Fetomaternal outcome in pregnancy with HELLP syndrome

Background: HELLP Syndrome is a serious complication of pregnancy induced hypertensive disorders. It is defined as a triad of hemolysis, elevated liver enzymes, and low platelet count (HELLP). Objectives of this study was to find out incidence of HELLP syndrome in pre-eclampsia, eclampsia and its overall incidence. To analyse the clinical profile of HELLP syndrome. To study maternal and perinatal outcome including morbidity and mortality.Methods: A retrospective study was conducted from July 2017 to September 2019 at a tertiary care center with inclusion criteria of abnormal peripheral blood smear, elevated liver enzymes (LDH, aspartate aminotransferase), and low platelet count.Results: HELLP syndrome was more common in younger age group (45%) and in primigravida (52.5%). Most of the patients presented at >36 weeks of gestation (40%) and most of the patients delivered by caesarean section (67.5%). Maternal complications were acute renal failure (27.5%), DIC (22.5%), maternal mortality (7.5%). Neonatal complications associated were intrauterine death (27.5%), prematurity (25%) and intrauterine growth retardation (15%).Conclusions: Thus, HELLP syndrome requires an early diagnosis and early initiation of treatment at tertiary care center with all the medical facilities available.

Mullerian ductal anomalies and its outcome

Background: The aim is to study various investigative modalities to diagnose Mullerian anomalies and to evaluate the reproductive outcome that occurs as a result of malformation of genital tract.Methods: A prospective study of reproductive anomalies and its outcome was performed by using data from women with congenital anomalies attended in OPD either with complains or for operative treatment or incidental diagnosis during caesarean section, manual removal of placenta, during laparoscopy or laparotomy at tertiary care center. Total 70 women with different types of congenital anomalies were included in study. Out of them gynecological cases (27) were diagnosed on basis of clinical examination and other diagnostic aids while Mullerian anomalies in obstetric cases (43) were observed and their outcomes were studied.Results: Most common utero-vaginal anomaly seen in present study was septate uterus with 18 (25.7%) cases, followed by bicornuate uterus with 13 (18.6%) cases. Most common presenting symptom is primary amenorrhea 21 (30%) followed by cyclical abdominal pain 11 (15.7). HSG, USG are the primary tools to detect genital tract anomalies. Surgical correction was required in 47.1% patients.Conclusions: Present study shows prevalence of congenital malformation of female reproductive tract is 0.17% at our tertiary care center. Utero-vaginal anomalies are a morphologically diverse group of developmental disorders. Establishing an accurate diagnosis is essential for planning treatment and management strategies. The surgical approach for correction of utero-vaginal anomalies is specific to the type of malformation and may vary in a specific group.