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Background: To study the lipid profile of 3rd trimester pregnant women and their cord blood with and without intrauterine growth restriction Design: Observational study, Setting: Department of Obstetrics and Neonatology, in a teaching hospital in North India during February 2013 to August 2014.Methods: Third trimester pregnant women and their neonates. Enrolled 250 women were divided in intrauterine growth restricted and control groups. Outcome Measures: Venous blood Lipid levels of 3rd trimester mothers and their neonate at birth.Results: Women of IUGR group had significantly lowered total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL) and low density lipoproteins (LDL)210.2 (19.8), 221.6 (36.2),65.4(11.7)and 130.7 (20.8)compared to 251(55.3), 234.7(35.6), 70.8(19.9) and 181.3(16.8) mg/dl control group. The TC, TG and LDL levels in cord blood of IUGR group were 93.6(16.5), 50.4 (6.5) and 51.8(12.6) as compared 106.4(17.7), 30.7(4.4) and 55.9(12.1) mg/dl to control group (p value <0.05). HDL levels were significantly lower 15.8(4.6) in IUGR group as compared to 26.5(5.4) in control group. The LDL: HDL and TC: HDL ratio was significantly higher in IUGR group. Maternal weight, gestational age, urban residence, primi parity, birth weight and APGAR score were lower, while maternal age, parity, smoking, blood pressure, cesarean sections (%) and male sex (%) of baby was higher in IUGR group.Conclusions: Lipid profile of mothers of IUGR fetuses had significantly lowered cholesterol levels and their cord blood had shown atherogenic phenotype
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Background: Vaginal hysterectomy is less commonly performed for benign pathologies if the uterine size exceeds 12 weeks in the belief that complications could be higher in this group. The aim of this prospective study was to compare surgical outcomes and safety of vaginal hysterectomy in women with non-prolapsed uteri of >12 weeks size to those with uteri of<12 weeks removed vaginally for similar indications.Methods: In this prospective cohort study, 92 patients were included who underwent NDVH for benign uterine conditions between May 2016 to December 2018. The index group comprised 32 women who underwent vaginal hysterectomy for non-prolapse uterus with uterine enlargement (>12 weeks), while the control group consisted of 60 women with uteri <12 weeks. Demographic data, duration of surgery, blood loss, intraoperative and postoperative complications were compared.Results: Women in the two groups had statistically similar mean age, Body Mass Index and parity (44 vs 42.77 years, 20.8 vs 21.56 kg m3 and 3.26 vs 3.83, respectively; p > 0.05). The mean operative time was significantly longer in the index group (62.47min; vs 48.17 min; p <0.0001). Women with enlarged uteri had greater mean estimated blood loss (123.2 ml vs 75.9 ml; p < 0.0001) but the mean length of hospital stay was similar (5.531 days vs 5.177 days; p > 0.05). Intra- and post-operative complications such as blood transfusion and pelvic sepsis, post-operative febrile illness and systemic infections were comparable in both groups.Conclusions: Vaginal hysterectomy in larger non-prolapsed uteri takes longer to perform and is associated with more blood loss compared to uteri <12 weeks but is not associated with a significant increase in complication rates.
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Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.
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Background: Pre-eclampsia is an important cause of maternal and neonatal complication and death. If hypertension in pregnancy is diagnosed at an early age, we can provide an efficient care to mother for good outcome of pregnancy. The aim of this study to evaluated the role of B-HCG and AFP as predictors of HDP. Methods: This prospective Investigation study was conducted on 100 pregnant women attending the antenatal clinic in Department of Obstetrics and Gynaecology, Jaipur. Estimation of serum β-HCG and AFP was done by ELISA technique. Then there finding were correlated with the value of serum β-HCG and AFP in second trimester to see whether there is any relation between levels of serum β- HCG and AFP in second trimester and development of HDP. Results: ‘Out of 100 women, 5 i.e. 5% were <20 years of age, maximum i.e. 62 (62%) were in 21-25 years of age group, 25 (25%) were in 26-30 years of age group and 8 (8%) were in 31-35 years age of group. Significantly higher mean S. β-HCG (mIU/ml) was observed in HDP group i.e. 13450.5±3420.8 as compared to 7732±2024 in normotensive group and a test of full model was statistically significant indicating that the predictors reliably distinguish between HDP group and normotensive group (Chi square 55.328, df 4, p<.001). Conclusion: We conclude from this study the measurement of serum β-HCG and AFP should be routinely done in second trimester of pregnancy, to predict the occurrence of HDP for better fetomaternal outcome.