OUTCOMES OF COMPARISON BETWEEN EMERGENCY VS ELECTIVE LOWER SEGMENT CESAREAN SECTION

Objective; To compare emergency vs elective LSCS for their various outcomes. Study setting; Sheikh Zayed Hospital, Rahim Yar Khan Duration; 01-09-2018 to 28-02-2019 Methodology: This was a randomized controlled-trial, in which pregnant females irrespective of their duration of gestation, gravida and parity having age equal more than 20 years were included. The cases were subdivided into 2 equal groups. The cases in group A were operative for emergency C section surgery and those, who were in group B underwent elective surgery. These cases were then followed to look for various surgical outcomes. Results: In this study total 150 cases of C section were included with 75 in each group. The mean age of the group A and B was 28.87±4.43 vs 29.54±5.13 years and mean duration of gestation at presentation was 37.13±2.56 vs38.67±1.39 weeks. SSI was seen in 3 (5.33%) cases in emergency group vs 2 (2.66%) in elective group with p= 0.07. PPH was observed in 2 (2.66%) of the cases each with p= 1.0 and both hysterectomy and maternal mortality was observed in 1 (1.33%) cases each in emergency group with p= 0.81 each. Conclusion; Complications are rate are relatively higher in emergency as compared to elective C section and SSI is nearly significantly high in this group.

ASSOCIATION OF LOW VITAMIN D WITH PRE ECLAMPSIA

Objective: To determine the association of preeclampsia and vitamin D deficiency. Study design: Cohort study. Place and duration of study: Gynecology Department, Khwaja Muhammad Safdar Medical College, during 01-07-2018 to 31-12-2018. Material and Methods: In this study the pregnant females irrespective of their gravida and parity status and having gestational age more than 20 weeks were included. The cases that had vitamin D level lower were labelled as cases and those with normal levels as controls. They these cases were followed monthly until delivery and during this period they were followed for protein urea and BP to label pre eclampsia. Results: In this study 100 cases were selected. 50 in each group. Mean age in case and control group was 29.57±4.57 vs 28.43±3.79 years and mean duration of gestation at presentation was 26.43±5.11 vs 27.42±5.23 weeks. There were 39 vs 41 multigravida and 37 vs 38 uneducated females in cases and control group respectively. Preeclampsia was seen in 4 (08%) of control and 14 (28%) cases with odd ration of 4.47 (1.35 to 14.75) with p value 0.01. Conclusion: There is significant association of low vitamin D level and risk of pre eclampsia. Key words; pre eclampsia, vitamin D, Hypertension.

The influence of pregnancy duration of sows on the growth, development and livability of piglets during the pre-weaning period

The duration of gestation is one of the most important biological features of pigs, which affects the live weight of young animals at birth, the nature of their post-embryonic development, livability and future productivity, in particular the precocity and feed expenditures. The purpose of the research was to study the influence of the duration of sows’ gestation on the growth, development and livability of piglets during the pre-weaning period. The researches have been carried out on the basis of the farm of LLC “Russia” in the Mozhginsky district in the Udmurt Republic. Two groups of lactating sows of Large White breed have been formed for researches by using analogs method. The formation of groups of sows has been carried out taking into account the duration of gestation, age and number of farrows. It has been found as the result of the conducted researches that the piglets obtained from sows with the duration of gestation of 115,16 days significantly exceeded the herdmates born from sows with the duration of gestation of 110,08 days by live weight at birth by 6,40 %, live weight at weaning at the age of 30 days by 5,91 %, average daily gain by 5,85 % and the livability of piglets by 18,84 %. The indicator of the power of the influence of the duration of gestation on the live weight of piglets aged 30 days was 44,0 % with the Fischer confidence criterion (Fst) equal to 6,45 and the probability (reliability) of error-free forecasts at P > 0,99. The indicators of the power of the influence of the duration of pregnancy on the absolute and average daily weight gain, as well as on the number of piglets aged 30 days, respectively, were 43,0 and 46,0 %, with the Fisher confidence criteria of 6,26 and 6,91 and the probability of error-free forecasts P > 0,99 and P > 0,999, respectively. Positive correlation and regression coefficients have been found between the studied traits, which indicate that breeding for the duration of gestation will make it possible to increase the growth, development and livability of suckling piglets.

Perfluoroalkyl Substances Exposure in Early Pregnancy and Preterm Birth in Singleton Pregnancies: A Prospective Cohort Study

Background: Preterm birth (PTB, < 37 completed weeks’ gestation) is one of the global public health concerns. Epidemiologic evidence on the potential impact of perfluoroalkyl substances (PFAS) on PTB is still limited and inconsistent. We aimed to investigate the associations between prenatal PFAS exposure and PTB among singleton live births.Methods: We studied 2849 mother-infant pairs in the Shanghai Birth Cohort (SBC) from 2013 to 2016. Ten PFAS in maternal plasma in early pregnancy (gestational age, median (interquartile range): 15 (13 - 16) weeks) were measured. Primary outcomes were duration of gestation, PTB, spontaneous PTB and clinically indicated PTB. A linear regression model was used to assess the associations between ln-transformed PFAS and duration of gestation (in weeks). Logistic regression models were applied to estimate the relative risks of these outcomes. Results: The incidence of overall PTB was 4.8% (95% confidence limit: 4.0% - 5.6%, n = 136) in this study population. In the linear regression analyses, PFAS were not associated with the duration of gestation after controlling for potential confounders. In the multiple logistic models, no significant associations were observed between PFAS and overall PTB, spontaneous or indicated PTB. Conclusion: Our prospective cohort study shows that maternal plasma PFAS concentrations in early pregnancy was not associated with gestational length, overall PTB, spontaneous or indicated PTB.

The influence of the duration of gestation of sows on the development and the preservation of piglets in the suckling period

The duration of gestation is one of the important characteristics of pigs, which affects on the live mass young animal under birth, the him postembryonic development and him future productivity, in particular on the early maturity and the spending of feeds. The aim of the researches was to study the influenceof the duration of gestation of sows on the growth, development and preservation of suckling piglets. The researches were contacted on the basis of the economy of LLC «Russia» of the Mozhginsky district of the Udmurt Republic. For conduct researches the method of the analogs was formed 2 groups of the sucking sows of large white breed. In the first group of sows the average duration of gestation was 110.08 days, and in the second group of sows – 115,16 days. The age of the sows was 36 months, and the number of farrow was 4. The number of the sows in the groups was 12 and 30 heads; respectively. In the results conducted researches was established that young animals obtained from the sows with duration of gestation – 115,16 days authentically exceeded peers born from sows with duration of gestation – 110,08 days on the live mass under birth – by 6,40%, live mass under weaning in the 30 days – by 5,91%, average daily gain – by 5,85% and the preservation of piglets – by 18,84%.

Comparison of modern quantitative methods for determining level of D-dimer based on immunoturbidimetry

The object of this paper is the comparative analysis of the results of determination of the D-dimer level with the new home-produced reagent on the basis of original monoclonal antibodies with the results of the widespread diagnostic analogues. The research study included blood samples of 80 patients. 22 of these patients (27.5 %) were diagnosed venous thrombosises of the lower limbs, 28 patients (35.0 %) did not have any thrombotic complications (control group). Besides, the research included 30 pregnant women (37.5 %) with different duration of gestation. Despite some distinctions when determining the D-dimer level, contemporary quantitative methods of the D-dimer level study demonstrate comparability of the research results which is documented by the high rates of correlation. The new diagnostic kit Tech-D-dimer-auto, based on the use of original monoclonal antibodies, demonstrates good comparability with analogues and is suitable for detection of thrombosis.

Perfluoroalkyl Substances Exposure in Early Pregnancy and Preterm Birth in Singleton Pregnancies: A Prospective Cohort Study

Background: Preterm birth (PTB, < 37 completed weeks’ gestation) is one of the global public health concerns. Epidemiologic evidence on the potential impact of perfluoroalkyl substances (PFAS) on PTB is still limited and inconsistent. We aimed to investigate the associations between prenatal PFAS exposure and PTB among singleton live births. Methods: We studied 2849 mother-infant pairs in the Shanghai Birth Cohort (SBC) from 2013 to 2016. Ten PFAS in maternal plasma in early pregnancy were measured. Primary outcomes were duration of gestation, PTB, spontaneous PTB and clinically indicated PTB. A linear regression model was used to assess the associations between ln-transformed PFAS and duration of gestation (weeks). A logistic regression model was applied to estimate the risks of these outcomes within a ln-transformed continuous PFAS concentrations and across non-transformed quartiles of PFAS concentrations. A Cox proportional hazards model was also used to examine the associations by treating PFAS as continuous ln-transformed variables. Results: The incidence of overall PTB was 4.8% (95% confidence limit: 4.0% - 5.6%) in this study population. In the linear logistic regression analyses, PFAS were not associated with duration of gestation after controlling for potential confounders. In the multiple logistic model and Cox model analyses, no significant associations were observed between PFAS and overall PTB, spontaneous PTB or indicated PTB. Conclusion: Our prospective cohort study shows that maternal plasma PFAS concentrations in early pregnancy was not associated with gestational length, overall PTB, spontaneous PTB or indicated PTB.

Maternal periodontitis and its influence on duration of gestation and fetal birth weight

Background: There has been a lot of interest in knowing the effects of oral health on adverse pregnancy outcomes like preterm births and low birth weight. Studies have yielded contradicting results and there are lot of confounding issues that blur the picture. Aim of the study is to determine the prevalence of periodontitis is pregnant population and determine the effect of periodontitis on preterm births and low birth weight.Methods: This was a cross sectional study of singleton pregnant women attending ante-natal checkups with oral interview and clinical examination. Oral examination was done at the beginning of third trimester of pregnancy. They were followed up to delivery to note the duration of gestation, birth weight of babies.Results: The prevalence of periodontitis was 22% with 90.9% having mild and 9.1% having moderate periodontitis. Maternal education (high school and above) was associated with lower prevalence of periodontitis (p=0.042). There was no difference in the birth weights between the group with and without periodontitis (2.9±0.41kgs vs 2.74±0.36kgs, p=0.11). The incidence of low birth weights was also similar (p=0.22). The average gestational age was slightly less in the group with periodontitis (38 weeks 3 days vs 37 weeks 5 days) but the rates of preterm births were similar between the two groups (p=0.61).Conclusions: Mild/moderate periodontitis does not appear to have a significant effect on pre-term births and low birth weight. Maternal education and awareness seem to mitigate development of periodontitis and adverse pregnancy outcomes.