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Background: Ovarian cancer stands as the daunting third most prevalent cancer among females. The aim of this study is to assess the clinical epidemiology, treatment patterns (including end-of-life care), and survival outcomes among patients diagnosed with epithelial ovarian cancer.Methods: This retrospective analysis encompassed all patients diagnosed with epithelial ovarian cancer and enrolled at the tertiary cancer center, IGMC Shimla in Himachal Pradesh. The study included patients registered between January 2014 and December 2018, spanning all age groups.Results: During the aforementioned period, ovarian cancer accounted for 18.7% of gynaecological cancers among females out of which epithelial ovarian cancer accounted for 14.8% of the cases. The median age of patients diagnosed with epithelial ovarian cancer (EOC) was 54.5 years. Most patients hailed from Shimla, followed by Mandi and Kullu districts, among the twelve districts in the state of Himachal Pradesh. The majority of patients were diagnosed at advanced stages FIGO III and IV, comprising a total of 77.1%. Chief complaints included abdominal pain, followed by abdominal distention, heaviness, or bloating. The median duration of follow-up was 27 months (with a standard deviation of ±9.175). The median overall survival (OS) for stage I, II, III, and IV was 92.59 months, 87 months, 82.17 months, and 52.5 months, respectively, and these differences were statistically significant.Conclusions: Ovarian cancer patients are often diagnosed in advanced stages III and IV, primarily due to late diagnosis and the presence of vague symptoms. Achieving optimal cytoreduction significantly improves overall survival. Therefore, it's crucial to raise awareness among general physicians in rural healthcare settings and the public about the symptoms of ovarian cancer to facilitate early detection. Additionally, there's a notable deficiency in end-of-life discussions and palliative care management, which should be accessible to every patient.
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Background: The aim of the study was to compare the efficacy and safety of novel once-daily extended-release (ER) dydrogesterone 20 mg versus conventional twice-daily dydrogesterone 10 mg in Indian patients with endometriosis.Methods: A phase III prospective, randomized, double-blind, single-dummy, two-arm, active-controlled, parallel, multicenter study was performed in six gynecology centers across India. The patients of 18 to 45 years of age with a confirmed diagnosis of endometriosis on ultrasonography (USG) and having endometriosis-associated pelvic pain score (EAPP) of at least 30 mm on a 100 mm visual analog scale (VAS) were randomly assigned to a 1:1 ratio to either once-daily dydrogesterone ER 20 mg or twice-daily dydrogesterone 10 mg arms for a treatment period of 90 days. The primary outcome was a change from baseline in EAPP score at the end of the treatment.Results: A total of 228 patients with a mean age of 31.8±6.9 years were enrolled in the study. At day 90, both the treatment arms showed a significant reduction (p<0.05) in EAPP score from baseline (i.e. -34.2±15.3 mm and -33.1±14.8 mm in once daily dydrogesterone ER and twice daily dydrogesterone 10 mg, respectively), with no significant difference between the two arms (p=0.53). With both formulations, patients experienced a significant reduction in the size of endometrioma, serum vascular endothelial growth factors (VEGF) levels, use of rescue analgesics, and significant improvement in the health-related quality-of-life parameters. A favorable safety profile of dydrogesterone was confirmed, and no significant safety concerns were reported during the study.Conclusions: Once daily dydrogesterone ER 20 mg and twice daily dydrogesterone 10 mg demonstrated a significant and similar reduction in EAPP and all other secondary parameters along with marked improvements in parameters related to quality of life.
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Background: AUB accounts for 70% of gynecological pathology. Prevalence of AUB is 3%-30% among reproductive aged women. Early diagnosis by endometrial biopsy is the most effective way to rule out malignancy in peri-menopausal women with AUB. TVS can be used as an aided diagnostic tool. Aims and objectives of this study is to evaluate endometrial causes of abnormal uterine bleeding in perimenopausal women and to correlate transvaginal sonography findings with histopathology by endometrial biopsy.Methods: This prospective observational study was conducted on 80 perimenopausal women with abnormal uterine bleeding. Uterine pathology, endometrial thickness, was assessed by TVS. Endometrium was considered hyperplastic if thickness is ?10 mm in perimenopausal women and was taken up for endometrial sampling. Endometrial biopsy by Pipelle’s curette was done as an outpatient procedure and sent for HPE.Results: Total of 80 women with perimenopausal bleeding were examined during the study. Majority of the patients with AUB presented in 40-44 years age group and belonged to second parity. As per the TVS findings, 42 (52.5%) subjects had normal findings, 25 (31.3%) showed endometrial hyperplasia and remaining had other benign uterine pathology. Majority of women had ET 10 mm. The most common finding on histopathological examination was Proliferative endometrium.Conclusions: Trans vaginal scan when incorporated along with bimanual pelvic examination and Pipelle’s aspiration can enhance our anatomic diagnosis. This study proves that transvaginal findings correlate well with the histopathology findings.
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Abstract Objective Despite an increase in the rate of successful live donor renal transplantation done annually, the number of potential recipients with acceptable donors is relegated to the ever-expanding cadaver-donor waiting list due to sensitization to human leukocyte antigen (HLA) antibodies. If not sufficiently suppressed, these preformed HLA antibodies can trigger antimicrobial resistance (AMR) and early graft loss. To ameliorate this situation, various desensitization treatments are administered to provide a survival benefit to highly sensitized patients. Method One hundred and six patients in the time frame of January 2017 to March 2019 were included in the study group. The desensitization protocol included therapeutic plasma exchange and administration of low-dose intravenous immunoglobulin (100 mg/kg per therapeutic plasma exchange (TPE) session) to highly sensitized patients (treatment group) who subsequently underwent renal transplantation after negative pre-transplant Centers for Disease Control and Prevention Luminex crossmatch (CDC/LumXM). We compared graft survival rates between the group undergoing desensitization (treatment group) and matched control group of patients that underwent HLA-compatible transplantation. Results In the treatment group, Kaplan-Meier analysis estimates an average rate of patient graft survival of 95.2% at 3 years post-transplant, as compared with the rate of 86.9% in the same time frame for the control-matched group (p < 0.05 for both comparisons). Conclusion Desensitization treatment with TPE before live donor renal transplantation in the case of patients with HLA sensitization provides better survival benefits along with monitoring for donor-specific antibodies (DSAs) and other infections, rather than waiting for a compatible organ donor. The data lays out evidence that desensitization treatments can assist overcome HLA incompatibility barriers in live donor renal transplantation.
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HistocompatibilidadRESUMEN
@#Mass of the vulva include both benign and malignant lesions. Benign mass lesions of the vulva include tumors, hamartomas, cysts, infectious disorders, and non-neoplastic epithelial disorders. Some are rare mass lesions. Here, we presented three rare mass lesions of the vulva. The first case presented with the complaint of vulvar lesion since childhood, while the two cases presented in reproductive age and perimenopausal age. All three cases presented as mass lesions in the vulva with pain or uneasiness during work. In all these cases, excision was done. On histopathological examination, the lesions have different diagnoses which are common in other parts of the body, but rarely present at the vulva. A definitive diagnosis of a vulvar mass lesion is difficult to make, especially in the case of rare mass lesion. Histopathology is the principal tool of diagnosis.
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Linfangioma , FibroadenomaRESUMEN
In the realm of cancer diagnostics, imaging and therapeutics, nanocarrier-based drug delivery systems have gained extensive importance owing to their promising attributes and potential to enhance therapeutic effectiveness. The primary area of research revolves around formulating innovative intelligent nanocarriers such as nanoparticles (NPs) which are capable of selectively responding to cancer-specific conditions and efficiently delivering medications to target cells. These nanocarriers, whether operating in a passive or active manner, can transport loaded therapeutic cargos to the tumor site while minimizing drug elimination from the drug delivery systems. This review primarily focuses on presenting recent advancements in the development and utilization of nanoparticles in the treatment of various cancer types, such as pancreatic cancer, prostate cancer, colorectal cancer, cervical cancer, and breast cancer.
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A field investigation to ascertain the response of rice varieties at varying nitrogen level was conducted at Crop Research Farm, Department of Agronomy, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, U.P, during the Kharif – 2022 with nine treatments replicated thrice in randomized block design, which consists of three rice varieties (NDR-359, Sahbhagi Dhan, BPT-5204) and three nitrogen levels (100, 120, 140 kg ha-1). The results revealed that application of nitrogen 120 kg ha-1 in Sahbhagi Dhan recorded significantly higher plant height (146.20 cm), dry weight (103.77 g hill-1), grain yield (4.27 t ha-1) and straw yield (7.23 t ha-1), maximum gross returns (1,00,166.70 INR ha-1), net returns (60,185.92 INR ha-1) and benefit cost ratio (1.52). However, number of tillers hill-1 (30.87), number of productive tillers hill-1 (8.93), number of grains panicle-1 (115.87) and harvest index (38.71%) were recorded significantly higher in BPT-5204 with nitrogen 120 kg ha-1.
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Background: In this study, we compared ophthalmic artery Doppler indices between normotensive and hypertensive pregnant women in third trimester and then evaluated if the alterations in ophthalmic artery doppler indices were seen in all the types of hypertensions in pregnancy or confined to preclaampsia. Further we tried to see correlation of ophthalmic artery Doppler indices with perinatal outcomes in terms of fetal growth restriction (FGR), prematurity, neonatal intensive care unit admission (NICU) and maternal outcomes and tried to arrive at mean values of ophthalmic artery Doppler indices to predict adverse outcomes.Methods: 50 hypertensive and 50 normotensive pregnant women were recruited in third trimester. A thorough history about hypertension was taken, obstetric scan was done to know estimated fetal weight, and doppler of umbilical, middle cerebral artery, uterine arteries was done. Simultaneously maternal ophthalmic artery Doppler readings were taken, women were followed up after delivery and perinatal outcomes were recorded.Results: Comparison of mean values of ophthalmic artery doppler parameters in women with and without hypertension showed statistically significant differences with respect to the peak systolic velocity 2 (PSV2), PI (pulsatility index), RI (resistivity index) and peak ratio (PR) (PR=PSV2/PSV1). Significant difference was found only in PR value in preeclampsia group compared to other subgroups of hypertension. In the hypertension group complicated with FGR the mean peak ratio=0.8 whereas in the hypertension group requiring preterm delivery the mean peak ratio=0.78, and in the hypertension group requiring NICU admission the mean peak ratio=0.81. At ophthalmic artery PR cut off ?0.725, the sensitivity and specificity were 76% and 65% respectively to predict FGR.Conclusions: Pregnancy complicated by hypertension showed alterations in ophthalmic artery Doppler indices. Among the subgroups of hypertension, ophthalmic artery PR was the best index for discriminating preclampsia from other types and it was significantly higher in hypertensive pregnant women who had adverse perinatal outcomes. Ophthalmic artery PR has almost similar performance as uterine artery PI in indicating FGR in our study. It could also indicate maternal disease severity such as hypertensive crisis requiring ICU admission, the study number was small.
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Background: In this study, we compared ophthalmic artery Doppler indices between normotensive and hypertensive pregnant women in third trimester and then evaluated if the alterations in ophthalmic artery doppler indices were seen in all the types of hypertensions in pregnancy or confined to preclaampsia. Further we tried to see correlation of ophthalmic artery Doppler indices with perinatal outcomes in terms of fetal growth restriction (FGR), prematurity, neonatal intensive care unit admission (NICU) and maternal outcomes and tried to arrive at mean values of ophthalmic artery Doppler indices to predict adverse outcomes.Methods: 50 hypertensive and 50 normotensive pregnant women were recruited in third trimester. A thorough history about hypertension was taken, obstetric scan was done to know estimated fetal weight, and doppler of umbilical, middle cerebral artery, uterine arteries was done. Simultaneously maternal ophthalmic artery Doppler readings were taken, women were followed up after delivery and perinatal outcomes were recorded.Results: Comparison of mean values of ophthalmic artery doppler parameters in women with and without hypertension showed statistically significant differences with respect to the peak systolic velocity 2 (PSV2), PI (pulsatility index), RI (resistivity index) and peak ratio (PR) (PR=PSV2/PSV1). Significant difference was found only in PR value in preeclampsia group compared to other subgroups of hypertension. In the hypertension group complicated with FGR the mean peak ratio=0.8 whereas in the hypertension group requiring preterm delivery the mean peak ratio=0.78, and in the hypertension group requiring NICU admission the mean peak ratio=0.81. At ophthalmic artery PR cut off ?0.725, the sensitivity and specificity were 76% and 65% respectively to predict FGR.Conclusions: Pregnancy complicated by hypertension showed alterations in ophthalmic artery Doppler indices. Among the subgroups of hypertension, ophthalmic artery PR was the best index for discriminating preclampsia from other types and it was significantly higher in hypertensive pregnant women who had adverse perinatal outcomes. Ophthalmic artery PR has almost similar performance as uterine artery PI in indicating FGR in our study. It could also indicate maternal disease severity such as hypertensive crisis requiring ICU admission, the study number was small.
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An experiment was conducted with wheat genotypes NWL-14, K-9162, NWL-1014, NWL-12-2, NWL-12-4, NWL-10-4, K-910-30, NWL-4035, DBW-16, DBW-187, NWL-12 (3) T, Halna, HD-2967 to evaluate heat tolerant in wheat at instructional farm and in the laboratory of Crop Physiology & Plant Molecular Biology and Genetic Engineering, Acharya Narendra Deva University of Agriculture and Technology, Kumarganj, Ayodhya, India, during rabi season of 2021-2022. Heat stress was induced by delayed sowing 45 days from normal date of sowing (02 December 2022)-(17 January 2023) so that delay sown wheat genotypes could experience heat stress at reproductive stage. Heat tolerant wheat genotypes screened on the basis of Relative Water Content, Catalase activity, plant height, tiller number, number of grains per spike, test weight and grain yield per plant over control under heat stress condition. Heat stress reduces the the growth and yield irrespective of wheat genotypes but heat tolerant genotypes Halna, NWL-1293)T, NWL 10-2 and NWL-12-4 showed less reduction over susceptible ones. Relative water content, proline and catalase activity can be used as a physiological screening indices for heat tolerant genotypes.
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This study conducted in Kerala, evaluated the role of conservation tillage (zero tillage (ZT), minimum tillage (MT), and conventional tillage (CT)) with five treatment combination of potassium (12 kg/ha, 20 kg/ha, 40 kg/ha) and magnesium sulphate (60 kg/ha and 80 kg/ha) on total DMP, physiology and grain yield of the test variety Anaswara (cowpea). In pot culture study, application of K: MgSO4, 10:80 kg/ha resulted in highest total chlorophyll content. While higher chlorophyll a content was obtained with the levels 20:60 kg/ha, and highest total DMP was recorded with the application at 40:100 kg/ha. Different levels of K and MgSO4 nutrition positively influenced 100 seed weight and grain yield, while there found no significant difference on chlorophyll b content, days to flowering, and grains/pod with any of the treatments imposed. Higher values for test weight and grain yield were recorded with K: MgSO4 40:60 kg/ha. In field experiment, tillage practices failed to produce notable difference in chlorophyll a, chlorophyll b, total chlorophyll contents, chlorophyll a/b ratio, grains per pod and test weight. Early flowering (45 DAS) and highest total DMP up to 75 DAS were recorded under CT. ZT produced highest LAI, while highest grain yield was noted under MT practice (734.5 kg/ha). Nutrient treatments failed to produce significant differences in chlorophyll b and chlorophyll a/b ratio. However, application at 40:80 kg/ha produced highest LAI, and higher content of chlorophyll a and total chlorophyll content (1.34 mg/g). K:MgSO4 applied at 40:60 kg/ha recorded highest grain yield. LAI was recorded highest under ZT with K:MgSO4 at 40:80 kg/ha. MT + K:MgSO4 at 40:60 kg/ha reported highest chlorophyll a/b ratio (4.71). K: MgSO4 applied at 40:60 kg/ha produced highest grain yield (806 kg/ha). In interactions, MT + K: MgSO4 at 40:60 kg/ha registered highest grain yield (914.8 kg/ha). Overall, in terms of grain yield, the test crop responded well to MT with application of K: MgSO4 at 40:60 kg/ha.
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Objective: We examined the ‘nutrients of concern’ in pre-packaged food products that are commonly advertised, as per WHO standards and Nova Classification. Methods: This was a qualitative study, using a convenience sampling method, to identify advertisements of prepackaged food products. We also analyzed their content from information on the packets, and their compliance with applicable Indian laws. Results: We found that all the advertisements of the food products in this study did not provide important information about the amount of nutrients of concern i.e., total fat, sodium, and total sugars. These advertisements mostly targeted children, made health claims, and used endorsements of celebrities. All the food products were also found to be ultra-processed in nature and high in one or more nutrients of concern. Conclusion: Most of the advertisements are misleading, needing effective monitoring. Health warnings on the front-of- pack label and restrictions on marketing of such food products may go a long way in reducing non-communicable diseases.
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Background: Aim of the study was to compare the suture techniques using interrupted mattress and continuous subcuticular and stapler in terms of wound closure time; pain in stitch line on post-operative day 3, 5 and 7 and patient satisfaction.Methods: All patients fulfilling the inclusion criteria, were divided into 3 categories (interrupted mattress, subcuticular and staples) by random selection. Assessment parameters being skin closure time; induration and discharge on day 4 and 8; pain score using visual analogue scale on day 3, day 5 and 7; wound gaping and Patient satisfaction in terms of cosmesis using Likert’s scale after 4-6 weeks.Results: The skin closure time in mattress, subcuticular sutures and staples are found to be 8.891±1.343; 11.390±1.438 and 1.518±0.502 respectively. Pain on day 3, 5 and 7 were: severe pain was maximum seen in staples group (n=21) as compared to 7 patients in subcuticular group and 6 in mattress group. Wound complications were seen least in mattress group. One patient (1.20%) had wound gaping in mattress group, 3 (3.65%) of the patients in subcuticular group and 5 (6.17%) in staples group had wound gaping. Patient dissatisfaction rate was higher in staples group (8.64%) as compared to 6.09% patient in subcuticular group and 4.8% in mattress group.Conclusions: The mattress suturing technique has least wound related complications and most patients satisfaction. Staples are quick in application and subcuticular technique gives a good scar, but is associated with similar complications as staples.
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Adenosarcoma is an infrequent malignancy which consists of benign glandular epithelium and malignant mesenchymal component. We report a 63-year-old woman diagnosed with adenosarcoma with sarcomatous overgrowth of the uterine corpus, with history of mucinous carcinoma of the breast in her daughter. Although endometrial and breast cancers share few similar hormonal, reproductive and genetic risk factors, the association of endometrial cancer with breast carcinoma is not well established. 63 years old, P4L4, postmenopausal lady presented to our hospital with post-menopausal spotting, foul smelling vaginal discharge and pain abdomen for 1 week. After evaluation she underwent total abdominal hysterectomy with bilateral salpingo-oopherectomy. Intraoperatively, a pedunculated fundal polyp measuring 6×7 cm distending the uterine cavity was noted. Post-operative histopathology examination was reported as adenosarcoma with sarcomatoid overgrowth of the uterine cavity. Immunohistochemistry revealed CK7 (epithelium (+), Vimentin (+), cluster of differentiation 10 (CD10) (+) and, Wilms tumor 1 (-). The possible association between these two conditions, adenosarcoma of uterus in mother and mucinous carcinoma of breast in daughter is explored and presented in this case report.
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Mental health of people in India is becoming a growing concern. Most mental health problems diagnosed in adulthood begin in adolescence. In the context of the Covid-19 pandemic, the concept of resilience gained momentum and deserves special attention. Resilience is a vital skill for navigating life's ups and downs. Resilience is a major and significant asset which adolescents need to combat the adversities and the toll these stressful experiences have on their well-being and mental health. Thus, it is important to explore and understand the resilience among the adolescents. The current paper aims to study the resilience of adolescents with respect to gender, type of family and birth order. The sample comprised of 47 adolescents (13-15 years of age) of Mumbai Metropolitan Region. Data was collected using a researcher made tool. The findings revealed that resilience of adolescents does not vary on the basis of gender, type of family and birth order. Thus, it can be concluded that gender, type of family and birth order has no effect on resilience of adolescents.
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The cultivated tomato Solanum lycopersicon L., a commercial annual crop that is grown all over the world for local consumption or export purpose. It belongs to the Solanaceae family and has diploid chromosome number (2n= 2X= 24). Application of fertilizers, insecticides and herbicides is crucial for improving productivity per unit area, however excess usage more than that of a recommended dose can lead to issues including environmental contamination (air, water and soil pollution). According to a thorough study, farmers exposed to chemical insecticide spray for a period of 18 months experience impaired vision symptoms like eye stinging or burning (18.42%), dry sore throat (21.05%), blurred vision (23.68%), nose burning (28.9%), shortness of breath and excessive sweating (34.2%), and skin itching or redness (50.0%). The purpose of this brief review article is to explore the function of various organic and inorganic nutrient sources in tomato crop by analysing previous works and studies. Integrated Nutrient Management (INM) is an approach that boosts the agricultural production and safeguards the environment for future generations.
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Background: Hypertension in pregnancy is common complication of pregnancy with incidence 5-15% and associated with maternal and perinatal mortality and morbidity. Platelet count is most simple, rapid and economical method of prediction of pregnancy induced hypertension. The aim and objective of study was to corelate with severity of thrombocytopenia and its association with fetal and maternal outcome.Methods: This study was a case control study and was conducted in department of obsterics and gynecology, SVBP hospital attached to LLRM medical college, Meerut, from October 2020 To June 2022. Total number of 100 pregnant females out of which 50 pregnant females with hypertension as cases and 50 pregnant females without hypertension as control were included in study. Observations were tabulated, analysed and conclusions were drawn.Results: Out of 50 cases 43 patients developed preeclampsia thus giving incidence of 43 % and out of which 21 patients had mild thrombocytopenia,13 moderate thrombocytopenia and 4 severe thrombocytopenia. The mean age amongst cases was 26.73�19SD and the mean age amongst control was 28.09�83. There was very high significant relationship between the degree of thrombocytopenia with severity of hypertension during pregnancy (at p <0.01). 24% fetuses had preterm birth, 8% had fetal growth restriction, 2% were IUD and 2% mortality. 2% of mothers had DIC,8% had post-partum hemorrhage, 6% had abruption ,4% had pulmonary edema and 6% mortality.Conclusions: Thrombocytopenia is most common and can be life threatening complication of pregnancy induced hypertension. Therefore, platelet count can be used as an early, easy, simple, most economical and rapid test to assess severity of preeclampsia and to prevent its progression to eclampsia, HELLP syndrome and DIC.
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Purpose: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects. Methods: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi?square test was used for statistical analysis. Results: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2). Conclusion: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.
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Background: This study was conducted to compare the safety and effect on maternal and perinatal outcome of expectant versus interventional management in women with preterm severe preeclampsia with gestational age between 28 to 34 weeks.Methods: This was a non-blinded prospective analytical study carried out in the department of obstetrics and gynaecology, SSG hospital, Vadodara from January 2021-December 2021. 40 women diagnosed with severe pre-eclampsia remote from term meeting the inclusion criteria were divided in two groups (20 in each). First group comprised of women undergoing interventional management i.e. prompt delivery and the second group comprised of women undergoing expectant management till 34 completed weeks. The women in the expectant management underwent pregnancy termination before 34 weeks if any complication arises (e.g. anhydramnios, abruption, eclampsia etc).Results: The mean prolongation of pregnancy in the expectant management group was 11.45 days (range: 4-35 days). There was no increase in incidence of maternal complications (p value: 0.003). The fetal outcome was favourable in the expectant management group in terms of higher gestational age at delivery (33 versus 31 weeks; p value: 0.001), higher birth weight (1.7 versus 1.5 kg; p value: 0.05), higher APGAR score at 1 minute (7.5 versus 7; p value :0.05), lesser incidence of neonatal complications (55% versus 95%; p value 0.003).Conclusions: Considering the results of this study, it can be concluded that expectant management is recommended in patients with severe preeclampsia remote from term with intensive monitoring.
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Background: Pregnancy-induced hypertension occurs in approximately 3 to 5% of pregnancies and is still a major cause of both fetal and maternal morbidity and mortality worldwide. Pre-eclampsia is risk factor for stillbirth, intrauterine growth restriction (IUGR), low birth weight (LBW), preterm delivery, respiratory distress syndrome, and admission to neonatal intensive care unit. Overall, the incidence of preeclampsia ranges from 5 to 15% in India. This study conducted to assess the predictive value of raised beta-human chorionic gonadotropin (?-hCG) levels in development of pregnancy-induced hypertension in antenatal women and follow up the risk patients and reduce both maternal and perinatal morbidity and mortality.Methods: The present study was conducted in the department of obstetrics and gynaecology, L.L.R.M Medical College and associated SVBP Hospital, Meerut during the period of January 2021 to December 2021 on 400 antenatal women with 12 to 20 weeks of gestation. Estimation of serum beta hCG level was done by enzyme linked fluorescence immunoassay. The cases were followed up in antenatal clinics, 4 weekly till 28 weeks, fortnightly up to 34 weeks and thereafter weekly till delivery for the development of PIH.Results: From the study it was found that women with elevated beta hCG values in 12-20 weeks were at increased risk of developing PIH. The sensitivity of ?-hCG for development of PIH was found to be 90%. It was found that specificity, positive predictive value (PPV), negative predictive value (NPV) of ?-hCG for development of PIH was 82%, 41.7%, 98.3% respectively. However, p value of ?-hCG for development of PIH is 0.001 which is highly significant.Conclusions: From this study we found that that measuring second trimester serum beta-hCG levels is a good predictor of pregnancy induced hypertension and showed association with elevated levels of beta hCG with development and severity of PIH, but sensitivity and positive predictive value of beta hCG are low in this study to be useful for mass screening marker on its own.