A one year prospective study of acute renal failure in pregnancy and its maternal and fetal outcome

Background: Pregnancy related acute renal failure is still common in developing countries. This study is aimed to evaluate the etiological factors responsible for ARF in pregnancy, and, maternal and fetal outcome of this condition. It contributes upto 20-22% of the referrals to higher centers and is associated with high risk of maternal mortality (9 to 55%) in developing countries.Methods: This is a prospective study carried out at M. R. medical college and Basaweshwara teaching hospital, Kalaburagi (Gulbarga), for one year from January 2017 to December 2017.Results: A total of 38 patients were hospitalised with renal failure in pregnancy. Majority of the patients (73.68%) were multigravida. Eclampsia (42.10%) and severe post-partum hemorrhage (21.05%) were the most common causes of acute renal failure in late third trimester and in post-partum period. Edema (65.78%) and oliguria (50%) were the most common presenting complaints. Most cases (73.68%) responded to diuretics and IV fluids. 21.05% required dialysis, 39.47% needed ICU admissions. Maternal mortality amounted to 13.15%. Fetal IUGR (18.42%), preterm delivery (13.15%), fetal distress (10.52%), NICU admissions (15.78%), and still births (7.89%) were noted.Conclusions: Pregnancy related acute renal failure is still high in developing countries. Good antenatal care, correction of anaemia, early diagnosis and management of pre-eclampsia, good transport facilities to shift to tertiary care centers are essential requirements to reduce maternal and fetal mortality and morbidity due to acute renal failure in pregnancy.

A study of urinary tract infection in pregnancy and its effect on maternal and perinatal outcome

Background: Urinary tract infection (UTI) during pregnancy is very common in developing countries like India. UTI is caused by the growth of micro-organisms in the urinary tract. This study aims to determine the incidence of UTI in whole pregnancy and its adverse effects on mother and fetus.Methods: This is a prospective study conducted in outpatient department of ESIC medical college for one year from January 2017 to December 2017. A total of 182 pregnant women attending OBG OPD for ANC check-up without any medical disorders or previous adverse pregnancy outcomes of 18-35 years of age were included in the study. Urine routine and urine culture sensitivity were done for all.Results: Out of 182 pregnant women tested for UTI, the incidence of UTI in pregnancy was found to be 19%. Asymptomatic UTI was noted in 65% patients with UTI. Primigravida were commonly affected (56%). Highest cases were in 18 to 25 years (63%) age group. 56% cases showed 6-10 pus cells/HPF. Prevalence of UTI was more common in winter seasons. Commonest causative organism was E. coli in 38% cases. Maternal complications like anaemia (26%) and puerperal pyrexia (23%) were observed. Adverse fetal outcomes like preterm birth (35%) and fetal growth restriction (15%) were observed.Conclusions: In this study, the prevalence rate of UTI during pregnancy is high (19%). The physiological changes of pregnancy predispose the women to UTI so does the other factors such as age, sexual activity, hygiene, multiparty, previous history of UTI and socio-economic conditions. All pregnant women should be screened for UTI with a urine routine and urine culture, treated with antibiotics if the culture is positive and then retested for cure. Awareness has to be created about good hygienic practices and adequate hydration among pregnant women.