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Background-The human life has a distinct sphere– the world of play makes childhood more meaningful, happy & motivate the child to learn, develop & mature. Parents, teachers, nurses, psychologists are becoming increasingly aware of the importance of play and its influence upon bringing of children. The study was designed to assess the knowledge and attitude of parents regarding play needs of children. Materials & Methods- 100 couples were selected using purposive sampling technique. A structured questionnaire was prepared for assessing the knowledge & attitude of parents regarding play needs of children (under 5 years of age). Results- 20% of them had moderately adequate knowledge whereas 22% had moderately adequate attitude with. Knowledge & attitude of parents correlated. There is no significant association between socio demographic variables and knowledge except gender, religion, and mass media exposure, type of family, and monthly income and number of children as demographic variables. There is no significant association between socio demographic variables and attitude except gender, religion, qualification, type of family, and number of children as demographic variables. Conclusion-This study was conducted in Govt. Hospital of Durg (Chattisgarh) with the parents having children under 5 years of age. The findings of the study recommended the further interventional approaches regarding play needs of children. Parents need to be educated about meaning and importance of play for child. It creates awareness play know, attitudes, play needs, under five.
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Objetivo : Determinar los efectos de la infección Covid-19 asintomática, leve y moderada en el primer y segundo trimestres en los resultados del embarazo. Métodos : El estudio se realizó en las gestantes que acudieron al Departamento de Perinatología de la Universidad de Ciencias de la Salud de Izmir entre octubre de 2021 y julio de 2022. Se registraron las mujeres embarazadas que presentaban infección asintomática, leve y moderada por Covid-19 en el 1º y 2º trimestre y se siguió el desarrollo de la gestación. Resultados : Un total de 437 pacientes participaron en el estudio. El número de pacientes asintomáticos, leves y moderados de Covid-19 fue de 142, 157 y 138, respectivamente. Cada grupo se analizó como subgrupo del 1º y 2º trimestre según el momento de la infección por Covid-19. La edad media de las pacientes con Covid-19 moderado era superior a la de las pacientes con Covid-19 leve/asintomático (p=0,021). Se observó que el índice de masa corporal era mayor en las pacientes con Covid-19 moderado que en las pacientes con infección leve/asintomática (p=0,048). El parto pretérmino (entre las semanas 34 y 37) fue significativamente mayor en los casos con infección moderada por Covid-19 (p=0,041). Este aumento ocurrió principalmente en pacientes con infección por Covid-19 en el 2º trimestre. No hubo modificaciones significativas en las tasas de cesárea, trastornos hipertensivos del embarazo, pérdida fetal, retraso del crecimiento intrauterino, colestasis del embarazo y diabetes gestacional. Conclusiones : Los efectos de la infección por Covid-19 al inicio del embarazo (1º y 2º trimestres) siguen siendo objeto de investigación. La infección moderada por Covid-19, especialmente en el 2º trimestre, puede provocar un aumento de la tasa de partos prematuros.
Objectives: To evaluate the effects of asymptomatic, mild and moderate Covid-19 infection in the 1st and 2nd trimesters on pregnancy outcomes. Material and methods: The study was performed among patients who applied to the Perinatology Department of Izmir University of Health Sciences, between October 2021 and July 2022. Pregnant women who had asymptomatic, mild and moderate Covid-19 infection in the 1st and 2nd trimesters were registered and their pregnancy processes were followed. Results: A total of 437 patients participated in the study. The numbers of asymptomatic, mild and moderate Covid-19 patients were 142, 157 and 138, respectively. Each group was analyzed as 1st and 2nd trimester subgroups according to the time of Covid-19 infection. The mean age of patients with moderate Covid-19 was higher than with mild/asymptomatic Covid-19 (p=0.021). Body mass index was found to be higher in patients with moderate Covid-19 compared to patients with mild/asymptomatic infection (p=0.048). Preterm labor (between 34th and 37th weeks) was significantly higher with moderate Covid-19 infection (p=0.041). This significant increase was mainly due to the preterm birth rate in patients with previous Covid-19 infection in the 2nd trimester. There was no significant change in the rates of cesarean section, hypertensive disorders of pregnancy, fetal loss, intrauterine growth restriction, cholestasis of pregnancy and gestational diabetes. Conclusions: The effects of Covid-19 infection in early pregnancy (1st and 2nd trimester) are still the subject of research. Moderate Covid-19 infection, especially in the 2nd trimester, may lead to an increase in the rate of preterm birth.
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Background: Diabetic Pregnant women with hypothyroidism are associated with adverse obstetric outcome with various maternal and fetal complications. The aim of this study was to evaluate hypothyroidism in diabetic pregnancy and its effect on maternal and fetal outcome. Material & Methods: This cross-sectional study was conducted in department of Obstetrics and Gynaecology, Women & Children Hospital, NHN, Uttara, Dhaka, Bangladesh, during the period from 13th February 2020 to 9th December 2021. Total 120 pregnant women with diabetes were included in this study. All patients were divided into two groups which include- Group A: 60 pregnant women with diabetes and Group B: 60 pregnant women with diabetes and hypothyroidism. Results: Mean age was 29.3 years (SD±4.9 years) in group A and 29.9 years (SD±6.1 years) in group B. Mean TSH was 2.2 ?IU/ml (SD±1.7 ?IU/ml) and in group A and 4.4 ?IU/ml (SD±3.0 ?IU/ml) in group B. Mean TSH was higher in group B than group A with statistically significantly difference (p< 0.0001). Most of the pregnant women had lower uterine cesarean section in both group A (51.7%) and in group B (68.3%) with statistically significant difference (p=0.0409) between the groups. The commonest maternal complication was fetal distress in both group A (13.3%) and in group B (16.7%). Most of the neonates had normal weight in both group A (83.3%) and group B (78.3%). Majority of the neonates had normal Apgar score in one minute in both group A (50%) and group B (58.3%). The Apgar score in 5 minutes was also normal in most of the neonates of both group A (71.7%) and group B (78.3%). The neonatal mortality rate in group B was 1.7%. The commonest fetal complication was low birth weight in both group A (16.7%) and in group B (21.7%). There was no statistically significant (>0.05) difference among both groups in neonate’s outcome. Conclusion: Fetal distress and preeclampsia are most common complication in diabetic pregnant women with hypothyroidism. For neonates, low birth weight, hypothyroidism and respiratory distress are commonly seen. There is higher death rate of neonates in diabetic pregnant women with hypothyroidism. Majority of the pregnant women needed lower uterine cesarean section for the complications.
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Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. Aim and Objective: The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight. Methods: The study was conducted in antenatal women attending antenatal outpatient department of of Obstetrics and Gynecology in a teriary care referral hospital in Mumbai. Results recorded in simple percentages. Results: Eighteen percent cases developed gestational diabetes mellitus during their antenatal period and 15% developed gestational hypertension. 44% patients underwent lower segment caesarean section. The need for induction of labour and caesarean section was found to be 37% which is significantly higher. Increased NICU admissions due to hypoglycemia or congenital malformations,prematurity was found to be on a higher side. Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.
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Background: Referral is a crucial aspect of emergency obstetric care in India. Adequate and timely referrals help to improve the quality of health‑care services and maternal and child well‑being. Objectives: Studies are needed to assess the outcome of obstetric mothers’ emergency admissions in relation to referral patterns. Materials and Methods: A hospital‑based cross‑sectional descriptive study was done among obstetric patients admitted to a tertiary care hospital’s emergency department (emergency medical service [EMS]). Aretrospective cohort was analyzed. The data were entered in Epicollect5 and imported to STATA software version 16 for analysis. Results: A total of 685 mothers admitted to EMS were selected for the study, with a mean (standard deviation) age of 26.5 years (4.2). Among the study participants, 181 (26.4%) were referred from other institutions, 382 (55.8%) were nonreferral who received antenatal checkups in the tertiary hospital, and 122 (17.8%) were self‑referral who had not received any antenatal checkup in the tertiary hospital. The adverse fetal outcome was 1.88 (1.21–2.95) times higher in the referred mothers compared to the self‑referral. Conclusion: We observed that a higher percentage of referrals were from the primary health centers. This kind of direct referral to tertiary care hospitals can be avoided by availing the emergency obstetric services at secondary hospitals to prevent adverse fetal outcomes and unnecessary referrals to the tertiary hospital.
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Background: Raised body mass index (BMI) and excessive gestational weight gain (GWG) are important determinants in development of gestational diabetes.Methods: A prospective, observational study carried out on antenatal women since their first trimester. These women were screened for gestational diabetes mellitus (GDM) by diabetes in pregnancy study group of India (DIPSI) criteria. All participants were followed up by measuring their BMI, weight gain, blood sugars in every trimester. Also, data was collected regarding any adverse outcomes.Results: Among all participants, 16.8% were diagnosed as GDM. 44% women of study group had weight gain beyond Institute of Medicine (IOM) recommendations. Higher risk of GDM was observed in women with raised BMI and excessive GWG. Also, odds of preeclampsia, preterm deliveries, caesarean section, macrosomia, intrauterine fetal death, neonatal intensive care unit (NICU) admissions were higher in women with GDM.Conclusions: Compliance of recommended weight gain during pregnancy have a strong impact on the fetal outcome. Amount and timing of weight gain plays a crucial role in GDM.
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Background: Thyroid disorder is often overlooked in pregnant women this is because of nonspecific symptoms and hyper metabolic state of normal pregnancy. To evaluate the thyroid function in pregnant women in all the three trimesters and to study their impact on pregnancy outcome.Methods: A prospective study in 200 randomly selected antenatal cases was carried out during a period of two years in a tertiary care medical college in Western Maharashtra. A detailed general and systemic examination was carried out and Thyroid stimulating hormone (TSH) was done in all cases. Any case with an abnormal TSH level was further tested for T3 T4 levels.Results: The mean TSH level was 1.6 µIU/l which was less than the standard cut off of 2.5 µIU/l. 61% had decreasing level of TSH with advanced gestation. An abnormal thyroid function was seen in 8.5% cases.Conclusions: Standardization of TSH, T3, T4 is still a concern as it varies significantly in different studies. Estimation of TSH with T3 T4 could not be correlated during pregnancy with advancing gestational age. The real impact of hypo/hyperthyroidism on fetal outcome could not be statistically established.
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Background: Caesarean sections performed in the second stage of labour are difficult and have many implications on both mother and baby. This study was conducted to analyse fetal and maternal outcome in case of caesarean section at full cervical dilatation.Methods: This prospective study was conducted at one of tertiary care teaching institute for period of 1st August 2019 to 31st January 2020. It includes all women delivered by caesarean section at full cervical dilatation at study institute during study period. Cases were looked for parity, maternal age, gestational age, baby birth weight, indication of cesarean section and associated factors.Results: Out of total 3657 deliveries 1690 were delivered by caesarean section, out of which 65 (3.8%) caesarean sections were conducted at full cervical dilation. The most common indication of caesarean section was deep transverse arrest in 66.15% of cases. The maximum number of cases (69.23%) were seen between the age group of 20 to 25 years. Majority of second stage cesarean section (70.77%) were performed in primi gravida. 80% of caesarean sections at full cervical dilatation were performed after 37 weeks of gestation. 15.38% of patients had anemia, 20% had hypertension, 4.61% had history of previous caesarean section. Baby weight at time of birth was 2.5 to 3.5 kg in 67.70% of cases. 15.38% of patients required blood transfusion.Conclusions: A skilled obstetrician is required to take timely and proper decision in such cases and also to conduct cesarean section at second stage of labour.
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Background: There is a growing concern about the high prevalence of vitamin D deficiency and its relationship with variety of diseases worldwide. The objective of this study was to determine the prevalence of vitamin D deficiency and its association with pregnancy outcome.Methods: This was a cross sectional study conducted among 150 antenatal women from October 2014 to April 2015. Data containing socio-demographic details, vitamin D level, serum calcium, pregnancy complications and growth situation of newborns were collected and analyzed.Results: A total 150 pregnant women participated in the study, 75.3% were vitamin D deficient, 22.1% vitamin D insufficient and 2.6% normal. There was no significant adverse maternal outcome. NICU admission was required in 28.3 and 15.2% in the vitamin D deficient and insufficient groups respectively.Conclusions: Women from different socioeconomic status, irrespective of parity and educational levels had vitamin D deficiency and insufficiency. This study fails to show a relation of vitamin D deficiency with other high-risk factors of pregnancy and does not show any adverse fetal outcome.
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Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.
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Resumen OBJETIVO: Describir los desenlaces maternos y perinatales en embarazadas de edad avanzada. MATERIALES Y MÉTODOS: Estudio de dos cohortes, prospectivo y retrospectivo efectuado con base en la información de expedientes clínicos de pacientes atendidas en el Complexo Hospitalario Universitario de Ourense entre 2017 y 2018. Se establecieron dos cohortes: la cohorte A con edad mayor o igual a 40 años y la cohorte B con edad menor de 40 años. Se realizaron pruebas paramétricas y no paramétricas para determinar la asociación potencial entre las variables de estudio (χ2, t de Student, U de Mann-Whitney). RESULTADOS: Las pacientes de la cohorte A (n = 207) tuvieron significación estadística: índice de masa corporal mayor al inicio del embarazo (p = 0.028), mayor cantidad de embarazos previos (p = 0.001), a expensas de mayor cantidad de abortos (p < 0.001), estados hipertensivos del embarazo (p = 0.03), prematurez (p = 0.009), retraso en el crecimiento intrauterino (p = 0.006), macrosomía fetal (p = 0.04), inducciones (p < 0.001), cesáreas programadas o intraparto y hemorragia posparto (p = 0.001). No se encontraron diferencias en la paridad, amenorrea al parto, diabetes pregestacional-gestacional, peso fetal medio, Apgar, pH de la arteria umbilical y cantidad de recién nacidos con requerimiento de ingreso a la unidad de Neonatología. CONCLUSIONES: La edad materna avanzada es un factor de riesgo importante de morbilidad materna y perinatal. La mayor tasa de complicaciones descritas refleja la importancia del control exhaustivo del embarazo y vigilancia periparto minuciosa.
Abstract OBJECTIVE: To describe the maternal and perinatal results in pregnant women with advanced age. MATERIALS AND METHODS: A cohort study was conducted with prospective follow-up and retrospective data collection of the Clinical History of the University Hospital Complex of Ourense between 2017 and 2018. Two cohorts were established, cohort A with age greater than and equal to 40 years and the cohort B with age under 40 years. Parametric and non-parametric tests were performed to determine the potential association between the study variables (Chi-Square, Student's T, Mann-Whitney U). RESULTS: The cohort A patients (n = 207) presented with statistical significance: body mass index higher at the beginning of pregnancy (p = 0.028), higher number of previous pregnancies (p = 0.001), but at the expense of a higher number of abortions (p <0.001), hypertensive states of pregnancy (p = 0.03), prematurity (p = 0.009), intrauterine growth retardation (p = 0.006), fetal macrosomia (p = 0.04), inductions (p < 0.001), of both scheduled and intrapartum caesarean sections and postpartum hemorrhage (p = 0.001). No differences were found in parity, amenorrhea at delivery, pregestational / gestational diabetes, mean fetal weight, Apgar score, umbilical artery pH and number of newborns who required admission to the Neonatal Unit. CONCLUSIONS: Advanced maternal age is an important risk factor for maternal and perinatal morbidity. The higher rate of complications described reflects the importance of thorough pregnancy control and careful peripartum surveillance.
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Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.
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Background: First trimester bleeding is one of the common complications during pregnancy which affects almost 16-25% of all pregnancies. To evaluate and ascertain the adverse maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding.Methods: Prospective case-control study. A case control study involving 60 pregnant women with vaginal bleeding in the first 13 weeks + 6 days of gestational age with 60 matched controls. The study period was from March 2015 to March 2016 and conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu.Results: The complications seen in the study group were: first trimester abortion (16.7%), second trimester abortion (6.7%), preterm labour (25%), abruption (6.7%), neonatal intensive care admission (25%), ectopic (6.7%), IUGR (10%), IUD (1.7%) and PROM (8.3%). When compared with the parity matched controls there was statistically significant increase in first and second trimester abortions, preterm labour, abruption, NICU admission and ectopic pregnancy whereas there was no significant difference between the two groups with regard to intrauterine growth restriction (IUGR) and intrauterine death (IUD).Conclusions: Women with first trimester vaginal bleeding had several adverse outcomes in both the mother and the fetus, and it is very important to explain about the possibility of these outcomes and ensure proper follow up with close antenatal surveillance.
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Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.
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Background: Preeclampsia (PE) is a pregnancy specific,hypertensive disorder. It affects 2-8% pregnancies.Oxidative stress and systemic inflammation areproposed to contribute significantly to the preeclampsiapathophysiology. The present study, aim is to determineand compare the markers of oxidative stress, endothelialdysfunction, systemic inflammatory markersNeutrophil/Lymphocyte Ratio (NLR) and Platelet/Lymphocyte Ratio (PLR) in preeclampsia andgestational age matched healthy controls. Material andMethods: This study was conducted in the Departmentof Biochemistry and Department of Obstetrics andGynecology, Sri Devaraj Urs Medical College, Kolar,Karnataka. The study included 98 preeclamptic womenand 98 normotensive pregnant women. Five ml venousblood was collected from all the study subjects. Bloodsample in EDTA vials was used for the complete bloodcount. NLR and PLR were calculated. Plasma was usedfor Ferric Reducing Ability of Plasma (FRAP) assay.Serum was used for the estimation of Malondialdehyde(MDA), nitric oxide, blood sugar, renal parameters andliver enzymes i.e., Aspartate Transaminase (AST),Alanine Transaminase (ALT), Lactate Dehydrogenase(LDH) and magnesium. Corresponding urine sampleswere collected for urinary protein analysis by dipstickmethod. Fetal outcome was recorded. Results:Gestational age was significantly low in preeclampticwomen as compared to those of controls. Bloodpressure (Systolic and diastolic), mean arterial pressure,body mass index, pulse rate, serum creatinine, uric acid,AST, ALT, LDH, MDA and NLR were increasedsignificantly in preeclamptic women as compared tothose of controls. In subgroup analysis, NLR wasincreased significantly in severe preeclamptics ascompared to mild preeclamptics. Serum Nitric Oxide(NO) and FRAP levels were decreased significantly inpreeclamptic women as compared to those of controls.Significantly decreased birth weight was observed inbabies born to preeclamptic mothers compared withcontrols. Conclusion: The present study resultsconclude that increased oxidative stress in termsincreased MDA, decreased NO and reduced antioxidantstatus (FRAP) in preeclamptic women, results inadverse perinatal outcome. In addition, maternal NLRcould be considered as a marker for severity ofpreeclampsia
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Background: Emergency LSCS can be categorized based on RCOG guidelines into category I and II which indicates maternal or fetal compromise. Here an urgent delivery and the DDI (decision to delivery interval) within 30 and 45 minutes respectively is needed.Methods: This is a retrospective cross-sectional analysis conducted on a sample of 630 patients who underwent caesarean section over a year, from June 2016 to June 2017. The DDI were further classified into ≤30 and >30 minutes for category I, ≤45 and >45 minutes for category II LSCS. The primary objective is to determine whether DDI in Category I and II emergency LSCS has an impact on fetal outcome and secondary objective is to ensure that DDI is within the standard criterion as per RCOG protocol.Results: Out of 630 samples of caesareans, it was found that 173 falls in Category I and 189 falls in Category II. Out of 87 (50.29%) patients delivered within 30 minutes in Category I, 29 babies required NICU admission. DDI was more than 30 minutes in 86 (49.71%) cases in Category I out of which 38 babies got admitted in NICU with low APGAR scores. Out of 176 (93.12%) patients who delivered within 45 minutes in Category II, 56 babies required NICU admission. DDI was more than 45 minutes in 13 (6.88%) cases in Category II and all these babies got admitted in NICU.Conclusions: Decision -delivery interval has a significant impact on fetal outcome.
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Background: Diabetes is the most common medical complication of pregnancy. Vitamin D deficiency which was initially considered only to influence bone metabolism, is now known to exert a wide spectrum of extra-skeletal effects. Vitamin D deficiency is closely associated with gestational diabetes mellitus, it also leads to adverse maternal and child outcome. Objective of this study was to compare the vitamin D levels in healthy pregnant women and women with gestational diabetes mellitus and to observe the feto-maternal outcome.Methods: This prospective study was carried out on 160 pregnant women between the age group 20-40 years attending the Obstetrics and Gynaecology department of JNMC, AMU, Aligarh from October 2016 to October 2018. Women were divided into group A- normal pregnant women and group B- women with GDM. Estimation of vitamin D was done in both the groups.Results: Mean vitamin D levels were lower in women with GDM as compared to normal pregnant women.Conclusions: Women with vitamin D deficiency have an increased risk of developing GDM and adverse feto maternal outcome as compared to those who had normal level of vitamin.
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Background: Amniotic fluid is an indicator of placental function on the fetal development. It is regulated by several systems, including transmembraneous pathway, fetal production (fetal urine and lung fluid) and uptake (fetal swallowing), and the balance of fluid movement via osmotic gradients. The amniotic fluid index is the most commonly used method of measuring amniotic fluid. An AFI between 5 to 8 cms is borderline oligohydraminos. To compare the fetal and maternal outcome in pregnancies with borderline amniotic fluid index (5 to 8 cms) and normal AFI.Methods: This prospective cohort study was carried out on 94 pregnant patients attending the antenatal clinic of MES Medical College, Perinthalmanna between January 1st and December 31st 2016. Women with a singleton pregnancy in the third trimester were enrolled into the study. Of these 47 cases were in the normal AFI group and 47 cases in the borderline group. Adequate information was obtained from the patient’s medical record and the groups were compared on maternal and fetal complications.Results: The study results showed that more cases with borderline AFI had their non stress test to be nonreactive (59.6% versus 23.4%) and was associated with more fetal heart rate abnormalities (51% versus 17%). The number of meconium stained amniotic fluid (48.9% versus 19.1%) and caesarean deliveries (51.1% versus 21.2%) were also more among the borderline group.Conclusions: Findings indicated that there are more adverse fetal and maternal outcome among the borderline AFI group.
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Background: There has been a rising incidence of pregnancy complicated by heart disease in India. The importance of heart disease in pregnancy lies in its high morbidity and mortality in both maternal and fetal outcomes combined with lack of enough established guidelines in its management.Methods: A study was done in department of obstetrics and gynaecology, KEM hospital, Mumbai from January 2016 to April 2017 retro prospectively studying the different manifestations of heart disease in pregnancy and the maternal and fetal outcomes.Results: During the study period, there were 6500 deliveries in the study center and of them 135 presented with heart disease. Of the 135 cases observed, 100 cases came under the inclusion criteria and were included in the study. The incidence of heart disease in pregnancy in the current institute is 2%. In the 100 cases, 55% were seen to have Rheumatic heart disease, 32% with cyanotic and acyanotic congenital heart disease and 13% with other conditions such as peripartum cardiomyopathy and mitral valve prolapse. Maternal outcome shows 44 patients delivered vaginally, 21 by assisted vaginal delivery and 35 required caesarean section. Maternal adverse cardiac events comprised of heart failure seen in 11 cases, ICU admissions required in 14 patients and maternal mortality in one case. Neonatal outcome comprised of 31 preterm births, still births 2, low birth weight seen in 41 and 16 needing NICU admissions.Conclusions: Early diagnosis and prompt management with a multidisciplinary approach is fundamental in managing a case of heart disease in pregnancy.
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Background: Induction of labour is an iatrogenic deliberate attempt to terminate the pregnancy in order to achieve vaginal delivery in cases of valid indication. It should be carefully supervised as it is a challenge to the clinician, mother and the fetus. Aim of this study was to find out common indications for IOL in a tertiary care teaching centre and its feto-maternal outcome.Methods: An institutional based retrospective observational study was conducted to describe the prevalence of labour induction and factors associated with its outcome, during the time-period of one year from January 2018 to December 2018, at SRMS IMS, Bareilly. Logistic regression analysis was employed to assess the relative effect of determinants and statistical tests were used to see the associations.Results: Most of the patients were primigravidas of younger age-group. Idiopathic oligohydramnios and postdatism were the commonest indications for induction of labour and Misoprost was the commonest drug used for it. Though majority had vaginal delivery, as the method was changed to combined method it was significantly associated with increased likelihood of LSCS. Similarly there was increased association with maternal cervico-vaginal tear / lacerations as the method was changed to combined type. However there were no association between post-partum hemorrhage, meconium stained liquor or fetal distress.Conclusions: Common indications for induction of labour were oligohydramnios and postdatism. Misoprost can be safely used for induction of labour without any increased risk for LSCS or any fetal / neonatal risks.