Résumé
Background: To study the effect of human immunodeficiency virus (HIV) infection on pregnancy outcomes and new born as mother to child transmission of HIV is a major route on new infections in children and compare it with HIV uninfected pregnancies.Methods: Prospective comparative study conducted on 40 HIV seropositive and 40 HIV seronegative pregnant women attending ANC and delivering in the department of obstetrics and gynecology, S. M. S. Medical College, Jaipur, Rajasthan, India.Results: CD4 count had no effect on birth weight of baby or term of delivery. HIV seropositive pregnancies were more prone to IUD, still birth and preterm birth (p=0.029). Mother to child transmission was 2.7%.Conclusions: HIV infection increases the risk of adverse foetal outcome in terms of intrauterine demise, still birth and preterm labour.
Résumé
Background: Diabetes mellitus is the commonest medical problem complicating pregnancy, with possibility of grave consequences. With the present study, incidence, management and perinatal outcomes in the cases of GDM were studied.Methods: All the pregnant patients attending antenatal clinic at the study centre during study period of three years were studied. Those with positive history were screened for GDM as early as possible and rest screened at 24-28 weeks gestation. Carpenter and Coustan criteria were used for the diagnosis of gestational diabetes mellitus. All the diagnosed cases of gestational diabetes mellitus were followed up throughout the course of gestation and complications, if any, recorded.Results: A total of 39 patients were diagnosed as GDM. Majority were multigravida (69.3%, 27) and weighed over 75 kg (56%, 22). Patients were mostly diagnosed at the gestational age of 31-35 weeks (n-15) and 21-25 weeks (n-11). Fifteen patients (38.4%) had HbA1c values between 6-7%, 14 patients (35.8%) between 7-8% and 3 patients had HBA1c levels more than 10%. Twenty-three percent (9) patients had PIH, 13% (5) polyhydramnios and 7.6% (3) had PROM. Three mothers had babies suffering from IUGR. Sixteen (41%) had full term normal delivery while 2 (5.1%) patients had preterm labor and delivered normally. Twenty-one mothers (53.84%) had LSCS, out of which 3 had preterm LSCS.Conclusions: Diabetes during pregnancy is associated with risk factors as well as high maternal and foetal morbidity. GDM has good maternal and foetal outcomes depending upon how well the blood sugar levels are controlled.
Résumé
Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.