A Comparative Study to Assess the Knowledge and Attitude Regarding Intra Uterine Growth Retardation and its Prevention Among Antenatal Mothers in Rural and Urban Areas

Intra Uterine Growth Retardation is an important cause of fetal and neonatal morbidity and mortality. The present study was undertaken to compare the knowledge and attitude regarding intra uterine growth retardation and its prevention among antenatal mothers in rural and urban areas Khammam, Telangana. The objectives of the study were to describe the levels of knowledge and attitude, to compare the levels of Knowledge and attitude in rural and urban areas, to find out the association between knowledge and attitude scores with their selected socio-demographic variables. A quantitative survey approach and comparative descriptive design was used for this study. The sample for current study is antenatal mothers who were residing at Raghunadhapalem rural area and Ballepalli urban area, Khammam. The sample size was 100((50 rural+50 urban) and the sample was selected by non-probability convenience sampling technique. Data was collected by using structure interview schedule. The Findings revealed that the knowledge means of antenatal mothers in rural and urban areas were 14.10 and 16.68 respectively. Standard deviations were 3.29 and 3.3 respectively. The ‘t’ calculated value was 3.89 which is significant at 0.05. The attitude means of antenatal mothers in rural and urban areas were 36.08 and 36.02 respectively. Standard deviations were 2.15 and 2.48 respectively. The ‘t’ calculated value was 0.12 which is significant at 0.05. The study concluded that the level of knowledge is low in rural area by comparing with urban area. There is an increased need for awareness program regarding intra uterine growth retardation and its prevention in selected setting in order to promote the health of the fetus and the mother.

Fetal Outcomes of Abnormal Placental and Birth Weight Ratio

Objective: To find out the fetal complications of abnormal placental and birth weight ratio. Materials and methods: This is a cross sectional study conducted from January 2019 to January 2020 at department of Gyn/Obs PMCH Nawabshah. Total 110 patients who met the criteria were included in this study. After history, clinical examination and required radiological and biochemical investigations, participants were delivered and weight of placenta and bay was measured and ratio was recorded. Results were made and conclusion was drawn. Results: Age difference was also seen in participants. Maternal age ranged from 18-35 years. 65(59%) patients ranged from 18 to 25 years. 30(27%) patients were of age between 26-30 years. 16(14%) aged from 31-35 years. Regarding fetal outcomes, Intra Uterine Growth Retardation (IUGR) was found to be among 30(27.27%), IUD in 3(2.72%), fetal distress in10 (9.09%), low APGAR in 7(6.36%), respiratory distress in 6(5.45%) and Cardio Vascular Diseases in 0% patients. Conclusion: To sum up, it is concluded that in our study, the common fetal outcome due to abnormal Abnormal Placental And Birth Weight Ratio (PBWR) was intra uterine growth retardation (IUGR) followed by IUD, fetal distress and low APGAR.

Comparison of Head Circumference and Abdominal Circumference Ratio in Normotensive and patients with Pregnancy Induced Hypertensive Disorders after 28 weeks of gestation

Background: Hypertensive disorders are an important medical problem of gestation. Hypertensive disorders of pregnancy (HDP) are a significant cause for maternal and fetal morbidity as well as mortality. Intrauterine growth retardation (IUGR) commonly describes the condition of fetus whose size or growth is subnormal. IUGR fetus is frequently described as symmetrical and asymmetrical IUGR in term of their body proportions. Asymmetric growth retardation is typically linked to uteroplacental inadequacy. Hypertension is one of the maternal causes of placental insufficiency. Aim: To compare head circumference and abdominal circumference ratio in normotensive and patients with pregnancy induced hypertensive disorders after 28 weeks of gestation. Methodology: A cross sectional analytical study was carried on 113 pregnant females in which 57 women were normotensive and 56 women were hypertensive. All individuals were scanned by two- dimensional ultrasound following 28 weeks of pregnancy to evaluate sonographic parameters HC and AC. The HC/AC ratio was estimated by dividing head circumference with abdominal circumference. Results: Out of 57 normotensive patients 27 (36.48%) fetuses were diagnosed with IUGR having HC/AC ratio more than 1, while 30 had normal HC/AC ratio. In 56 hypertensive patients 47(63.51%) fetuses were diagnosed with IUGR having HC/AC ratio greater than 1, however 9(23.07%) fetuses had HC/AC ratio within normal range. So out of total 113 patients, 74 fetuses were found with IUGR while 39 fetuses had HC/AC ratio within normal ranges. Our study found that a cut off value of ≥ 1.0974 for HC/AC ratio could be used as diagnostic parameter in predicting IUGR. Conclusion: HC/AC ratio is a useful parameter for the detection of IUGR. Keywords: Head Circumference, Abdominal Circumference, Intra Uterine Growth Retardation

Neonatal Gallstones

A term male infant was born by spontaneous vaginal delivery to a 23 year old gravida 2 para 2 mother. His weight, length, and head circumference were 2720g (8%), 47cm (6%) and 31.5cm (1%) respectively; the remainder of his physical examination was unremarkable. The pregnancy was complicated by intra-uterine growth retardation, gestational diabetes controlled with glyburide, and gestational thrombocytopenia. The mother had a past medical history of obesity, BMI of 32 (>95%), HPV infection, and atypical squamous cells of the cervix. A fetal ultrasound at 38 weeks gestational age showed echogenic foci consistent with cholelithiasis (Figure 1); a previous US at 37 weeks gestational age was normal. On routine laboratory testing the mother’s blood type was O positive and the infant’s was A+ (positive). His transcutaneous bilirubin was 4.3 mg/dL at 36 hours of life. Both mother and son were discharged after two days without problem.

EFFICACY OF ASHWAGANDHA AND YASHTIMADHU VATI WITH SHARKARAYUKTA DUGDHA IN INTRAUTERINE GROWTH RETARDATION (IUGR)

Background and Objective: To study the Efficacy of Ashwagandha and Yashtimadhu Vati with Sharkarayukta Dugdha in Intra-Uterine Growth Retardation (IUGR) and to see the side effects and adverse effects of Ashwagan- dha & Yashtimadhu during treatment. Methodology: The research was carried out at the Prasuti Avum StreeRoga Vibhag of Bharati Vidyapeeth’s Ayurved Hospital, Dhankawadi, Pune 43. In the clinical randomized study, a total of 25 patients, where they received Ashwagandha-2 BD (each vati 500mg) Yashtimadhu - 1 BD (each vati 500mg) with Sharkarayuktadugdhaand follow up after every 7 days for 1 month. Results: Comparing the as- sessment criteria before and after treatment, it was seen that there was significant action on IUGR. Treatment had no adverse effects in a clinical trial. Statistical Analysis: As per statistical analysis, Ashwagandha and Yash- timadhu Vati with Sharkarayukta Dugdha showed a significant effect. Conclusion: 1. In the present study, it has been proved that Ashwagandha Vati and Yashtimadhu Vati with Sharkarayukta Dugdha had a good effect on IUGR. 2. No adverse and side effects were found during or after the treatment neither on the mother nor on the fetus. Keywords: Ayurveda treatment, IUGR.

Probable Mode of Action of Sita kasmaryadi Herbal Decoction in Placental Compliance – A Review

The occurrence of IUGR (Intra uterine growth retardation) is estimated to be approximately 5% in the population and it is considered as the third leading cause for perinatal mortality in India. Despite plentiful management options, none is effectively proved in improving placental circulation and foetal weight gain. Indian medicine practices a herbal decoction with <em>Glycyrrhiza glabra</em> Linn., <em>Gmelina arborea Roxb</em>. ex. <em>Smith</em> and sugar. The pharmacological potentials of this decoction was attempted to explore here in this review based on available researches. Thorough internet search was performed to derive the data. Recent researches on detailed chemical composition and its possible pharmacological action also had been detailed. It is an effective formulation in improving placental and umbilical cord circulation, aids in improving foetoplacental circulation to a greater extent with negligible side effects.

Pregnancy outcome study between Pradhan mantri surakshit matriva abhiyan service utilization group and pradhan mantri surakshit matriva abhiyan service non-utilization group: a comparative study

Background: Safe pregnancy has become a social movement in our country. Almost 15 % of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancies at earliest stage will be useful in directing appropriate intervention. Hence this study was done to evaluate the betterment of pregnancy outcome of the women who had taken the adequate service of Pradhan Mantri Surakshit Matriva Abhijyan service (PMSMA) than who had not.Method: A longitudinal study was conducted at Malda medical college during January 2019 to June 2019. 385 women selected who had taken at least three antenatal checkups (from record analysis) at PMSMA designated clinic and another 385 women selected who had not taken PMSMA services. Women of both groups were followed up their delivery events and puerperal days till discharge from hospital. Pregnancy outcomes were compared and statistical analysis of both groups were done by SSPS software. Results: A significant outcome difference of PMSMA service utilized and non-utilized groups in respect to fetal and maternal parameters including moderate to severe anemia, (12.98% vs 26.49%), intra uterine growth retardation (IUGR, 20.0% vs 29.87%), hypertensive disorders in pregnancy (HDP, 8.31% vs 13.50%), low-birth-weight (21.30% vs 31.16%) and stillborn (1.29% vs 2.89%) were observed.Conclusions: This study showed positive pregnancy outcome of PMSMA utilized group than non-utilized group. Improving the availability and accessibility of quality antenatal and delivery care through PMSMA services in all our institutions, will improve pregnancy outcome.

EDUKASI GIZI PADA IBU HAMIL DI KELURAHAN PISANG KECAMATAN PAUH KOTA PADANG

Kekurangan Energi Kronis merupakan masalah pada ibu hamil yang prevalensinya fluktuasi dan dapat menimbulkan dampak negatif pada bayi yang akan dilahirkannya. Kegiatan ini bertujuan untuk memberikan penyuluhan dan edukasi kepada ibu hamil dengan Kurang Energi Kronis yang berada di wilayah kerja Puskesmas Pauh tepatnya Kelurahan Pisang untuk mengetahui, memahami dan mengaplikasikan pengetahuan tentang asupan gizi yang baik untuk ibu hamil sehingga dapat menurunkan insidensi intra-uterine growth retardation yang mampu berujung pada status gizi anak yang buruk. Kegiatan ini dilakukan di Kelurahan Pisang Kecamatan Pauh Kota Padang dengan melibatkan seluruh sektor yang terkait. Kegiatan ini berupa serangkaian acara berupa pelatihan kader dan penyuluhan pada ibu hamil dengan kekurangan energi kronis yang didahului dengan pretest, launching kelas ibu hamil, demonstrasi memasak dan konsultasi kehamilan. Hasil kegiatan setelah acara dilakukan post-test untuk menilai peningkatan pengetahuan ibu hamil dan kader. Peningkatan tingkat pengetahuan pada ibu hamil setelah dilakukan penyuluhan gizi yang baik pada kehamilan dari 54,5 % menjadi 63,6 % tergolong baik, 36,3 % ke 27,2 % tergolong cukup dan yang memiliki pengetahuan kurang sebesar 9 %. Program bantu siaga asupan gizi mama kekurangan energi kronik terbukti dapat meningkatkan pengetahuan ibu hamil dan kader tentang pentingnya asupan zat gizi dalam mencegah terjadinya kekurangan energi kronis pada ibu hamil, serta pentingnya nutrisi pada ibu hamil dengan kekurangan energi kronis agar tidak berdampak pada bayi yang dikandungnya.

A COMPARATIVE STUDY OF MACROSCOPIC MORPHOLOGY OF PLACENTA AMONG NORMAL AND COMPLICATED PREGNANCIES

The placenta being a foetal organ, undergoes the same stress and strain to which the foetus is exposed. Common yet life threatening complications of Pregnancy like Gestational Diabetes, Hypertension, Anaemia and Intra uterine growth retardation result in both macroscopic as well as microscopic changes in the placenta. Hence study of the placenta will give a valuable insight in cases of adverse foetal outcome. The present study was conducted on a total of two hundred and ninety two freshly delivered placentae with umbilical cord obtained from the labour rooms and operation theatres of the Department of Obstetrics & Gynaecology and received at the Department Of Anatomy, PMCH, Patna, Bihar. Exclusion criteria was multiple pregnancy. Inclusion criteria's were normal uncomplicated primigravida and multigravida and pathological factors complicating pregnancy like Anaemia, Gestational Diabetes mellitus, Pregnancy induced Hypertension and prematurity. The 292 placentae were divided into four categories according to the risk factors and clinical diagnosis of pregnant women namely normal patients (147), patients with Pregnancy induced hypertension (15), Gestational Diabetes mellitus (30), anaemia (65) and preterm (35). The circular type of placenta is the common shape of placenta. The diameter of the placenta is increased in anaemia, gestational diabetes and decreased in prematurity. The weight of the placenta is increased in gestational diabetes mellitus, anaemia and decreased in prematurity. The number of maternal cotyledons is decreased in prematurity and increased in gestational diabetes mellitus. The eccentric type of cord attachment is the most common type in complicated pregnancies. The diagnosis of such risk factors in pregnancies during antenatal period and early intervention will improve the perinatal outcome.