ABSTRACT
Background: Peripartum cardiomyopathy (PPCM) is a disorder of unknown cause in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the last month of pregnancy and the first 5 months postpartum. PPCM remains a diagnosis of exclusion. There have been numerous proposed causes including hormonal abnormalities, inflammation, viral pathogens, autoimmune response, and genetic predisposition. Aim of study was to study the clinical profile, risk factors, and the management along with obstetric and perinatal outcome, in women with peripartum cardiomyopathy.Methods: This retrospective observational study was conducted on the antenatal women of age group of 18 years to 40 years, admitted in the labour ward of R. L. Jalapa hospital who presented with heart failure in last month of pregnancy till 5 months postpartum, without previously having a heart disease over the 5 year period, January 20 15 to December 2019.Results: Majority of the patients (15/18) presented with complaints of exertional dyspnoea. Mean LVEF at the time of diagnosis was 38.39%. There were 5 (27%) maternal mortality and all of them had global hypokinesia on echocardiography and presented in NYHA class III and IV. Two (11%) out of eighteen patients had intrauterine death, and all the patients who had IUFD belonged to class IV. Four babies (22.22%) had intrauterine growth restriction.Conclusions: The present study came to conclusion that in rural tertiary center, maternal outcome and prognosis was poor as patients presenting to us were majority of them in cardiogenic shock and lower LVEF in terminal stages. The associated risk factors were preeclampsia, anemia and multiple gestation which could also contribute to the poor prognosis which was noticed in the study. Early recognition of the disease is of paramount importance as the clinical manifestations can conceal and can lead to high morbidity and mortality especially within 3 months postpartum.
ABSTRACT
Background: Vitamin D deficiency is currently a global pandemic affecting all age groups. Vitamin D is considered a fundamental hormone in calcium homeostasis and bone health. Risk of vitamin D deficiency increases during pregnancy due to increased maternal and fetal demands and altered vitamin D metabolism. Recently, maternal vitamin D deficiency has been linked to adverse pregnancy outcomes, including preeclampsia, gestational diabetes, fetal growth restriction and preterm birth. Adequate vitamin D status appears to be relevant to health at all ages, and even in prenatal life.Methods: This is a cross sectional, observational study conducted in the department of obstetrics and gynaecology at R. L. Jalappa Hospital. A total number of 160 subjects were included. 5 ml of venous blood was collected and was centrifuged at 3000 rpm and stored at - 80°C till analysis. Analysis of 25-hydroxy Vitamin D was done using ELISA.Results: Majority of the subjects were vitamin D deficient (81.87%) and 12.5% were vitamin D insufficient and only 5.63% were vitamin D sufficient. The prevalence of vitamin D deficiency was more among primigravidas (85.6%) and was associated with higher rates of caesarean section (92.4%). High prevalence of vitamin D deficiency was seen in lower middle socioeconomic class (62.5%). Maternal vitamin D deficiency was associated low birth weight of neonates (100%).Conclusions: In this study it was concluded that majority of subjects were vitamin D deficient and belonged to lower middle socioeconomic class. Majority of this subjects who underwent caesarean section were vitamin D deficient. Vitamin D deficiency was associated only with low birth weight of neonates and no other adverse obstetric outcome.
ABSTRACT
Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%). Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.