:Objective(s) : To compare the role of middle cerebral artery and umbilical artery Doppler pulsatility indices in predicting the fetal outcome in intrauterine growth restriction. Method(s) : The prospective study was conducted on 121 subjects. They were divided into two groups. The study group (n=71) consists of high risk group of pregnant women with growth restricted fetuses. The control group (n=50) consists of pregnant women with healthy fetuses. Both the groups were evaluated by middle cerebral artery and umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Results : Mothers with abnormal velocimetry had more number of cesarean sections to prevent fetal distress than those with normal velocimetry. The subjects with high risk factors had more number of abnormal waveforms than those without high risk factors. The predictive value of Doppler P.I for detecting abnormal fetal outcome was 94% in middle cerebral artery as against 83% for umbilical artery. The sensitivity was 71% for middle cerebral artery versus 44% for umbilical artery. Conclusion : Growth restricted fetuses with normal flow velocimetry are at a lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower as compared to that of neonates with normal velocimetry. Thus middle cerebral artery doppler indices were a better predictor for fetal outcome in IUGR when compared with umbilical artery in terms of sensitivity and predictive value.

LDH is the earliest marker seen in blood during hypoxia and oxidative stress. It is a useful biochemical marker that reflects the severity of and the occurrence of complications of PE & E; these are preventable if identified at an earlier stage and adequately managed at a higher center. Test is easily available, so screening of all cases of PE & E with LDH levels must be made mandatory.

Background: From conception the embryo is dependent on the mother for all nutritional requirements until birth. Vitamin D deficiencies have adverse effect on pregnancy outcome result in poor growth, prematurity, NTD, even congenital anomalies. The aim and objectives of the study was to assess the prevalence of deficiencies among pregnant woman attending M.Y. Hospital and assess the correlation with the pregnancy complications.Methods: Total 110 patients were studied for vitamin d levels and associated obstetrical complications and risk factors over a period of six months. 53 pregnant women were found to be deficient with vitamin D.Results: 53 pregnant women out of total of 110 were deficient in vitamin D levels. Maximum patients belonged to group (21-30yr) of age. Vitamin D deficiency was more in housewives (65.3%) and in urban(86.8%). Low birth weight<2.5kg were born 50(45.5%) and 2 IUD. 2 were diagnosed NTD in USG reports. 80% low birth weight babies were born in vitamin D deficient women.Conclusions: Our study fails to show a causal relation between low vitamin D level and adverse maternal and fetal outcome in terms of preeclampsia, cesarean delivery, oligo and diabetes. There was a relation between vitamin D deficiency and low birth weight babies.

Pregnancy in sickle cell disease is associated with increased risk of maternal and fetal morbidity and mortality. Sickle cell disease is very common in tribal populations. The objective of this study was to review the maternal and perinatal outcome in patients with sickle cell disease of tribal populations. This is a retrospective study. The data extracted from the patients' case files included age, gravidity, family history, complications during pregnancy or at time of delivery or postpartum period, mode of delivery, and fetal outcome. There were 25 deliveries to women with sickle cell disease and 54 with sickle cell trait. Preeclampsia and disseminated intravascular coagulation were common problems associated with sickle cell disease as compared to the sickle cell trait and normal groups. No maternal mortality occurred during the period under study. However, a total of five intrauterine fetal deaths and one early neonatal death did occur. The present study confirms the previous reports, the increased risk of fetal death in women with sickle cell disease, however, in contrast to previous studies, no maternal mortality was found.

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Objectives: To analyze the significant risk associated with obesity and its consequences on obstetrics management and perinatal outcome. Materials and methods:A prospective study was carried out in the Department of Obstetric and Gynecology, MGM Medical College and My Hospital, Indore. The study enrolled 200 pregnant women with body mass index (BMI) >25 and equal number of women with normal BMI (18-24.9) as control.Results: A total of 76 (38%) out of 200 pregnant women were overweight, 70 (35%) were obese type 1 (BMI: 30-34.9), 44 (22%) had BMI (35-39.9) and 10 (5%) had BMI >40. In comparison to normal BMI pregnant women, women with BMI >25 had significant risk of gestation hypertension (p = 0.004), pre-eclampsia (p = 0.04) gestational diabetes mellitus and shoulder dystocia (p = 0.021), cesarean section (0.0001), induced labor (0.0001) and decreased incidence of VBAC (p = 0.037) with postoperative wound infection. Neonates of these women were mostly macrosomic (p = 0.021) and had high incidence of shoulder dystocia. Conclusion:High maternal BMI at booking is associated with increased risk of pregnancy complications. Achieving a normal BMI prior to conception with the institution of healthy eating and exercise regimens may represent an ideal option.

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