The study of association between maternal serum magnesium levels and preterm labour in a tertiary care hospital

Background: Serum magnesium level in pregnancy is a valuable tool to find out preterm onset of labour. In the asymptomatic group, greater surveillance and administration of steroids, tocolytics and transfer to a higher centre wherever necessary has to be done with mothers with low serum magnesium level. The objective of the study is to find association between serum magnesium levels and women with preterm labour, and to compare these values with those patients who have a term delivery.Methods: The subjects included 100 pregnant women with preterm labour (cases) between 28 and 37 weeks gestation (Group A) and similar number of pregnant women with term labour (controls) between 37 and 40 weeks (Group B). Inclusion criteria for cases was singleton pregnancy, painful uterine contractions more than two in 30 minutes, intact fetal membranes, cervical dilatation (at least 1 cm) and effacement (80%). Serum magnesium levels were done in both the groups. Patients were followed until delivery. Routine antenatal investigations were done. Serum levels of magnesium were estimated by Erba’s semi auto-analyser.Results: 62% patients in Group A were from rural areas. More patients in Group A (70%) were from low socioeconomic class. More women in Group A were anaemic (44%). Mean value of hemoglobin in Group A was 9.93gm/dL. More patients in Group A had muscle cramps (89%). VLBW (<1500gm) neonates were more in Group A (21%). Also, LBW (1500-2499gm) neonates were more in Group A (60%). Mean neonatal birth weight in Group A (1907.3gm) was less. Neonatal morbidity and mortality was observed significantly more in Group A. Mean serum magnesium was less in Group A. Mean serum magnesium levels in primi and multigravida patients were less in Group A. Moreover, mean serum magnesium levels were less in urban and rural patients in Group A. Mean serum magnesium levels were less in normal and overweight patients in Group A. Also, mean serum magnesium levels were less in patients with cervical dilatation <3cm and >3cm in Group A.Conclusions: Low maternal serum magnesium level is associated with preterm labour. Patients with preterm labour have significantly low serum magnesium level when compared with labour at term.

Comparative Study of Efficacy of Misoprostol Vs Dinoprostone Gel For Induction of Labour.

Abstract This study has been undertaken to compare the safety and efficacy of intra-vaginal misoprostol (PGE1 analogue) with intra-cervical dinoprostone (PGE2) in progress and induction of labour, the maternal side effects and the foetal outcome. Group I comprised of 50 patients who underwent induction with misoprostol vaginal tablets and Group II comprised of 50 patients who underwent induction with dinoprostone intra cervical gel. Labour induction was considered successful if subjects delivered within 24 hours of initiation of either of two methods. The maternal and foetal outcome were measured i.e., Bishop's score, time intervals from induction to delivery, need for oxytocin, mode of delivery, maternal and foetal side effects. The results of the present study show that the time intervals from induction-delivery intervals were significantly shorter and the requirement of oxytocin was less for augmentation of the labour in the misoprostol group than dinoprostone gel group. Intravaginal misoprostol is an effective agent for induction of labour than intra cervical gel. The drug is easy to use, effective and safe to mother and the foetus. Misoprostol can be routinely used for induction of labour than dinoprostone gel.

LDH Levels in Pregnancy and its Association with Severity of the Disease and Feto-maternal Outcome in Pre-eclampsia and Eclampsia.

Abstract The aim of present study was to correlate LDH levels in pregnant women and women with Preeclampsia and eclampsia in antepartum period and to study the correlation of maternal and perinatal outcome with LDH levels. Pregnant women in this study were enrolled in 3rd. trimester from 28 weeks onwards . Case control study was done in 100 women with normal B.P and in another 100 women having Pre-eclampsia and Eclampsia . Serum LDH level was measured using commercially available kits. Serum levels of LDH were significantly increased in women with Pre-eclampsia and eclampsia as compared to control group A significant positive correlation was found in patients with Pre-eclampsia and Eclampsia . LDH levels gradually increased with increase in the severity of the disease .. Regular monitoring of serum LDH levels in women with Pre-ecalmpsia and Eclampsia may help in detecting severity of the disease and associated end organ damage.

Surviving Brain Tumor in Pregnancy.

A young woman of 22 years attended Obstetrics OPD with the complaints with sudden onset of severe headache and forward protrusion of the right eye ball for four months, it was painless and progressive in nature. On Ophthalmoscopy examination, she was found to have vision 6\6 on left and 6\9 with Relative Afferent Pupillary Defect (RAPD) in on right side. Bilateral extra ocular muscles were normal. MRI showed a well defined, heterogeneous extra axial mass lesion seen in right temporal region with both intracranial and intra orbital components suggestive of sphenoid wing meningioma. The patient underwent surgery and the histopathology proved the diagnosis as meningioma. The case of epidermoid brain tumor in a young female with pregnancy is reported for its unusual presentation.

Endocervical Polyp

Endocervical Polyps are uncommon inflammatory non-neoplastic tumours. We report here a case of a young female who presented with a mass hanging out of vagina. The mass was removed mannually under general anaesthesia. Histopathology showed features suggestive of endocervical polyp.