A study to correlate admission non stress test and immediate post-partum umbilical cord arterial pH with neonatal outcome

Background: Continuous electronic fetal monitoring in labour has become a standard practice in developed countries; this may not be possible in low middle-income countries. So, this study was conducted to correlate admission non stress test (NST) and immediate post-partum umbilical cord arterial (UCA) pH with neonatal outcome.Methods: This prospective observational study was conducted at tertiary care centre in North India. After informed and written consent, 100 pregnant women with singleton live pregnancy of gestational age ≥32 weeks admitted in labour, were subjected to admission NST and immediately after delivery sample for UCA pH was taken. Clinically relevant neonatal outcome was correlated with admission NST and UCA pH. Appropriate statistical tests were used and p-value <0.05 taken as significant.Results: Admission NST was normal, suspicious, pathological in 67%, 27%, 6% subjects, respectively. Study found statistically significant correlation between admission NST and UCA pH with neonatal outcomes (i.e. fetal distress, need of advanced resuscitation, delayed oral feeding). Fetal distress was seen in 9 newborns, in these 8 delivered by CS and 1 required ventous application. Admission NST had high sensitivity (88.89%) and NPV (98.5%) for detection of fetal distress. The optimal cut off for pH and lactate was 7.25 and 2.55 mmol/L, respectively to predict fetal distress.Conclusions: Admission NST can be considered as a screening modality to detect fetus in distress and it showed good correlation with umbilical cord arterial pH for predicting short term neonatal outcome.

An unusual case of complete heart block with triplet pregnancy.

A young primigravida presented at 36 weeks of gestation with complete heart block and triplet pregnancy. She underwent a lower segment cesarean section, and was managed successfully. The patient remained asymptomatic and did not require antiarrhythmic drugs or pacing.

A study of prevalence of Chlamydia trachomatis infection in women with first trimester pregnancy losses.

The study included 125 patients in the first trimester of pregnancy, who were divided into group A (50 control subjects with normal intrauterine pregnancy), Group B (50 patients with spontaneous abortion), group C (25 patients with ectopic pregnancy). All the patients were investigated including routine blood and urine tests and special tests related to the cause of pregnancy loss. The patients were tested for IgG antibodies to Chlamydia trachomatis by ELISA technique and conjunctival smear were tested for presence of inclusion bodies to C. trachomatis. It was concluded that C. trachomatis is one of the important cause of spontaneous abortion and ectopic pregnancy. It is highly prevalent in our population, the prevalence being 10% in group A, 26% in group B, 28% in group C. Conjunctival smear showed presence of inclusion bodies in 0.8% patients. With abortions then risk of lower genital tract chlamydia infection spreading to upper genital tract increases. ELISA for C. trachomatis should be done when women are being investigated for the cause of spontaneous abortion and ectopic pregnancy.