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Introduction: The significant risks posed to mothers and fetus by COVID-19 in pregnancy have sparked a worldwide debate surrounding the antenatal SARS-CoV-2 infection and vaccination. ACOG and CDC recognize pregnancy as a risk factor, Recent data demonstrated that pregnant women with COVID-19 infection are at increased risk for intensive care unit (ICU) admission, mechanical ventilation, and death, compared with properly matched nonpregnant women. Moreover, COVID-19 illness increases the risk for pregnancy complications such as preterm birth, pregnancy-induced hypertensive diseases, and thromboembolic diseases. Maternal IgG antibodies to SARS-CoV-2 where transferred across the placenta after asymptomatic as well as symptomatic infection during pregnancy. Proper transfer of neutralizing antibodies may be critical during pregnancy, as a greater proportion of neonates and infants have severe or critical illness upon COVID-19 infection than older pediatric counterparts. To detect cord bloodAims and Objectives: IgG antibodies against SARS CoV-2 in pregnant women. To assess the association between maternal and fetal SARS-CoV- 2 specific antibodies. A brief questionnaire was administered to 42 antenatal women attending for delivery atMethods: Mediciti Institute of Medical Sciences, Hyderabad, Telangana State. The questionnaire included information such as vaccination status, previous history of Covid infection, presence of any symptoms at the time of admission, comorbid conditions like DM, HTN, Thyroid disorders, etc. Following delivery, 2ml cord blood sample has been collected. Serum has been separated and used for detection of SARS CoV-2 IgG antibody titers by quantitative ELISA. Among 42Results: antenatal cases,4 were controls among them two were positive control and two were negative controls. Out of remaining 38, the SARS-CoV-2 IgG antibodies are detected in 14 cases. IgG was detected in the cord blood for 33.3% of the total cases. Among those detected positive for antibodies, 50% had preterm deliveries. IgG antibodies haveConclusion: been detected in the cord blood collected from the vaccinated women as well as the women affected with SARS-Co-2 and even increased the risk for pregnancy complications such as preterm birth, pregnancy-induced hypertensive diseases, Gestational Diabetes.
ABSTRACT
Background: In modern obstetrics practice has witnessed an increase in the caesarean section rates everywhere. The incidence of instrumental deliveries varies between 10-12% in UK. The incidence of instrumental deliveries varies between 2.7-5% in India. There is an urgent need to reintroduce instrumental need in the modern obstetrics. Instrumental delivery is one of the basic functions of emergency care according to WHO. This study was done to know the prevalence, indications and fetal outcomes of forceps deliveries.Methods: A retrospective study was conducted at a tertiary teaching hospital, India from January 2014 to December 2018. All cephalic singleton pregnant mothers who underwent forceps delivery after 28 weeks were included. All the forceps delivery done in twins and breech vaginal delivery were excluded. Demographic data, Indication of forceps delivery, maternal complications of forceps delivery like episiotomy extension, cervical tear, vaginal wall tear, PPH and neonatal outcome like low birth weight, NICU admissions, stillbirth, APGAR score at 1 and 5 minutes were recorded. Equal number of mothers of reproductive age group 20-45 ages who underwent normal non breech vaginal deliveries were randomly selected as control.Results: The prevalence of forceps delivery was 5.25%. The most common indication was fetal distress (55%). Most of the mothers were primigravidas in age group 20-30 years (p<0.001). Regarding the neonatal outcome, 72% of the babies were having weight >2.5 kgs. APGAR <7 at 1 and 5 min was not significant.Conclusions: As fetal distress is the most common indication, every obstetrician should learn the skill of forceps delivery and it should not be a dying art.
ABSTRACT
Background: Teenage pregnancy accounts for 11% of births worldwide and 95% of these occur in low middle income countries. Pregnancy and its complications are leading cause of death among these girls. This study was done to know the prevalence and to determine whether teenage mothers are at risk of adverse pregnancy outcome.Methods: A retrospective study was conducted at a tertiary teaching hospital, India between July 2015 to Dec, 2017. All teenage mothers delivered after 28 weeks of gestation were included. Women with Diabetes mellitus, renal disease, thyroid disorders were excluded. Demographic data, maternal complications like anaemia, hypertensive disorders of pregnancy, preterm birth, mode of delivery, low birth weight, NICU admissions, stillbirth and early neonatal death were recorded.Results: In the present study, the prevalence was 7% which is less than that of other studies. Incidence of caesarean-Section in the present study was 31%. Amongst the complications oligohydramnious was found to be significantly associated with teenage pregnancy. NICU admissions were needed for 43% of the cases and 31% were LBW.Conclusions: High NICU admission and high LBW in newborns of teenage mothers were noted in the current study. Hence, there is urgent need to focus on the teenage pregnancy.
ABSTRACT
Background: Caesarean section is the most commonly performed surgery in obstetrics and there is a rise in caesarean section rates in recent times. This study was undertaken to know the changing trends in caesarean section rate in a rural hospital and to examine the indications contributing to it. The objective of the present study was to know the prevalence and changing trends in caesarean section over the last 6 years (April 2012-March 2018).Methods: Demographic data for all the deliveries, mode of delivery and indications of caesarean sections performed from April 2012 to March 2018 that occurred at MIMS were collected in a retrospective manner.Results: Among a total of 12,522 women delivered during the study period of 6 years, 44.93%, 48.49%, 48.41%, 50.9%, 45.48% and 49.62% were delivered by caesarean section during 2012-2013, 2013-2014, 2014-2015, 2015-2016, 2016-2017 and 2017-2018 respectively. Increase in repeat caesarean section is the primary reason for these increased rates followed by fetal distress. There is a rise in the repeat caesarean section from 44.36% in 2012-2013 to 55.67% in 2016-2017 and 47% in 2017-2018. Whereas primary caesarean section rate reduced from 55.63% in 2012-2013 to 44.32% in 2016-2017 and 53% in 2017-2018.Conclusions: As repeat caesarean section and fetal distress are the most common causes of caesarean section we need to address these to bring down the caesarean section rate.