouping & Rh typing, Blood urea, Serum creatinine, Urine for protein, Sugar & ketone, High vaginal Swab for Culture & sensitivity, All investigations & interventions will be done interventions will be done under the guidance & supervision of the guide.

7.3 Is Ethical clearance obtained from your institution in case OF 7.2?

YES, Ethical clearance has been obtained from VIMS Ethical committee.

8. LIST of References.

1. Debdas 2003 – obstructed Labour

2. ADIKARY S, DASGUPTHA M, SANGHAMITA M _ Management of Obstructed Labour retrospective study Journal OBG INDIA 55; 48-51; 2005

3. BHATTACHARYA S, MARU L_ a Study outcome of obstructed Labour in developing countries

International journal of OBG 44; 15-19; 1994

4. DEWHURST CJ 1957 Journal of OBG 113-118

5. DUTTA DC & PAL SIK 1978 –Obstructed Labour a review of 307 cases journal of OBG INDIA 1991 28; 55-58

TEXT BOOKS

1. DEBDAS-2003

2. OBG for post graduates by SS RATHNAM, K BASKAR RAO, and S ARULKUMARAN

3. Management of Labour _ Arul kumar

9 / Signature of the candidate
10 / Remarks of the guide / RECOMMENDED
& FORWARDED
11.1. / Name and designation of the Guide / Dr. MUMTAZ BENDIGERI,
PROFESSOR ,
DEPARTMENT OF OBG,
VIMS, BELLARY.
11.2. / Signature
11.3. / Co-guide
11.4. / Signature
11.5. / Head of the Department / Dr. A.A.KHAZI,
PROFESSOR & HEAD,
DEPARTMENT
OF OBG ,
VIMS, BELLARY.
11.6. / Signature
12.1. / Remarks of the Chairman and Principal
12.2. / Signature.