Evaluation of Mood Changes AmongPeripartum Women at PKDAS Institute of Medical Science, Vaniyamkulam, Palakkad: A Prospective, Observational, Longitudinal Study

Background: The perinatal period is well established as an increased risk for development of serious mood disorders. Maternal mental health in developing countries gets less than its due attention. The present study was undertaken to evaluate mood changes in Peripartum period in our population and to identify demographic, obstetric, social and psychosocial risk factors associated with Peripartum depression using established scales.Material & Methods:A prospective, observational, longitudinal study conducted in PK das institute of medical science, vaniyamkulam, with 387 perinatal women for 12 months (February 2018– January 2019). Various scales EPDS (Edinburgh Postnatal Depression Scale), CMSS (Couple Marital Satisfaction Scale, IMS (Index of Marital Satisfaction), LES (Life Event Scale) were studied in Peripartum Period.Results:Among a total of 387 participants about half 189 (48.8%) were in 19-25 years of Age. Almost 30% and 40% had dissatisfied married life as per the CMS and IMS scales respectively. Just above 42% were screen positive for depression antenatally with EPDS & 39% (n = 151) in the immediate postpartum period. From these 151 screen positive cases in immediate postpartum period, 138 participants were followed up at 4-6 weeks (13 were lost to follow up) and up to 115 of 138 (83.3%) were screen positive for depression (N= 387, 29.7%), which was statistically significant (p<0.001). With EPDS during antenatal period there was no statistically significant relationship of depression with Education (p = 0.195), Occupation (p = 0.651) and pregnancy planned or unplanned (p = 0.223), whereas, Joint family, participants with dissatisfied marital relationship had increased risk of depression as evidenced by IMS and CMSS (p < 0.001). Participants with a previous male gender baby had less risk of developing depression (p< 0.001) & participants with previous 2 female children had increased risk of depression (p< 0.001).Conclusions:This study highlights importance of screening for maternal mental health problems during Peripartum period. Depression in immediate postpartum period is good predictor for increased risk of depression at 4-6 weeks postpartum.

MATERNAL AND PERINATAL OUTCOMES IN PREGNANCY ASSOCIATED WITH ABRUPTIO PLACENTA

Background: Placental Abruption is an important cause of antepartum haemorrhage. It is defined as the separation of the placenta either partially or totally from its implantation site before delivery. APH is a major cause of maternal and perinatal morbidity and mortality. Therefore the study was planned to study the maternal and perinatal outcomes in patients of abruption placenta. Methods: The present study was conducted in the department of obstetrics and gynaecology, SMGS, Hospital, Govt. Medical College Jammu over a period of 1 year. It was a prospective study and all case of Abruptio placenta ≥ 28 weeks of gestational age were included. Results: It was observed that maximum cases of Abruptio Placenta i.e 67.65% were multigravida. 41.47% of cases of Abruptio Placenta had hypertension. 4.41 % had Polyhydramnios. 61.76% delivered vaginally. 23.53% patients had postpartum haemorrhage whereas only 2.98% had undergone Postpartum Hysterectomy. The most common fetal complication in Abruptio Placenta was prematurity (35.71%). 5.89% patients of Abruptio Placentas died during Peripartum period. Perinatal mortality was high 48.58%. Conclusions: Abruptio placent is associated with significant maternal and perinatal morbidity and mortality. Good regular antenatal care and availability of emergency medical services remains the backbone for the good maternal and perinatal outcomes.

Lipid Metabolism in the Cattle in Different Stages of Reproductive Cycle

The aim of this study was to evaluate the effect of feeding dairy cows in different stages of reproductive cycle on biochemical parameters and oxidative stress. To evaluate the effect of oxidative stress on lipids and lipid metabolism and to determine the impact of nutrition and energy balance on oxidative stress in peripartum period and in early lactation. Concentrations of different biochemical parameters were measured but for this paper the most important ones were indicators of oxidative stress, cholesterol and triglycerides and also albumin. Factors associated with oxidative stress were period 3 weeks before calving and related to that negative energy balance and also content of nonfiber carbohydrates in the diet in peripartum period. However, further studies will be needed to more precisely determine the specific effects of diet and energy balance on oxidative stress in cows and to establish normal ranges for these biomarkers of oxidative stress.

Takotsubo cardiomyopathy in peripartum period: a case report

Cardiomyopathy is a group of disorders characterised by structural and functional abnormalities in the myocardium in the absence of other cardiac diseases of myocardial abnormality. Its occurrence in pregnancy is uncommon and exact incidence is unknown even though some studies shows that the incidence of peripartum cardiomyopathy is 1 in 1000 to 4000 births. Here we have discussed about a 34 years primigravida with twin pregnancy conceived after 12 years of married life by assisted reproductive technique (ART), admitted with preterm premature rupture of membranes (PPROM) at 28 weeks of gestation who developed a rare condition called Takotsubo cardiomyopathy (TC) in the peripartum period. She was managed in intensive care unit with oxygen supplementation, beta blockers, diuretics and heparin. Patient had an excellent recovery in the early postoperative period.