Management of Upapluta Yonivyapad (Vulvovaginitis) during Pregnancy - A Case Study

Author(s):  
Dr. Karishma Kapoor ◽  
Dr.Padmasaritha K ◽  
Dr. Ramesh M

Pregnant women commonly develop increased vaginal discharge, which in many instances is not pathological. Pregnancy is associated with specific anatomical, physiological and immunological changes that can predispose to infection and also alter the response to the disease process. Infections in pregnancy demands prompt adequate and careful management. Vulvovaginitis during pregnancy may be considered under the umbrella of Upapluta Yonivyapad. Pregnant women are more prone to vulvovaginitis which is a great challenge for obstetricians today. In Ayurveda, Upapluta Yonivyapad described by Acharaya Charaka, Sharangadhara and both Vagbhata can be compared to vulvovaginitis during pregnancy. Here Panchawalkala Kwatha Prakshalna followed by Jatyadi Taila Pichu externally and Tab Leukol internally has been used to correct Garbhini Upapluta.

2021 ◽  
Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.


Author(s):  
Aakriti Gupta ◽  
Jyoti Hak ◽  
Isha Sunil ◽  
Amita Gupta

Background: Hypertension in pregnancy is one of the serious complications of pregnancy with an incidence of 5% to 7% of all pregnancies, particularly in cases with preeclampsia and eclampsia. Though platelet count during pregnancy is within the normal non pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity of the disease process and duration of PIH syndrome.Methods: A prospective observational study was conducted on 200 pregnant women attending OPD Or Inpatients in the Department of Obstetrics and Gynecology, SMGS Hospital, GMC Jammu from November 2015 to October 2016. Pregnant women beyond 28 weeks gestation of pregnancy are included and divided into two groups i.e. the study and control group. Platelet counts will be done every 4 weeks in controls and weekly in subjects from 28 weeks till delivery.Results: The mean platelet count observed among cases of mild preecclampsia, severe preeclampsia and ecclampsia was 2.26, 1.63 and 0.99 lakh/mm3 respectively. The difference in mean platelet count among cases and controls was statistically significant. The association of platelet count with severity of different categories of PIH was analysed statistically and was highly significant.Conclusions: Platelet count is a very important investigation for the antenatal mother having PIH, as it is directly related to maternal and perinatal outcome. Routine and regular monitoring of platelet count can be included in the routine antenatal checkup among the pregnant women with PIH.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Nkosinathi Joyisa ◽  
Dhayendre Moodley ◽  
Thandeka Nkosi ◽  
Raesetja Talakgale ◽  
Motshedisi Sebitloane ◽  
...  

Background. High rates of bacterial vaginosis (BV) have been described in nonpregnant South African women. Studies of BV in South African pregnant women are sparse. Diagnosis and prompt treatment of BV in pregnancy are expected to have a positive impact on pregnancy outcomes and HIV prevention. This study was undertaken to determine the prevalence of BV in pregnant women in a high HIV burden periurban setting in KwaZulu-Natal and explore how to enhance BV diagnosis in this setting where syndromic management of sexually transmitted diseases is the standard of care.Methods. In this cross-sectional study, consenting HIV uninfected pregnant women were examined for abnormal vaginal discharge; nurses determined the vaginal pH and collected a vaginal swab for Gram-stain and Nugent scoring.Findings. Among 750 HIV uninfected pregnant women, 280 (37.3%; 95%CI 33.9-40.9) tested positive for BV. Using a vaginal pH > 4.4, 65% of women with BV were correctly identified, while an abnormal vaginal discharge correctly identified a significantly lower proportion (52.9%) of women with BV (p=0.005). The sensitivity, specificity, and positive and negative predictive values of vaginal pH testing were 65.9% (95%CI 60.0 – 71.5%), 61.4% (95%CI 56.8 – 65.9%), and 50.1% and 75.4%, respectively. The 20-24 year-old pregnant women were twice more likely to test positive for BV than the adolescent pregnant women (43.6% vs 21.1%) (p = 0.037) and BV was not associated with the duration of a sexual relationship, frequency of unprotected sex during pregnancy, number of lifetime sex partners, or the partner’s age.Conclusion. There is a high burden of primarily asymptomatic BV in HIV uninfected pregnant women in this periurban setting. Both the sensitivity and specificity of vaginal pH testing are superior to the symptomatic diagnosis of BV but not good enough to be used as a screening tool.


2021 ◽  
Vol 1 ◽  
pp. 1669-1673
Author(s):  
Lutfiah Febriana ◽  
Nina Zuhana

AbstractAnemia is a condition where the level of hemoglobin in the blood is less than the normal limit (<12 g%) caused by a lack of iron in the body due to malnutrition. While anemia in pregnancy is a condition where the hemoglobin level in pregnant women is <11gr% or <10.5gr% in third trimester pregnant women which generally occurs due to the hemodilution process. The purpose of this case to find out the cause of anemia in late pregnancy and the treatment that can be done to prevent complications that occur with care to routinely consume blood-added tablets (Fe) and recommend foods high in iron. This care design used a comprehensive care method for pregnant women in the third trimester who experience mild anemia (haemoglobin <10,5gr%) in Kalimade Village, Kesesi District, Pekalongan Regency. The results of this care showed an increase in hemoglobin levels in the mother. The conclusion of this case study shows that regularly consuming Fe tablets can increase hemoglobin levels in the blood so that it can prevent and treat anemia. For this reason, pregnant women are expected to routinely consume Fe tablets during pregnancy and midwives are expected to provide education about the benefits of Fe tablets to pregnant women to prevent anemia.Keywords: Haemoglobin; Anemia; Pregnancy AbstrakAnemia merupakan suatu kondisi dimana kadar haemoglobin dalam darah kurang dari batas normal (<12 gr%) yang disebabkan karena kurangnya zat besi didalam tubuh akibat kurang gizi. Sedangkan anemia pada kehamilan adalah kondisi dimana kadar haemoglobin pada ibu hamil <11gr% atau <10,5gr% pada ibu hamil trimester III yang umumnya terjadi karena adanya proses hemodilusi. Tujuan dari kasus ini yaitu untuk mengetahui penyebab terjadinya anemia pada kehamilan lanjut serta penanganan yang dapat dilakukan guna mencegah terjadinya komplikasi yang mungki terjadi dengan asuhan untuk rutin mengkonsumsi tablet tambah darah (Fe) serta anjuran mengkonsumsi makanan tinggi zat besi. Rancangan Asuhan ini menggunakan metode asuhan komprehensif pada ibu hamil trimester III yang mengalami anemia ringan (Haemoglobin <10,5gr%) di Desa Kalimade Kecamatan Kesesi Kabupaten Pekalongan. Hasil asuhan ini menunjukan adanya peningkatan kadar haemoglobin pada ibu. Simpulan studi kasus ini menunjukan bahwa dengan rutin mengkonsumsi tablet Fe dapat meningkatkan kadar Haemoglobin dalam darah sehingga dapat mencegah serta mengobati anemia. Untuk itu ibu hamil diharapkan agar rutin mengkonsumsi tablet Fe selama kehamilan. Bidan diharapkan agar bisa memberikan edukasi tentang manfaat tablet Fe pada ibu hamil guna mencegah terjadinya anemia.Kata kunci: Haemoglobin; Anemia; Kehamilan


2020 ◽  
Author(s):  
Etienne KAJIBWAMI BIRINDWA ◽  
Guy MULINGANYA MULUMEODERHWA ◽  
Olivier NYAKIO ◽  
Guy-Quesney MATESO MBALE ◽  
Serge ZIGABE MUSHAMUKA ◽  
...  

Abstract Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.


2017 ◽  
Vol 38 (02) ◽  
pp. 174-184 ◽  
Author(s):  
Amita Gupta ◽  
Jyoti Mathad

AbstractPregnant women experience physiological and immunological changes that increase the risk or severity of certain pulmonary infections. These changes also affect drug disposition, which impacts treatment choices. In this article, we review the available data on (1) the physiological and immunological changes that specifically impact tuberculosis, influenza, and varicella pneumonia; (2) active and latent tuberculosis management, including drug monitoring and maternal–infant outcomes; (3) the treatment and prevention of influenza; and (4) the diagnosis and management of varicella pneumonia. Clinical trials often exclude pregnant women, but there is a consensus that treating pregnant women for tuberculosis, influenza, and varicella pneumonia improves outcomes for both the woman and her child.


Author(s):  
Vaibhav Suresh Khairnar ◽  
Manjushri Ravi Waikar

Background: Pregnancy represents a risk factor in the occurrence of vaginal infection. This study was undertaken to define the persistence of vaginal flora in 280 pregnant women at 14 to 34 weeks' gestation and to evaluate the role of cytology in diagnosis of vaginal infections. It aims to study the maternal and neonatal outcome in pregnancy with vaginal discharge.Methods: High vaginal swab samples and data on epidemiological characteristics were collected from 280 pregnant women between 14-34 weeks with complaints of abnormal vaginal discharge at booking clinic of Indira Gandhi Government Medical College, Nagpur. Vaginal swab was collected and sent to laboratory for further investigation to establish etiological diagnosis. After diagnosis by vaginal swab report, subjects were treated with the specific treatment to individual infection. Subjects were followed up during antenatal period for complications. A birth weight of delivered baby was noted. The data was analysed using software Graph Pad in stat 3.Results: The incidence of abnormal vaginal discharge in pregnancy was 23.9% in one year. The frequency of abnormal discharge was 53% among those aged 20-24 years (97/183), 49.2% in primigravida (65/132). Pain in lower abdomen and back was the most common symptoms i.e. 88.19% in Cases, while 17.36% had vulval pruritus and 14.58% had dysuria.Conclusions: This study recommend that women complaining of vaginal discharge in pregnancy should be evaluated for infections. this study supports CDC-P recommendation as all women who have symptomatic vaginitis, should be treated regardless of pregnancy status.


2019 ◽  
Vol 6 (3) ◽  
pp. 922
Author(s):  
Pooja Sutaria ◽  
Meera Cholera ◽  
Shilpa B. Donga

Background: Pregnancy is associated with specific anatomical, physiological and immunological changes that can predispose to infection and also alter the response to the disease process. Infections in pregnancy demands prompt adequate and careful management. The disease process as well as the treatment protocol may have profound effects on the outcome of pregnancy. Pregnant women frequently develop vaginal discharge which can lead to complications during pregnancy like abortions, premature birth, low birth weight and other morbidities. Some of the infections may be serious and life threatening for the mother while others may seriously jeopardize the fetus or neonate leaving the mother asymptomatic. The aim and objective of this study was based on the present study was aimed to study the prevalence of vaginal candidiasis among pregnant patients who were visited in outdoor patient’s department of Prasutitantra and Streeroga.Methods: About 135 high vaginal swabs were collected from the women who carrying 2nd and 3rd trimester of pregnancy with symptoms of vaginal infection. These samples were tested under microscopic examination and culture on Mac Conkey agar, blood agar and Sabouraud dextrose agar respectively. Colonial morphology, wet/K.O.H. preparation, gram staining, germ tube test, were carried out for identification of the isolated organisms.Results: Out of 135 samples collected, 61 (45.18%) patients were shown positive fungal infection of candidial species. The age group showing the highest number of positive candidiasis was of 20 to 25 years. Multigravida (60%) were more commonly affected than primigravida (40%) and commonly seen in third trimester (67.41%).Conclusions: Vaginal Candidiasis was common in pregnant women with more common in young adults.


2020 ◽  
Author(s):  
ETIENNE KAJIBWAMI BIRINDWA ◽  
Guy MULINGANYA MULUMEODERHWA ◽  
Olivier NYAKIO ◽  
Guy Quesney MATESO MBALE ◽  
Serge ZIGABE MUSHAMUKA ◽  
...  

Abstract Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.


Author(s):  
Etienne Kajibwami Birindwa ◽  
Guy Mulinganya Mulumeoderhwa ◽  
Olivier Nyakio ◽  
Guy-Quesney Mateso Mbale ◽  
Serge Zigabe Mushamuka ◽  
...  

Abstract Introduction Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus. Case presentation We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-CoV-2 during the last term of her pregnancy. She gave birth by caesarean at 34 weeks of gestation to a newborn baby also infected with SARS-CoV-2. The peri-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels. Conclusion This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.


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