ABSTRACT
Introduction: Hypertensive disorders of pregnancy comprisea spectrum of diseases that include chronic hypertension,gestational hypertension, preeclampsia, eclampsia andHELLP syndrome- are uniquely challenging as its pathologyand management simultaneously affects both the mother andbaby. Preeclampsia (PE) is an important cause of maternaland perinatal morbidity and mortality and is a most fearedcomplication of pregnancy. In India the incidence of PE isreported to be 2%-8%.Material and methods: In this study 200 pregnant womenwere enrolled from March 2018 – November 2019 for a periodof 21 months in Lalla Ded hospital department of Obstetricsand Gynaecology Government Medical College Srinagar.Inclusion criteria, first trimester of pregnancy (8 – 12 weeks),singleton gestation, pregnancies with aneuploidies ruled out.A detailed history taking and examination was done. Historyregarding their age, parity, smoking and past medical historyof hypertension was taken and their mean arterial pressure(MAP) was taken.Results: In our study out of 200 patients enrolled in firsttrimester 14 developed Pre Eclampsia (PE) in third trimester.Out of which majority were in the age group of 15-20 years(10%) and > 35 years (9%), 12.7%were nulliparous, 15.5% hada MAP of more than 89 mmHg, 11.5% of them were smokersmajority, 10% of them had past history of hypertension and30.7% of them had BMI of more than 30 kg/ m2.Conclusion: It can be concluded from the study that these riskfactors can be used as a screening method for preeclampsiaprediction and its early diagnosis, thus allowing time forintervention and thereby decreasing maternal mortality andmorbidity
ABSTRACT
ntroduction: The universal aim of maternity care provision is birth of a healthy baby to a healthy mother. Various invasive andnon-invasive antepartum surveillance tests have been devised to access the fetal well-being. In developing countries like India,where workload is heavy with shortage of technical manpower and resource settings are poor, we need techniques which areadequate, simple, cost effective, easy to use, and less time consuming for better postpartum outcome.Materials and Methods: This study was conducted over a period of 1½ years in 251 primigravidae with low-risk pregnanciesat or near term who were observed with admission cardiotocography (CTG) and amniotic fluid index (AFI) and was followedduring the course of labor to access mode of delivery, Apgar score at 0, 1, and 5 min of birth, and need for neonatal intensivecare unit (NICU) admission.Results: When both AFI and CTG together were correlated with mode of delivery, it was seen that in patients with cat 1 CTGirrespective of AFI, most of the patients were delivered by NVD and in cat 3 CTG patients irrespective of AFI, most of them weredelivered by lower segment cesarean section (LSCS). In patients with cat 2 CTG, significant number of those was deliveredby LSCS who had low AFI. When AFI and CTG together were studied for Apgar score at “1-min” of birth and NICU admission,it was seen that irrespective of AFI, low Apgar, and NICU admission was mostly seen in cat 3 CTG patients, but there was noneonatal mortality in our study.Data were entered into a Microsoft Excel Spreadsheet, relationship between categorical variableswas analyzed using a Chi-square test and data were analyzed using STATA version 15.Conclusion: Therefore, admission CTG along with AFI can effectively detect fetal distress if already present at admissionand thereby avoid unnecessary delay in decision to deliver timely and improve fetal outcome. These simple, cost effective,non-invasive, and less time-consuming tests can identify those patients who need continuous fetal monitoring in low resourcesettings and fetal outcome can be improved.