ABSTRACT
Objectives: To calculate the frequency of use of smokeless tobacco by pregnant women and determine their awareness about its hazards. Study design, settings and duration: Questionnaire based study conducted in the Obstetrics OPD of Isra university hospital. Hyderabad over 6 months from 1[st] January 2011 to 30[th] June 2011
Patients and Methods: All obstetric patients who came to the Obstetrics and Gynecology OPD during this period were enrolled and 302 of them were selected at random. A structured proforma was used to collect information like age, gravidity, gestational age, socioeconomic status, residence, occupation and literacy status. Starling age of use of smokeless tobacco, frequency of usage before and during pregnancy was also inquired. Women smoking cigarette were excluded. Data were analyzed on statistical software SPSS version 16. Frequencies and percentages were calculated, the final outcome was recorded
Results: A total of 302 pregnant women were interviewed. One hundred and sixty-four [54.3%] were using smokeless tobacco before pregnancy and they continued it throughout pregnancy except three, while 26 women started its use during pregnancy making a total of 187 [61.9%] women who were using smokeless tobacco during pregnancy. Usage was 2-3 times before pregnancy and remained same during pregnancy. The most common smokeless tobacco was Ghutka 116 [62%]. Hazards of using smokeless tobacco during pregnancy were known by 189 [62.6%] women and health care provider was the most common source of passing this information. Regarding social taboos, 240 [79.5%] pregnant women said that using smokeless tobacco is not acceptable for women
Conclusion: Majority of pregnant women were using the smokeless tobacco in spite of knowing the hazards of smokeless tobacco
ABSTRACT
To determine the etiology, and outcome of thrombocytopenia in pregnancy. An Observational hospital based study was conducted at Isra University hospital Hyderabad for three years from 1[st] January 2009 to 31[st] December 2011. Total 3576 obstetric patients were admitted in Obstetrics and Gynecology department during this period of whom 71[1.9%] had thrombocytopenia in pregnancy. Depending on the number of platelets; thrombocytopenia was divided into four groups, i.e. those having platelets below 20,000, between 20-50,000, between 50-100,000 and more than 100,000. Patients with chronic liver disease and drug induced thrombocytopenia were excluded from the study. A predesigned structured proforma was used. All results were analyzed on statistical software SPSS version 16 Frequencies and percentages were calculated, the final outcome was recorded. The most common cause of thrombocytopenia was gestational thrombocytopenia seen in 24[33.8%] patients followed by HELLP syndrome 9 [26.7%] and hepatitis E in 10[16.3%] patients. There were 11 cases who had platelets below 20,000, 18 had levels between 20-50,000 and 19 had between 50-100,000. The common symptoms were bleeding seen in 30[42.2%] cases and purpura or easy bruising seen in 11[15.4%] cases while, 30 cases were asymptomatic. Of 11 cases that had platelets below 20,000, 10 mothers died along with their 7 babies while, only 3 surviving babies were those of mothers dying of post partum hemorrhage. Eighteen mothers had platelets between 20-50,000 and out of these 9 mothers and 11 neonates died. Nineteen mothers had platelets between 50-100,000 and out of these one mother and 3 neonates died. Overall maternal mortality was 20[28.1%]. Maternal and fetal deaths occurred in almost all cases with DIG, HEV and malaria while, in PPH mothers died but their newborns survived irrespective of platelet count. Diseases causing platelets below 50,000 in pregnancy should be rated as high risk pregnancies and dealt with accordingly to reduce high fetal or maternal mortality