Background: Thrombocytopenia is second most common haematological abnormality in pregnancy after anemia. The aim of this study was to find out the prevalence, causative factor of thrombocytopenia and to observe the obstetrics outcome of pregnancies complicated with thrombocytopenia.Methods: This is prospective study of maternal outcome in pregnancy with thrombocytopenia carried out at tertiary care center from February 2019 to January 2020. Out of 350 antenatal screened women, 25 women who were diagnosed with thrombocytopenia, were included in the study.Results: The incidence of maternal thrombocytopenia in this study was 7.1%. 60% of the women had mild thrombocytopenia while 24% and 16% of women were moderate and severe thrombocytopenic respectively. Amongst 25 thrombocytopenic women 68% had gestational thrombocytopenia, 24% had gestational hypertensive disorder,4% had HELLP syndrome, 4% had immune thrombocytopenic purpura. 60% were delivered vaginally and 40% were delivered by LSCS. The most common indication of LSCS was acute fetal distress (40%) followed by failed induction (30%), breech (10%), and the rest (20%) for other obstetrical indications. The most common indication for induction was pre-eclampsia followed by IUGR, and post-date.Conclusions: In pregnancy with thrombocytopenia, gestational thrombocytopenia is the commonest and benign condition which does not alter the obstetrical management. Still a vigil 4 should be kept on maternal platelet count in antenatal period to prevent unfavorable outcome in serious conditions that may require specific and urgent management (HELLP syndrome, severe pre-eclampsia, ITP).
Background: The aim of induction was to achieve successful vaginal delivery where continuation of pregnancy is not desirable. Unfavourable cervix is one of the main causes of failed induction. Introduction of intravaginal prostaglandins E2 has revolutionised the method of cervical ripening. More than one dose of prostaglandin E2 (PGE2) gel may be necessary to facilitate cervical ripening and increase the chances of vaginal delivery.Methods: This retrospective study was done to find the efficacy of repeat instillation of intravaginal PGE2 gel and to compare the maternal and fetal outcome between the single instillation group and repeat instillation group. The women who went into labour or achieved cervical ripening with a single instillation of PGE2 gel forms Group A. Those who required repeat instillation of PGE2 gel forms Group B. Both groups were compared for specific parameters.Results: Primigravidas required repeat instillation. Postdated pregnancy was the most common indication for induction of labour. 45.2% of primis required only single dose and 54.8% required repeat dose. About two third (77.8%) of multipara required only one dose and a third of multipara needed repeat dose. In Group A 90.7% had vaginal delivery, 9.3% had Caesarean section. Group B 95.7% had vaginal delivery and 4.3% had Caesarean section.Conclusions: Prostaglandins PGE2 (0.5 mg) gel is recommended to be used intravaginally. We applied 2 doses of intravaginal PGE2, 24 hours apart and no complications like uterine hyperstimulation was seen. There is no increased fetal risk with repeat instillation of intravaginal PGE2 gel.
Introduction: Congenital anomaly is a structural or functional defect that occurs during intrauterine life and can beidentifiedprenatally,at birth or sometimelater in infancy. Congenital anomalies may be caused by genetic or environmental factors. Most congenital anomalies, however, show the familial patterns expected of multi-factorial inheritance. Methods:Cross sectional observational hospital based study conducted during the period of august 2020 to august 2021.All new-borns delivered in the hospital with congenital anomalies were included in study. Relevant information regarding maternal age, parity, gestational age, sex and the outcome were documented.Results:Incidence of congenital anomalies are more associated with increasing maternal and paternal age. Higher incidence was found in higher order pregnancy. Maximum cases of congenital anomalies affected musculoskeletal system followed by gastrointestinal system and genitourinary system.Conclusion:With the help of proper antenatal screening,diagnostic modalities and better health care facilities, congenital anomalies can be diagnosed earlier and interventions planned accordingly. Morethan one risk factors can be linked with congenital anomalies. Earlier Central nervous system anomaly was commonly involved but increase folate supplementation in target population reducing the incidence. Keywords: Antenatal scan, Gross congenital malformation, New born
Background: Meconium staining amniotic fluid is associated with lots of adverse outcome and has long been considered to be a bad predictor of fetal outcome. This prospective observational study was undertaken to find out immediate fetal outcome in meconium-stained liquor.Methods: The design of the study was prospective. This study was conducted from July 2021 to December 2021.The study included women with meconium-stained amniotic fluid in labor with gestational age >37 completed weeks.Results: Total 100 cases were enrolled. Majority of the patients (74%) were in the age group of 21-30 years with the mean age being 24.6±2.4 years. Fetal distress occurred in 30% of babies, more in association with thick meconium (15%). Caesarean deliveries were 70%. Apgar scores between 0-3 was seen in 17% babies and 1% at fifth minute, between 4-6 in 21% babies and between 7-10 in 62% babies at first minute of birth. Admission in neonatal ward was 32% with perinatal mortality of 6%.Conclusions: Meconium-stained amniotic fluid was associated with higher rate of caesarean delivery, increased need for neonatal resuscitation, increased rate of birth asphyxia with hypoxic ischemic encephalopathy, meconium aspiration syndrome, hospital admission and mortality. It is more commonly associated with pregnancy induced hypertension (PIH), post-datism, oligohydramnios and gestational diabetes mellitus.
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