Résumé
Haemolysis (H), elevated liver enzymes (EL) and low platelet count (LP) i.e., HELLP syndrome is a vaguely understood condition of pregnancy which can present with rapid onset. It is commonly associated with pre - eclampsia. HELLP is also known to manifest itself without the clinical features of pre - eclampsia. The present study aims to assess the maternal and foetal complications associated with HELLP syndrome. METHODSThis retrospective study included all the pregnant women who developed HELLP / partial HELLP with gestational age of ≥ 28 weeks. The variables analyzed were obstetric history, menstrual history, antenatal complications, laboratory investigations (haemolysis, ALT / AST, LDH, CBC), mode of delivery, postnatal complications, maternal outcomes and perinatal outcomes. RESULTS72 patients were included in the present study. The mean age of pregnant women with HELLP syndrome was 23.6 ± 4.15 years. The average age of gestation was 33.17 ± 4.02 weeks. 58 % patients were primigravida. As per Mississippi triple-class system 82 % patients had partial HELLP, 18 % had complete HELLP. 4 %, 4 % & 10 % patients had HELLP class I, II & III respectively. Among the total cases, 74 % patients had antepartum onset, 10 % had intrapartum & 17 % postpartum onset of HELLP syndrome respectively. 65 % patients delivered vaginally & rest 35 % underwent caesarean section. High risk factors such as pre - eclampsia (65 %), eclampsia (3 %) & previous history of HELLP (8 %) were noted in study cases. Abruptio placentae (18 %), postpartum haemorrhage (17 %), pulmonary oedema (14 %), renal failure (14 %) & DIC (7 %) were the maternal complications noted. Maternal mortality was 7 %. The major perinatal morbidities noted were prematurity (67 %) & FGR (42 %). Intrauterine death was noted in 19 % babies. Neonatal intensive care (NICU) was required for 58 % babies, of which 42 % had respiratory distress. Neonatal death was noted in 17 %. CONCLUSIONSHELLP syndrome is a life threatening condition of pregnancy which has serious maternal and perinatal morbidities. Prompt referral, timely and appropriate interventions can save lives. Availability of Intensive Care Units (ICU) facilities, dialysis units and blood and its components along with Neonatal Intensive Care Unit (NICU) facilities can remarkably reduce the maternal and neonatal complications.
Résumé
Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.
Résumé
Background: Overweight and increased Body MassIndex (BMI) have been among the major changes ingirls and is one of the likely factors affecting themenarche age. Aim and Objectives: To determinecorrelation of age at menarche with BMI in adolescentgirls of urban and rural schools of Vijayapura, NorthKarnataka. Material and Methods:Aprospective crosssectional study was conducted by Department ofObstetrics and Gynaecology, Shri. B. M. Patil MedicalCollege Hospital and Research Centre, BLDE (Deemedst thto be University), between 1 July 2019 to 29 February2020.Girls below the age of 19 years who had attainedmenarche were included. Height and weight weremeasured, and BMI was calculated. Statistical analysiswas carried out in SPSS software, version 23.0 andMicrosoft 2010. Correlation between age at menarcheand BMI was assessed in adolescent girls of urban andrural schools of Vijayapura. Results: The mean age atmenarche among adolescent girls of urban and ruralschools was about 13.6 ± 1.2 years. Among allparticipants, 60.2% were from urban area and 39.8%were from rural area. The mean age of the menarchewas 13.8 ± 1.2 in rural population and 13.5 ± 1.3 inurban population (p value <0.001). Among all studyparticipants, 48.3% had normal BMI; however, 29.8%,15.4%, 5.8% and 0.7% were underweight, severeunderweight, overweight, and obese respectively.Majority of girls had normal BMI in both urban (49.2%)and rural settings (47.0%). Conclusion: A statisticallysignificant association (p< 0.05) was noticed betweenonset of menarche and area of residence. There was aninverse correlation between BMI and age at menarche,although this was not statistically significant.