Perinatal outcome in uncomplicated pregnancies with oligohydramnios

Background: Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. We aimed to assess the perinatal outcomes in pregnancies with oligohydramnios.Methods: The prospective study was conducted in the Department of Obstetrics and Gynecology, Pravara Medical College, Loni in which 200 consecutive singleton pregnancies delivered vaginally, with intact membranes were included. Amniotic fluid index was determined using the Phelan’s technique at the time of admission and women were diagnosed with oligohydramnios if AFI was five or less, which formed the first group and the rest of mother formed the second group. Perinatal outcomes were noted in the proforma as well.Results: Of the 200 mothers included in the study, 38 had AFI ≤ 5. Baseline characteristics was similar in both the groups. Most common antenatal risk factors studies were pregnancy induced hypertension (29% vs 12%; p value <0.05), intrauterine growth restriction (34% vs 10%; p value <0.001) and severe anemia (21% vs 9%; p value <0.05). Proportion of pregnancies needing induction of labor and birth weight less than 2.5 kgs were significantly higher among mothers with oligohydramnios.Conclusions: Authors observed that induction of labor and low birth weight were significantly associated with oligohydramnios. Prospective randomized trials are needed to establish whether early induction of labor in the presence of a oligohydramnios improves perinatal outcome.

Efficacy, Tolerability And Safety Of Intravenous Iron Sucrose In Postpartum Anaemia

Background:Anemia is one of major contributing factor in maternal mortality and morbidity in third world countries and according to the WHO, contributes to 40% maternal deaths. Postpartum anemia is observed in up to 27% of wom-en.It is a common problem throughout the world. Treatment of postpartum iron deficiency anemia includes oral and parenteral iron supplmentaion as well as blood transfusion in severe cases. Methods: This was a prospective longitudi-nal study carried out in Department of Obstetrics & Gynaecology of PRH, Loni. Total 80 women suffering from post-partum anemia of age above 18 years with haemoglobin (HB) level below 11gm/dl and above 6gm/dl were included for the study. After history taking, clinical examination and baseline Hb level, all of them were administered intrave-nous iron sucrose 200 mg per dose per day till the total calculated dose was administered. The post therapy evaluation was done with the estimation of Hb on day 1, day 7, day 14 and day 21. Results:31.25% women belonged to the age group each of 19-21 years and 22-24 years. Maximum number of patients received 3 doses of IV Iron sucrose (i.e. total 600mg) followed by 2 doses (i.e. total 400mg), 4 doses (i.e. total 800mg) and 5 doses (i.e. total 1000mg) respec-tively. Hb level rises extremely significantly (p<0.001) after IV Iron Sucrose administration on day 1, 7, 14 & 21 as compared to corresponding values before delivery as analyzed by Friedman Test (Nonparametric Repeated Measures ANOVA) . 16 patients (20%) experienced thrombophlebitis to IV Iron Sucrose administration. About 12 (15%) pa-tients experienced rigor followed by sweating in 10 patients (12.5%) and fever in 8 patients (10%). About 62 patients (77.5%) from total 80 reported well tolerability to IV Iron Sucrose while remaining 18 patients (22.5%) reported poor tolerability to IV Iron Sucrose Conclusion:Intravenous iron sucrose increases the haemoglobin more rapidly in first week as compared to second and third week in women with postpartum iron deficiency anemia. Hypersensitivity reac-tion, chest pain, dyspnoea reported with iron dextran and iron sorbitol citric acid were not observed with iron sucrose. Intravenous iron sucrose can be used safely to fill a rift between blood transfusion and oral iron in treatment of post-partum iron deficiency anemia.

A study of efficacy of labetalol in pregnancy induced hypertension.

Background: Pregnancy induced hypertension is a common medical complication associated with pregnancy. When untreated ,it has serious implications on maternal and fetal health. Labetalol is a new an anti hypertensive agent with alpha adrenergic and non selective beta –adrenergic receptor blocking actions. Objectives: 1)To assess the effect of labetalol on control of blood pressure in moderate to severe Pregnancy induced hypertension2)To study the side effects of labetalol 3)To analyze the maternal and perinatal outcome. Material and Methods: A prospective observational study of 50 cases of moderate to severe Pregnancy induced hypertension, treated with Labetalol ,was conducted over a period of two years. Cases were divided in Labetalol-respondent and non respondent group. Pregnancies from non-respondent group were terminated either by induction of labour or by caesarean section .Cases who responded to labetalol, were treated with oral Labetalol. Obstetric and perinatal outcome in both the groups was analyzed. Results: Fifty six percent cases did not respond to intravenous labetalol therapy (maximum dose 120 mg over 30 minutes) and thus pregnancy was terminated. Forty four percent cases responded to labetalol therapy and pregnancy was continued for average of 8 days .Forty eight percent cases were delivered by caesarean section. Seventy eight percent babies were live born .There were twelve stillbirths and five neonatal deaths .Twenty percent cases had mild and transient side effects related to labetalol. Conclusion:The effective control of blood pressure with the use of Labetalol in the dosage used ,was observed in less than fifty percent cases of moderate to severe pregnancy induced hypertension.

Androgen insensitivity syndrome – A case report.

Androgen insensitivity syndrome (AIS), formerly known as testicular feminization, is an X-linked recessive condition resulting in a failure of normal masculinisation of the external genitalia in chromosomally male individuals. It affects 2 to 5 per 100,000 people who are genetically male. A case of Androgen insensitivity syndrome is reported in a 20 year-old married woman, who presented with a history of primary amenorrhea. Her karyotype report revealed a male karyotype (46XY). Transvaginal sonography revealed absence of cervix, uterus and ovaries. Ultrasound of abdomen pelvis reported – bilateral inguinal testes. Bilateral inguinal gonadectomy was done. Histopathology of the gonads revealed seminiferous tubules lined by germ cells exhibiting various stages of normal spermatogenesis. She was treated with hormonal replacement therapy.

A Cross Sectional Study of Maternal Factors Influencing Low Birthweight.

Birth weight is a powerful predictor of infant growth and survival. The infant mortality rate is also higher in low birth weight babies. Low birth weight (LBW) is one of the most serious health challenges in developing as well as developed countries. A retrospective study was done in a tertiary care hospital to estimate the incidence and study the associated maternal risk factors. The magnitude of the Low Birth Weight problem at Pravara Rural Hospital (tertiary care hospital ) Loni was 23.68%. In 41.6% of LBW babies, the maternal age was less than 20 years Most of the low birth weight babies were born to mothers with secondary level of educational status. Percentage of LBW among higher order pregnancies was 66.6%. Spacing less than 1 year was responsible for 46.2% of LBW babies. Majority of LBW cases was seen in mothers with gestational period being less than 37 weeks. Mothers with height less than 145cm contributed to 22.2% of LBW babies. The incidence of LBW among women weighing 41-50kg was 52.77%.