ABSTRACT
Background:Pregnancy induced hypertension is an important cause of maternal and fetal morbidity and mortality affecting 5-10% of pregnancies.PIH is more frequently associated with elevated TSH. Hypothyroidism is one of the causes of hypertension in nonpregnant state. Hypertension is completely reversible in 50% cases of hypothyroidism by levothyroxine therapy. Treating hypothyroidism in pregnancy may help to reduce PIH prevalence. Objectives- This is an observational study to find out association of PIH with hypothyroidism and to know result of levothyroxine treatment on PIH prevalence and its severity. Methods: 75 singleton pregnancies with PIH admitted to labour ward, evaluated with their TSH status in groupA. In Group B, 75 singleton pregnancies with subclinical or overt hypothyroidism treated with levothyroxine to maintain euthyroid state throughout pregnancy and observed for development of PIH. Overt hypothyroidism considered when TSH value ≥10 and subclinical hypothyroidism when TSH value between 3 and 10.. Result: Overt and subclinical hypothyroidism was present in 12% (9 out of 75) and 57.3%(43 out of 75) cases of PIH respectively. In group B, all hypothyroid pregnancies treated with levothyroxine throughout pregnancy, prevalence of PIH was 6.66% (5 out of 75) . Significant association of PIH and hypothyroidism demonstrated by Fisher’s exact test (p<0.001). PIH prevalence significantly reduced in treatment group demonstrated by chi square test (p<0.001). Conclusion: Subclinical and overt hypothyroidism prevalence is significantly high among PIH patients. Treating subclinical and overt hypothyroidism in pregnancy, reduces prevalence of PIH and its severity.
ABSTRACT
Background: Hysterectomy is a frequently performed operation for the benign conditions of uterus, but the route of hysterectomy is always a matter of discussion .Laparoscopic hysterectomy has been criticised many a time regarding its complication and duration of surgery. But availability of newer machines and techniques has popularised it recently. Most of the studies regarding this have been done by the single surgeon with expert hand .This study has been conducted in a university teaching hospital where there are many surgeons with different expertise along with the beginners. Methods: It is a retrospective observational study conducted in IMS and SUM hospital Bhubaneswar which is an university teaching hospital.286 Total laparoscopic hysterectomy patients between July 2014 to June 2015 were analysed regarding the demography, indication of operation ,duration of operation, intra operative blood loss and perioperative complication along with duration of hospital stay. Result: Major indication of surgery was fibroid uterus accounting for 40.20% followed by AUB 28.32%. Mean time of surgery in TLH is 2.34±0.67hrs and average blood loss is 150.9±58.8ml. 4.54% cases had major intra operative complications; minor post operative complications were in 14.68% cases. The conversion to laparotomy rate was 1.39% and 0.68% cases had urinary tract injury. Mean duration of hospital stay was 2.58± 1.98days. Conclusion: TLH is a safe procedure with minimal blood loss and shorter duration of hospital stay with surgical expertise .we can never ignore the machine behind the man.
ABSTRACT
Background: Intrauterine fetal death is a very tragic event for the parents and a great challenge to the obstetrician. It contributes to perinatal mortality and detail analysis of it may help to reduce the still birth rate in India. The aims and objectives of the study is to find out the prevalence, socio-demography, maternal risk factor and fetal characteristics of intrauterine fetal demise cases. Methods: This is a retrospective observational study carried out in Institute of Medical Science and SUM Hospital Bhubaneswar from October 2014 to April 2015. Ante partum events leading to fetal demise were recorded, socio-demographic and clinical characters were noted and analysed. Results: There were 2899 deliveries and 90 fetal deaths in this period. The incidence of IUFD was 31.04/1000 live births in our study. Conclusion: Pregnancy induced hypertension, severe anaemia; abruption of placenta, congenital malformation of the fetus is the main cause of fetal demise. All the main causes of fetal death observed here is preventable. Proper preconceptional counselling, antenatal care is mandatory to reduce the still birth rate by 2030.