ABSTRACT
Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.
ABSTRACT
Background: About 80% of all pregnant women experience some form of nausea and vomiting during their pregnancy. Hyperemesis gravidarum, the commonest indication for admission to hospital in the first half of pregnancy affects approximately 0.3%-2.0% of pregnancies. Helicobacter pylori infection has been implicated in the cause of nausea and occasional vomiting in early pregnancy. The objectives of this study are to determine the proportion of H. pylori seropositivity among women with hyperemesis gravidarum (HG) and determine its relation with socio-economic status.Methods: This was a prospective study conducted in a tertiary hospital in Bangalore among 60 pregnant women with HG for a period of 12 months. Venous blood samples were obtained and serum IgG for H. pylori was measured using enzyme-linked immunosorbant assay (ELISA). Details regarding socioeconomic status, recurrence of symptoms and severity were noted.Results: The proportion of H. pylori seropositivity among pregnant women with hyperemesis in our study was 70%.There was a significant increase in severity and recurrence of vomiting among seropositive cases. Women belonging to rural areas had 1.17 times the risk of infection compared to women with urban area. We also found women belonging to the lower socioeconomic status had 0.52 times more risk to develop Helicobacter pylori infection.Conclusions: This study suggests that H. pylori is an independent risk factor for vomiting in pregnancy. Effective treatment and eradication of H pylori infection may help reduce severity and recurrence of vomiting among positive cases thus reducing its adverse consequences.
ABSTRACT
Plaque Psoriasis, a common type of Psoriasis typically characterized by circular to oval red plaques distributed over extensors of body surface and scalp.The plaques usually exhibit scaling as a result of epidermal hyperproliferation and dermal inflammation with well defined sharply demarcated boundaries sometimes carry a violacious tint. Both early onset and a family history of disease are considered poor prognostic indicators. We here by presenting a case of chronic plaque psoriasis admitted to the IPD of SJIIM Hospital simulating the lakshanas of kitibhakushta treated with shodhna and shamana therapies with the objective of reducing the frequency of relapses,duration of remission and alleviating the symptoms.