RETROSPECTIVE ANALYSIS OF COVID-19 POSITIVE PARTURIENTS POSTED FOR CAESAREAN SECTION IN TERTIARY CARE CENTRE

Background And Aims: Parturients posted for LSCS present with physiological changes due to pregnancy and gravid uterus, may have associated co-morbidities, superadded by COVID 19 infection poses a real challenge for an anesthesiologist. Urgency in obstetric anesthesia and extreme precautions needed to avoid this contagious disease further increase the burden on the anesthesiologist. This study focuses on perioperative presentation, management, and outcome of patients in a tertiary level hospital. Method: 329 pregnant females with RAT or RTPCR positive for COVID 19 and undergoing cesarean section from 1st May 2020 to 31st July 2021 were included in this retrospective observational study. Data was collected and analyzed from OT, ICU, WARD records, patient medical and electronic records, and maternal mortality data. Results: Amongst 329 parturients, 98.48%(324/329) received spinal anesthesia, one received epidural anesthesia (0.30%) and 1.21%(4/329) required general anesthesia. The incidence of hypotension was 5.77% (19/329), managed with inj. Mephentermine without inotropes. The intraoperative course was uneventful except for one case of CRA, revived successfully. Nine patients (2.73%) required ICU care. Oxygen support by either nasal prongs or face masks was given to 3.95% (13/329) patients. Three patients (0.91%) required NIV support and three patients (0.91%) required invasive ventilation postoperatively.The overall mortality was 0.61% (2/329). The mean duration of hospital stay was found to be 8.2 ± 5.03 days Conclusion: Neuraxial anesthesia remains a technique of choice for LSCS and can be safely employed in the parturients even with moderate pneumonia. General anesthesia can be reserved for patients of severe covid pneumonia

Association between TSH status and prevalence of miscarriages and stillbirth

Thyroid hormones play a significant role in normal human body growth. Abnormalities in thyroid stimulating hormone (TSH) levels can result in pregnancy loss due to miscarriages and intrauterine death (IUD). The objective of the study was to assess the levels of association of thyroid stimulating hormone with miscarriages and IUD. The descriptive study involving 110 samples between 18-40 years of age fulfilling inclusion criteria were sampled for TSH testing (2ml blood) after attaining their written informed consent. The mean age of participants was 29.49±4.26 year. The prevalence of hypothyroidism and hyperthyroidism was 3.64% and 2.73%, respectively. Complications like gestational hypertension, depression and oligomenorrhea were found prevalent in these females. Majority of females were taking high/low iodine than recommended iodine level (150mcg). This work shows that there is a significant association between pregnancy loss and disturbed TSH levels among pregnant females.

Impact of coronavirus on pregnant females in India: an observational study

Background: Coronavirus (COVID-19) has emerged as a rampant pandemic and the entire world is struggling against it. The entire nations are trying to device measure like national lockdowns, diverting resources towards fighting coronavirus, extensive media coverage, closing of elective services in hospitals. All this has influences the masses to a deep level. Coronavirus not only is morbid for the sick, but also the healthy pregnant females seeking health care and impacted them more mentally than physically.Methods: In this study 103 pregnant females from the entire nation of India were made to answer a well thought and made questionnaire which aimed at assessing the mental state and impact of coronavirus on the pregnant females.Results: Majority of the females answered that they felt anxious and were undergoing stress due to the coronavirus. They fear impending doom for the child and also are struggling a lot to seek apt healthcare for themselves and their children because of the ongoing pandemic.Conclusions: Coronavirus has not only affected people who are directly affected with the virus, but also who are still not affected but are mentally stressed because of it. National lockdown and alteration in the healthcare services are also stress- inducing for the pregnant females.

Seroprevalence of syphilis among pregnant females attending antenatal clinic at a tertiary care hospital in North India

Background: Syphilis is a sexually transmitted disease caused by bacteria named Treponema palladium, subsp. pallidum. Nearly 1.36 million pregnant women are known to be affected by syphilis in the developing countries. When left untreated syphilis during pregnancy can result in adverse fetal outcomes such as spontaneous abortion and stillbirth. Objective of the study was to evaluate the seroprevalence of syphilis among pregnant females attending Antenatal Clinic (ANC).Methods: A hospital based cross-sectional study was done over a period of six months from January to June 2019. A total of 132 pregnant females were included in the study who attended Antenatal Clinic for routine checkup whose blood samples were sent to Microbiology Laboratory for screening for syphilis by Rapid Plasma Reagin (RPR) test.Results: Out of 132 samples of pregnant females screened for syphilis, none of the sample was found reactive for syphilis by RPR test. Maximum patients (57.6%) belonged to age group 20-25 years followed by (27.3%) of 26-30 years. 30.3% patients belonged to urban areas and 69.7% patients belonged to rural areas. Majority of patients (80.3%) belonged to first trimester, followed by (18.9%) patients to second trimester and (0.8%) patients to third trimester. 78.8% patients were from lower socio-economic class followed by 12.9% patients from middle class and 8.3% patients from upper class.Conclusions: Although zero percent syphilis prevalence was observed in this study, it is recommended that free screening for syphilis should be offered to all pregnant females visiting Antenatal Clinic.

Prevalence of hepatitis C among pregnant females attending antenatal clinic at a tertiary care hospital in Lucknow, Uttar Pradesh, India

Background: Hepatitis C virus (HCV) is a major causative agent of parenterally acquired hepatitis. Vertical transmission of HCV occurs from mother to infant during pregnancy, delivery, or neonatal period. Hepatitis C infection among pregnant females can adversely affect both mother and fetus, leading to chronic infection in infants who later develop liver cirrhosis and hepatocellular carcinoma. Objective of the study was to evaluate the prevalence of hepatitis C among pregnant females attending antenatal clinic.Methods: A hospital based cross-sectional study was done over a period of six months from January to June 2019. A total of 550 pregnant females were included in the study who attended Antenatal Clinic for routine check-up and whose blood samples were sent to Microbiology Laboratory for screening of anti-HCV antibodies by Enzyme linked Immunosorbent Assay (ELISA) method.Results: Out of 550 pregnant females tested, 3 were found to be reactive to anti-HCV antibodies by ELISA; hence the prevalence was found to be 0.5%. All 3 seropositive females belonged to age group 26-35 years, were indoor patients (IPD) and belonged to lower socio-economic class. Majority of seropositive females belonged to urban areas (66.7%, 2/3) as compared to those from rural areas (33.3%, 1/3).Conclusions: Although, prevalence of hepatitis C was found to be less among pregnant females attending ANC of this institute, still routine screening of all pregnant females for anti-HCV antibodies is highly recommended, for timely detection of disease in mothers and prevention of its transmission to infants.

Seroprevalence of hepatitis B virus surface antigen among pregnant females attending antenatal clinic at a tertiary care hospital in North India

Background: Hepatitis B infection is one of the most common public health problems worldwide. Hepatitis B virus Surface Antigen (HBsAg) positive mothers may transmit the virus vertically to neonates transplacentally during pregnancy, perinatally during delivery or postnatally through breast milk. Such neonates being carriers of virus are at a very high risk of developing chronic liver diseases at a younger age and also, they act as reservoirs of infection in the community. Objective of the study is to evaluate the seroprevalence of HBsAg in pregnant females attending Antenatal Clinic.Methods: A hospital based cross-sectional study was done from January to June 2019. A total of 840 pregnant females were included in the study who attended Antenatal Clinic for routine checkup whose blood samples were sent to Microbiology Laboratory for screening of HBsAg by Enzyme Linked Immunosorbent Assay (ELISA).Results: Out of 840 pregnant females included in the study, 8 were reactive to HBsAg, hence, prevalence was found to be 0.95%. The seroprevalence of HBsAg was found to be more (1.40%) in 26-35 year females. Maximum seropositivity was seen in females from urban areas (1.0%), those attending OPD of ANC (1.03%) and those who belonged to lower socio-economic class (1.02%).Conclusions: Routine free screening for HBV infection should be offered to all antenatal females to reduce the risk of vertical transmission to the neonates born to infected mothers, thereby, preventing them from becoming carriers and developing chronic hepatitis and hepatocellular carcinoma later in life.

Evaluation Of Postural Balance In Third Trimester Pregnancy

Background: Pregnancy is a state of various physiological and anatomical changes in a female’s body. The increasing body weight leads to the shift in COG and increase in abdominal contents leading to reduced stability and increased use of visual cues which occur in pregnant females as pregnancy advances. Several physiological responses to pregnancy diminish the body’s ability to maintain adequate balance, and place the women at a higher risk of injury and falls. Thus assessment for postural stability is very important to prevent such complications. Objective: To evaluate postural balance in third trimester pregnant females using Four square step test. Materials and methodology: Study was cross sectional observational study. Data was collected by convenient sampling method .60 Healthy women, 30 pregnant and 30 non-pregnant, of age group 20-30 years were selected. Evaluation of postural stability was done using 4 square step test (FSST). The mean of two time trial (in seconds) was noted. The data was collected and analysed using paired t-test. Results: There was statistically significant difference in mean time taken to complete the test between pregnant group and non-pregnant group. (p<0.05) Conclusion: Thus, our study showed that pregnant females took longer time to complete the postural balance test.

Knowledge, attitude, practice and determining factors regarding nutrition during pregnancy among females of rural Punjab

Background: The health of a pregnant mother and her nutritional status can influence the health and survival of the growing foetus because of the biological link between them. This study was conducted to assess the knowledge, attitude, practice and determining factors regarding nutrition during pregnancy among females of rural Punjab.Methods: 359 mothers of 2 months to 24 months old children were selected from Verka block of district Amritsar using stratified random sampling technique. Data was collected using a semi structured and pretested questionnaire. Analysis was done using frequency distribution, simple percentages and inferential statistics of chi-square was used to test hypothesis at 5% level of significance.Results: Findings reveal that 81.1% of respondents stressed on adding extra diet during pregnancy out of which only 77.3% of mothers actually added or increased one or more food items. Place of residence, education and parity were significantly associated with knowledge regarding diet increase during pregnancy. Fear of caesarean section and difficult labour were the main reasons given for not adding extra diet during pregnancy.Conclusions: The study however suggests that there is a need for educating the mothers regarding importance of diet during pregnancy.

Prenatal care perception of Saudi females of childbearing age: an epidemiological study

Background: The purpose of this study is to assess perception of Saudi women of childbearing age regarding prenatal care.Methods: Participants were invited to participate in a voluntary online survey. The brief survey consisted of 15 basic multiple choice questions administered in Arabic, and delivered as a secure link through private social media messaging services. The survey permitted only 1 attempt per user. In order to reach and capture non-respondents, 2 follow-up reminders 10 days apart were sent through the same channels of communication. The survey data was collected and analyzed using the survey software platform, Qualtrics by Qualtrics © LLC 2017.Results: Approximately 9% of participants reported previous pregnancy without use of prenatal care. Nearly 12% of respondents thought that prenatal care is only indicated for malnourished pregnant females, and 7% reported not knowing who prenatal care is specifically indicated for. Nearly 21% reported prenatal care should start after confirmation of pregnancy, 14% thought proper start is anytime within the first 3 months, 8% reported proper start should be after confirmation of healthy pregnancy and 8% reported not sure when to initiate prenatal care. Approximately 12% thought taking prenatal vitamins should be once weekly or some days of the week, while 5% do not advice women to take prenatal vitamins during pregnancy at all.Conclusions: The majority of Saudi women are well educated on prenatal care. However, women in early and late twenties are less aware of proper usage of prenatal care.

Seroprevalence of Toxoplasmosis in Pregnant Females Attending a Tertiary Care Hospital in Uttar Pradesh, India and its Effect on Perinatal Morbidity and Mortality.

Objective: To document the seroprevalence of toxoplasma in pregnant females attending a tertiary care hospital and to study its effect on perinatal morbidity and mortality. Design: Prospective follow-up study. Setting: Queen Mary’s Hospital, a tertiary level hospital affiliated to King George Medical University (earlier known as KGMC), Lucknow, Uttar Pradesh, India. Sample: All pregnant women coming to this hospital for antenatal care in the Obstetrics and Gynaecology Dept. Methods: Pregnant females were selected through systematic random sampling. A pre-tested semi-structured questionnaire was administered. Blood sample was drawn to detect IgM and IgG antibodies against toxoplasma. Delivery outcomes were recorded with reference to abortions, still births, delivery of congenitally malformed baby and gestational age at delivery. Main outcome measures: Perinatal outcomes among those positive for toxoplasma antibodies. Results: Out of 260 subjects screened, 23 (8.8%) were IgM positive and 40 were IgG positive (15.4%). IgM sero-positivity was observed more in females aged >30 years, those ≥3 gravida, belonging to low socio-economic status, Muslims, those predominantly non-vegetarian and those exposed to raw meat. Still births (17.4% vs. 3.8%; p=0.006), congenital abnormalities (8.7% vs. 0.5%; p=0.002) and abortions (17.4% vs. 2.7%; p=0.001) were more common in those positive for IgM antibodies compared to sero-negatives. Conclusions: Toxoplasma infection plays a role in adverse foetal outcome. Socio‑epidemiological aspects constitute an important contributing factor for the spread of the disease. All pregnant women should be educated and counselled for Routine serological testing for toxoplasma-specific antibodies.

Necesidades de conocimientos de profesionales de la salud sobre la atención a la gestante y madre adolescente / Learning requirements of health professionals on care for adolescent pregnant woman and mother

Introducción : el embarazo en la adolescente constituye un problema de salud; ya que es una etapa en que no existe la madurez necesaria para cumplir el rol de madre, lo cual repercute en el desarrollo futuro de ella y sus descendientes. Objetivos: Identificar las necesidades de conocimientos sobre la atención integral a las gestantes y madres adolescentes en profesionales de la salud que laboran en los municipios de Regla y Guanabacoa. Métodos : se realizó una investigación descriptiva, prospectiva y transversal, se diseñó un cuestionario aplicado en el periodo octubre-diciembre de 2012, con temas necesarios para la atención integral. Resultados : se logró reunir a 100 profesionales que acudieron en el momento de la aplicación. El 43 % presentó una calificación entre 70 y 79 puntos, 29 % entre 80 y 89; y un 15 % entre 60 y 69. Solo un 7 % obtuvo muy buenos conocimientos. Los temas de mayor carencia fueron, complicaciones del embarazo en la adolescencia, utilización de métodos anticonceptivos y anticoncepción de emergencia, manejo del neonato, técnica y ventajas de la lactancia materna. Es notoria la impericia en la psicoprofilaxis; así como el desconocimiento de la frecuencia en que deben realizarse las consultas de seguimiento a las gestantes, puérperas adolescentes y sus recién nacidos. Conclusiones: existen necesidades de conocimientos en los profesionales para el manejo integral y correcto a la adolescente gestante y madre, así como en las orientaciones para la crianza de su descendiente. Se necesita una estrategia de superación profesional para satisfacer las carencias cognitivas.

Introduction: pregnancy in adolescents represents a health problem because they have not reached the necessary maturity to fulfill the maternal role, all of which has an impact on her future development and on her children. Objectives: to identify the learning requirements of health professionals concerning the comprehensive care for adolescent pregnant and mother in Regla and Guanabacoa municipalities. Method: descriptive, prospective and cross-sectional study was carried out based on a questionnaire about necessary topics in the comprehensive care that was applied from October to December 2012. Results: the questionnaire was applied to 100 professionals. In this group, 43% had 70 to 79 point score, 29% attained 80 to 89, 15% scored 60 to 69 and just 7% showed very good knowledge about this topic. The lack of adequate knowledge was mostly noticed in issues such as complications of pregnancy in adolescence, birth-control methods, and use of emergency contraception, management of neonates, breastfeeding, and techniques and advantages of breastfeeding. The lack of expertise in psychoprophylaxis and the lack of knowledge about the frequency of follow-up consultations for the pregnant women, adolescent puerperas and their newborns were evident. Conclusions: health professionals require acquiring knowledge on the comprehensive and correct care for adolescent pregnant and mother as well as on the adequate raising of their children. A professional upgrading strategy is needed to meet these requirements and to eliminate the cognitive gaps.

La pesquería de tiburones oceánicos-costeros en los litorales de Colima, Jalisco y Michoacán

Fishery of oceanic and coastal sharks in Colima, Jalisco and Michoacán. Shark fishery is one of the most important activities in the Mexican Pacific coast, nevertheless, there is few data available about the specific captures done by the fleet along the coast. This study describes fishery biology aspects of the shark species catched by the semi-industrial long-line fleet of Manzanillo. Monthly samplings were made on board of these vessels during an annual period from April 2006 to April 2007. Captured species composition (n=1 962 organisms) was represented by nine species. The one that sustains this fishery was Carcharhinus falciformis (88.12%), followed by Prionace glauca (8.21%). Low frequency species were represented by Sphyrna zygaena (1.78%), Alopias pelagicus (0.82%), Carcharhinus longimanus (0.45%). Furthermore, rare species were Alopias superciliosus (0.35%), Carcharhinus leucas (0.1%), Carcharhinus limbatus (0.1%) and Isurus oxyrinchus (0.05%). Fishery activity affected principally (60-92.70%) young males of C. falciformis, S. zygaena, C. longimanus and I. oxyrinchus; adult males (56-75%) of A. pelagicus, A. superciliosus, and C. limbatus; for P. glauca there were primarily female adults. For all the species found, females showed the bigger sizes when compared to males (with the exception of S. zygaena, that showed sexual dimorphism). Considering the lineal regressions made between precaudal length and total length, and, fork length and total length for C. falciformis, P. glauca, S. zygaena and A. pelagicus, the determination coefficients (r²) showed that both lengths can be useful to obtain the total length of fish with some damage or absence of its caudal fin. The estimated fecundity for C. falciformis was of 3-7 offspring/female of 30-45cm LT (average of 40.57+2.03cm LT); and for P. glauca 5-52offspring/female of 5-18.6cm LT (average of 11.61±0.21cm LT). In the case of C. longimanus only one female was captured with a total of eight embryos, with an average of 45cm LT each; for this reason we assumed that the fishery areas do not coincide with the nursery oness for this species. According to the information obtained, we concluded that C. falciformis has a concurrent cycle and P. glauca a consecutive biannual one. Rev. Biol. Trop. 59 (2): 655-667. Epub 2011 June 01.

La pesquería de tiburón es una de las más importantes en el Pacífico mexicano, en la actualidad no se cuentan con los datos de la composición específica de las capturas de las diferentes flotas. En el presente trabajo se describen aspectos biológicos-pesqueros de las especies de tiburón, capturadas por la flota palangrera de mediana altura del puerto de Manzanillo, en un periodo anual de abril 2006-abril 2007, los muestreos se realizaron mensualmente a bordo de estas embarcaciones. La composición de las capturas estuvo representada por nueve especies (n=1 962), de las cuales Carcharhinus falciformis (Bibron, 1839) (88.12%) sostiene esta pesquería y en segundo lugar Prionace glauca (Linnaeus, 1758) (8.21%). Las especies poco frecuentes fueron Sphyrna zygaena (Linnaeus, 1758) con (1.78%), Alopias pelagicus (Nakamura, 1935) (0.82%), Carcharhinus longimanus (Poey, 1861) (0.45%), Alopias superciliosus (Lowe, 1839) (0.35%), Carcharhinus leucas (Valenciennes, 1839) (0.1%), Carcharhinus limbatus (Valenciennes, 1839) (0.1%) é Isurus oxyrinchus (Rafinesque, 1810) (0.05%). La fecundidad estimada para C. falciformis fue de 3-7 crías/hembra con tallas de 30-45cm LT; 40.57+2.03cm LT y P. glauca con 5-52 crías/hembra, con tallas de 5-18.6cm LT; 11.61±0.21cm LT. Por lo tanto se asume que C. falciformis presenta un ciclo concurrente y P. glauca probablemente un ciclo bianual consecutivo.

Burns during pregnancy: a socio-cultural disease.

Burns during pregnancy poses a serious threat to the life of baby, as well as to the mother. More severely it is associated with various social and economical problems, as well as associated with illiteracy and poverty which many cases complicate its prevention. Burns during pregnancy influence maternal as well as foetal outcome. Keeping this in view a comprehensive task was undertaken to assess the maternal and foetal outcome in relation to burn extent and gestational age of foetus. A total of thirty two cases of burn females with pregnancy were analyzed. There were 23 maternal and 26 foetal deaths. Percentage of abortion during the third trimester was highest. Rate of maternal mortality increased with percentage of Total Body Surface Area (TBSA) burnt. Maximum incidence of maternal mortality rate was with cases of burns involving more than 50% TBSA.