scholarly journals Dengue Shock Syndrome Complicating High Risk Twin Pregnancy during Late Gestation: Extinguishing Fuel added Flames

Author(s):  
Sparsh Madaan ◽  
Dhruv Talwar ◽  
Sunil Kumar ◽  
Arpita Jaiswal ◽  
Neema Acharya ◽  
...  

Incidence of Dengue has been on the up rise ever since the second wave of the pandemic of COVID19 has ended introducing an old enemy on the frontline to the health care professionals.A 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy presented with fever along with chills and retro orbital pain along with body ache since two days in the emergency department  with the gestational age of 36 weeks.She tested positive for Dengue NS1 antigen.Patient was having thrombocytopenia and was managed with intravenous fluids,platelet and blood transfusion and was taken for caesarian section and she delivered twins with normal birth weight.During the post operative period the patient went into dengue shock syndrome and which was managed with fluids and inotropic support and patient ultimately recovered and was discharged on day seventeen of admission .This case report emphasises on the importance of prompt detection and management of dengue in a case of high risk pregnancy such as twin pregnancy.After extensive review of literature we found that this is the first case report to report the association of twin pregnancy with dengue shock syndrome making it an important topic of discussion.

Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.


Author(s):  
Seeta Sunil Garag ◽  
Vinay Raju D.

Background: Development of two fetus inside the uterus is called twin gestation. Twin gestation is considered as high-risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies. The past two decades have witnessed a sharp rise in the incidence of twin and higher order gestations.Methods: Prospective analytical study of all women admitted in Obstetrics and Gynaecology department with twin pregnancy at KIMS Hubli, over a period of one year between November 2016 and October 2017.Results: There were 11,127 deliveries occurred in study period of one year, out of which there were 174 twin deliveries accounting for 1.56% of prevalence rate. Anemia was the commonest complication occurring in 160 cases contributing around 90%. Preterm delivery was the second complication occurring in 124 cases accounting for 71%. Among 348 babies, there were 40 perinatal death accounting 11%. There was no maternal death.Conclusions: Twin pregnancy is a high-risk condition, should have mandatory hospital delivery. Early detection, proper treatment improves both maternal and neonatal outcome.


2010 ◽  
Vol 30 (5) ◽  
pp. 511-515 ◽  
Author(s):  
Hyungsuk Kim ◽  
Min-Jeong Park ◽  
Tae-Jung Sung ◽  
Ji Seon Choi ◽  
Jungwon Hyun ◽  
...  

Author(s):  
Pooja Chandak ◽  
Shobha Toshniwal

Multifetal gestation is often a high-risk pregnancy and especially the monochorionic twin pregnancy significantly contributes to fetal morbidity and mortality. Acardiac twinning, earlier known as chorioangiopagus parasiticus, is the most extreme manifestation of this condition. An acardiac twin is a rare complication of multifetal pregnancy, in the literature reported at an incidence of 1% of monochorionic twin pregnancies, i.e. 1 of 35,000 pregnancies. Often results from abnormal placental vascular anastomoses. This leads to twin reversal arterial perfusion with complex pathophysiology. Here authors present a case of acardiac twin pregnancy presented at 26 weeks with the ultrasonography report suggested?? Placental teratoma of size 11×11×13 cm with polyhydramnios as there was no reason to suspect something else as the picture described in the USG report with the polyhydramnios was fitting with the diagnosis of placental teratoma but as the scan was done at taluka place and the images provided were not clear authors decided to confirm the diagnosis from fetal medicine specialist as MTP was not the option for the patient as she was 28 weeks who confirmed that as a case of acardiac twin pregnancy and the case was managed accordingly.


Author(s):  
Bijal D. Rami ◽  
Somika Kaul

Background: Twin pregnancy being one of the causes of high-risk pregnancy is associated with both maternal and fetal complications. This study aims at analysing the fetal and maternal outcome in such cases. All cases were studied according to their parity, maternal age, fetal presentation, mode of delivery and gestational age.Methods: This prospective study was conducted at one of the tertiary care teaching institutes over a period of one year from January 2018 to December 2018. Out of a total number of 7295 deliveries, 130 were twin pregnancy. It included all women admitted in labour room with clinical or ultrasound diagnosis of twin pregnancy after 20 weeks of gestation.Results: In the present study incidence of twin pregnancy was 1.78%. We observed the highest incidence of twins in the age group of 20-29 years. The least incidence was below the age of 20 years. Incidence of twin pregnancy in our study in primipara was 47.7% and in multipara was 52.3%. Most of the patients (43%) delivered at 32-36 weeks of gestation. Maternal complications were noticed as anemia in 29.2% patients, pregnancy induced hypertension in 55.4% patients, post-partum hemorrhage in 4.6% patients, polyhydramnios in 3.1% patients, premature rupture of membranes in 8.5% patients, gestational diabetes in 0.8% patients and urinary tract infection in 2.3% patients. Majority of the patients delivered vaginally (60.8%), others by lower segment cesarean section (LSCS). In this study 95.8% babies were low birth weight. There were 34 neonatal deaths (13%).Conclusions: Twin pregnancy is a high-risk pregnancy associated with significantly increased maternal morbidity, neonatal morbidity and mortality. Such pregnancies require good antenatal care, early detection of maternal and fetal complications and timely referral to a centre well equipped for management of such cases. 


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