scholarly journals Impact of Dengue Fever on Pregnancy and Its Outcome

2021 ◽  
Vol 10 (44) ◽  
pp. 3742-3746
Author(s):  
Suvarna Vishnu Nimkar
Keyword(s):  
Intensive Care ◽  
Pregnant Women ◽  
Dengue Fever ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Simultaneous Occurrence ◽  
Foetal Distress ◽  
New Born ◽  
Vector Borne ◽  
In Pregnancy

BACKGROUND Dengue fever is a vector-borne disease common in the tropics. It is known to have an adverse effect on pregnant women with unfavourable foetal outcomes. However, only a few studies are addressing this problem. Many of the studies had confounding factors such as the simultaneous occurrence of other vector-borne diseases and maternal health conditions. Therefore, the actual impact of dengue fever on pregnancy and pregnancy outcome is not clear. We wanted to study maternal and foetal outcomes in dengue positive pregnant females. METHODS This is a retrospective study done over 6 months in a tertiary care institute. Data regarding demography, obstetric history, biochemical parameters / blood investigation and pregnancy outcomes were collected and analysed. RESULTS Most of the dengue positive women presented with fever and thrombocytopenia in 44 % of cases. Obstetric complications such as preterm labour, abruption and postpartum haemorrhage (PPH) were common. Caesarean section rate was increased and the most common indication was foetal distress. The need for new-born intensive care unit (NICU) admission for new-born and foetal death was also increased. No evidence of congenital anomaly was found in the study. CONCLUSIONS Antenatal complications like preeclampsia, oligohydramnios; intrapartum complications like abruption, DIC, foetal distress and immediate postpartum complications like postpartum haemorrhage, need for blood, platelet transfusion were common in women with a history of dengue fever especially more in the low platelet group. The maternal and foetal outcomes were compromised and both required intensive care. A high index of clinical suspicion is essential in pregnant women presenting with fever and thrombocytopenia. Early diagnosis and management are essential. KEY WORDS Dengue Fever, Dengue in Pregnancy, Complications of Dengue Fever in Pregnancy

SERIES OF DENGUE CASES IN PREGNANCY AND ITS OUTCOME

2021 ◽  
pp. 91-93
Author(s):  
Srinisha Soundararaja ◽  
Meghna Treesa Anton ◽  
K. Saraswath
Keyword(s):  
Dengue Fever ◽  
South Asian ◽  
Adult Population ◽  
Viral Disease ◽  
Fetal Outcome ◽  
Infected Mosquito ◽  
Asian Countries ◽  
Fetal Anomalies ◽  
Vector Borne ◽  
In Pregnancy

Dengue is a vector-borne viral disease. It is a disease caused by any one of the four closely related viruses (DEN-1, DEN-2, DEN-3, or DEN-4). The viruses are transmitted to humans by the bite of an infected mosquito (Aedes aegypti). Recently, there is an increase in the incidence of dengue fever in adult population in South Asian countries. With an increasing rate of adult dengue fever victims, the number of pregnant women infected with dengue has also increased. Dengue, during pregnancy may be associated with various complications, including abortions, preterm delivery, maternal mortality, low birth weight, neonatal admissions, and fetal anomalies. Timely intervention can improve the maternal as well as fetal outcome. This study was aimed to assess the clinical prole, maternal and fetal outcome of dengue fever during pregnancy and post-delivery. This study shows various outcomes in different trimesters of pregnanc

scholarly journals The consequences of obesity and excess weight gain in pregnancy

2011 ◽  
Vol 70 (4) ◽  
pp. 450-456 ◽  
Author(s):  
Jane E. Norman ◽  
Rebecca Reynolds
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Maternal Obesity ◽  
Adverse Pregnancy Outcome ◽  
Operative Delivery ◽  
Adverse Pregnancy ◽  
In Pregnancy

The prevalence of obesity in pregnancy is rising exponentially; about 15–20% of pregnant women now enter pregnancy with a BMI which would define them as obese. This paper provides a review of the strong links between obesity and adverse pregnancy outcome which operate across a range of pregnancy complications. For example, obesity is associated with an increased risk of maternal mortality, gestational diabetes mellitus, thromboembolism, pre-eclampsia and postpartum haemorrhage. Obesity also complicates operative delivery; it makes operative delivery more difficult, increases complications and paradoxically increases the need for operative delivery. The risk of the majority of these complications is amplified by excess weight gain in pregnancy and increases in proportion to the degree of obesity, for example, women with extreme obesity have OR of 7·89 for gestational diabetes and 3·84 for postpartum haemorrhage compared to their lean counterparts. The consequences of maternal obesity do not stop once the baby is born. Maternal obesity programmes a variety of long-term adverse outcomes, including obesity in the offspring at adulthood. Such an effect is mediated at least in part via high birthweight; a recent study has suggested that the odds of adult obesity are two-fold greater in babies weighing more than 4 kg at birth. The mechanism by which obesity causes adverse pregnancy outcome is uncertain. This paper reviews the emerging evidence that hyperglycaemia and insulin resistance may both play a role: the links between hyperglycaemia in pregnancy and both increased birthweight and insulin resistance have been demonstrated in two large studies. Lastly, we discuss the nature and rationale for possible intervention strategies in obese pregnant women.

scholarly journals Knowledge and Practices of Pregnant Women regarding Oral Health in A Tertiary Care Hospital in Nepal

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Neha Gupta ◽  
Manisha Chhetry
Keyword(s):  
Oral Health ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Health ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Institutional Review ◽  
In Pregnancy

Introduction: Poor dental hygiene has been associated with various perinatal complications in studiesdone worldwide but few studies in Nepal have explored the knowledge of pregnant ladies regardingdental hygiene. The aim of the study was to know the knowledge and practices of pregnant womenregarding oral health in a tertiary care center in Nepal. Methods: A qualitative study was carried out in Nobel Medical College and Teaching Hospital fromJanuary 15, 2018 to June 15, 2018 after approval from the Institutional Review Committee of NobelMedical College. Convenience sampling was done. Fifty pregnant women admitted in antenatalward were interviewed regarding their knowledge of dental care in pregnancy, the common dentalproblems they faced and the treatment taken. A predesigned proforma was used and results wereanalyzed using SPSS version 17. Results: Twenty two (44%) patients reported dental problems during pregnancy. Bleeding gumswas seen in 7 (14%) and toothache in 7 (14%) were commonly reported dental problems. Forty seven(94%) patients acknowledged that routine dental care was needed for health, only 6 (12%) wereaware that poor dental health could affect baby weight. Oral health not seen as priority in 24 (48%)was the main barrier to seeking dental care in pregnancy followed by costs of treatment in 18 (36%)and safety concerns in pregnancy in 8 (16%) cases. Conclusions: Though dental problems were a common occurrence in pregnancy, utilization ofservices was low for the same. The participants reported significant barriers to obtaining dental careincluding lack of knowledge about the importance of maternal oral health and the treatment costs.

scholarly journals Thyroid disorder in pregnancy and postpartum with neonatal outcome a study in tertiary care centre

2019 ◽  
Vol 8 (5) ◽  
pp. 1795
Author(s):  
Bharati Das ◽  
Puspanjali Khuntia
Keyword(s):  
Thyroid Function ◽  
Post Partum ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
New Born ◽  
Pregnancy And Postpartum ◽  
Function Test ◽  
In Pregnancy

Background: Thyroid disorders are well known entity in pregnancy. Both mother and baby have to suffer from the consequences.  Lot of works has been done and many guidelines too came out over the years but what is actual understanding of the disease process by the mothers about themselves and for their babies especially in developing country like India remained uncovered. This has been analysed in present study.Methods: It is a prospective observational study done in the post-partum programmed department of SCB medical college and hospital, a tertiary care center in eastern part of India for 3 years period. Thyroid dysfunction of the mothers and new born screening of thyroid function of their babies has been assessed.Results: During this period total no of the babies along with their mothers were evaluated were 3762. Total no of thyroid disorders detected in 85 (2.25%) of mothers, among which hypothyroidism in 79 (2.09%) and hyperthyroidism in 6 (0.16%) were found. From total 85 cases, 79 (93%) mothers were hypothyroid   and 6 (7%) were hyperthyroid. Among the hypothyroid mothers 32 (40.5%) were diagnosed before present pregnancy and (59.5%) were diagnosed during pregnancy. In the babies of hypothyroid mother, new born screening for thyroid function was done only in 14 (17.7%) cases between 5-10 days.Conclusions: Thyroid screening should be done in pregnancy as universal screening instead of high-risk cases. Documentation and interdepartmental coordination are very much essential in thyroid disorders for further decision by the physician for necessity of continuation of treatment and thyroid function test in the post-partum period for the mothers and its long-term consequences. It also guides the neonatologist or pediatrician doing thyroid function test of their babies. Ideally All newborns should be screened for congenital hypothyroidism as a part of new born screening (NBS) programmed. Effective communication with the mother and the family is very much essential for monitoring and treatment of both mother and the baby.

scholarly journals A study to determine the prevalence of urinary incontinence in antenatal women at a tertiary care centre in central India

2020 ◽  
Vol 9 (3) ◽  
pp. 956
Author(s):  
Deepa Joshi ◽  
Sheetal Achale ◽  
Nilesh Dalal ◽  
Alka Patel
Keyword(s):  
Urinary Incontinence ◽  
Pregnant Women ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Previous History ◽  
Case Report Form ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Pregnancy And Postpartum ◽  
In Pregnancy

Background: Urinary incontinence is a common condition in pregnancy and postpartum. There are more than a thousand articles on urinary incontinence (UI) in pregnancy but very limited literature from Indian subcontinent is available. Incidence and prevalence figures of UI in association with pregnancy vary substantially. Not many reviews have focused solely on incidence and prevalence of UI in association with pregnancy. Prevalence of UI in pregnancy ranges from 32% to 64%.Methods: A cross sectional observational study was conducted in the department of obstetrics and gynecology, MGM Medical College and M.Y. Hospital, Indore over the period of 6 months on 1000 pregnant women who were following antenatal care (ANC) clinic. Pregnant women, who were severely sick, diagnosed with kidney or urinary infection and vaginal infections women were excluded from the study. The data were collected using a structured questionnaire. After the purpose of the study was explained, written consent was obtained from each voluntary participant. This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA 12.1.Results: In the present study the prevalence of urinary incontinence reported is 16.4% of women during pregnancy.Conclusions: In this study the prevalence of UI during current pregnancy was found to be lower compared to previous studies conducted. The previous history of surgery, constipation, obesity and respiratory problems were found to be significantly associated with UI during pregnancy.

scholarly journals Prevalence of Iron Deficiency in Pregnancy: A Single Centre Canadian Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4896-4896
Author(s):  
Grace Tang ◽  
Andrea Lausman ◽  
Jessica Petrucci ◽  
Jameel Abdulrehman ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Serum Ferritin ◽  
Iron Status ◽  
Tertiary Care ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Iron Deficient ◽  
In Pregnancy

Abstract Background Iron deficiency (ID) is the most common and widespread nutritional deficiency in both developing and developed countries (WHO, 2001; Mei et al., 2011). Women of child bearing age are at the highest risk, but this risk increases even more during pregnancy. The expansion of blood volume, growth of the fetus and placenta increase demand for iron to approximately 5.0mg/day by the third trimester (Met et al., 2011). Common symptoms of ID during pregnancy include fatigue, shortness of breath, and difficulty concentrating (WHO, 2001). Poor prenatal iron status is associated with diminished cognitive performance, language ability, and motor functions in the child (Tamura et al, 2002). For the mother, it is associated with risk of blood transfusion and post-partum depression. Despite international recommendations and guidelines on the management of ID in pregnancy, it remains a problem of epidemic proportions and is often unrecognized and left untreated. To increase awareness of ID, a quality improvement project, IRON Deficiency project in Pregnancy: Maternal Iron Optimization (IRON MOM) was implemented January 1st, 2017 at St. Michael's Hospital (SMH), in Toronto, Canada. Phase 1 of the project involved adapting lab requisitions and workflow in the obstetrics clinic to incorporate routine measurement of ferritin in week 12, 16 and 28 of pregnancy. As part of the IRON MOM, laboratory requisitions were modified to include ferritin as part of routine screening for all pregnant women. Objective The primary objective of this study was to assess the prevalence of ID in pregnant women consistently screened for ID after the implementation of the IRON MOM quality improvement project at a tertiary hospital in Toronto, Canada. Methods Administrative laboratory data was collected from the electronic medical record system at SMH, Toronto, Canada between January 1 and December 31, 2017. Suboptimal iron stores was defined as serum ferritin between 30-50μg/L. ID was defined as serum ferritin between 15-29μg/L, and severe ID was defined as <15μg/L. Significant anemia was defined as hemoglobin levels <100 g/L. Descriptive statistics were used to calculate proportions. SAS version 9.4 was used to perform the analyses. Results In 2017, 2400 ferritin tests were completed on pregnant women at our institution. A total of 76.8% (1844/2400) of tests demonstrated iron deficiency with a ferritin <30μg/L. Of those, 30.2% (726/2400) had ferritin between 15-29μg/L, and 46.6% (1118/2400) were severely iron deficient with a ferritin <15μg/L (Figure 1). 3282 hemoglobin checks, at delivery, occurred in this same one-year period and 10.5% (345/3282) were significantly anemic (<100 g/L). Of those, 6.2% (204/3282) had hemoglobin levels between 90-99g/L, 2.6% (85/3282) had hemoglobin levels between 80-89g/L, and 1.7% (56/3282) had hemoglobin levels <80g/L. Conclusion We found an extremely high prevalence of ID in our pregnant patient population. This confirms that ID remains an underappreciated problem, even at a tertiary care centre. Our findings highlight a tremendous gap in awareness, which demands strategies to improve knowledge translation. Future directions include the simplification and digitization of IRON MOM to empower pregnant patients to advocate for their care. Figure 1. Figure 1. Disclosures Lausman: Ferring: Other: gave a talk.

scholarly journals DILEMMAS IN MANAGEMENT OF PREGNANT PATIENTS WITH MECHANICAL PROSTHETIC VALVES IN RURALAND SEMI-URBAN NORTH INDIAN POPULATION AT A TERTIARY CARE INSTITUTION.

2020 ◽  
pp. 44-45
Author(s):  
Amrit Gupta ◽  
Varuna Varma ◽  
Indrani Ghosh ◽  
Nirmal Kumar Gupta ◽  
Neeraj Kumar
Keyword(s):  
Pregnant Women ◽  
Heart Valves ◽  
Economic Status ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Mechanical Heart Valves ◽  
Successful Outcome ◽  
Congenital Defects ◽  
Care Hospital ◽  
In Pregnancy

Pregnancy is a prothrombotic stage, and in women with mechanical heart valves, anticoagulation is a challenge to attain an optimal outcome in mother and fetus. The use of combinations coumadin derivatives and various heparins is still in inconclusive stage due to various socioeconomic and demographic situation. In developing countries due to the cost of surgery, and compliance with lifelong anticoagulation there is contradiction for efficient outcome. Hence a safe protocol is necessary for implementation. Objectives: To evaluate the most effective, practical and uniform “Anticoagulation Regimen” suited to rural and semi-urban Indian pregnant women with mechanical heart valves with low socio-economic status and to observe its impact on the pregnancy outcomes. Methodology: Retrospective observational cohort study carried out at tertiary institute, between July 2006 to June 2015. 69 women became pregnant during the period from 2006 to 2015 on 1 or multiple occasions. 21(30.43%) pregnancies ended in early abortions and 46 (66.7%) pregnancies were continued. Anticoagulation protocol that was followed in these women was H-A-H protocol. These pregnancies were managed by obstetric team of tertiary care hospital under same consultant. Outcome measures were analyzed. Data was expressed as mean with standard deviation or frequency with percentage as appropriate. Results: Of 292 women, who underwent valve replacement surgery, 69 pregnancies were reported during this period on 1 or multiple occasions. 46 women had successful deliveries and rest 23 had single or multiple pregnancy failure. Incidence of stillbirth in those who delivered successfully was lower (2.89%). Fetal morbidity was 37.68% and none of the pregnant women had valve thrombosis. In 46 women majority had successful outcome except 6(13.04%) children out of 46 who developed anticoagulation related congenital defects. This was mainly seen in those women who presented late in pregnancy. Conclusion: Our Experience showed that Heparin-Acitrome-Heparin protocol is effective and safe in pregnancy than heparin alone, or acitrome alone regimen. The fetal outcome was good, maternal compliance was better and this protocol is widely recommended.

scholarly journals A RETROSPECTIVE STUDY ON PREVALANCE OF ANEMIA IN PREGNANCY IN A TERITIARY CARE HOSPITAL

2021 ◽  
pp. 106-108
Author(s):  
SYEDA ZAINEB KUBRA HUSSAINI ◽  
BUSHRA SHEREEN ◽  
SIRISHA D ◽  
MADHAVI E ◽  
HARI PRIYA E ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Iron Therapy ◽  
Care Hospital ◽  
Oral Iron Therapy ◽  
Moderate Anemia ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objective: To study about prevalence in anemia among the antenatal women, its clinical features, and access the severity and its treatment response. Methods: A hospital-based retrospective study on the prevalence of anemia among the antenatal women in tertiary care hospital for 6 months duration in gynecology and obstetrics department. In evaluating pregnant women with anemia, it is essential to do a complete history and physical examination, as well as complete blood count with indices and a blood smear examination. Based on these findings, other test such as ferritin and serum or red cell folate may be ordered. Because of normal physiologic changes in pregnancy that effect the hematocrit, indices, and some other parameters, diagnosing true anemia, as well as the etiology of anemia, is challenging. Results and Discussion: In this retrospective study, the prevalence of Anemia in pregnancy in a tertiary care hospital was evaluated and determined in fifty patients. The most common age group was between 21 and 25 years i.e., (21 patients) 42%. Among 50 patients, majority of them, i.e., 35 patients (70%) were treated with Injection. Iron Sucrose (200 mg). In this study, increase in prevalence were seen majorly in the third trimester, i.e., 25 patients (50%) of which 22 patients (88%) were with moderate anemia with 7.9 gm/dl average hemoglobin (Hb) percentage and 3 patients (12%) were with mild anemia with 9.3 gm/dl average Hb percentage. Conclusion: The plan of management for anemia complicating pregnancy depends on the type of anemia. Oral iron therapy is the route of choice in women with mild to moderate anemia and for severe anemia in pregnant women <30 weeks of gestation. The rise of Hb with parenteral iron therapy is almost the same (avg: 1gm/dl/week) as that of oral iron therapy.

scholarly journals A study on prevalence of anemia in pregnancy in South India

2019 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Sarala V. ◽  
Ushadevi Gopalan
Keyword(s):  
Pregnant Women ◽  
Economic Status ◽  
Tertiary Care ◽  
Structured Interview ◽  
Deficiency Anemia ◽  
Major Health Problem ◽  
Socio Economic Status ◽  
Anemia In Pregnancy ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Background: Anemia in pregnancy is a major health problem worldwide, especially in developing countries like India. Maternal and fetal outcomes are poor in pregnant patients with anemia. The most important cause of anemia is iron deficiency anemia which can be prevented by early oral iron supplementation.Methods: This cross-sectional study was conducted in the department of obstetrics and gynecology of our tertiary care teaching institution for a period of one year. 1290 pregnant women coming to the antenatal OPD were screened for anemia and 490 women. Patients who were not anemic were excluded. 800 patients were enrolled in the study. Each patient was interviewed using a structured interview schedule and the data obtained was analyzed.Results: The percentage of anemia in pregnant women was 62% in our study of which 40% were mildly anemic, 55% were moderately anemic and 5% were severely anemic. Maximum number of anemic women -mild, moderate and severe was seen in the age group 20-24 years. Mild and severe anemia was seen more in the secondary educated women. Maximum percentage of anemia was seen in the lower socio-economic status followed by middle and was lowest in the higher socio-economic status group. Prevalence of anemia was almost equal in primigravida and multigravidas (around 50%) but 80% of severely anemic patients were multigravida. Almost 68% took iron and folic acid tablets regularly.Conclusions: Treating anemia in pregnant women will go a long way in improving maternal and fetal outcome. Hence a future healthy younger generation can be produced. Iron tablets can be distributed at school to young girls to prevent anemia in future women.

Pragmatic Experience with Risk-based versus Universal Hepatitis C Screening in Pregnancy: Detection of Infection and Postpartum Linkage to Care

2021 ◽  
Author(s):  
Elisa T. Bushman ◽  
Lakshmi Subramani ◽  
Aalok Sanjanwala ◽  
Jodie Dionne-Odom ◽  
Ricardo Franco ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Pregnant Women ◽  
Universal Screening ◽  
Task Force ◽  
Care Center ◽  
Tertiary Care ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Hcv Screening ◽  
In Pregnancy

Objective Despite the Centers for Disease Control and Prevention (CDC) and U.S. Preventive Services Task Force (USPSTF) recommending universal hepatitis C virus (HCV) screening in pregnancy Society for Maternal-Fetal Medicine (SMFM) and American College of Obstetricians and Gynecologists (ACOG) continue to endorse risk-based screening for HCV in pregnancy. We hypothesized that universal screening is associated with increased HCV diagnosis and postpartum linkage to HCV care compared with risk-based screening. Study Design This retrospective cohort study included pregnant women screened for HCV at a single tertiary-care center. We defined two cohorts: women managed with risk-based (January 2014–October 2016) or universal HCV screening (November 2016–December 2018). Screening was performed with ELISA antibody testing and viremia confirmed with HCV ribonucleic acid (RNA) polymerase chain reaction (PCR). Primary outcomes were the rate of HCV screen positivity and postpartum linkage to care. Results From 2014 to 2018, 16,489 women delivered at our institution, of whom 166 screened positive for HCV. A total of 7,039 pregnant women were screened for HCV: 266 with risk-based and 6,773 with universal screening; 29% (76/266) were positive HCV antibody screening (HCVAb + ) in the risk-based cohort and 1.3% (90/6,773) in the universal cohort. HCVAb+ women in the risk-based cohort were more likely to have a positive drug screen. Only 69% (62/90) of HCVAb+ women in the universal cohort met the criteria for risk-based testing. Of the remaining 28 women, 6 (21%) had active viremia (HCV RNA+). Of the 166 HCVAb+ women, 64% (103/166) were HCV RNA+—51 of 266 (19%) in the risk-based and 52 of 6,773 (0.8%) in the universal cohort. Of HCVAb+ women, 75% (125/166) were referred postpartum for HCV evaluation and 27% (34/125) were linked to care. Only 9% (10/103) of women with viremia initiated treatment within 1 year of delivery. Conclusion Universal HCV screening in pregnancy identified an additional 31% of HCVAb+ women compared with risk-based screening. Given low rates of HCV follow-up and treatment regardless of screening modality, further studies are needed to address barriers to postpartum linkage to care. Key Points

Sign in / Sign up

Export Citation Format

Share Document