Background and Aims: The association of gestational diabetes mellitus and serum Vitamin D levels in different trimesters of pregnancy has been studied recently. We conducted this study in an prospective observational cohort of well-characterized healthy pregnant women to examine the relationship between 1 st trimester Vitamin D levels and Gestational Diabetes Mellitus (GDM) status during pregnancy. Methods: All pregnant women attending the out-patient department of Gynecology & Obstetrics, aged less than 35 years, and who were in their first trimester were included in the study. Socio-demographic, anthropometric details, clinical details, food frequency questionnaire and physical activity data was collected using validated pretested questionnaire. Results: The comparison between those with GDM and those with normal glucose levels has been illustrated. Women in the GDM are older than those in the non-GDM group. The women in GDM group were taller, heavier and their BMI was greater than those in the non-GDM group. There were no significant differences in dietary intake at baseline between mothers with GDM and those with normal glucose levels. Further, it was found that Vitamin D concentration of <30 nmol/L was found among higher among those with GDM and the relationship was statistically significant. Conclusion: There is an association between maternal Vitamin D deficiency and increased risk for GDM in early pregnancy among Kashmiri women.
Background: One of the most common and potential life-threatening complications of pregnancy is pregnancy induced hypertension. Though platelet count during pregnancy is within the normal non-pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity and severity of PIH.Methods: This prospective study was conducted in the Department of obstetrics and gynecology in Jhalawar medical college from January 2018 to April 2018.Total 120 pregnant women during third trimester (32-40 weeks) aged 18 to 35 years were selected. Among them 63 were preeclamptic patients and 63 were healthy normotensive control. Subjects and healthy pregnant women (control) visiting the Obstetrics and Gynecology department of Jhalawar Medical College were registered in the study and followed during their pregnancy. Both, subjects and control participants were subject to platelet count manually and MPV was determined by an automated analyser (sysmex XN-1000™) performed using standard methods on.Results: The mean platelet count of the subject group (131.4937±62.05999 lakh/mm3) was significantly lower than that of the control group (324.9683±230.78764 lakh/mm3). This shows that there is thrombocytopenia found in patients with P.I.H in their third trimester. On the other hand, the p value of “mean platelet volume” in patients with preeclampsia was (p<0.0001) which shows that there is no significant difference in MPV of cases (7.1438±2.62 femtolitre) and control (7.8976±3.08 femtolitre) (p>0.142), regular monitoring of platelet counts in women with Pregnancy Induced Hypertension must be subject of the management protocols.Conclusions: In present study we observed that the number of thrombocytopenic subjects was higher in cases of preeclampsia as compared to the control group. These extrapolations indicate that there might be some important mechanism which interferes with platelets life span thus reducing the number of functional platelets in circulation. The platelet count has an association at prediction of increasing grade of PIH. There is an inverse relationship between the severity of PIH and platelet count. The depleted platelet counts are concluded to be consistently associated with clinical groups of severe preeclampsia and the risk of consumptive coagulopathy.
Background: Lactate Dehydrogenase (LDH) is mainly an intracellular enzyme. Its level is an useful biomarker for cellular injury which may suggested as a potential marker to predict the severity of preeclampsia and indicator for multi-organ involvement have significant role in management of preeclampsia. We conducted this study to examine the relationship between lactate dehydrogenase concentration and the severity of the disease and occurrence of complications. The objective of the present study was to assess role of serum LDH level in mild and severe preeclamptic women Methods: This prospective study was conducted in the Department of obstetrics and gynecology in Jhalawar medical college from Jan 2017 to Oct 2017 Total 120 pregnant women during third trimester (32-40 weeks) aged 18 to 35 years were selected. Among them 40 were severe preeclampsia and 40 were mild preeclampsia patients and 40 were healthy normotensive control. Serum LDH level was estimated by continuous spectrophotometric method. Demographic, hemodynamic, and laboratory data were compared among the three groups. The symptoms and complications of severe pre-eclampsia along with foetal outcome were analyzed according to the levels of LDH. Results: In this study, serum LDH level was significantly higher (P<0.001) in preeclamptic compared to those of control. Again, this value was significantly higher in severe preeclamptic than those of mild preeclamptic. The symptoms and complications of preeclampsia along with perinatal mortality were increased significantly in patents with LDH> 800IU/I compared with those who had lower levels. Conclusions: From this study, it can be concluded that elevated serum LDH level is associated with severity of preeclampsia. LDH has been evaluated as a biochemical marker for preeclampsia and as a prognosticator of the disease severity. Detection of high-risk patients with increased levels of LDH mandate close monitoring and management to prevent maternal and fetal morbidity and mortality.
Background: Adequate amount of amniotic fluid was required for normal growth of fetus. Oligohydramnios or reduced amount of amniotic fluid is associated with adverse maternal and perinatal outcome due to increase in induced labour and operative deliveries. Idiopathic oligohydramnios is a condition in which no other risk factors are associated with pregnancy. This study was done to compare the effect of L-arginine and IV hydration on improvement of amniotic fluid index and fetal growth.Methods: Total 50 patients were included in the study according to inclusion criteria and divided equally into two groups randomly. IV hydration was given to one group and other group received L- arginine sachet orally. The effect on AFI and fetal outcome was compared.Result: The result was compared with respect to age, gravidity, gestational age and AFI at the time of study and after giving treatment. Maternal and fetal outcome was compared which shows that L-arginine was more effective in increasing the AFI and thereby leading to favorable results in the form of increase in gestational age at time of delivery and fetal weight.Conclusion: This study shows that both IV hydration and L-arginine are useful in treatment of oligohydramnios. But L-arginine appears more advantageous over IV hydration in improving pregnancy outcome and reducing perinatal morbidity and mortality.
PPH is almost entirely a preventable condition when management is based on scientifically proven methods. It occurs in approximately 4% of vaginal deliveries, and estimates are that it causes significant morbidity and 25% of all the maternal child birth related deaths. We conducted this study with the following aims to compare the effectiveness of rectal misoprostol (600mcg) with intravenous methylergometrine (0.2mg) and intramuscular PGF2α (125mcg). To find out the percentage of pregnant women having postpartum hemorrhage, amount of blood loss and efficacy and safety of uterotonic drugs during third stage of labor. Patients with full-term singleton pregnancy in the age group of 20-35 years admitted in the maternity ward for vaginal delivery were enrolled in the study after taking written informed consent. The third stage of labor was actively managed in these patients by either 600mcg of misoprostol per rectally (Group A) or 0.2mg of IV methylergometrine (Group B) or 125mcg of PGF2α intramuscularly (Group C) and some were given any prophylactic oxytocic (Group D). Majority 110 (55%) of the studies participants were in the age group of 20-24 years. Moreover, 109 (54.5%) belonged to upper middle (II) socioeconomic class as per modified Kuppuswamy’s socioeconomic scale update for 2018. Only, 7 (3.5%) of the participants were grand multipara’s while 24 (12%) had gestational age greater than 40 weeks. Mean maternal age, gestational age and duration of third stage of labor was comparable in all the study groups. Maximum amount of blood loss was seen among participants who were in control group (201.80 ± 122.81 ml) and the maximum ‘mean difference in Hb’ was also seen in control group (0.83 gm%). Reported side effects during the study included diarrhea, nausea, shivering and vomiting in (1.5%) participants. Postpartum hemorrhage and retained placenta was reported among 7 (3.5%) and 2 (1%) participants only.Misoprostol can be used as a safe and effective alternative agent in active management of third stage of labor.
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