ABSTRACT
Background: Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases with incidence varying with geographic region. Aim was to review all molar pregnancies admitted at our institution and to study the incidence, clinical presentation, management, complications and outcome of molar pregnancies.Methods: An observational study was done in department of obstetrics and gynaecology at Dr. BSA Medical College and Hospital among women with molar pregnancy over two years.Results: The incidence of molar pregnancy of the institute was 1.05/1000 deliveries. 21- 25 years age group and nulliparous women constituted 28.1% of patients. Amenorrhea (100.0%) was the commonest presenting complaints followed by abnormal vaginal bleeding (90.62%). Anemia (37%) was the commonest complication followed by acute hemorrhage (31%) and hyperthyroidism (18%). Suction evacuation was done in 96.8% of patients and 87.5% required blood transfusion. Only 6.2% (2/32) of patients had post evacuation chemotherapy. None of the cases developed choriocarcinoma. Limitation of the study was that the incidence of subsequent pregnancies after complete treatment of molar pregnancies was not studied.Conclusions: Early diagnosis of complete molar pregnancy can change the clinical presentation, diagnosis, and treatment of molar pregnancy. There is need for early recognition, timely referral, prompt and proper treatment of this condition. Adequate follow-up of the patients and need for contraception should be reinforced.
ABSTRACT
Background: Gestational diabetes mellitus is a common medical complication of pregnancy associated with several fetal and maternal complications. There are several screening tools for detecting gestational diabetes mellitus including recent DIPSI criteria of non-fasting single plasma 2-hour value after 75 grams glucose (single step test). The present study was aimed at calculating prevalence of GDM, sensitivity and specificity using non-fasting single plasma 2-hour value after 75 grams glucose for screening and diagnosis of gestational diabetes mellitus and to study the high-risk characteristics for GDM in this study population.Methods: This was a prospective study conducted for a period of one year. 750 antenatal women attending Antenatal outpatient department(OPD) with period of gestation 24-28 weeks were enrolled in the study. All women were first tested by 75 gm glucose and then by OGTT for confirmation. Prevalence rates, sensitivity, specificity, positive predictive value and negative predictive value were studied. History based questionnaire was used to study the risk characteristics for GDM.Results: Prevalence rate, sensitivity, specificity, positive predictive value and negative predictive value for patients were 14.13%, 73.58%, 95.03%, 70.90% and 95.67%. Among the risk factors 7.2% patients were more than 30 years in age. 0.93% had GDM in previous pregnancy.4.21% had GCA in previous pregnancy, 12.4% had SB/IUD/NND in previous pregnancy. 1.17% had previous pregnancy with birth weight more than 3.5 kg and 9.73% had family history of diabetes mellitus. Past history of GDM (50%) was the most common risk factor in GDM group followed by age > 30 years (29.6%), and family history (24.6%).Conclusions: Screening using DIPSI criteria has good sensitivity and negative predictive values. It can serve as both screening and diagnostic test besides being simple, user friendly, cost effective and evidence-based test in less resource countries like India.