scholarly journals Prevalence of Hemolysis, Elevated Liver Enzymes, Low Platelet Count Syndrome in Pregnant Women in a Tertiary Care Hospital

2020 ◽  
Vol 58 (226) ◽  
Author(s):  
Sarita Sitaula ◽  
Tara Manandhar ◽  
Baburam Dixit Thapa ◽  
Ramesh Shrestha ◽  
Dinesh Dharel
Keyword(s):  
Platelet Count ◽  
Confidence Interval ◽  
Liver Enzymes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count

Introduction: Hemolysis, Elevated Liver Enzymes, Low Platelet count syndrome refers to biological syndrome occurring in pre-eclamptic and eclamptic women. There is a higher rate of maternal and perinatal morbidity and mortality due to the syndrome. So, the objective of the study is to find the prevalence and maternal- perinatal outcome in the syndrome. Methods: A descriptive cross-sectional study was done in a tertiary care hospital from 1st April 2017 to 30th March 2018 after obtaining ethical clearance from the Institutional Review Committee. The inclusion criteria were patients giving consent for participation and those who delivered in our hospital. Patient with the syndrome who delivered outside and referred in the postpartum period was excluded because details of the neonate may not be available. The Statistical Package for Social Sciences version 21 was used for the analysis of the data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 11974 deliveries, the prevalence of Hemolysis, Elevated Liver Enzymes, Low Platelet count syndrome was 83 (0.69%) at 95% Confidence Interval (59.06-78.94). Maternal complications were seen in 19 (22.9%) and common complications being acute renal failure 9 (47.37%) followed by postpartum hemorrhage 4 (21.05%). Nearly 27 (33%) of patients required maternal ICU stay and there was one maternal mortality. Conclusions: Hemolysis, Elevated Liver Enzymes, Low Platelet count syndrome is one of the major causes of maternal and perinatal morbidity and mortality. Hence early recognition and prompt management may improve maternal and fetal outcomes.

scholarly journals Audit of Clinical Profile and Outcomes of Acute Variceal Bleed in a Tertiary Care Hospital

2019 ◽  
Vol 10 (03) ◽  
pp. 166-171
Author(s):  
Anurag Lavekar ◽  
Vijaykumar TR ◽  
Nandeesh HP ◽  
Deepak Suvarna ◽  
Aradya HV ◽  
...  
Keyword(s):  
Platelet Count ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Serum ◽  
Clinical Profile ◽  
Serum Total Bilirubin ◽  
Care Hospital ◽  
Variceal Bleed ◽  
Increased Risk ◽  
Low Platelet Count

Abstract Aims The main purpose of this article is to conduct audit of clinical profile and outcomes of patients presenting with acute variceal bleed in a tertiary care hospital. Methods and Material This was a retrospective study of patients presenting with variceal bleed in a tertiary care center. Data were generated through a computerized electronic record system. Data of patients admitted for acute variceal bleed from August 2018 to December 2018 were collected and considered for analysis. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) 22.0 version. Results Overall, 107 cases were analyzed. In 89.7% (96) cases, cirrhosis of liver was a cause of variceal bleed. Besides, 77.6% (83) patients had large esophageal varices. Five patients (4.7%) required glue injection. Rebleed rate in present study was 0.9%. Mortality due to variceal bleed was 9.3% (10). Acute rebleed (p = 0.002), low mean arterial pressure (MAP; p = 0.001), low platelet count (p = 0.001), high serum creatinine (p = 0.001), high serum total bilirubin (p = 0.001), high international normalized ratio (INR; p = 0.001), and higher model for end stage liver disease (p = 0.001) were associated with increased risk of mortality. Door to endoscopy time (<12 hours or 12–24 hours) did not affect the mortality rate (p = 0.699). Terlipressin given 24 hours after endotherapy is equally effective as terlipressin given 5 days after endotherapy. Conclusion Mortality due to acute variceal bleed can be reduced with timely intervention. Low MAP, low platelet count, higher serum bilirubin and creatinine, and higher INR are predictors of increased mortality due to variceal bleed. Endoscopy done within 12 to 24 hours of presentation did not affect the outcome.

scholarly journals Clinical features, laboratory profile and outcomes among dengue patients admitted in a tertiary care hospital, Delhi NCR

2020 ◽  
Vol 7 (8) ◽  
pp. 3232
Author(s):  
Mohit Tiwari ◽  
Abhishek Tibrewal ◽  
Varun S. Pichika
Keyword(s):  
Dengue Fever ◽  
Clinical Features ◽  
Liver Enzymes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Elevated Liver Enzymes ◽  
Laboratory Profile

Background: Globally, dengue, a mosquito-borne viral infection, is the most rapidly spreading vector-borne disease. Dengue fever is endemic in >100 countries including India. Dengue has a variety of clinical presentations. The objective of the study was to understand the clinical features, laboratory profile and outcomes of dengue fever among patients admitted in a tertiary care hospital in Delhi, National Capital Region.Methods: This was a cross-sectional study among 75 dengue confirmed (NS-1 antigen and/or IgM antibody positive) patients with fever <1 week. The variables included were socio-demographic; clinical features; laboratory and radiological profile and outcomes. Descriptive analysis was used.Results: The majority of the patients were aged between 18-40 years 72% and predominantly males 68%. A total of 18.7% patients (malaria: 13.3% and chikungunya: 5.3%) had co-infection. Fever was present in all the patients, followed by myalgia (74.7% patients), retro-orbital pain/headache 69.3%, and vomiting 45.3%. The mean hemoglobin was 13.9 gm/dl, leukopenia 46.7% patients, thrombocytopenia 96.0% and elevated liver enzymes 69.3%. Radiological examination showed pleural effusion 6.7%, gallbladder wall thickening 6.7%, splenomegaly 4.0%, and hepatomegaly 2.7%. The outcomes included ICU care 17.3%, ventilator support 13.3%, blood transfusion 14.7%, and mortality 1.3% during the hospital stay.Conclusions: Dengue has become a major public health problem in India. The most common clinical features are fever, myalgia, headache and vomiting; laboratory abnormalities are leukopenia, thrombocytopenia and deranged liver enzymes. No specific treatment exists, but early detection and proper medical care lowers fatality rates. 

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

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.

scholarly journals Clinico-Demographic Profile and Pregnancy Outcome in Placenta Previa: A Study from Tertiary Care Hospital

2017 ◽  
Vol 15 (1) ◽  
pp. 2-4
Author(s):  
Husneyara Haque ◽  
Upendra Pandit
Keyword(s):  
Birth Weight ◽  
Blood Transfusion ◽  
Low Birth Weight ◽  
Pregnancy Outcome ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
College Teaching ◽  
Morbidity And Mortality ◽  
Care Hospital

Introduction: Placenta previa is an obstetric complication which causes considerable maternal and fetal morbidity and mortality during pregnancy. This study is done with the objective to find out the clinico-demographic factors associated with placenta previa and to analyze maternal and perinatal outcome in these cases. Methods: This was a retrospective study done in the department of Obstetrics and Gynecology of Nepalgunj Medical College Teaching Hospital, Nepalgunj, a tertiary care hospital from Midwestern Nepal. Relevant data were retrieved from maternity register from June 2015 to May 2017. All women who had undergone caesarean section for placenta previa were included in this study. Result: Out of total 5812 deliveries during the study period there were 50 caesarian sections done for placenta previa which is 0.86% of total deliveries. Maximum number of mothers belonged to 26- 30 years of age group. Commonest type of placenta previa was minor type. About 72% were multiparous. 20% had previous LSCS and 24% had previous abortion. Postpartum hemorrhage was present in 36% mothers and 32% received blood transfusion. About 64% new born were preterm and low birth weight. 34% babies had less than 7 apgar score at 5 min. Still births were 6%. Conclusion: Placenta previa poses greater risk and need of blood transfusion to mother as well as birth of preterm and low birth weight babies which leads to perinatal morbidity and mortality. Timely diagnosis, regular antenatal check up and effective management may improve pregnancy outcome.

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