Prevalence of iron deficiency anemia during pregnancy in tertiary care hospital of Lahore

Objective: The objective of this study was to determine prevalence of iron deficiency anemia during pregnancy in tertiary care hospital of Lahore

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at the Department of Obs and Gynae, Lady Aitcheson Hospital Lahoreand was completed in 6 months

Materials and Methods: Data was collected using random sampling from 985 females in their last trimester. All pregnant females aged 1 6-40 years during their 3[rd] trimester were taken whereas the pregnant women with known history of thalassemia and sickle cell anemia were excluded from the study. Their demographic information regarding age, gestational age and parity was taken on predesigned Proforma. Venous blood sample was obtained and sent to hospital laboratory for analysis of their hemoglobin [Hb] level. All data was collected by principle investigator

Results: In this study the mean age of all pregnant females was 26.42 +/- 4.55 years with age range of 24 years [16 -40 years]

The average Hb level during third trimester was 9.18 +/- 0.98 with minimum Hb recorded as 4 and maximum Hb as 12. According to WHO classification 93.8% females were anemic and rest of 6.2% females were non-anemic but their Hb was not more than 12 mg/dL. On further classification it was found that 761 [77.3%] had moderate anemia, 157 [15.9%] had mild anemia, and 6 [0.6] were severe anemic. We found insignificant negative correlation of Hb with maternal age [r= -0.009, p-value = 0.767] and found significant positive correlation with number of antenatal visits [ r= 0.090, p-value = 0.005]

Conclusion: Moderate to severe anemia was highly prevalent in our study that may have serious feto-maternal outcomes

Further studies are suggested to address the problem of anemia and its associated causal factors

Frequency of group B streptococci in pregnant women in a tertiary care hospital

Objective: To determine the frequency and risk factors of Group B Streptococci [GBS] in pregnant patients in third trimester in a tertiary care hospital in Lahore

Study Design: Cross-sectional, prospective study

Place and Duration of Study: Lady Willingdon Hospital, Lahore, from October 2014 to March 2015

Methodology: Sterile lower vaginal swabs were taken from 200 women aged 20 years and over, in third trimester, with no history of vaginal bleeding, ruptured membrane, recent intake of antibiotics or chronic illness. These swabs were cultured for detection of GBS. The risk factors of GBS and its frequency were noted in the pregnant population. Quantitative and qualitative data was analyzed by SPSS version 20. Chi-square test was applied to see association between diagnosis of GBS and other categorical variables. P-value

Results: In this study, the mean age of all the females was 26.36 +/- 4.32 years and mean duration of pregnancy was 35.54 +/- 2.65 weeks. Frequency of GBS in pregnant women was found as 14%. We observed significant association of GBS with parity and previous history of miscarriage [p-value = 0.033 and 0.010 respectively]. Moreover, significant association between vaginal discharge and GBS was also found [p = 0.027]

Conclusion: GBS is present in a small but significant number of pregnant women in our setting and it has association with multiparity, vaginal discharge during pregnancy, and previous history of miscarriage

study of correlation of child birth weight with maternal body mass index

Objective: The objective of this study was to determine correlation of child birth weight with maternal body mass index [BMI]

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Department of Obstretics and Gynaecology Lady Aitchison Hospital Lahore and was completed in 14 months

Materials and Methods: Data was collected using random sampling from 1000 females during post partum period. All pregnant females aged 18-35 years were taken and babies with intra uterine growth retardation [IUGR] were excluded.Data was managed in SPSS and was analyzed using same software

Results: In this study, the average maternal weight, height and BMI were 63.50 +/- 9.47 Kg, 154.10 +/- 4.85 cm and26.77 +/- 4.03 respectively.The mean babies' weight on delivery was 2.83 +/- 0.583 kg.There was significantpositive correlation of fetal weight with maternal weight [r=0.072, p-value = 0.024] and maternal BMI [r=0.086, p-value = 0.007].This correlation was stronger in females who had normal vaginaldelivery

Conclusion: Birth weight has a significantly positive correlation with maternal weight and BMI. Being modifiable risk factors, controlling these may considerable reduce the risk of low birth weight and associated complications for both mother and newborn

JAK2 V617 mutation triggers erythropoiesis and patients present with good hemoglobin level in idiopathic myelofibrosis [IMF]

To document the impact of JAK2 mutation on hemoglobin [Hb] level in patients with IMF. Thirty five patients were studied out of which 19 were JAK2 positive and 16 were JAK2 negative. Sample collection technique was purposive non-probability sampling. Variations were observed among the studied JAK2 positive and JAK2 negative patients regarding hemoglobin level. In JAK2 positive and negative patients mean hemoglobin level was 10.6g/dl and 8.6g/dl respectively [p=0.29]. Due to the better hemoglobin level, patients with JAK2 mutation have less transfusion requirements and are partially protected against severe anemias compared to patients with no mutation.

Primary postparyum haemorrhage prevention by misoprostol and oxytocin

Objective: to determine the efficacy of rectal misoprostol combined with intravenous oxytocin for prevention of primary postpartum haemorrhage

Material and Methods: a total of 600 cases were included in this study. Patients were given 600mcg rectal misoprostol and intravenous oxytocin at the delivery of anterior shoulder of baby. These patients were followed in 24 hours for postpartum haemorrhage

Results: mean age of the patients was 27 .1 +/-4.9 years. Mean gestational age was found to be 37.2+/-5.8 weeks. According to parity distribution, primigravida were 220 [37%], gravida 2-4 were 312 [52%] and gravida 5-6 were 68 [11 %]. Majority of the patients i.e. 554 [92.3%] had blood loss < 500 ml and 46 patients [7.3%] had blood loss> 500 ml. rectal misoprostol with intravenous oxytocin was effective in 554 patients [92.3%]

Conclusions: rectal misoprostol combined with intravenous oxytocin is effective in the prevention of primary postpartum haemorrhage

Blood transfusion reaction: In obstetrical and gynaecological practice

To determine the frequency of reaction with whole blood transfusion in obstetrics and gynecology practice. Descriptive study. The study was carried out from January 2011 to December 2011, at the Department of Obstetrics and Gynaecology, Unit-Ill, Services Institute of Medical Sciences / Services Hospital, Lahore, Pakistan. A total of 300 patients who had whole blood transfusions were included. All transfused patients were kept under observation for 6 hours. Post transfusion reactions [signs and symptoms] were noted half hourly. Post-transfusion reactions were observed in 43 [14.4%] out of 300 patients. Post transfusion reactions were further categorized into reactions fever [n=23, 7.7%], rashes [n=14, 4.7%], shortness of breath [n=4, 1.3%] and hypotension [n=2, 0.7%].It can be concluded that post transfusion reactions are common in obstetrics and gynecology practice. However, with appropriate precautions, before and during blood transfusions, the post-transfusion reactions can be minimized