Summary We describe two cases which illustrate the difficult diagnostic and therapeutic problems posed by delayed haemolytic transfusion reactions in patients with sickle-cell disease. The cases emphasize the need for meticulous phenotypic and serological assessment of sickle-cell patients prior to transfusion therapy.

No abstract

BACKGROUND: Anemia during pregnancy is highly prevalent in India. There is predominance of iron deficiency anemia (nutritional anemia). Pregnancy is the condition which increases requirement of nutrients especially iron and folic acid & also causes hemodilution. Because of these reasons, anemia gets aggravated in pregnancy. The incidence varies with literacy, socioeconomic status, family support and financial stability. Anemia in pregnancy has adverse effects on maternal and fetal health. Chronic anemia during pregnancy can cause glossitis, stomatitis, changes in nails and skin, breathlessness, cardiac failure in mother. Obstetrical complications like low birth weight babies, IUGR, increased rate of preterm deliveries & increased perinatal mortality are also known. PPH also worsens the situation. Severe anemia in mother may lead to serious neurological damage in the fetus. This study is aimed at finding out the prevalence and type of anemia during pregnancy. This study will definitely help to decrease the burden of anemia and its complications. OBJECTIVES: To study the Hb level in pregnant women during first visit, 30th week, and 36th weeks of gestation. To note the type and degree of anemia. To note the need for medical therapy and its route of administration and/or blood transfusion. To note the maternal and neonatal outcome thereafter. METHODS: The study was carried out in the Department of Obstetrics and Gynaecology, Dr. B. R. Ambedkar Medical College and Hospital, Bangalore for a period of two years. A prospective randomized study conducted on 200 pregnant women. All subjects were analyzed in full details and hemoglobin estimation done during 1st visit, at 30th week and 36th week of gestation. They were classified according to WHO criteria. According to degree of anemia all the subjects were treated and maternal and perinatal outcome were studied. RESULTS: The incidence of mild anemia 29.5%, moderate anemia 53% and 17.5% severe anemia noted. In the booked cases, perinatal outcome was good compared to unbooked and referred cases. The parameter of poor fetal outcome like preterm birth, IUGR, IUD and NICU admission were more in the unbooked and referred cases. CONCLUSION: Anemia in pregnancy continues to be a major problem in developing countries with maternal and fetal complications. Correct diagnosis and treatment of the underlying cause can improve the diagnosis. Ensuring maternal iron sufficiency during gestation is the most cost effective method of preventing perinatal iron deficiency and related morbidities.

. Inclusion criteria were pregnancies with history of previous abortions. These cases were compared with a group of controls. RESULTS: There were 412 cases with previous history of abortions. There were 272 (66 %) booked cases while 140 (33.9%) were unbooked cases. 347 (84.2%) patients crossed viable period of pregnancy (more than 28 weeks). 56 (13.5%) patients had repeat abortions. Pregnancies complicated by high risk factors were 177(42.9%). 176(49.43%) patients underwent vaginal delivery and 138 (38.7%) underwent cesarean section. 77 (21.6%) of Babies were low birth weight while others were above 2.5 kg. There were 46 (12.9%) preterm babies and 12 (2.9%) Intrauterine demise of fetuses. These were compared to a group of controls and discussion is carried out. CONCLUSION: Patients with previous history of abortions are at increased risk of adverse maternal and perinatal outcome.

No abstract