Predicting maturity of the foetal lung is extremely important in many obstetric situations as respiratory distress syndrome caused by surfactant deficiency remains one of the leading causes of neonatal morbidity and mortality. The need for predicting the foetal lung maturity by means of an accurate test which is done rapidly and available in majority of centres was the objective for this study. AIM To find out the optimum lamellar body count which correlates with foetal lung maturity and to compare the lamellar body count with shake bubble test. MATERIAL AND METHODS This prospective study was designed to evaluate the lamellar body count by standard haematology cell counter that is coulter counter and compare it with shake bubble test. Both the tests were done on 100 amniotic fluid samples in women with gestational age more than 28 weeks. Patients recruited were those who were sure of their last menstrual period (LMP), who were in active labour, and likely to deliver within 72 hours of collection of sample. Amniotic fluid samples obtained by transabdominal amniocentesis or by aspirating the forewaters per vaginum. Both shake bubble test and lamellar body count were done on the sample. RESULTS Lamellar body counts ranged from 10,000-2,43,000/microlitre and had a linear relationship with gestational age. The cutoff level of 30,000/microlitre was considered to be optimum to predict foetal lung maturity. Sensitivity and negative predictive value of lamellar body count at 30,000/microlitre and shake bubble test were comparable at 91.7%/91.7% and 97.3/96.6% respectively whereas with respect to specificity and positive predictive value, lamellar body count was superior to shake bubble test at 93.4%/73.7% and 81.5%/50%. CONCLUSION Lamellar body count is a rapid, inexpensive, simple and more reliable test to assess foetal lung maturity.
BACKGROUNDSeizures in the postpartum period are the major cause of mortality and morbidity. A variety of neurological disorders causing seizures may be encountered during pregnancy and puerperium. These disorders may be unrelated to pregnancy (e.g. Meningitis) or peculiar to pregnancy (e.g. Eclampsia) or. Pregnancy may affect the course of the pre-existing neurological disorders such as epilepsy. So, keeping in mind the varied aetiology of postpartum seizures and its response to appropriate treatment, our study has been conducted to find out the most common causes in our setup to guide the optimal therapy. AIM OF THE STUDYTo study the varied aetiology and clinical presentation of new onset seizures in the postpartum period over a period of two years. MATERIALS AND METHODS50 patients who developed first episode of seizures in postpartum period (that is after delivery to 6 weeks) admitted to Osmania General Hospital on random selection. All women complaining of new onset seizure with in postpartum period up to 6 weeks. All those women who are known epileptics and who had seizures in the antenatal period were excluded from the study. The selected patients were studied in detail with history and physical examination. RESULTSDifferent causes for first episode of seizures in postpartum period are enlisted here. Cavernous sinus thrombosis in 17 patients, late postpartum eclampsia accounted for 13 patients, intracranial haemorrhage in 6 patients, ischaemic stroke in 5 patients, posterior reversible encephalopathy syndrome in 4 patients, CNS infections in 6 patients, glioma in 1 patient, viral hepatitis in one patient, idiopathic in 3 patients. CONCLUSIONSCavernous sinus thrombosis and late postpartum eclampsia constitute the major aetiology of first onset of seizes occurring in the postpartum period. KEYWORDSNew Onset Seizures, Postpartum Seizures. HOW TO CITE THIS ARTICLE: Sudarsi RK, Ratikrinda A. A study of the varied aetiology and clinical presentation of new onset seizures in postpartum period.
BACKGROUND Ectopic gestation though potentially life threating, timely diagnosis and appropriate treatment can reduce the risk of maternal mortality and morbidity. The benefits of medical therapy particularly with single dose methotrexate and the cure rate are high. The objective of the study was to explore the efficiency of medical management with single-dose methotrexate in unruptured ectopic gestation. MATERIALS AND METHODS Women with an ectopic pregnancy, meeting the criteria for medical treatment were included in the study. All the patients were hospitalized. The protocol was a single dose of methotrexate 50mg IM or 1 mg/kg body weight. All the patients were reviewed after 4 days. If the beta-HCG level drops by 15%, then the women were reviewed weekly until the HCG level falls to less than 5 IU/L. The 2 nd dose was given if the HCG falls below 15% or if there is no drop. RESULTS The overall success rate of single-dose methotrexate was 64%. 2 nd dose methotrexate was required in 11% of patients. In 25% of the cases, surgery was required. Laparoscopic procedure was done in 12% of cases and emergency laparotomy was performed in 13% of the cases. CONCLUSION Single-dose methotrexate therapy is effective in a selected group of patients.
BACKGROUNDThe purpose of this study was to evaluate the effectiveness of antepartum transabdominal amnioinfusion in cases of severe oligoamnios and to prolong the pregnancy to improve the foetal prognosis. MATERIALS AND METHODSThe study comprised of a prospective analysis of 100 pregnant women with oligoamnios in which study and control group consists of 50 patients in each group. Transabdominal amnioinfusion is performed in the study group. RESULTSIn study group, improvement in the biophysical score, APGAR score, and perinatal outcome are noted. Intrapartum complications reduced. The incidence of operative intervention is decreased. CONCLUSIONAntepartum transabdominal amnioinfusion is of great help to a patient with severe oligoamnios as it reduces the neonatal morbidity and mortality.
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