Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure. [Int J Basic Clin Pharmacol 2012; 1(3.000): 174-177
Background: Hypertensive disorders are among the commonest medical disorders during pregnancy and continue to be a major cause of maternal and perinatal morbidity and mortality.Methods: In this study total 100 cases and their doppler findings were recorded, Cases of PIH between 20 - 36 weeks of gestation in 2 years with B.P ≥140/90 mm hg and protienuria ≥1+ in this prospective analytical study investigations and color doppler scanner for studying uterine, umbilical PI, RI and fetal middle cerebral arteries as the indicator to evaluate perinatal outcome.Results: Increase incidence of low birth weight (less than 2.5) observed in group of umbilical and uterine PI was (>1.5,>1 respectively)67% and 83%. Apgar score at 5 minutes <7 58%and 61%, NICU admission 46% and 45%, perinatal mortality 42%and 45% respectively. for group of umbilical artery and uterine artery RI (>0.7, >0.6respectively) newborn delivered with weight less than 2.5 kg 76% and 80%, Apgar score at 5 minutes <7 33% and 80%, NICU admission 46% and 50%, perinatal mortality 60%and 42% more than that of with group of low RI. High rate of incidence seen where MCA PI < 1.3,90% newborns less than 2.5 kg birth weight,70% poor Apgar score at 5 minutes. abnormal ductus venosus group shows birth weight <2.5 kg 83%, Apgar at 5 minutes < 7 were 81%, NICU admission were 39%and perinatal mortalities 78% higher than normal ductus venosus group.Conclusions: The sensitivity of the Doppler significantly increased by studying multiple vessels (91.6%) of in the fetoplacental circulation. It would predict early compromise of blood supply to the fetus at the stage when the fetus is still not compromised and if timely measures are taken it helps in improvement of perinatal out-come.
Introduction Mothers, though delivered well, managed well, face certain issues in the postpartum phase due to lack of preparedness for this very important phase and lack of knowledge of basic hygiene practices – referred to as post partum well being. Aim To explore important domains of women's postpartum experiences as perceived by postpartum mothers as in to determine pain index, physical and emotional well being and to investigate how postpartum preparedness could enhance patient care for the postpartum period. Materials And Methods Qualitative research study was conducted to explore women's perceptions of the postpartum experience. Postpartum women (n = 100) were questioned at a tertiary care center C U SHAH MEDICAL COLLEGE AND HOSPITAL, Surendranagar, Gujarat. Mothers did not expect many of the symptoms they experienced after childbirth. We classied all the complaints and covered various parameters for overall physical and emotional wellbeing. Also differences existed in the major postpartum concerns of mothers and obstetricians. However, both mothers and obstetricians agreed that preparation during the antepartum period could be benecial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study ndings raise the hypothesis that capturing patient-centered domains that dene the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes.
BACKGROUNDIn 1993, the World Bank ranked anaemia as the 8th leading cause of disease in girls and women in the developing world. Apart from maternal morbidity and mortality, neonatal mortality is high among the babies of anaemic mothers. Pregnant women are particularly considered to be the most vulnerable group because of the additional demands that are made on maternal stores.Objectives of the study are-1) To study effects and benefits of interventions offered to patients. 2) To study the outcome of foetus in pregnant patients suffering from anaemia. 3) To screen and diagnose all the patients suffering from anaemia and give them appropriate treatment for the same and further prevention in context to public health. 4) To find out the underlying causes and factors associated with anaemia and assess the awareness in the patients regarding these causes. MATERIALS AND METHODSThis study involved total of 300 antenatal anaemic booked patients in group A treated with haematinics, iron sucrose injections and folic acid supplementation. Group B contains unbooked patients who came to emergency department, corrected their anaemia level with blood transfusion. RESULTSBooked patients detected early to be anaemic and treated with inj. iron sucrose and inj. Vit B12 and folic acid have better prognosis with better foetal and maternal outcome. Patients who came to the emergency department and who were given blood transfusion to combat anaemia had maximum preterm labour, eclampsia, PPH and sepsis. CONCLUSIONThe results show early detection and correction of anaemia with iron sucrose and oral haematinics lead to better prognosis in many aspects in regard to foetomaternal health compared to group of patients who are not registered, treated with blood transfusion to correct their anaemia status. One of the causes observed for early labour or pre-term labour, low birth baby, poor Apgar score was when blood transfusion was given to unregistered patients with poor Hb% level as an emergency in this study.
Background: Hypertensive disorder along with hemorrhage and infection contribute greatly to maternal mortality and morbidity. Pregnancy induced hypertension remains among the most significant and intriguing unsolved problems in obstetrics.Methods: In this prospective analytical study investigations and color doppler findings 0f umbilical artery PI, RI and end diastolic flow in same, uterine PI, RI and persistent diastolic notch in uterine artery recorded. Total 100 Cases of PIH between 20-36 weeks of gestation in 2 years with B.P ≥ 140/90 mm hg and protienuria ≥ 1+ were observed.Results: In this study, out of 100 cases, there were 58 cases of mild PIH (58%) and 42 cases of severe PIH (42%). Umbilical artery PI was elevated in 43(43.0%) patients and was normal in 57(57.0%) patients. Umbilical artery RI was more than and equal to 0.7 in 77 patients (77%) and was below of 0.7 in 23 (23%) pa-tients.9(9.0%) fetuses showed absence and 14 (14.0%) fetus had reversal and 46 (46.0%) had reduced end diastolic umbilical artery flow with total 69 out of 100 fetuses having abnormal waveforms.65 (65%) mothers had an elevated uterine artery PI and 35(35%) patients had normal uterine artery PI. in observation 69 (69%) patients were having RI more than 0.6, while 31 (31%) were having less than 0.6 out of 100 patients. In this study, 65 (65.0%) women were having persistent diastolic notch.Conclusions: This study was to evaluate arterial flow velocities as a predictor of impending pregnancy induced hypertension with raised RI and PI along with umbilical ab-sent or reverse end diastolic flow velocities and elevated RI and PI in the presence of a diastolic notch are considered as abnormal uterine doppler findings doppler finding with unfavorable outcome.
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