Asmita Muthal Rathore

Emergency contraception: Knowledge, attitude, and practices among health care providers in North India

Aims:  The present study was conducted to assess knowledge, attitude, and practice of emergency contraception in health care providers and users in North India.

Intensive care for critically ill obstetric patients

Care of the critically ill pregnant patient is an important aspect of obstetric services delivered in a tertiary care hospital. This study presents a retrospective case record analysis of obstetric patients who required shifting to the Intensive Ž . Care Unit ICU over a 5-year period from September 1993 to August 1998 at Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi. A total of 50 patients were shifted to ICU over the study period, with a total of 26 986 deliveries during this period, the rate of ICU admissions was 1 per 540 deliveries. Of these, 6% were teenage pregnancies, 22% were elderly gravidas, with the majority of 72% in the 20]34-year age group. The indication for ICU admission was shock in 46% of the patients. Hemorrhagic shock was the predominant cause in 28% of the patients, whereas endotoxic shock accounted for 16% of the cases. Other causes were hypertensive disŽ . orders of pregnancy 18% , medical disorders

Uterine tamponade using condom catheter balloon in the management of non‐traumatic postpartum hemorrhage

Aim:  To study the efficacy and complications of uterine tamponade using condom catheter balloon in non‐traumatic postpartum hemorrhage (PPH).

Fetal scalp stimulation test: An adjunct to intermittent auscultation in non‐reassuring fetal status during labor

Aims:  To evaluate fetal scalp stimulation test (FSST) as an adjunct to intermittent auscultation in diagnosis of intrapartum fetal acidosis and associate result of FSST with cord blood pH and immediate neonatal outcome.

Facility‐based review of 296 maternal deaths at a tertiary centre in India: Could they be prevented?

The aim of this study was to identify causes of maternal mortality at the facility and to assess the standard of care, deficiencies in health services and preventability of these deaths using facility‐based maternal death reviews.

Vulval tuberculosis: an unusual case

A 50-year-old woman presented with complaints of discharge per vaginum, itching over the external genitalia for 4 months and a 2-month history of ulceration and swelling over the genitalia. The patient was a parous, postmenopausal woman and a chronic smoker. The patient denied any history of a cough, loss of appetite or weight loss. No other contributory factor was ascertained on history. On examination, the patient was found to have a growth involving the clitoral area, distal urethra and the periurethral region. The distal anterior vaginal wall and both labia were also involved. On speculum examination, the cervix was found to be healthy and on bimanual examination the uterus was anteverted, normal sized with free fornices. There was no inguinal lymphadenopathy and per rectal examination was found to be normal. A clinical diagnosis of carcinoma of the vulva was made. On investigating the patient, a chest X-ray revealed bilateral nodular opacities, diffusely scattered. A CT scan showed some nodular opacities suggestive of pulmonary metastasis. Multiple biopsies taken from the growth revealed granuloma with epitheloid cells, some showing caseous necrosis. A diagnosis of tuberculosis was made and the patient was put on a four-drug antitubercular therapy of isoniazid, rifampicin, pyrizinamide and ethambutol. A response to treatment was evident within 1 month and the lesions almost cleared by 2 months. After 3 months, this was followed-up by resolution of the chest lesions (the patient’s husband had a negative workup for tuberculosis).