ABSTRACT
Background: PIH is associated with increased vascular resistance and decreased utero -placental perfusion resulting in an increased incidence of foetal hypoxia and impaired foetalgrowth.The objective of this study was to assess the diagnostic performance of S/D ratio, resistance index(RI), pulsatility index (PI) and cerebro-placental ratio (CPR) in the prediction of adverse perinatal outcome in PIH and IUGR. Objective: is to determine S/D ratio, RI, PI, CPR and asses their diagnostic values in the prediction of adverse perinatal outcome.Material& Methods:50 pregnant patients with PIH and IUGR, beyond 28 weeks of gestation, were prospectively studied at P k das institute of medical college,vaniyamkulamand subjected for Doppler study of the umbilical artery and foetal middle cerebral artery. The abnormality of above parameters was correlated with the major adverse perinatal outcome.Results:Patients with abnormal Doppler parameters had a poor perinatal outcome, compared to those who had normal Doppler study. The cerebro-placental ratios(CPR) had the sensitivity and specificity, positive and negative predictive values of 95%,76%,73%,95% respectively with Kappa value of o .68(good agreement) and p value of .000 which was statistically significant, for the prediction of major adverse perinatal outcome.Conclusions:This study shows that Doppler study of umbilical and foetal middle cerebral artery can reliably predict the neonatal morbidity and helpful in determining the optimal time of delivery in complicated pregnancies. The CPR is more accurate than the independent evaluation of S/D, RI, PI, in identifying foetus with adverse perinatal outcome.
ABSTRACT
Background: The perinatal period is well established as an increased risk for development of serious mood disorders. Maternal mental health in developing countries gets less than its due attention. The present study was undertaken to evaluate mood changes in Peripartum period in our population and to identify demographic, obstetric, social and psychosocial risk factors associated with Peripartum depression using established scales.Material & Methods:A prospective, observational, longitudinal study conducted in PK das institute of medical science, vaniyamkulam, with 387 perinatal women for 12 months (February 2018� January 2019). Various scales EPDS (Edinburgh Postnatal Depression Scale), CMSS (Couple Marital Satisfaction Scale, IMS (Index of Marital Satisfaction), LES (Life Event Scale) were studied in Peripartum Period.Results:Among a total of 387 participants about half 189 (48.8%) were in 19-25 years of Age. Almost 30% and 40% had dissatisfied married life as per the CMS and IMS scales respectively. Just above 42% were screen positive for depression antenatally with EPDS & 39% (n = 151) in the immediate postpartum period. From these 151 screen positive cases in immediate postpartum period, 138 participants were followed up at 4-6 weeks (13 were lost to follow up) and up to 115 of 138 (83.3%) were screen positive for depression (N= 387, 29.7%), which was statistically significant (p<0.001). With EPDS during antenatal period there was no statistically significant relationship of depression with Education (p = 0.195), Occupation (p = 0.651) and pregnancy planned or unplanned (p = 0.223), whereas, Joint family, participants with dissatisfied marital relationship had increased risk of depression as evidenced by IMS and CMSS (p < 0.001). Participants with a previous male gender baby had less risk of developing depression (p< 0.001) & participants with previous 2 female children had increased risk of depression (p< 0.001).Conclusions:This study highlights importance of screening for maternal mental health problems during Peripartum period. Depression in immediate postpartum period is good predictor for increased risk of depression at 4-6 weeks postpartum