ABSTRACT
OBJECTIVES: To evaluate the parameters of oxidative stress and anti oxidant defense in preeclampsia and thereby find any etiological correlation. METHODS: Study was carried out on pregnant and non pregnant women attending or admitted in the Obstetrics and Gynecology Department of SSG Hospital, Baroda between 1st June 2007 to 31st May 2008. Each serum sample from different groups was evaluated for malondialdehyde (MDA), a product of lipid peroxidation process as a marker for oxidative stress and reduced Glutathione, Superoxide Dismutase, and Catalase for antioxidant enzyme activity and a comparison drawn and analyzed using t-test and χ(2) test. RESULTS: The levels of MDA (a lipid peroxidation product) increased significantly in pregnancy compared to non-pregnant females and further significantly increased in preeclampsia compared to normal pregnant females. The superoxide dismutase levels, catalase levels and vit-E levels were found to be increased in preeclamptic females as compared to normal pregnant females. CONCLUSION: Preeclampsia is found to be a condition with markedly increased oxidative stress as is evidenced by highly significantly increased levels of MDA, a marker of lipid peroxidation. Levels of antioxidant enzymes, viz. reduced glutathione, superoxide dismutase, catalase and vitamin E have been found to be increased in preeclampsia as compared to normal pregnant females. This may be a compensatory mechanism for handling the increased oxidative stress.
ABSTRACT
OBJECTIVES: To evaluate lipid profiles in subjects with preeclampsia. To determine if there is any change in lipid profiles in subject of preeclampsia as compared to normal antenatal females, non-pregnant females and post partum females. METHODS: Study was carried out on pregnant women and non pregnant women attending or admitted in the Obstetrics and Gynecology Department of SSG Hospital, Baroda between 1st June 2007 to 31st May 2008. Each serum sample from different groups was evaluated for Total cholesterol(mg/dl), Triglyceride (mg/dl), HDL-cholesterol (mg/dl), LDL-cholesterol (mg/dl) and VLDL-cholesterol (mg/dl) using diagnostic kits and a comparison drawn and analyzed using t-test and chi-square test. RESULTS: Dyslipidemia in the form of significantly decreased HDL concentration and significantly increased total cholesterol, LDL, VLDL & Triglycerides concentration is conspicuously evident in subjects of preeclampsia as compared to non pregnant, normotensive pregnant and postpartum subjects. CONCLUSION: Dyslipidemia is significantly evident in preeclampsia and plays an important pathological role. The various causative factors for dyslipidemia and its prevention need to be further studied and evaluated.
ABSTRACT
OBJECTIVES: The purpose of the study was to compare the efficacy of misoprostol 400 µg per rectally, injection oxytocin 10 IU intramuscular, injection methylergometrine 0.2 mg intravenously and injection (0.5 mg ergometrine + 5 IU oxytocin) intramuscular on reducing blood loss in third stage of labor, duration of third stage of labor, effect on haemoglobin of the patient, need of additional oxytocics or blood transfusion and associated side effects and complications. STUDY DESIGN: A prospective non-randomized uncontrolled study was carried out in the Department of Obstetrics and Gynecology, SSG Hospital and Medical College, Baroda enrolling 200 women and dividing them into four groups. Active management of 3rd stage of labor was done using one of the 4 uterotonics as per the group of the patient. The main outcome measures were the amount of blood loss, the incidence of postpartum hemorrhage and a drop in hemoglobin concentration from before delivery to 24 h after delivery. RESULTS: Methylergometrine was found to be superior to rest of the drugs in the study with lowest duration of third stage of labor (P = 0.000096), lowest amount of blood loss (P = 0.000017) and lowest incidence of PPH (P = 0.03). There was no significant difference in the pre-delivery and the post-delivery hemoglobin concentration amongst the four groups with P = 0.061. The need of additional oxytocics and blood transfusion was highest with misoprostol as compared to all other drugs used in the study with P = 0.037 and 0.009, respectively. As regards side effects, misoprostol was associated with shivering and pyrexia in significantly high number of patients as compared to the other drugs used in the study while nausea, vomiting and headache were more associated with methylergometrine and ergometrine-oxytocin. However all the side effects were acceptable and preferable to the excessive blood loss. CONCLUSION: Methylergometrine has the best uterotonic drug profile amongst the drugs used, strongly favouring its routine use as oxytocic for active management of third stage of labor. Misoprostol was found to cause a higher blood loss compared to other drugs and hence should be used only in low resource setting where other drugs are not available. The role of misoprostol in third stage of labor needs larger studies to be proved.
