Background: WHO has declared COVID-19 infection a health emergency of international concern on 11th March, 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 differ from those of nonpregnant women and whether it aggravates COVID-19 symptoms and whether antiviral therapy is necessary for COVID-19 infected pregnant women.Methods: This is prospective study of 125 cases based on the compiled clinical data for pregnant women with COVID-19 between 15th April 2020 and 10th June 2020. A laboratory confirmed positive case of COVID-19 infection in pregnant women were included.Results: The most common symptoms at presentation were cough in 61.6% (77/125) and fever in 46.4% (58/125). Other reported symptoms were sore throat in 13.6% (17/125), myalgia in 10.4% (13/125) while 38.4% (48/125) were asymptomatic. There were total 97 deliveries (including 2 twins’ deliveries) among which 3 cases had IUD. Present study reported 96 live births. The incidence of missed abortion was 2.4% (3/125). The incidence of preterm birth before 37 weeks was 8.2% (8/97). Ninety-six (96.9%) of neonates were tested for SARS-CoV-2 viral nucleic acid on nasopharyngeal and pharyngeal samples and 16.67% (16/96) were resulted positive.Conclusions: At present, there is no evidence regarding the greater risk of pregnant women to succumb to COVID-19 infection and experience severe pneumonia. The risks of spontaneous abortion and preterm birth are not increased as reported in this study but shows possibility of vertical transmission when it manifests during the third trimester of pregnancy.
Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.Methods: All This is a retrospective study of 88 cases of placenta previa, which were admitted under department of obstetrics and gynecology in our institute during July 2017 to June 2019. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by ultrasound examination. Outcome measures prevalence of placenta previa, maternal and neonatal outcomes, and case fatality rate.Results: The total number of deliveries performed during the study period was 16330, of them, 88 cases were placenta previa. Thus, the prevalence of PP was 0.53%. Multiparity was one of the etiological factors in 84.09%, whereas previous LSCS was 47.73%, previous H/O D and E was 14.73%, previous H/O placenta previa was 7.95%. Obstetric hysterectomy was done in 7 (7.95%) patients out of 88 patients. 92.04% of patients delivered with cesarean section and 7.95% patients delivered with normal vaginal delivery. 22 (26.50%) babies out of 83 live born were admitted in NICU.Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta previa remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. Measures to reduce the primary caesarean section rate should be adopted.
Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients.
Background: Preterm labour and delivery cause major health burden to the society due to high perinatal morbidities and mortality and long-term health implications and also affects maternal. An effective and objective way for predicting preterm delivery is measurement of cervical length by transvaginal sonography as it allows better quality and accurate visualization of uterine cervix. Cervical length (<25 mm) is good and accurate cervical biometry for prediction of preterm birth. The objective of this study was to measure cervical length by transvaginal sonography for predicting preterm labour and fetal outcome.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology, at SVPIMSR hospital, Ahmedabad from July 2018 to December 2019 in 150 antenatal women to assess cervical changes (cervical length, dilatation of internal OS, funnelling etc.) between 16 to 24 weeks of gestation and these cases followed till delivery and results were analysed.Results:150 antenatal women who fulfilled the selection criteria were studied using transvaginal ultrasound between 16-24 weeks of gestation, out of them 36 (24%) women delivered preterm babies. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) recorded in this study were 80.5%, 94.73%, 82.85% and 93.91% respectively.Conclusion: Transvaginal sonography is the most useful and better, safe, accurate, most effective, less expensive, objective and acceptable technique for assessing cervical length in all antenatal women and predicting the preterm labour when assessed between 16 -24 weeks of gestational age.
Background: Eclampsia is a common medical and life-threatening emergency condition mainly seen in 5-10% of all pregnancies and that is a major cause of maternal and perinatal morbidity and mortality The aim of the study to find out the fetomaternal outcomes of eclampsia in tertiary care hospital and to analyse the trend of eclampsia and associated epidemiological variables.Methods: This retrospective analytical study was undertaken with 40 clinically diagnosed women with eclampsia in their third trimester of pregnancy in the Department of Obstetrics and Gynaecology, at tertiary care hospital from July 2020 to December 2021. Women who came to the hospital with eclampsia or developed eclampsia during hospital stay were included in our study.Results: In our study, the antepartum eclampsia was in 32 cases (80%), primigravida 27 cases (67.5%), maternal age (21-30 years) 26 cases (65%). Cesarean section was the mode of delivery in 26 cases (65%). NICU admission is required by 20 neonates (50%).Conclusions: Eclampsia is an important cause of maternal and perinatal morbidity and mortality. Providing quality antenatal health care services, increasing awareness of patients about warning symptoms, proper investigations, timely delivery, and proper monitoring in the intrapartum and postpartum period have the potential to improve maternal and perinatal outcomes.
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