Maternal anaemia and its effects on neonatal anthropometric parameters in patients attending a tertiary care institute of Solan, Himachal Pradesh, India

Background: Anaemia during pregnancy is a significant concern in India. The consequences of iron deficiency anaemia during pregnancy are often serious and long lasting for both the mother and the foetus. Haematocrit measurement is an acceptable and recommended method for anaemia determination especially in situations where limited resources are available, and the technical support is poor. There is a rough conversion factor of 3 which converts the HCT value to approximate haemoglobin level. Present study desires to know the prevalence of anaemia (with classification into mild, moderate and severe) in 3rd trimester pregnancy, to know effect of anaemia in pregnancy on new-born anthropometric parameters and to assess the validity of the threefold conversion between haemoglobin and haematocrit for the determination of anaemia in pregnancy.Methods: The estimation of haematocrit was done by micro-haematocrit method and estimation of haemoglobin was done by automated blood cell analyzer based on cyanmethemoglobin method. Welch's ANOVA, Post Hoc games Howell test and Bland Altman limits of agreement method were used for statistical analysis.Results: Present study showed that 53.75% women in their 3rd trimester were anaemic (mild, moderate and severe anaemic mothers were 22.25%, 28.25% and 3.25% respectively). The standard 3-fold conversion between the haemoglobin and haematocrit was not found to be valid for the assessment of anaemia in the 3rd trimester pregnancy. Finally, while comparing anthropometric measurements between mild/ no anaemia group with severe anaemia group we found that all measurements were less in severe anaemia group and this difference was statistically significant.Conclusions: This study shows that 53.75% women in their 3rd trimester were anaemic, which closely mimic the WHO data but is about 11% more than the prevalence in Himachal Pradesh. Secondly, the standard 3-fold conversion between the haemoglobin and haematocrit was not found to be valid for the assessment of anaemia in the 3rd trimester pregnancy. Finally, birth weight, height, head circumference, chest circumference and mid-arm circumference were significantly affected by third trimester haemoglobin that too the most in severe anaemia cases.

Download Full-text

Safety and Efficacy of Intravenous Ferric Carboxymaltose for Treatment of Iron Deficiency Anaemia in Pregnancy - An Intervention Study Done in a Tertiary Care Hospital of Pune

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/340 ◽

2021 ◽

Vol 8 (22) ◽

pp. 1803-1807

Author(s):

Anish Kumar Vishal ◽

Dinesh Bhasin ◽

Vidhu Dhar Dangwal ◽

Anurakshat Bhasin

Keyword(s):

Iron Deficiency ◽

Blood Transfusion ◽

Serum Ferritin ◽

Iron Deficiency Anaemia ◽

Tertiary Care ◽

Ferric Carboxymaltose ◽

Third Trimester ◽

Deficiency Anaemia ◽

Anaemia In Pregnancy ◽

In Pregnancy

BACKGROUND Anaemia is one of the major public health problems in developing nations. Iron deficiency anaemia (IDA) is the commonest type of anaemia in pregnancy. Parenteral iron therapy is a recommended modality of treatment of IDA. Inj. Ferric Carboxymaltose (FCM) is a dextran free preparation which is safe, easy to deliver and better tolerated. A maximum of 1000 mg can be infused at a time. The present study was intended to assess the efficacy and safety of Inj. FCM in the treatment of iron deficiency anaemia in the second and third trimester. METHODS This prospective study was conducted at a tertiary care centre at Pune. Pregnant women with iron deficiency anaemia of moderate and severe grade were infused 1000 mg of Inj. FCM by longer infusion protocol. A total of 165 pregnant women were included in the study. The efficacy of Inj. FCM was monitored by the rise in the haemoglobin level at 03-, 06- and 08-weeks post infusion of FCM injection and serum Ferritin levels. The safety was assessed by analysing the adverse reactions. RESULTS No serious adverse reaction was recorded in any of the patients. The rise in haemoglobin (Hb) in second and third trimester of moderate and severe grade of anaemia was significant (P < 0.001). The target level of 10 g / dl was achieved in every patient. Only 03 patients received blood transfusion and that was for obstetric indications. No blood transfusion was because of anaemia per se. The rise in serum ferritin level was also statistically significant (P < 0.001). CONCLUSIONS Inj. FCM is an excellent modality to treat iron deficiency anaemia in pregnancy. It is safe and the rise of haemoglobin with correction of anaemia is satisfactory in a short span of time. In our country where only a handful of patients had regular antenatal check-up and non-compliancy and refractory anaemia is rampant, Inj. FCM is a big boon. KEYWORDS Iron Deficiency Anaemia, Inj. Ferric Carboxymaltose, Serum Ferritin, Blood Transfusion

Download Full-text

Moderate to severe maternal anaemia in pregnancy and its impact on perinatal outcome in tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201210 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1498

Author(s):

Ashram Khatana ◽

Suniti Verma ◽

Ram Narain Sehra ◽

Kanti Yadav

Keyword(s):

Perinatal Mortality ◽

Low Socioeconomic Status ◽

Tertiary Care ◽

Geographic Area ◽

Severe Anaemia ◽

Care Hospital ◽

Maternal Anaemia ◽

Anaemia In Pregnancy ◽

Moderate Anaemia ◽

In Pregnancy

Background: Anaemia is the commonest medical disorder in pregnancy and has a varied prevalence, etiology and degree of severity in different populations. The purpose of this study was to evaluate the prevalence of maternal anaemia in pregnancy and its impact on perinatal outcome.Methods: This was a prospective observational study conducted in department of obstetrics and gynecology JLN Hospital Ajmer, Rajasthan, India from October 2015 to December 2016. Total 325 pregnant women were included in the study who fulfilled the inclusion criteria and found to have moderate to severe anaemia.Results: Prevalence of anaemia in pregnancy was 80% in present study. Perinatal mortality was 13.3% in moderate anaemia and in severe anaemia 42%. In present study maximum 56% of cases were in the age group of 20-25 years, and maximum number of cases were primigravida (33.84%). Out of 225 cases of moderate anaemia only 50 cases (22.22%) had antenatal check-up once or twice. Out of 225 cases of moderate anaemia, 66.66% cases were rural and 33.33% cases were of urban group. Fetal outcome in present study was in form of 49.23% premature birth with 33.12% perinatal mortality.Conclusions: Maternal anaemia in pregnancy is associated with illiteracy, low socioeconomic status, multiparity, inadequate antenatal care and rural geographic area. Severe anaemia was associated with high perinatal mortality.

Download Full-text

Analysis of intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy at tertiary care hospital

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2019.v3.i5f.381 ◽

2019 ◽

Vol 3 (5) ◽

pp. 392-395

Author(s):

Dr. Ashok Kumar Devoor ◽

Dr. Rashmi K

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Intravenous Iron ◽

Severe Anaemia ◽

Iron Sucrose ◽

Care Hospital ◽

Anaemia In Pregnancy ◽

In Pregnancy

Download Full-text

Variability in unconjugated and total estriol in serum during normal third trimester pregnancy.

Clinical Chemistry ◽

10.1093/clinchem/26.13.1800 ◽

1980 ◽

Vol 26 (13) ◽

pp. 1800-1803 ◽

Cited By ~ 7

Author(s):

L L Penney ◽

W J Klenke

Keyword(s):

Birth Weight ◽

Third Trimester ◽

The Third ◽

Trimester Pregnancy ◽

Data Support ◽

Daily Data ◽

Unconjugated Estriol

Abstract We determined unconjugated and total estriol concentrations in serum during the third trimester in 34 normal gestations. Data were obtained weekly for 13 women for as long as nine weeks; 21 others were studied daily for up to 15 days. No correlation between birth weight and either estriol fraction was demonstrated. Between-patient variability was less for unconjugated estriol and was similar for weekly and daily data. Within-patient variability was also less for unconjugated estriol and, as expected, was less for daily than for weekly data. The CV for daily samples, within patient, averaged 13.0% for unconjugated estriol and 20.3% for total estriol. Our data support the daily determination of unconjugated estriol in serum, evaluated for percent changes from single or mean preceding values, as the preferred method of monitoring estriol during pregnancy.

Download Full-text

Comparative assessment of informational content of the equations of F.P. Hadlock and the computer program of V.N. Demidov in determination of term of gestation and fetal weight in the III trimester of gestation

10.21516/2413-1458-2017-16-2-145-150 ◽

2017 ◽

Author(s):

E.A. Derkach , O.I. Guseva

Keyword(s):

Computer Program ◽

High Precision ◽

Gestational Age ◽

Computer Programs ◽

Comparative Assessment ◽

Fetal Weight ◽

Informational Content ◽

Third Trimester ◽

The Third

Objectives: to compare the accuracy of equations F.P. Hadlock and computer programs by V.N. Demidov in determining gestational age and fetal weight in the third trimester of gestation. Materials: 328 patients in terms 36–42 weeks of gestation are examined. Ultrasonography was performed in 0–5 days prior to childbirth. Results: it is established that the average mistake in determination of term of pregnancy when using the equation of F.P. Hadlock made 12,5 days, the computer program of V.N. Demidov – 4,4 days (distinction 2,8 times). The mistake within 4 days, when using the equation of F.P. Hadlock has met on average in 23,1 % of observations, the computer program of V.N. Demidov — 65,9 % (difference in 2,9 times). The mistake more than 10 days, took place respectively in 51,7 and 8,2 % (distinction by 6,3 times). At a comparative assessment of size of a mistake in determination of fetal mass it is established that when using the equation of F.P. Hadlock it has averaged 281,0 g, at application of the computer program of V.N. Demidov — 182,5 g (distinction of 54 %). The small mistake in the mass of a fetus which isn't exceeding 200 g at application of the equation of F.P. Hadlock has met in 48,1 % of cases and the computer program of V.N. Demidov — 64,0 % (distinction of 33,1 %). The mistake exceeding 500 g has been stated in 18 % (F.P. Hadlock) and 4,3 % (V.N. Demidov) respectively (distinction 4,2 times). Conclusions: the computer program of V.N. Demidov has high precision in determination of term of a gestation and mass of a fetus in the III pregnancy.

Download Full-text

935. Effect of Tesamorelin in People with HIV with and without Dorsocervical Fat: Post Hoc Analysis of Phase III Double Blind Placebo Control Trial

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1121 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S500-S501

Author(s):

Farah Rahman ◽

Marilyn de Chantal ◽

Pedro Mesquita ◽

Judith A Aberg

Keyword(s):

Growth Hormone ◽

Abdominal Fat ◽

Fat Deposition ◽

Phase Iii ◽

Placebo Control ◽

People Living With Hiv ◽

Anthropometric Parameters ◽

Double Blind ◽

Post Hoc Analysis ◽

Post Hoc

Abstract Background Lipohypertrophy is defined as excess fat deposition in abdominal defined as visceral adipose tissue (VAT) as well as in the dorsocervical region, breasts, trunk, and along with possible fat deposition in liver, muscle, myocardium and epicardium. Multiple factors have been described as contributing to lipohypertrophy in people living with HIV (PLWH), including patient characteristics, antiretroviral therapy (ART) and also impaired growth hormone (GH) secretion. Tesamorelin, a synthetic form of growth-hormone-releasing hormone (GHRH), is indicated for reduction of excess abdominal fat in PLWH with lipodystrophy Methods Post-hoc analysis was done on phase 3 randomized, double-blind, multicenter trials. Patients were eligible if between 18 and 65 years of age, had confirmed HIV infection, had evidence of excess abdominal fat accumulation and on stable ART regimen for 8 weeks or more. Participants were randomized to receive tesamorelin 2 mg daily or placebo daily for 26 weeks. Only tesamorelin responders, defined as patients with at least 8% decrease in VAT and who were adherent to the medication, were used for this analysis. Results are reported for patients with and without dorsocervical (DC) fat deposition. Results Demographic characteristics of responders at week 26 are shown according to presence or absence of DC fat (Table 1). At week 26, on average, the patients with DC fat deposition had higher BMI and waist circumference (WC) than the group without DC fat. Most patients in both groups had lipoatrophy. Metabolic and anthropometric parameters were measured at week 26 in patients with and without DC fat (Table 2). There was a decrease in VAT and also an improvement in their WC at week 26 in both groups. Table 1: Baseline Characteristics of Tesamorelin Responder Subjects at Week 26, by Dorsocervical Status Table 2: Change in Abdominal Adiposity, Insulin-Like Growth Factor-1 Levels, and Metabolic Parameters Between Baseline and Week 26 Among Tesamorelin Responders Conclusion This data demonstrates that tesamorelin is effective at reducing VAT in both patients with and without DC fat. The medication was well tolerated without significant changes to metabolic based measurements. Treatment of excessive VAT with tesamorelin has seemingly positive results in fat reduction in patients with or without DC fat deposition and our study contributes to the growing literature. Disclosures Marilyn de Chantal, PhD, Theratechnologies Inc (Employee) Pedro Mesquita, PhD, Theratechnologies, Inc. (Employee) Judith A. Aberg, MD, Theratechnology (Consultant)

Download Full-text

Determination of Ethnic Variation in Infant Nasolabial Anthropometry Using 3D Photographs: Implications for Bilateral Cleft Lip Nasal Correction

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211024470 ◽

2021 ◽

pp. 105566562110244

Author(s):

Diana S. Jodeh ◽

Jacqueline M. Ross ◽

Maria Leszczynska ◽

Fatima Qamar ◽

Rachel L. Dawkins ◽

...

Keyword(s):

African American ◽

Interrater Reliability ◽

Cleft Lip ◽

Pearson Correlation ◽

Statistical Significance ◽

3D Analysis ◽

Pediatric Clinic ◽

Bilateral Cleft Lip ◽

Post Hoc

Objective: We aimed to assess significant ethnic variabilities in infants’ nasolabial anthropometry to motivate variations in surgical correction of a synchronous bilateral cleft lip/nasal anomaly, specifically whether a long columella is a European feature, therefore accepting a short columella and/or delayed columellar lengthening suitable for reconstruction in ethnic patients. Methods: Thirty-three infants without craniofacial pathology (10 African American [AA], 7 Hispanic [H], and 16 of European descent [C]), ages 3 to 8 months, presenting to the Johns Hopkins All Children’s general pediatric clinic were recruited. Four separate 3D photographs (2 submental and frontal views each) were taken using the Vectra H1 handheld camera (Canfield Imaging). Eighteen linear facial distances were measured using Mirror 3D analysis (Canfield Imaging Systems). Difference between ethnicities was measured using analysis of variance with the Bonferroni/Dunn post hoc comparisons. Pearson correlation was employed for interrater reliability. All statistical analyses were carried out using SPSS version 21.0 (IBM Corp), with statistical significance set at P < .05. Results: Nasal projection (sn-prn) and columella length (sn-c) did not differ significantly between groups ( P = .9). Significant differences were seen between ethnic groups in nasal width (sbal-sbal [C-AA; P = .02]; ac-ac [C-AA; P = .00; H-AA; P = .04]; al-al [C-AA; P = .00; H-AA; P = .001]) and labial length (sn-ls [C-AA; P = .041]; sn-sto [C-AA; P = .005]; Cphs-Cphi L [C-AA; P = .013]; Cphs-Cphi R [C-AA; P = .015]). Interrater reliability was good to excellent and significantly correlated for all measures. Conclusions: African American infants exhibited wider noses and longer lips. No difference was noted in nasal projection or columella length, indicating that these structures should be corrected during the primary cleft lip and nasal repair for all patients and should not be deferred to secondary correction.

Download Full-text