Background: Gestational hypertension is a significant threat both to maternal and fetal health. However, it is still a distant dream to predict accurately its occurrence in early pregnancy. Objective was to find out if β HCG levels determined between 13 to 20 weeks of gestation can be used as a predictor for gestational hypertension.Methods: This prospective observational cohort study was conducted from August 2014 to January 2016. Serum β HCG levels were determined at 13 to 20 weeks of gestation of 190 normotensive pregnant women attending the antenatal clinics. They were followed for the development of gestational hypertension till 40 weeks of gestation or delivery.Results: Out of the total 190 women, 25 (13.1%) developed gestation hypertension. Of those who developed gestational hypertension, 22 (88%) were having β HCG levels >2 MOM (p<0.001). Absolute β HCG levels (Mean±SD) were also significantly higher (54907±29509 V/S 41095±19103; p<0.001) in subjects who later developed gestational hypertension. Sensitivity, specificity, positive predictive value and the negative predictive value for β HCG at >2 MOM were 83.3, 96.9, 80.0 and 97.5 respectively (95% CI).Conclusions: Pregnant women with high Beta HCG levels in early pregnancy have significantly higher risk for development of gestational hypertension.
Objective To find out whether placental laterality and abnormal uterine artery waveform and resistance index, as determined by antenatal ultrasonography and Doppler, can be used as a predictor for the development of preeclampsia. Methods This prospective observational cohort study was conducted from August 2013 to October 2014. Two hundred and one (201) normotensive, primigravida women with singleton pregnancies attending the antenatal clinics without any high-risk factor for development of hypertension were subjected to ultrasonography at 18-22 weeks of gestation to determine the placenta location. All the subjects with lateral placentas were subjected to Doppler ultrasonography to look for abnormal Doppler waveform and resistance index. They were followed for the development of preeclampsia till 40 weeks of gestation or delivery. Result In subjects with lateral placentas alone (n = 33), 2 (6 %) developed preeclampsia while as those with lateral placentas with Doppler abnormality (n = 38), 35 (92 %) developed preeclampsia (p \ 0.001). The overall risk of developing preeclampsia with laterally located placenta was 9.27 (odds ratio), and 95 % confidence interval was (4. 30-19.98). Conclusion Pregnant women with lateral placentas are at significant risk for development of preeclampsia. Lateral placentas when associated with uterine artery Doppler abnormality, risk for development of preeclampsia increases significantly as compared to lateral placentas alone.
Objectives: The objective of this study was to evaluate the performance of a secondary-level neonatal intensive care unit (NICU).
Methods:A total of 336 neonates were enrolled in the study. Their clinical profiles at admission and final outcomes were recorded in a predesigned pro forma.Results: Hyperbilirubinemia, sepsis, and perinatal asphyxia were the most common reasons for admission. Eighty-five percentage of the neonates could be managed in secondary-level newborn unit with comparable mortality and mortality to a tertiary-level newborn care unit.
Conclusion:Strengthening of secondary newborn care units is a viable option that will help to decrease the burden of tertiary-level NICUs.
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