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A 22 year old primigravida with full term pregnancy with morbid obesity and short stature presented to us with complaints of labour pains six hours prior to admission. Her dating, anomaly and term growth scan showed a single live intrauterine foetus with foetal heart rate, amniotic fluid and growth parameters corresponding to the gestational age with no significant anomalies and normal adnexa.Following a thorough examination and pelvic assessment, diagnosis of cephalopelvic disproportion was made and the patient was posted for emergency caesarean section. A healthy male baby of weight 3.5 Kg extracted and the placenta and membrane were expelled in toto. Uterus was closed in double layer. On examination of adnexal structures, a right sided ovarian mass of around 10 x 8 x 6 cms of size, solid in consistency and proliferative in appearance was found. Suspecting it to be a malignancy and due to the unavailability of frozen section facility, a right sided oophorectomy was performed, and the specimen was sent for histopathological reporting which revealed a diagnosis of pregnancy luteoma of ovary
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Haemolysis (H), elevated liver enzymes (EL) and low platelet count (LP) i.e., HELLP syndrome is a vaguely understood condition of pregnancy which can present with rapid onset. It is commonly associated with pre - eclampsia. HELLP is also known to manifest itself without the clinical features of pre - eclampsia. The present study aims to assess the maternal and foetal complications associated with HELLP syndrome. METHODSThis retrospective study included all the pregnant women who developed HELLP / partial HELLP with gestational age of ≥ 28 weeks. The variables analyzed were obstetric history, menstrual history, antenatal complications, laboratory investigations (haemolysis, ALT / AST, LDH, CBC), mode of delivery, postnatal complications, maternal outcomes and perinatal outcomes. RESULTS72 patients were included in the present study. The mean age of pregnant women with HELLP syndrome was 23.6 ± 4.15 years. The average age of gestation was 33.17 ± 4.02 weeks. 58 % patients were primigravida. As per Mississippi triple-class system 82 % patients had partial HELLP, 18 % had complete HELLP. 4 %, 4 % & 10 % patients had HELLP class I, II & III respectively. Among the total cases, 74 % patients had antepartum onset, 10 % had intrapartum & 17 % postpartum onset of HELLP syndrome respectively. 65 % patients delivered vaginally & rest 35 % underwent caesarean section. High risk factors such as pre - eclampsia (65 %), eclampsia (3 %) & previous history of HELLP (8 %) were noted in study cases. Abruptio placentae (18 %), postpartum haemorrhage (17 %), pulmonary oedema (14 %), renal failure (14 %) & DIC (7 %) were the maternal complications noted. Maternal mortality was 7 %. The major perinatal morbidities noted were prematurity (67 %) & FGR (42 %). Intrauterine death was noted in 19 % babies. Neonatal intensive care (NICU) was required for 58 % babies, of which 42 % had respiratory distress. Neonatal death was noted in 17 %. CONCLUSIONSHELLP syndrome is a life threatening condition of pregnancy which has serious maternal and perinatal morbidities. Prompt referral, timely and appropriate interventions can save lives. Availability of Intensive Care Units (ICU) facilities, dialysis units and blood and its components along with Neonatal Intensive Care Unit (NICU) facilities can remarkably reduce the maternal and neonatal complications.
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Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.
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Background: Pancytopenia is the reduction in all three major cellular elements of blood; hence it is the simultaneous presence of anaemia, leukopenia and thrombocytopenia. Pancytopenia is associated with many maternal and foetal complications during pregnancy like maternal sepsis, postpartum haemorrhage, pre-eclampsia and preterm labour, IUGR and intrauterine foetal demise.Methods: The study was conducted at BLDE (Deemed to be) University, Shri B. M. Patil Medical College Hospital and Research Centre. It’s an observational study done from November 2019-April 2020. The participants enrolled in the study were subjected for further clinical and laboratory evaluation and followed for feto-maternal outcome.Results: The incidence of pancytopenia with pregnancy in this study was 3% and all the patients were vegetarian by diet along with vitamin B12 and folic acid deficiency. They were associated with different maternal and foetal complications.Conclusions: Proper dietary counselling and well-balanced dietary plans even with plant originate food can prevent the micronutrients deficiency and avoid the deleterious consequences like pancytopenia.
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Background: Pregnancy induced hypertension is one of the major causes of feto maternal morbidity and mortality in pregnancy. The exact cause of PIH is unknown certain factors are known to increase the risk of PIH such as risk factor includes that young women with first pregnancy.Methods: The objective of this study was to assess the socio-demographic and clinico-pathological profile of the patients with hypertensive disorders of pregnancy and its associated fetal outcomes. A prospective study was conducted in department of obstetrics and gynecology Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura Karnataka from 15th July to 15th December 2018. All women admitted to labour ward with diagnosis of hypertensive disorders of pregnancy were included in the study after ruling out the exclusion criteria and thorough history, examination and laboratory evaluation were done and followed till delivery.Results: A total of 123 pregnant women with hypertensive disorder of pregnancy were enrolled in the study. Most of the participants were in the age group of 20 to 30 years. The PIH was seen mostly in primigravida, lower socioeconomic status and with lower educational levels. Emergency LSCS is the most common mode of delivery.Conclusions: The hypertensive disorder in pregnancy affects the majorly younger age group. It is most commonly seen in low socio-economic and uneducated population. Hence, there should be provided with proper antenatal care, early detection of hypertensive disorders for better feto-maternal outcome.
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Background: Overweight and increased Body MassIndex (BMI) have been among the major changes ingirls and is one of the likely factors affecting themenarche age. Aim and Objectives: To determinecorrelation of age at menarche with BMI in adolescentgirls of urban and rural schools of Vijayapura, NorthKarnataka. Material and Methods:Aprospective crosssectional study was conducted by Department ofObstetrics and Gynaecology, Shri. B. M. Patil MedicalCollege Hospital and Research Centre, BLDE (Deemedst thto be University), between 1 July 2019 to 29 February2020.Girls below the age of 19 years who had attainedmenarche were included. Height and weight weremeasured, and BMI was calculated. Statistical analysiswas carried out in SPSS software, version 23.0 andMicrosoft 2010. Correlation between age at menarcheand BMI was assessed in adolescent girls of urban andrural schools of Vijayapura. Results: The mean age atmenarche among adolescent girls of urban and ruralschools was about 13.6 ± 1.2 years. Among allparticipants, 60.2% were from urban area and 39.8%were from rural area. The mean age of the menarchewas 13.8 ± 1.2 in rural population and 13.5 ± 1.3 inurban population (p value <0.001). Among all studyparticipants, 48.3% had normal BMI; however, 29.8%,15.4%, 5.8% and 0.7% were underweight, severeunderweight, overweight, and obese respectively.Majority of girls had normal BMI in both urban (49.2%)and rural settings (47.0%). Conclusion: A statisticallysignificant association (p< 0.05) was noticed betweenonset of menarche and area of residence. There was aninverse correlation between BMI and age at menarche,although this was not statistically significant.
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Background: The incidence of Caesarean Section (CS)is increasing day by day among urban and ruralpopulation globally. Hence, a need of the study wasrequired to find out the incidence of CS amongpopulation in a backward district of Karnataka. Aimand Objectives: To evaluate the rising trends in CS ratein both primigravida and multigravida. Material andMethods: This cross-sectional study was carried outamong 513 patients (92.7% rural and 7.3% urban)admitted in labour ward at a tertiary referral centre,Vijayapura, Karnataka. The indications were analysedby standard procedures and the decision for CS wereunder taken by qualified professionals accordingly.Results: Total incidence of CS in the present study was200(38.98%) out of 513 patients admitted. Out of 200patients who underwent CS, were found to beprimigravida 83 (41.5%) and were multigravida 117(58.5%). The most common indication of CS in thisstudy was found to be the Foetal Distress (FD) (35.5%)followed by Cephalo-pelvic Disproportion (CPD)(21%) and others (43.5%). Study also shows 90% ofrural patients (n=180) and 10% of urban patients (n=20)had underwent CS (n=200). Interestingly it was noticedthat age group of 21-30 years had maximum number ofCS (74%). Conclusion: The results indicate the highincidence of CS among rural population of Vijayapura,Karnataka of which the common indication was FD,dystocia and failure to progress of labour. The increasedincidence of CS is in primigravida and primary CS inmultigravida in the perspective of various societal andmedico-legal issues.