Outcome of pregnancy in Saudi women with sickle cell disease attending the tertiary care university hospital in eastern province of Saudi Arabia

Sickle cell disease (SCD) is a chronic genetic hematological disorder with multiorgan involvement and is associated with complications during the pregnancy. This is a well-known disorder in Saudi Arabia, but no study has reported its outcomes in pregnant Saudi females of the Eastern region. This study was carried out to compare the fetomaternal outcome in patients with SCD with those without SCD. This was a retrospective cohort study done in the Eastern Province of Saudi Arabia in a tertiary care, teaching hospital, by retrieving the data through the code ICD-9 for SCD, the control group was also selected with comparable characteristics. A total of 302 SCD pregnant patients were included for comparison with 600 pregnant women without SCD as control, during the period of Jan 1, 2008 to December 31, 2018. After the data retrieval, percentages of complications were calculated between the study and control groups. Fischer's exact test and t-test were used for statistical analysis by using SPSS version 22. The results showed higher complication rates in pregnancies of patients with SCD. Hypertensive disorders (13.3%), abruptio placenta (1.6%), intrauterine growth restriction (19.2%), thromboembolism (6.6%) and stroke (2.6%) were all higher in SCD as compared to the control group .The complications of SCD itself including anemia (89.4%), acute chest syndrome (13.2%) and sickle cell crisis (39.2%) were also increased during the pregnancy. Both still birth (3.3%) and neonatal intensive care unit admission (1.6%) were also higher in SCD. SCD during the pregnancy is a high-risk situation and can lead to many fetomaternal complications; however, preconceptional counselling, early booking, a careful monitoring during pregnancy and multidisciplinary management approach can prevent potential adverse outcome in this regard

Eclampsia; trends in maternal morbidities and mortalities. [a review of neglected parameters in developing countries]

Hypertensive disorders during the pregnancy are seen in 5- 8% of cases. The worst form is eclampsia, associated with fits or convulsions. It is a rare event in developed countries. Eclampsia can not only lead to maternal mortalities but also cause maternal morbidities. Lot of studies have been done about different aspects of this disease. This study aims to see the maternal morbidities, mortalities but also to dig down the underlying parameters, which are responsible for them. They include Personal, Social, Educational, Medical and National problems. [1] To compare the Fetomaternal outcome and complication in low risk and eclamptic patients. [2] To find out the underlying parameters or variables associated with this catastrophy. It is a Descriptive Study. Lady Aitchinson Hospital, Obstetrics/Gynecology Unit 1, Lahore, Pakistan. It is a teaching, tertiary care centre affiliated with King Edward Medical University which is a well known all over the Asia. 1st Jan 2008 to 31st Dec 2010. 10557 patients presented in emergency room for Obstetrical causes. 1200 patients had one or the other form of hypertensive disorders.400 patients with Eclampsia presented with hypertension, fits and generalized body swelling. The patients who fulfilled the inclusion criteria were included in the study. According to the results it is seen that maternal mortality is higher in Eclampsia as compared to low risk [p=0.01] The maternal morbidities are also higher than normal low risk population [p=0.011]. Perinatal outcome is again better in low risk than high risk group [p=0.099] .It was observed that illiteracy, poor socioeconomic status lack of awareness about health facilities, poor arrangement at Basic Health units of villages, delayed decision making, delay in referral and management are the underlying variables and pitfalls which have to be addressed. It is concluded from this study that although Eclampsia is a major killer and an uphill battle, but the measures can be taken at missed and neglected parameters, responsible for the condition, to reduce the maternal morbidity and morality

Ruptured uterus; an ongoing tragedyof motherhood

To analyze the risk factors for uterine rupture and to share the 5 years experience of ruptured uterus with other colleagues of the specialty. Case series descriptive study. Gynae/Obstetrics Unit-I Lady Willingdon Hospital Lahore. Five years i.e 1st May 2004 to 30th April 2009. Obstetric patients who presented with ruptured uteri. Results showed that risk factor for ruptured uteri include cesarean sections [61.11%], grand multiparty [16.6%], Instrumental deliveries [4.44%] and undetected perforation [1.11%]. Ruptured uterus is a high risk category of patients. The patients with previous scar, grand multiparas, obstructed prolonged labour must be managed by proper trained personnel and in tertiary care centers in order to avoid the morbidity or mortality due to ruptured uterus

Perinatal outcome in multifetal gestations at Lady Willingdon Hospital, Lahore

To find out the perinatal outcome in multifetal gestations in relation to gestational age and birth weights of neonates after 24 weeks of gestation at Lady Willingdon Hospital, Lahore and also to identify the factors responsible for poor perinatal outcome in such pregnancies. Cross-sectional descriptive study Lady Willingdon Hospital Lahore. 1[st] July 2004 to 31[st] December 2004. Patients having multifetal gestations at or above 24 weeks of pregnancy, presenting in outdoor or in labour rooms during labour, and their neonates after birth till first week of life. One hundred cases were included in the study. The perinatal mortality in relation to gestational age and fetal weight at birth were calculated. The perinatal mortality rate was inversely proportional to gestational age and birth weights of neonates. The results were tabulated and perinatal mortality rate [PNMR] calculated for various groups. Overall PNMR in such gestation in terms of gestational age and weight was 533.33/1000 births. PNMR at 24-28 weeks was 1000, at 29-32 weeks 888/1000, at 33-36 weeks 456/1000 and was 117.5/1000 births at>/=37 weeks of gestation. PNMR was highest with birth weights of 0.5-1Kg while it decreased as the birth weight increased i.e 91/1000 at birth weight of more than 2.5 Kg. These results were compared with those of other national and international studies. Multifetal gestations are high risk pregnancies which need special care during antenatal, intrapartum and neonatal period. In order to decrease this high PNMR in such pregnancies extra vigilance on the part of obstetricians, anaesthetists and perinatologists is required

Causes of maternal mortality in lady Willingdon hospital Lahore

Was to observe the major causes of maternal mortalities in our hospital. Settings: All 3 units of Lady Willingdon Hospital Lahore. It was an observational analytical study. The data was collected with the help of the proformas. Total no. of births during 1[st] Sept 2004 to 31[st] August 2005 were 12011 and death were 40. Maternal mortality rate was 330.5579/100.000 live births. Haemorrhage was the major killer of such unfortunate patients. Maternal Mortalities can be prevented or reduced if proper and in time decision for referral and treatment is made

Asokarishta-Studies on Metabolism and Gastro-intestinal Motility

The 24 hours acute metabolic study revealed certain striking aspect of the pharmacological profile of Ascokarishta and Saraca asoca [Roxb]. Asokarishta causes no change in food intake but decreases the defecation rate and with low water intake maintains normal rate of excretion. But Saraca asoca [Roxb] causes no change in food intake and defecation followed by slight decrease in water intake but no difference on urinary output. The gastro-intestinal motility test revealed that Asokarishta did not change the motility at all, but Saraca asoca [Roxb] slightly increased the motility whereas the rest of the components lowered the motility. In 30 days chronic administration study all of the components slightly decreased the rate of gain in body weight compared to control