INTRODUCTIONGestational Diabetes Mellitus (GDM) affects up to 15% of pregnant women worldwide and an estimated 4 million women in India.1 Early detection and initiation of treatment reduces adverse maternal and foetal outcomes. Most of the pregnancies that develop GDM is associated with dyslipidemia, the assessment of which in the 2nd trimester could serve as a potential diagnostic tool. Pregnant women destined to develop GDM had higher total cholesterol, LDL, triglycerides, CRP, and t-PA but ABSTRACTBackground: Gestational Diabetes Mellitus is an emerging problem which affects pregnant women all over the world particularly in India. Early detection reduces adverse maternal and foetal outcome. Elevated central adiposity is a modifiable risk factor for abnormal glucose homeostasis in pregnancy and GDM. The Visceral Adiposity Index (VAI) is a gender-specific index of fat distribution and assessment. Methods: It is a hospital based, case control study among the subjects who attended a tertiary care centre. cases were 30 pregnant women newly diagnosed with GDM in their 2nd trimester, and Controls were 30 apparently healthy pregnant women in their 2nd trimester without risk factors for GDM such as obesity and family history for diabetes. Visceral Adiposity Index (VAI) was calculated using the formula (Waist circumference (WC)/ {36.58 +(1.89xBMI)}) x(TGL/0.81) x (1.52/HDL) where WC is expressed in cm, BMI in Kg/m2, TG in mmol/L, HDL in mmol/L. Results: The mean age of patients with GDM was higher when compared to controls (28.17 ± 3.34vs 24.40±3.07) and this difference was statistically significant (p value < 0.0001). The average weights were significantly different. The mean Body Mass Index (BMI) and waist circumference (WC) was 23.59 ± 4.19 and 88.46 ± 7.10 respectively among controls and 29.85 ±4.52 and 102.12 ± 6.96 respectively among GDM patients and these differences were highly significant (p value<0.0001). The lipid profile of these patients showed a significantly higher value of Triglycerides among patients. Conclusions:This study correlates GDM with Visceral adiposity index and found that the index to be elevated in the GDM group. The increased VAI in GDM patients shows their elevated adipose tissue distribution. VAI is less invasive and cost effective, can be used as a diagnostic index in GDM.

The hormonal and immunological changes which occur during pregnancy are the main contributing factors to the severity of the infection. Materials a n d MethodsThis was a prospective observational study done in the Department of Obstetrics and Gynaecology at Government Vellore Medical College, Vellore, Tamil Nadu, India, after obtaining Institutional Ethics and Research Committee clearance. The hospital is a introductionThe COVID-19 infection has emerged as an ongoing pandemic with several waves in different parts of the world in different seasons. In December 2019 in Wuhan, China, the first case of COVID-19 infection was identified and reported. 1 India reported the first COVID-19 case in January 2020 and World Health Organization declared COVID-19 as a pandemic in March 2020.COVID-19 is an airborne infection with an incubation period of 2-14 days, transmitted through droplets while sneezing, coughing, or aerosol contact. The reverse transcriptase polymerase chain reaction test is the gold standard test being done all over the world which detects viral ribonucleic acid. 1 The clinical presentation of COVID-19 infection during pregnancy can be symptomatic or asymptomatic. Most COVID-19 patients during pregnancy are usually asymptomatic, requiring home quarantine simply to curtail the spread of the infection. Fever, cough, cold, headache, malaise, sore throat, and gastrointestinal symptoms like diarrhea and vomiting are the commonly reported symptoms. 1,2 Pregnant mothers with COVID-19 also present with complications like hypoxia, respiratory failure, vascular thrombosis, and multiorgan dysfunction syndrome.Viral pneumonia occurring in pregnancy with COVID-19 is severe as well as less responsive to standard drug therapy. 2 It is associated with significant morbidity and mortality to both the mother and the fetus when compared to women without the infection. 3 The physiological changes reduce the cell-mediated immunity making the body vulnerable to viral infections in particular. The activation of the Th1 cells is the pathogenic mechanism implicated in the development of lung damage. 4

Background: Gestational Diabetes Mellitus (GDM) is an emerging problem which affects a large number of pregnant women in India. Women with GDM have been shown to have abnormal lipid profiles with higher serum triacylglycerol concentrations but lower LDL levels. Early detection reduces adverse maternal and foetal outcome. The Lipid Accumulation Product (LAP) is an index of fat distribution and assessment which can be easily measured in an outpatient setup. Methods: This study was a hospital based case control study. Cases were 30 pregnant women, newly diagnosed with GDM in their 2nd trimester while controls were 30 apparently healthy pregnant women without risk factors for GDM. Lipid accumulation product (LAP) was computed by multiplying a sex-specific estimate of waist circumference and the fasting triglyceride concentration, LAP = (WC [cm]-58) x TGL [mmol/L]. Result: The mean age of patients with GDM was higher when compared to controls. (28.17 ± 3.34 vs 24.40 ± 3.07, p < 0.0001) The lipid profile showed a significantly higher value of serum triglycerides among cases while the differences in HDL were not statistically significant. Lipid accumulation product (LAP) in GDM patients was found to be significantly elevated when compared to controls. (133.43 ± 64.02 vs 62.89 ± 30.68, p < 0.0001) Conclusion: Calculation of LAP can be done to identify the degree of risk for developing GDM. So LAP can possibly serve as in future as a screening tool for the diagnosis of GDM in an outpatient setting in resource poor settings.

Background: The Congenital anomalies were estimated to be the fifth largest cause of neonatal deaths in India. The purpose of our study was to determine the proportion and pattern of congenital anomalies and their association with risk factors like maternal diabetes, advanced maternal age and consanguinity among the babies born in a tertiary care teaching hospital in Chennai.Methods: This study is a cross sectional descriptive study where all the newborns including still born delivered with the presence of congenital anomalies and those fetuses terminated due to detection of presence of congenital anomalies were analyzed. The study was done at the OBG department in a tertiary care center for a period of one year 1st June 2015 to 31st May 2016.Results: The overall incidence of birth defects were 2.36%, of which musculo skeletal defects (18.88%) were commonly found. There was a definite correlation of risk factors with consanguinity showing an incidence of 1.5 times the overall incidence of birth defects (3.54%) and maternal diabetes mellitus was 6 times the total incidence (15.3%). The correlation between the incidence of birth defects and advanced maternal age was not statistically significant in our study.Conclusions: The study depicts the risk of occurrence of congenital anomalies in the presence of maternal diabetes and in consanguineous marriage and emphasizes on the necessity of adequate screening like first trimester and second trimester ultrasonogram for the early detection of anomalies in the fetus especially if these risk factors are present in the mother.

Background: Intrauterine insemination (IUI) is a cost-effective, non-invasive and its success depends on the various factors. The factors associated with the success of IUI and its literature is least available in the Indian context. Objectives were to analyze the outcome of patients undergoing homologous IUI in terms of pregnancy rates (clinical pregnancy) and its predictors for the outcomes.Methods: This is a prospective observational study among 200 couples with infertility undergoing therapeutic homologous IUI in a tertiary care centre. Among the study participants, undergoing IUI, after obtaining the informed written consent, the data related to the outcomes and associated factors were collected through a pre structured Questionnaire.Results: Among the study participants who undergone the procedure, 40 (20%) become positive for pregnancy. Of the 40 positive, 30 (15%) delivered normal babies and 7 (14%) went for spontaneous abortions and 1 (0.5%) went for D and C. Type of infertility, drug for induction of ovulation, age in years, years of marriage, day of ovulation, no. of ovulation induction and were not statistically significant with the outcomes. Endometrial thickness, greatest dimension of follicular size, increased total sperm count, percentage of motility, post wash count and post wash motility were significantly associated with the positive outcomes.Conclusions: Since the success rate of the IUI is comparable to the other studies reported, and the procedure is relatively cheaper, the same can be recommended as the simple and cost effective first line management of certain specific indications of the infertility.