To determine the role of histological chorioamnionitis in preterm deliveries and to study its fetomaternal outcome. Methods: Two hundred women in age group of 21 -30 years were recruited for the study. Among these, 100 cases with gestational age ≥ 28 and < 37 weeks were taken as cases and 100 women with gestational age > 37 weeks as controls. Histopathologic examination of placenta was carried out after delivery in both the groups to look for evidence of chorioamnionitis or funisitis. Fetal outcome and maternal outcome was then noted and analysed. Results: In cases, 49% subjects had evidence of histological chorioamnionitis (HCA) in their placenta and 26% subjects in controls had HCA (p=0.0007). The rates of neonatal complications were significantly higher in subjects with HCA both in cases as well as controls. Severe and high grade of histological chorioamnionitis was further associated with poor neonatal outcome. There was no significant difference between the maternal outcome of cases and controls. Conclusion: Histological chorioamnionitis was significantly more prevalent in preterm deliveries and Neonates of patients with evidence of histologic chorioamnionitis are at higher risk for developing various neonatal complications.
Background: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with the onset or first recognition during pregnancy. It is a disease entity that adversely affects maternal as well as fetal outcome. DIPSI guideline having suggested one-time plasma glucose level has emerged as a simple, practical and cheap method to detect GDM. This study was done to evaluate the prevalence of gestational diabetes using Diabetes in Pregnancy Study Group India (DIPSI) criteria and further assess its feto maternal outcome in Kamla Nehru State Hospital for Mother and Child, IGMC, Shimla.Methods: This study was conducted in 500 patients between 24 and 28 weeks of gestation, attending the antenatal OPD. These patients were given 75g oral glucose irrespective of last meal and their plasma glucose was estimated at 2h. Patients with plasma glucose ≥140mg/dl were diagnosed as GDM and the rest as control or the non GDM group. The GDM patients were followed up and treated with medical nutrition therapy (MNT) and/or insulin therapy till delivery and maternal and fetal outcomes were then noted.Results: The prevalence of GDM in this study was 6%. Maternal and fetal complications were more in the GDM patients. Vaginal candidiasis and PROM were the common maternal complications, while hypoglycemia and hyperbilirubinemia were common in the fetuses.Conclusions: GDM adversely affects the mother as well as fetus. DIPSI guideline having suggested a single plasma glucose level test has emerged as a practical and economical method to detect GDM.
Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although the much studied phenomenon but yet much is to be learnt about the disease, etiology, pathogenesis, clinical course as well as the complications. The present study was conducted with an objective to determine the clinical and biochemical profile of such disorders. Methods: The present study is a sub-part of a case control study conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh. Clinical, biochemical and blood pressure parameters of all the participants were documented for the study purpose. Results: Adverse findings in all aspects were seen more often in cases than in normotensives. All non-exposed had systolic and diastolic blood pressure and in normal range. Odoema, pallor and cyanosis were more likely to be seen in hypertensives than controls. Liver function tests, renal function tests and platelet counts were deranged more often in cases than controls. Hyperhomocysteinemia was more commonly encountered among the cases of pre-eclampsia and eclampsia. Fundus examination revealed worse status in hypertensives. Conclusion: The study associates pregnancy induced hypertensive disorders and adverse biochemical, clinical and lab parameters as highlighted by vast literature. Timely screening of such parameters can definitely aid in achieving better maternal and foetal outcomes. Incorporation of homocysteine analysis in routine strategy can definitely strengthen the maternal health care.
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