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Background: Vitamin D deficiency is currently a global pandemic affecting all age groups. Vitamin D is considered a fundamental hormone in calcium homeostasis and bone health. Risk of vitamin D deficiency increases during pregnancy due to increased maternal and fetal demands and altered vitamin D metabolism. Recently, maternal vitamin D deficiency has been linked to adverse pregnancy outcomes, including preeclampsia, gestational diabetes, fetal growth restriction and preterm birth. Adequate vitamin D status appears to be relevant to health at all ages, and even in prenatal life.Methods: This is a cross sectional, observational study conducted in the department of obstetrics and gynaecology at R. L. Jalappa Hospital. A total number of 160 subjects were included. 5 ml of venous blood was collected and was centrifuged at 3000 rpm and stored at - 80°C till analysis. Analysis of 25-hydroxy Vitamin D was done using ELISA.Results: Majority of the subjects were vitamin D deficient (81.87%) and 12.5% were vitamin D insufficient and only 5.63% were vitamin D sufficient. The prevalence of vitamin D deficiency was more among primigravidas (85.6%) and was associated with higher rates of caesarean section (92.4%). High prevalence of vitamin D deficiency was seen in lower middle socioeconomic class (62.5%). Maternal vitamin D deficiency was associated low birth weight of neonates (100%).Conclusions: In this study it was concluded that majority of subjects were vitamin D deficient and belonged to lower middle socioeconomic class. Majority of this subjects who underwent caesarean section were vitamin D deficient. Vitamin D deficiency was associated only with low birth weight of neonates and no other adverse obstetric outcome.
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Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.
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OBJECTIVE: The objectives of this study were to determine whether NF-kappa B-mediated pro-inflammatory cytokines signaling leads to COX-2 expression and PGE2 synthesis in human myometrial cells at term, and to compare cytokines-induced NF-kappa B activity and subsequent COX-2 expression and PGE2 synthesis between prelabor and in-labor myometrial cells. METHODS: Ten samples of human myometrium were obtained from 5 pregnant women with no labor and 5 in labor at term during cesarean section. Myometrial smooth muscle cells were harvested by cell culture and stimulated with TNF-alpha. PGE2 production and COX-2 expression were determined by ELISA and Western blotting analysis, respectively. NF-kappa B transcriptional activity was assessed by luciferase assay and by nuclear shifting using EMSA. RESULTS: Before the treatment of TNF-alpha, the levels of PGE2 production, COX-2 expression, and activity and nuclear shift of NF-kB in in-labor cells were higher than those in prelabor cells. By the stimulation of TNF-alpha, PGE2 output, COX-2 expression, and activity and nuclear shift of NF-kappa B increased in both of prelabor and in-labor cells. The increases of PGE2 production, COX-2 expression, and NF-kappa B activity were significantly greater in in-labor cells. CONCLUSION: Pro-inflammatory cytokines-induced COX-2 expression and subsequent PG synthesis, mediated by NF-kappa B, appears one of the important mechanisms of labor in term gestation.