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Background: Hypertensive disorders of pregnancy are one of the leading causes of maternal and neonatal morbidity and mortality worldwide. Hypertensive disorders of pregnancy (HDP) affects approximately 5-7% of all pregnancies. The reported incidence of HDP in India ranges from 5% to 15%. These disorders form a deadly triad-in conjunction with hemorrhage and infection, in significantly contributing to maternal morbidity and mortality. Objectives were to determine the correlation between the severity of HDP and low platelet count; to analyze maternal and fetal outcomes in relation to thrombocytopenia; to aid in early diagnosis and management and to prevent complications and thereby improving maternal and fetal outcomes.Methods: A hospital-based prospective study was conducted in women with a provisional diagnosis of gestational hypertension over a period of 18 months. The study group comprised of pregnant women who were more than 20 weeks and were subjected to detailed history: pre-obstetric history, family history, general physical examination, abdominal examination, routine laboratory investigations, and ultrasonography and Doppler.Results: In the study, platelet count at ?275000 cut-offs had the highest sensitivity of 52.11%, specificity of 82.76%, PPV of 88.1%, and NPV of 41.4% in predicting feto maternal complications. Platelet count at ?275000 cut-offs had the highest sensitivity of 62.86%, specificity of 69.23%, PPV of 52.4%, and NPV of 77.6% in predicting preeclampsia.Conclusions: From the study, it was concluded that in gestational hypertension the estimation of platelet count is thus a reliable method for early detection and management of hypertensive disorders of pregnancy. Platelet count was significantly decreased in subjects with maternal complications, fetal complications, and with respect to the severity of preeclampsia. Platelet count however had moderate validity in predicting fetomaternal complications.
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Uterine leiomyomas are the benign tumors arising from the muscle cells of the uterus. These are the most common tumors observed in reproductive age group and is seen in around 2% pregnant women. The effect of fibroids on the pregnancy varies according to the number, size and their location. Most of the patients are asymptomatic. Recent literature suggests myomectomy during pregnancy and caesarean section is safe in well selected cases with experienced obstetrician in a tertiary care center.
RESUMO
Background: Hypertensive disorders represent the most common medical complication of pregnancy complicating 5 to 10% of all pregnancies. Several changes have already occurred before the development of clinical syndrome of preeclampsia. One such change occurs in renal function leading to hypo-calciuria. Thus, in present study, urinary calcium creatinine ratio (UCCR) and doppler study are tested as parameters to predict development of preeclampsia in asymptomatic pregnant woman and assessing better predictor among them.Methods: Hospital based prospective study. Randomly selected pregnant women meeting inclusion and exclusion criteria, will be subjected to detailed history including age, parity, duration of pregnancy, examination including general examination, abdominal examination, routine laboratory investigations, calculate UCCR and ultrasound with doppler study at less than 20 weeks.Results: Out of 100 women, 25 had UCCR<0.04 and out of which 14 developed pre-eclampsia. Among them 33 had abnormal pulsatility index (PI) at 11-14 weeks and out of which 24 developed pre-eclampsia. In those 100 women, 58 had abnormal PI at 16-20 weeks and out of which 23 developed pre-eclampsia.Conclusions: Our study shows that we can predict preeclampsia by screening in early weeks of gestation i.e., by uterine artery doppler during NT scan around 11 to 14 weeks and during TIFFA appointment around 16 to 20 weeks and by UCCR. This study shows doppler study prediction is more sensitive and specific compared to UCCR.