ABSTRACT
Background: Oligohydramnios leads to feto-maternal morbidity and mortality. Though there is no specific treatment for oligohydramnios, use of L-arginine seems to be promising. As a nitric oxide donor, it causes vasodilatation, increases placental perfusion and finally increases amniotic fluid. However, data on the use of L-arginine for oligohydramnios is scarce. Hence, this study was aimed to evaluate the efficacy of oral L-arginine on Amniotic Fluid Index (AFI) and to document the pregnancy outcomes in women with oligohydramnios.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS), Ghanpur, Telangana, India from 1st January 2018 to 30th June 2018.Results: A total of 50 participants were enrolled and 4 participants among them were lost to follow- up. Mean age (SD) of the women enrolled was 23.3 (3.49) years. Mean gestational age (SD) at the time of diagnosis was 34.61 (1.53) weeks. Mean AFI (SD) at the time of diagnosis and after treatment with L-arginine were 6.8 (1.3) cm and 9.4 (2.82) cm respectively. After a mean treatment duration (SD) of 3.23 (1.38) weeks, a mean (SD) increase of AFI by 2.6 (1.57) cm (P <0.0001) was observed. An increase of AFI was noted in 84.78% of cases (P <0.0001). Mean (SD) Gestational age at the time of delivery was 38.25 (1.48) weeks. Only 37% of participants required operational deliveries. Mean (SD) birth weight of the new borns was 2.54 (0.47) kg. Neonatal Intensive Care Unit (NICU) admissions were required in 32.6% of new borns.Conclusions: L-arginine is efficacious in improving AFI in oligohydramnios. AFI improvement could possibly lead to better neonatal outcomes by reducing preterm deliveries and operative interventions.
ABSTRACT
Background: Pregnancy is a physiological condition during which immune system is weakened. Therefore, most women are prone to develop infections during this period for which antimicrobials are prescribed. Drugs used during pregnancy may lead to teratogenicity. Therefore, this study was done with the following objectives: 1.to determine the type of infections encountered, 2.to assess the prescription profile of antimicrobials and 3.to assess FDA categories of antimicrobials used in pregnant women in a tertiary care center in Telangana, India.Methods: This was a prospective observational study conducted on pregnant women attending antenatal clinic (ANC) at Mediciti Institute of Medical Sciences (MIMS) from 1st January 2018 to 30th June 2018.Results: Out of a total of 165 cases enrolled, 57 (34.5%) cases were prescribed antimicrobials and 108 (65.5%) were treated symptomatically. The mean (SD) age of women who were prescribed antimicrobials was 22.9 (2.97) years. Of the conditions encountered, respiratory tract infections (RTIs) accounted for 31%, followed by urinary tract infections (UTIs) 26% and gastroenteritis 25%. Most prevalent infections which required antimicrobials prescription were UTIs (36.84%), followed by Gastroenteritis (17.54%). Majority of the antimicrobials prescribed were from Betalactams (40.34%), followed by Nitrofuranes (29.82%), Nitroimidazoles (17.54%) and Antifungals (8.77%). Antimicrobials prescription was more in the 3rd trimester (63.1%), followed by 2nd trimester (31.6%) and 1st trimester (5.3%). Majority of the antimicrobials were administered orally (75.44%), followed by injections (15.79%) and per vaginal route (8.77%). Antimicrobials were mostly prescribed from FDA Category B (96%).Conclusions: RTIs were the most common among the conditions encountered. However, UTIs were the leading cause for antimicrobial prescriptions. Antimicrobials prescription was more during 3rd trimester. Most antimicrobials prescribed were safe as they were from FDA Category B.