PERINATAL STATISTICS

APRIL 2018

Dr. Sanjeeva Kumara (IMO)

GYN & OBS - B SIDE
OVERVIEW OF ADMISSIONS
TO WARD 9
 OVERVIEW OF DELIVERIES
APRIL 2018

No. of deliveries 197

No of live Births 199
Normal vaginal deliveries 124
No of twin deliveries 02
IUD  00
Breech deliveries  02
Retained placenta 01
PPH  00
B.W >2.5 kg 171
B.W <2.5 kg  28
Neonatal death  01
 NVD WITH REGARD TO MATURITY

PoA Number of
deliveries
<28w 28-32w 32-37 >37w
>37 weeks 183

32 – 37 13 183

28 – 32 3

<28 0

13

0
Category 1
 MODES OF DELIVERIES
APRIL2018

DELIVERIES Normal vaginal deliveries 124

140
NVD; 124
Lower segment caesarean
120  73
sections
100
EL-LSCS  43
80
EM-LSCS  30
60
EL LSCS; 43 Vacum deliveries  00
40
EM LSCS; 30
Forceps deliveries  00
20

0
VACCUM; 0 FORCEP; 0 Total 197+2
EM LSCS EL LSCS NVD VACCUM FORCEP
 LSCS JANUARY 2018

EM LSCS
41%

EL LSCS
59%
 ELECTIVE LSCS – INDICATIONS
APRIL 2018

Past section 23
INDICATIONS
Breech  02
Past 2 sections
07
OTHER
11%
Large baby  02
Fibroid 01
Bad Obs Hx 1
PS X 2
Unfavorable Cx 3 25%

Viral Warts 1
PS
Unstable wedge Fracture at L1 1 64%

Past Section + PIH 1

Elderly Primi 2
Major degree Placenta Preavia 1
 EMERGENCY LSCS – INDICATIONS
APRIL 2018

Lack of progress  05

Fetal distress 07
Past section + Pain  04
Breech + Pre-eclampsia (twin) 02
PIH  01
High head + Term + 5  01
PPROM + Impending Infection  01
Elderly Mother + Unfavorable Cx 01
Low liquor 01
PS + dribbling + pain 01
Vaccum Failure + Reduced FM 01
Absent diastolic flow 01
Large baby 01
Induction failure 01
twins 01
Brow presentation 02
Secondary arrest 01
Twins + dribbling + breech 02
 TRANSFERS FROM OUTSIDE HOSPITALS
APRIL 2018
DH Rambukkana 4
BH Warakapola 3
Kabagamuwa 1
TOTAL 8

INDICATIONS FOR TRANSFER

 IUGR
 Reduced fetal movements
 Assaulted and fallen
 Abdominal pain and back pain
NEONATAL DEATH
• DoA- 16. 04. 2018 DoD- 27. 04. 2018
– At 12.15pm

• Mrs A.P.H.I.N. Premathilaka

• 25 years old
• O+
• P1C0

• LRMP- 01. 08. 2017

• EDD – 08. 05. 2018
• POA – 37+1
PRESENTING COMPLAINT • T1 PIH0
Admitted due to IUGR for • T2 GDM0
1. CTG • T3 FeX2 : IDA SF 6.9
2. DOPPLER
3. REST
4. DELIVERY TT 
HYSTORY OF PRESENTING COMPLAINT Worm Rx 
FM good
No abdominal pain • PMHx
No back ache • PSHx NAD
Show0 • DHx
Bleeding PV0
Dribbling0
• All Hx – Foodo / Drugo / Plastero

• FHx – NAD

• SHx – She is a Housewife/ Husband is a

bussinessman
• ON EXAMINATION

• Paleo SLF Last USS @ 37w

CP
• Afebrile
SFH- 30 cm SLF
FHB+ CP
• PR = 68 bpm HNE BPD 30
• FL 30
BP = 100/70
FUNDAL PLACENTA
• DR+ Murmurso EFW – 1.6
VE: LQ – GOOD
OS TOF
CxL 2cm
STATION (-3)
Medium Cx

VB+ Candidiasis +
Clear bases
PLAN INVESTIGATIONS 16/4 24/4
FBC WBC 10.46 18.36
• FBC
• RBS HGB 10.3 10.6
PLT 269 258
• CTG bd
• FHS 6 hourly
• KCC

• FeSO4 1tab bd
• Vit C 1tab bd
• Folic Acid 1tab daily
• Cal Lactate 1tab daily

• USS by SHO
• Departmental USS with
Doppler study

• Rest
• Candid V6
• USS by SHO
– CP
– BPD 34+2
– FHB+
– PLACENTA POSTERIOR
– DOPPLER SATISFACTORY

• DAY 2
• S/B VOG –
» CERVICAL MASSAGING FROM 37+5
» DOPPLER
» TREAT CANDIDASIS
• DAY 3 REST
• DAY 4 CERVICAL MASSAGING DONE
• DAY 5 CERVICAL MASSAGING DONE
• S/B VOG –
» CERVICAL MASSAGE AND ASM FOR 2
DAYS
» IF NOT SUCCESSFUL, GLANDIN
INDUCTION ON MONDAY
• DAY 6 – VE
» OS < 1 cm
» CxL 2 cm
» Soft posterior cervix
» St (-3)
» Mx – IOL on MONDAY

• DAY 7 : IOL on MONDAY

• DAY 8 :
» CTG – REACTIVE
» GLANDIN ½ TAB INSERTED
• KEEP NBM
• CTG AT ½ HR,1 HR, 6 HR - ALL REACTIVE
• FHS ¼ HOURLY X 3HRS
• FHS ½ HOURLY X 3HRS

• DAY 9 :
» VE : OS 1CM
» CTG – REACTIVE

» GLANDIN ½ TAB INSERTED

• KEEP NBM
• CTG AT ½ HR,1 HR, 6 HR - ALL REACTIVE
• FHS ¼ HOURLY X 3HRS
• FHS ½ HOURLY X 3HRS

» FHS WAS LOW

» SHO INFORMED
» SEND TO LR
» DECISION TAKEN TO DO AN EM LSCS
» PT WASH RUSHED TO THE OT
» EM LSCS DONE
» CORD ROUND NOTED
» LIVE BABY GIRL WAS DELIVERED AT 9.19AM
• POST OPERATIVE PERIOD WAS UNREMARKABLE
• BREAST CARE WAS GIVEN

• NEONATAL DEATH ON 25.04.2018

• COD – SEVERE BIRTH ASPHYXIA

• PATIENT WAS EXPLAINED AND COUNSELLED BY VOG

• DISCHARGED ON POST OP DAY 3
THANK YOU ….. !!