Objective: The main objective of this study is to determine the level of C-reactive protein in pregnancy induced hypertension (PIH) along its relation with normal pregnant mothers and also to compare it with different grades of pregnancy. C-reactive protein and inflammation are interrelated. Another objective of this study is to find out the relationship of C-reactive protein, biochemical and hematological parameter in PIH as well as its clinical correlation. Materials and Methods: The study was conducted in the department of Gynaecology and department of Pathology in Burdwan Medical College West Bengal India after taking permission from ethical committee. 50 cases of PIH mothers and age and gestational matched 50 cases of normal control pregnant mothers and 50 normal healthy non pregnant adult women were included in this present study. CRP was estimated by turbidometric method. Serum Uric acid, SGPT, Serum Creatinine were estimated by semi auto analyzer, Serum ß HCG was estimated by ELISA technique. The total leukocytes count, absolute Neutrophils count, Platelet counts were done in hematological cell counter with correlation from peripheral direct smear and manual counting. Urine protein was detected by dipstick method. Results: Serum C-reactive protein was positively correlated with severity of in PIH. Results shows a significantly increased C-reactive protein in PIH (Mean SD 42.02 mg/L±18 .01 mg/L, P<0.001) in comparison to normal control mother (Mean SD 4.2 ±0.93 mg/L). Conclusion: Serum C-reactive protein levels can be used as marker for early diagnosis and intervention of PIH and can be reduced maternal as well as fetal morbidity and mortality.
We report an outbreak of Neisseria meningitidis serogroup W135, associated with a transient transmission event between asymptomatic individuals in a healthcare setting. Two elderly persons subsequently developed invasive meningococcal disease. The duration and type of close contact for those directly involved in the probable transmission incident would not have warranted chemoprophylaxis according to current guidelines. Meningococcal infection in older persons usually presents with pneumonia rather than meningitis or septicaemia with purpura.
Summary: We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS. Keywords: high-risk pregnancy, rheumatology, clinical genetics, complications CASE REPORTA 31-year-old woman booked at 14 weeks gestation in her seventh pregnancy. She had a past medical history of Ehler-Danlos syndrome (EDS) type 2, diagnosed at age 9 with characteristic features of easy bruising, scarring, loosejointedness and dislocations. She had a left shoulder dislocation at age 19 and two left hip dislocations by the age of 24. Interestingly, she also suffered recurrent spontaneous haemorrhages that included two severe mesenteric bleeds requiring blood transfusions and a laparotomy in one instance. Since these are atypical of EDS type 2 and recognized features of EDS type 4, a skin biopsy for culture and biochemical studies was performed. The results yielded a normal type 3 collagen level in cultured skin fibroblasts, thus making EDS type 4 an unlikely diagnosis.The patient had two first trimester miscarriages at age 16 and 17. At 22, her third pregnancy proceeded uneventfully to term. She laboured spontaneously and delivered through a large central perineal tear between the fourchette and anus. This was repaired in layers. The posterior vaginal wall was repaired in one continuous layer. The perineal muscles were repaired with interrupted sutures. The perineal skin was repaired with interrupted sutures to allow for drainage of any postoperative haematoma. Number 1 vicryl was used to allow for delayed wound healing. Healing was good and she was discharged home well on day 5 postrepair. In her next pregnancy, she had a normal term spontaneous vaginal delivery with an elective episiotomy. Her fifth pregnancy was a missed miscarriage and an evacuation of retained products of conception and elective laparoscopic sterilization was performed. Three years later, she met a new partner and moved from the region. She presented to another hospital requesting reversal of steril...
Objective To describe the prevalence of overall and asymptomatic SARS-CoV-2 infection in pregnant women admitted for delivery at 3 maternity units in North Wales. Design A prospective multicentre cohort study of universal testing for SARS-CoV-2 infection offered to all pregnant women admitted for delivery. Setting 475 women admitted for delivery in 3 maternity units in North Wales at Bangor, Bodelwyddan and Wrexham between 3rd June and 2nd July 2020. Population 95.8% (n=475) of all women admitted for delivery. Methods Testing performed by reverse transcription-polymerase chain reaction of nasopharyngeal swabs with concurrent universal screening for signs and symptoms of COVID-19 infection. Main Outcome Measures Overall and asymptomatic prevalence of SARS-CoV-2 infection in pregnant women admitted for delivery. Results The overall prevalence of SARS-CoV-2 infection in pregnant women in North Wales was 2.74% with an asymptomatic prevalence of 1.89%. 69% of women infected with SARS-CoV-2 at delivery were asymptomatic. Conclusions Pregnant women with SARS-CoV-2 infection are not reliably identified using symptom and temperature screening as most infected women are asymptomatic on admission. The prevalence of maternal infection and asymptomatic carrier rates vary based on geographic differences in disease prevalence. It is suggested that a trial period of universal testing may help determine whether such an approach is appropriate for an individual maternity unit. Funding – None Key words Universal testing, SARS-CoV-2, COVID-19, pregnant women, delivery
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