Perinatal outcome in pregnancy induced hypertension.

Perinatal outcome and the factors affecting it were studied in 140 pregnant women with hypertension. Perinatal mortality rate (PNM) was 140/1000 and the stillbirth rate was 8.7%. In severe hypertension PNM was 52.3% and all perinatal deaths were 8.7%, when the serum uric acid level were more than 4.5 mg%.

PIP: During December 1989-May 1991 in India, a prospective study was conducted of 140 pregnant women with hypertension admitted to Kamla Nehru Hospital in Shimla to examine pregnancy outcomes. These women represented 4.1% of all pregnant women admitted to this hospital during the study period. 52.8% of the 140 women were primigravidae. The mean diastolic blood pressure was 99.9 mmHg. The mean arterial pressure was 113.7 mmHg. 21 (14%) of the 149 infants (9 being twins) born to these women died, for a perinatal mortality rate (PMR) of 140/1000 births. 13 of the perinatal deaths were stillbirths, for a stillbirth rate of 8.7%. PMR increased as blood pressure increased: 9.5% for 140/90-149/94; 38% for 150/95-159/109; and 52.3% for 160/110 and above. Low birth weight (=or- 2000 g) infants comprised 17.4% of all births. All perinatal deaths had increased serum uric acid levels (4.5 mg%). PMR was highest for serum uric acid levels of 7.6-8.5 mg% (28.5% vs. 9.5-23.8%). Based on these findings, obstetricians are advised to regularly check the blood pressure and serum uric acid levels of pregnant women in order to reduce hypertension-related PMR.

Perinatal outcome of pregnancies complicated by threatened abortion.

One hundred and two cases of viable pregnancies with threatened abortion were studied in the department of obstetrics and gynaecology, Kamla Nehru Hospital, IG Medical College, Shimla between November 1987 and February 1989 and their perinatal outcome was evaluated. The pregnancies continued beyond 28 weeks in 61.7% of the cases. The incidence of prematurity was 19.0%. The incidence of low birth weight (LBW) babies was 23.8%. Apgar score was less than 7 in 22.3%. The incidence of neonatal complications was 25.3%. There was no perinatal mortality. In a control group of 50 cases, the incidence of prematurity and LBW was 8% and 4% respectively. Apgar score less than 7 was noted in 4% and neonatal complications were observed only in 4% of newborns.

Gynaecological neoplasms in postmenopausal women of Himachal Pradesh.

A controlled prospective study was conducted on 300 postmenopausal women attending the Kamla Nehru Hospital from November, 1990 to August, 1992. The incidence of gynaecological neoplasms was 31.3% in both the study group (300 postmenopausal women) and the control group (300 premenopausal women). The incidence of malignant neoplasms was 24.6% in study group and 8.6% in control group. This difference was highly significant (p < 0.001). Carcinoma cervix (16%) was the commonest gynaecological malignancy followed by ovarian cancer (6%). The incidence of benign neoplasms was lower in the study group (6.6%) as compared to the control (22.6%).

Epidemiological evaluation of excessive and/or irregular uterine bleeding.

PIP: In order to determine the epidemiological factors in cases of excessive and/or irregular uterine bleeding, a prospective study was conducted in consecutive women complaining of excessive and/or irregular uterine bleeding from menarche to menopause, who were admitted in Kamla Nehru Hospital of the Department of Obstetrics and Gynecology, Indira Gandhi Medical College, Shimla, from January 1, 1989 to September 15, 1989. A control group of 50 patients who had normal menstrual cycles was taken at random from the gynecological outpatient department. During the period there were 217 (22.7%) such patients out of a total of 995 gynecological admissions. 82 (37.7%) of the women were literate. The incidence of abnormal uterine bleeding was more prevalent in low socioeconomic classes, to which 88.3% of the patients belonged. The mean age of the study group patients was 37.1 +or- 9.19 years, and of the control group, 31.9 +or- 6.93 years, and the difference was significant [S.E.(d) = 1.1]. Patients over 30 years old were more numerous in the study group (80.1%) than in the controls (58%), and the difference was highly significant (chi square = 20.18, p 0.01). The mean parity of the patients was 3.7 +or- 2.2 and 2.7 +or- 1.8 in the study and the control groups, respectively, and this difference was significant [S.E.(d) = 0.30]. The incidence of abnormal uterine bleeding was higher in high parity women, as 72.7% were gravida III and above. 35% and 14% of the patients in the study and the control groups, respectively, had undergone a gynecological operation in the past, and the difference was highly significant (chi square = 8.37, p 0.005). In addition, 33.1% and 14% of the patients in the study and the control groups, respectively, had undergone tubal sterilization, and this difference was also highly significant (chi square = 7.16, p 0.01). The incidence of copper-T use was higher (13.8%) in the study group as compared to the controls (6%) (chi square = 2.27, p 0.5).^ieng

The age at menopause in the women of Himachal Pradesh, and the factors affecting the menopause.

PIP: Results of a study on age at menopause in India and the factors affecting it are presented. Data concern 500 post-menopausal women forming a representative sample of the population of Himachal Pradesh. The mean age at menopause was 43.55 years. Rural or urban residence and parity had no discernible effect on age at menopause. However, women of higher socioeconomic status and those living at lower altitudes had later onset of menopause.^ieng