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Background: Autoimmune disorders are chronic multisystem disorders affecting women of their reproductive age. Pregnancy among these women is complicated by the disease itself. Flaring up of disease, uteroplacental insufficiency due to vasculitis and drugs used for treatment are main reason for unfavourable pregnancy outcomes. The objective of this study was to analyze the pregnancy complications and outcome among 113 cases of autoimmune disorders.Methods: This study is a retrospective analysis of case records of pregnant women with autoimmune disorders. This study was conducted at PSG IMSR and Hospital, Coimbatore, and Tamil Nadu from July 2012 to June 2018. The case sheets were retrieved from medical record department and the details such as type of disease, maternal age, parity, status of disease at conception, treatment taken during pregnancy, maternal complications and fetal complications were collected and analyzed.Results: During 6-year period there were 113 pregnant women with autoimmune disorders, and they were studied of their previous and present pregnancy outcome. The disease incidence was 7.01% per 1000 deliveries. 40.7% were less than 25 years age group and 71.6% were multigravidae. We had forty-one patients (36%) who were positive for APLA syndrome which were the maximum number of patients with auto immune disorder in pregnancy and 37 patients (32.7) with SLE. We had significant numbers of maternal and fetal complications for common disorders. Most of the rare auto immune disorders were diagnosed before pregnancy and these pregnancies were managed by multi-disciplinary approach, and continued on immunomodulators throughout pregnancy, hence maternal and fetal complications were less for them.Conclusions: Adequate pre-conceptional counseling, vigilant monitoring during pregnancy and post-partum will avoid pregnancy related complications and have favorable outcomes.
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Background: Thyroid diseases are one of the commonest endocrine disorders affecting women of reproductive age group, and hence constitute one important disorders complicating pregnancy. The objective of this study was to determine the importance of universal screening for hypothyroidism in pregnancy at the first antenatal visit and to formulate whether this routine screening is mandatory in our country.Methods: This retrospective study was conducted in the year 2018 at PSG IMSR Hospital for all pregnant women who attended the first antenatal visit between Jan 2012 to Dec 2012 after obtaining ethical clearance. Pregnant women who were already taking treatment for hypothyroidism, diabetes mellitus, hypertension and those pregnant women who lost their follow up were excluded from the study.Results: The incidence of subclinical hypothyroidism among antenatal women were 7.06%. In our study the maternal complications like anemia 12 (8%), preeclampsia 26 (17.3%), gestational diabetes 25 (16.7%), fetal growth restriction 8 (5.3%), Oligohydramnios 13 (8.7%), pre mature rupture of membranes 25 (16.7%), placental abruption in 2 (1.33%), APLA syndrome 2 (1.33%), low birth weight 26 (17.3%) were observed.Conclusions: Universal screening for hypothyroidism is recommended for all antenatal women especially in iodine depleted country like India.
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Background: The objective was to evaluate the outcome of late second trimester emergency cerclage in patients with advanced cervical dilatation with bulging membranes. Methods: Setting: department of obstetrics and gynaecology, PSG Institute of medical sciences & research, Coimbatore, Tamil Nadu, India. This is a retrospective study of case files of patients who underwent emergency late second trimester cerclage for advanced cervical dilatation with bulging membranes between January 2009 to January 2014. McDonald’s technique was used in all the cases. Results: Altogether, 7 patients (100%) underwent late second trimester emergency cerclage between 20-28 weeks of gestational age, out of which three patients (42.86%) had term deliveries (>37w), and 3 patients (42.86 %) carried on their pregnancies to more than 32 weeks resulting in healthy live born babies. Two of them delivered by normal vaginal delivery, 4 underwent LSCS, and one patient had severe abdominal pain with bleeding and draining per vaginum after 3 days of cerclage, in view of which the stitch was removed. Subsequently, the patient expelled a live foetus weighing 620gms, which died in the Neonatal Intensive Care Unit (NICU) after 3 hours. This procedure prolonged the duration of pregnancy in all patients with a mean duration of 70.4 days. The mean gestational age at the time of delivery was 34.33 weeks. The mean birth weight was 2.18 kg and ranged between 1.97 to 2.64 kg. The mean APGAR at one minute was 8/10 and the mean duration of stay in NICU was 1.66 days. All the new-born babies were healthy at the time of discharge. The live birth rate following emergency late second trimester cerclage in this series was 85.75%. Conclusion: Favourable neonatal outcome can be accomplished in patients with cervical incompetence in the second trimester of pregnancy following emergency cervical suturing, even if performed when the membranes are bulging through the cervix.
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Background & objectives: As adult dengue fever increases it also affects women with pregnancy. Dengue fever is mainly treated conservatively. However, complications like pre-eclampsia, pre-term labour, increased risk of caesarean section and fetal transmission have been noted. During dengue epidemic in our region we noted many women with dengue fever and observed certain different problems. Methods: A retrospective analysis of all pregnant women admitted in obstetric ward with dengue fever over a period of 18 months was done. Results: The striking feature observed was the presence of severe thrombocytopenia in 78.57% of the study population. In addition, coexistence of other vector borne diseases was also noted. Conclusion: Most cases only require conservative treatment. Only women who went into labour required platelet transfusion. Outcome seemed to correlate with gestational age of occurrence of dengue fever.