Background: India is the diabetic capital of the world and gestational diabetes mellitus contributes to a significant number of cases. Gestational diabetes mellitus is a common medical complication of pregnancy and may lead to serious consequences. Because of these reasons, it was felt that if there was a biomarker for predicting carbohydrate intolerance in pregnancy, it could help in earlier intervention and mitigate the consequences related to it. Hence, for this purpose, the role of HbA1c was studied as a predictor of gestational diabetes mellitus.Methods: This was a cross sectional study. Five hundred antenatal cases were considered for this study. All antenatal patients before 18 weeks of gestation attending antenatal clinic for the first time were selected and these patients were subjected to HbA1c followed by diabetes in pregnancy study group of India (DIPSI) test between 24-28 weeks and the results were analyzed to find any correlation between the two.Results: The main objective of the present study was to find whether HbA1c can be used as a predictor of gestational diabetes mellitus. In this study out of 500 women screened, 60 women turned out to have gestational diabetes mellitus. When comparing DIPSI positivity with various levels of HbA1c, it was found that maximum number of DIPSI positive patients (93.33%), had raised HbA1c levels.Conclusions: Maximum number of DIPSI positive cases had HbA1c level between 5.5 to 6 and this association was found to be statistically significant and a positive correlation was established between the two.
Background: The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. The objective of the present prospective study is to study on incidence, diagnosis, and variable presentations of HELLP syndrome in preeclampsia to analyse the severity and complications, as it is associated with maternal, perinatal morbidity and mortality. HELLP syndrome is difficult to diagnose when it presents with atypical clinical features.Methods: In the prospective study of 300 admitted cases with more than 20 weeks of gestation, were having preeclampsia. The selected cases were analyzed clinically with relevant history, clinical data and detailed laboratory investigations made for better analyses of complications and outcome in HELLP syndrome.Results: Under further clinical diagnosis of 300 cases of preeclampsia, 34 cases (11.33%) were of HELLP Syndrome and 44 (14.66%) cases were of partial HELLP syndrome. The present study shows 2.9% maternal mortality in HELLP and 4.5% in partial HELLP syndrome. Perinatal mortality was 17.6% with HELLP and 25% with partial HELLP.Conclusions: The diagnosis of HELLP syndrome has been made as a severe variant and complication of severe preeclampsia and eclampsia. It needs early diagnosis, timely intervention to arrest further progress and complications like multi organ dysfunction, renal failure, DIC, abruption etc and to improve maternal and perinatal outcome.
Study question Is there a relationship between endometrial compaction and clinical pregnancy rate in frozen embryo transfer (FET) cycles? Summary answer Clinical pregnancy rate (CPR) were similar in both patients that demonstrated endometrial compaction or no compaction in FETs cycles. What is known already There has been increasing interest in the correlation between endometrial compaction and clinical outcomes but there has been conflicting evidence from prior investigations. Study design, size, duration Retrospective Observational data Analysis of (n-350) patients undergoing Embryo Transfer during January 2022 to December 2022 at our clinic. Participants/materials, setting, methods This study was performed at a single, academically affiliated fertility center in which patients who had an FET using programmed/modified natural cycle protocol were included. Endometrial thickness at time start of progesterone(T1)(TVS) & at time of Embryo transfer (T2)(TAS)was measured, and percentage on ET compaction in both HRT cycle and modified natural cycle was studied. The primary outcome (CPR) was based on proportion of compaction (percentage difference in EMT between T1 and T2). Main results and the role of chance Of the 350 participants included, 64%, 38% and10%, of women exhibited >0%, >5% and >10% endometrial compaction, respectively. Endometrial compaction was not predictive of Clinical Pregnancy Rate (CPR) at any of the defined cutoffs .Primary outcomes included CPR (defined as the presence of at least one gestational sac with a fetal pole with cardiac activity on transvaginal ultrasound between 6 and 9 weeks gestation), biochemical pregnancy rate and spontaneous abortion rate. Patients were discharged to their obstetrician when a clinical pregnancy was confirmed between 6 and 9 weeks gestation. Limitations, reasons for caution There was the potential for measurement error in the recorded EMTs. The T2 measurement was performed transabdominally, which may cause potential measurement error, as it is generally accepted that transvaginal measurements of EMT are more accurate, though, any bias is expected to be non-differential Wider implications of the findings Assessing endometrial compaction may lead to unnecessary cycle cancellation. However, further studies are needed to determine if routine screening for endometrial compaction would improve clinical outcomes. Trial registration number not applicable
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