Frequency of congenital anomolies in polyhydramnios

Polyhydramnios is a relatively uncommon but distressing complication associated with pregnancy. To find frequency of congenital anomalies with increasing severity of polyhydramnios. Prospective study. This study was conducted in Lady Willingdon Hospital, Lahore from July 2009 to June 2011. Total 70 diagnosed cases of polyhydramnios from 20-41 weeks of gestation were included in the study. Polyhydramnios was diagnosed in 170 pregnancies. Mild polyhydramnios [AFI 24.0-29.9cm] was found in 112 [65.88%] pregnancies, moderate [AFI 30.0-34.9 cm] in 38 [22.35%] pregnancies and severe [AFI 35.0 cm or more] in 20 [11.76%] pregnancies. Antenatal detection of anomalies was 71 [41.76%] fetuses. The prevalence of anomalies was higher in pregnancies with more amniotic fluid. A total of 83 anomalies were detected in 71 fetuses. Pregnancies complicated with severe polyhydramnios had maximum number of fetuses with multiple anomalies. 37 pregnant women out of 170 [21.76%] with polyhydramnios had maternal diabetes. Of these 37 pregnancies 11 [29.72%] had pregestational diabetes, 13 [35.13%] had gestational insulin treated diabetes, 13 [35.13%] had gestational diet controlled diabetes. Anomalous fetuses were present in 5 [13.51% of diabetic pregnancies with polyhydramnios. There were 7 [4.11%] fetal deaths in pregnancies complicated with polyhydramnios. This study proves that pregnancies with severe polyhydramnios have a greater frequency of fetal anomalies. Diagnosis of second trimester polyhydramnios should initiate a search for possible associated fetal anomalies and causative factors

Abdominal pain: a common presentation of dengue fever

Dengue fever [DF] is a mosquito born viral disease caused by dengue virus and is endemic in large areas of southeast of Asia. Pakistan is an endemic country for dengue virus infection. Abdominal pain is a commonly reported symptom in dengue fever [DF]. The most common causes of abdominal pain are acalculus cholecystitis, ascites, acute pancreatitis, acute hepatitis, pleural effusion and peptic ulcer disease. A case series study. This study was conducted at Mayo and Lady Willingdon Hospitals, Lahore from September and October 2011. 105 patients with fever and abdominal pain admitted to Mayo and Lady Willingdon Hospitals, Lahore during months of September and October 2011 were included in the study. A provisional: headache, retro orbital pain, myalgia, arthralgia, skin rash, hemorrhagic manifestations and leucopenia. The diagnosis was confirmed by enzyme immunoassay based serology. The cause of pain was determined by blood tests [Serum amylase, serum lipase, liver function tests [LFTs]] and radiology [ultrasound contrast enhanced CT [CECT] and chest xray [CXR] except for pregnant patients. 67 patient had dengue fever and 38 patients had other causes of fever and abdominal pain. In patient with dengue fever causes of abdominal pain were acalculus cholecystitis, ascites, acute pancreatitis, acute hepatitis, pleural effusion and peptic ulcer disease. Among 67 patients 2 were pregnant, one at 28 weeks and other at 32 weeks of gestation. Results of this study show that among 105 patients having fever and abdominal pain, 67 patients had serologically proven dengue fever. Table I shows that among patients with serologically proven dengue fever 29 had acalculus cholecystitis, 14 had ascites, 9 had acute pancreatitis, 11 had gastrointestinal disorder and 4 had bilateral pleural effusion. Among 3 patients with menorrhagia 2 had acalculus cholecystitis and 1 had gastrointestinal disorder. 2 patients were pregnant and 28 and 32 weeks of gestation. Both of them had peptic ulcer disease. Among 67 ranging from 101 [degree sign] F to 104 [degree sign] F while mean duration of fever was 5 days. In patient with dengue fever etiology of abdominal pain should be aggressively looked into for proper and better management. If carefully looked into, the etiology of abdominal pain in dengue fever can be found and appropriately managed