ABSTRACT
Background: Hypertensive disorder along with hemorrhage and infection contribute greatly to maternal mortality and morbidity. Pregnancy induced hypertension remains among the most significant and intriguing unsolved problems in obstetrics.Methods: In this prospective analytical study investigations and color doppler findings 0f umbilical artery PI, RI and end diastolic flow in same, uterine PI, RI and persistent diastolic notch in uterine artery recorded. Total 100 Cases of PIH between 20-36 weeks of gestation in 2 years with B.P ≥ 140/90 mm hg and protienuria ≥ 1+ were observed.Results: In this study, out of 100 cases, there were 58 cases of mild PIH (58%) and 42 cases of severe PIH (42%). Umbilical artery PI was elevated in 43(43.0%) patients and was normal in 57(57.0%) patients. Umbilical artery RI was more than and equal to 0.7 in 77 patients (77%) and was below of 0.7 in 23 (23%) pa-tients.9(9.0%) fetuses showed absence and 14 (14.0%) fetus had reversal and 46 (46.0%) had reduced end diastolic umbilical artery flow with total 69 out of 100 fetuses having abnormal waveforms.65 (65%) mothers had an elevated uterine artery PI and 35(35%) patients had normal uterine artery PI. in observation 69 (69%) patients were having RI more than 0.6, while 31 (31%) were having less than 0.6 out of 100 patients. In this study, 65 (65.0%) women were having persistent diastolic notch.Conclusions: This study was to evaluate arterial flow velocities as a predictor of impending pregnancy induced hypertension with raised RI and PI along with umbilical ab-sent or reverse end diastolic flow velocities and elevated RI and PI in the presence of a diastolic notch are considered as abnormal uterine doppler findings doppler finding with unfavorable outcome.
ABSTRACT
Background: Placenta is one of the most challenging organs; it is an instrument of transfer of essential elements, i.e. nutrients and oxygen from mother to fetus and waste product of metabolism in reverse manner.Methods: Cases of PIH between 20-36 weeks of gestation will be studied over a peri-od of 2 years having B.P ≥140/90mm Hg and protienuria ≥1+ in this prospective analytical study having color Doppler scanner with PI, RI of umbilical, uterine artery and middle cerebral artery PI along with placental morphological changes are observed.Results: In present study where, placental weight was <300g also has LBW babies born were higher 51(100%). In placental gross examination 58% infarction, 42% calcification and 48% retroplacental were found. among 58 samples with infarction 76%, 42 placentas had calcification 48% and among 49 samples retroplacental clots 61% were belonged to uterine artery PI >1 group. While 78% placental infarction, 57% calcification and 69% retroplacental clots be-longed to uterine artery RI > 0.6 group. Infarction were 77.50%, calcification were same as infarction 77.50% while retroplacental clots 80% in group having MCA PI <1.3 that were higher than group of cases having MCA PI >1.3.Conclusions: In recent years placenta has drawn attention as valuable indicator for maternal and fetal diseases in preeclampsia. Decreased circulation in placenta reflects on its morphological features and these changes causes alterations in Doppler flow velocities of uterine, umbilical and middle cerebral vessels pregnancy induced hyper-tension.
ABSTRACT
Background: Asymptomatic bacteriuria (ASB) refers to the presence of a bacterial isolate in urine culture in an asymptomatic person. Pregnant women with ASB are more likely to develop acute pyelonephritis in later pregnancy, postpartum urinary tract infection, hypertensive disease of pregnancy, anaemia, chronic renal failure, prematurity, low birth weight babies and prenatal death if untreated. The incidence of these can be reduced by treating ASB during pregnancy. Aims & Objective: To study the incidence of asymptomatic Bacteriuria in pregnancy. Material and Methods: Approximate 20 ml of clean catch midstream urine samples were obtained from 100 pregnant women attending the Obstetric Outpatient Department. Samples were processed as per standard guidelines. Results: Microscopic analysis of urine showed pus cells in 5 (45.45%) and Gram's stain smear showed bacteria in 9 (81.81%). Urine culture showed ASB in 11 (11%) pregnant women. Escherichia coli were found in 6 (54.55%), Klebsiella pneumoniae 3 (27.27%), Enterococcus sp. in 1 (9.09%) and Staphylococcus aureus in 1 (9.09%). Antibiotic sensitivity testing showed that all isolates were sensitive to all the antibiotics. Conclusion: Incidence of asymptomatic bacteriuria was 11% in 100 pregnant women. Microscopic analysis of all 11 urine culture positive samples showed pus cells in 5 (45.45%) and Gram's stain smear showed bacteria in 9 (81.81%). The most common bacterial isolate was Escherichia coli (54.54%), followed by Klebsiella pneumoniae (27.27%), Staphylococcus aureus (9.09%) and Enterococcus sp. (9.09%). Urine culture is necessary for screening pregnant women.
ABSTRACT
Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure.
ABSTRACT
Background: Menorrhagia interferes with the woman's physical, social, emotional, and/or material quality of life. Antifibrinolytic drugs are effective in decreasing excessive menstrual bleeding. The objective of this study was to compare the effects of tranexamic acid and ethamsylate on quality of life in women with menorrhagia. Methods: The 50 women with menorrhagia were randomised to receive either tranexamic acid or ethamsylate. Twenty five patients were allocated to receive tranexamic acid 500 mg six hourly, and 25 patients to receive ethamsylate 500 mg six hourly. Among the parameters measured by the MIQ were impairment in social activities, work performance, physical activities, productivity, hygienic condition, psychological condition. Health-related quality-of-life question scores (MIQ scores) at baseline and after treatment were calculated as mean for tranexamic acid group and ethamsylate group. Results: Tranexamic acid and ethamsylate treatment groups showed mean improvement in MIQ scores compared to baseline. However, the total mean score was higher in tranexamic acid group compared to ethamsylate group after three treatment cycles (21 Vs 17). Conclusions: Use of tranexamic acid and ethamsylate improved health-related quality of life in patients with menorrhagia. Tranexamic acid showed better improvement in health-related quality of life compared to ethamsylate in patients with menorrhagia.