scholarly journals Role of micronized progesterone in prevention of preterm labour in women with previous history of one or more preterm births: a research study at a tertiary care hospital

Author(s):  
Rashmi Ahuja ◽  
Anupa Sood ◽  
Anita Pal ◽  
Rita Mittal
Author(s):  
Bandaru Sailaja ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Sailcheemala ◽  
Surayapalem Sailaja

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.


2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Wajid Jawaid ◽  
Muhammad Irfan ◽  
Sundus Mehtab Shafee ◽  
Sidra Javed Barry ◽  
Sayed Mustafa Mahmood Shah ◽  
...  

Objectives: This study aimed to evaluate the etiology, outcomes and prognostic factors associated with status epilepticus (SE) admissions in Neurology Department of a tertiary care hospital. Methods: A retrospective review was performed on all SE admissions at Dr. Ruth K.M. Pfau Civil Hospital Karachi over a five-year period from July 2015 to June 2020. Demographic, clinical, and etiological factors were investigated for prognostic value. Statistical tests were applied to determine significant prognostic factors. A five percent significance level was used. Results: A total of 176 patients were included in the study. Mortality was reported in 22 cases (12.5%) and morbidity at six months was observed in 44 cases (25.0%). Male gender, previous history of SE, prolonged seizure duration, and late presentation to hospital were significantly associated with mortality (p<0.05). De novo cases of SE tended to be older (p=0.048) and were associated with morbidity at follow-up (p=0.000). The most common causes of epilepsy in our patients with SE were CNS infections (n=54) and Idiopathic epilepsy (n=34). Non-compliance to medicines/under-dosing was the most common provocative factor (n=68). Acute symptomatic causes of SE were more likely to be associated with greater morbidity (p=0.000). Refractory and super-refractory SE were strongly associated with higher mortality (p=0.000). A longer duration of hospital stay was associated with higher morbidity (p=0.000). Conclusion: Male gender, poor control of seizures, CNS infections, prolonged seizures, delayed hospital arrival and refractory/super-refractory status epilepticus were key determinants of mortality in our setting. Previous history of status epilepticus, and acute and symptomatic etiologies were associated with higher morbidity. doi: https://doi.org/10.12669/pjms.38.1.5195 How to cite this:Jawaid W, Irfan M, Shafee SM, Barry SJ, Shah SMM, Shahbaz N. Factors affecting prognosis of status epilepticus among patients presenting to a tertiary care hospital. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.5195 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Udayagiri Venkata Rohini ◽  
Gurram Swetha Reddy ◽  
Jithendra Kandati ◽  
Munilakshmi Ponugoti

Background: Asymptomatic bacteriuria (ASB) is defined as the presence of actively multiplying bacteria, which is greater than 105/ ml of urine within the urinary tract excluding the distal urethra, at a time when the patient has no symptoms of UTI. Untreated and undiagnosed ASB is associated with adverse maternal and perinatal outcomes. The objective was to determine the profile, prevalence, microbiological isolates with susceptibility, and risk factors of ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Andhra Pradesh, India.Methods: A prospective cross sectional study with 200 pregnant women was conducted for a period of 3 months from January to March 2016. The mid- stream urine specimen was collected and processed from all the cases and social and baseline obstetric data was collected. The isolates from all the cases of ASB were identified by standard biochemical tests. Antimicrobial susceptibility was performed by Kirby- Bauer disc diffusion method and interpreted as per CLSI guidelines.Results: Prevalence of ASB in our study was 30.5%, mean age of the cases was 27.3± 2.9 years. ASB was most common in 25- 30 year’s age group, during 3rd trimester and among multiparous and multigravidae. Previous history of UTI, pre-eclampsia was having significant association among cases with ASB. Escherichia coli was the predominant isolate in the study followed by K. pneumoniae, CONS (Coagulase-Negative Staphylococci), Staphylococcus aureus, citrobacter and Enterococci.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women during all trimesters must be considered in preventing the complications and adverse foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.


Author(s):  
Vivek Sunil ◽  
Sruthi Mankara Valsan

Background: Abortion is the spontaneous termination of pregnancy before 22 weeks or if the foetus weighs less than 500 gm. Spontaneous abortions may occur as a result of genetic factors, infectious agents, uterine abnormalities and other maternal factors. The present study was undertaken to study risk factors of abortion in a tertiary care hospital in Thrissur district.Methods: A hospital based case control study was done during a five month period. The sample size was calculated using the formulae [(Zα + Zβ)2 × 2 × PQ]/d2. Total 40 mothers admitted with abortion were taken as cases and 40 mothers admitted with conditions other than abortion of the same trimester were taken as controls. Data was collected with the help of an interviewer administered semi structured questionnaire.Results: Out of total 80 mothers, 46.2% of them belongs to 21-25 age group and more than half, 66.2% of the mothers were primi gravida. There was a statistically significant association between mother’s occupation and occurrence of abortion. The abortion rates were higher among overweight mothers, but this difference was not statistically significant. Among obstetric determinants, previous history of abortion, primi gravida mothers, and history of travel had higher risk for abortion with odds ratio 3.5, 2.8, and 2.72 respectively.Conclusions: Previous history of abortion and history of travel contributes to higher risk of abortion. Interventions could be targeted more on women with prevalent risk factors to increase health profits.


Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


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