ABSTRACT
Hypertensive disorder of pregnancy affecting multiple systems and woman has dangerously high blood pressure, swelling, and protein in the urine. Therefore serum albumin and uric acid are useful biochemical markers reflecting the severity of the occurrence of preeclampsia and eclampsia. Objective: The aim was to study the role of albumin and uric acid in preeclampsia and eclampsia. Methods: This is the case-control hospital based study carried in the Grant Government Medical College and Sir J.J. Group of Government Hospitals, Mumbai. Normotensive pregnant women (n=50) and women with preeclampsia (n=50) and eclampsia (n=50) were included in the study. Both the groups were in their third trimester and of same age and same gestational age. Serum albumin and uric acid were estimated by BCG endpoint and Uricase – PAP method respectively. Result: The alterations of serum albumin and uric acid levels in preeclampsia and eclampsia pregnant subjects were found as compared to those of control group. A negative and significant correlation (r = -0.492 and -0.602, p < 0.001) was observed between serum albumin with uric acid in study subjects. Conclusion: The results suggest that, albumin and uric acid are important factors in the pathogenesis of preeclampsia and eclampsia and are directly related to the severity of disease.
ABSTRACT
The objective of the study was to find out the factors predicting outcome of trial of labour after previous caesarean delivery among women living in a developing country. A retrospective study of 149 cases of trial of Labour was conducted in women with a history of one prior caesarean section. Binary logistic regression was used to identify predictive factors. The adjusted odds ratios with 95% confidence intervals (95%CI) were used to indicate risk of failure of the trial of Labour when the factor was present. It was found that success rate of vaginal birth was 24.16%. Factors significantly predictive of success of trial of Labour were previous vaginal delivery (OR 18.4, 3.3 -329.6), baby weight < 3 kg (OR 33.3, 5.4-62.6) and 2nd stage of labour during previous LSCS (OR 2.1, 1-4.2). The study has shown that trial of labour can be attempted successfully, in women with previous caesarean delivery, with due consideration of maternal and foetal outcome. A prior history of vaginal delivery and baby weight < 3 kgs are the best predictor of success of trial of labour.
ABSTRACT
Background: Mitral valve is the complex variable structure with 2 cusps and 2 papillary muscles which are connected by collagenous structure chordae tendineae supporting the entire free edge of the valvular cusps. Aims & Objective: To study the morphological and morphometric analysis of chordae tendineae and to compare the morphometric measurements among cadaveric and autopsied heart specimens of south Indians and the effect of formalin in causing shrinkage of chordae tendineae. The annulopapillary distances were measured for mitral allografts. Material and Methods: The prospective study was done on 45 cadaveric and 15 autopsied heart specimens. The left atrium and left ventricle were cut open and the measurements of the Mitral valve chordae tendineae were taken using Vernier calliper and recorded. The chordae tendineae was measured from tip of papillary muscles to the edges of the cusp. The annulopapillary distance was measured from tip of papillary muscles in 2 o', 4 o', 8 o', 10 o' clock positions to that of mitral annulus. The data’s were analyzed using student’s t test to compare between the cadaveric and autopsied heart specimens. Results: Aortic cusp chordae tendineae of both specimens were approximately same 1.6 to 1.8cm, whereas in mural and commissural cusp mild difference of 2-3mm was observed 1.5 to 1.7 cm. The annulopapillary distance was equal in both the specimens 2cm. Two heart specimens showed complete absence of commissural chordae and 6 hearts showed absence of basal chordae. Conclusion: Many studies were done on morphometry of mitral valve but the present study on morphometry of chordae tendineae of mitral valve did not show any significant changes among cadaveric and autopsied heart specimens. The data will be of great use to cardiac surgeons for surgical reconstruction of mitral valves and annulopapillary distance for mitral allografts.