Objectives:The objective of the present study is to compare the safety and efficacy of ferric carboxymaltose (FCM), intravenous (IV) iron sucrose and oral iron in the treatment of post = partum anemia (PPA).Materials and Methods:A total of 366 women admitted to SCB Medical College, Cuttack between September 2010 and August 2012 suffering from PPA hemoglobin (Hb) <10 g/dL were randomly assigned to receive either oral iron or IV FCM or iron sucrose. FCM, IV iron sucrose, and oral iron were given as per the protocol. Changes in hemoglobin (Hb) and serum ferritin levels at 2 and 6 weeks after treatment were measured and analyzed using ANOVA. Adverse effects to drug administration were also recorded.Results:A statistically significant increase in Hb and serum ferritin level were observed in all three groups, but the increase in FCM group was significantly higher (P < 0.0001) than conventional iron sucrose and oral iron group. The mean increase in Hb after 2 weeks was 0.8, 2.4, and 3.2 g/dL and 2.1, 3.4, and 4.4 g/dL at 6 weeks in oral iron, iron sucrose and FCM groups, respectively. The mean increase in serum ferritin levels after 2 weeks was 2.5, 193.1, and 307.1 and 14.2, 64, and 106.7 ng/mL after 6 weeks in oral iron, iron sucrose and FCM groups, respectively. Adverse drug reactions were significantly less (P < 0.001) in FCM group when compared with other two groups.Conclusion:Ferric carboxymaltose elevates Hb level and restores iron stores faster than IV iron sucrose and oral iron, without any severe adverse reactions. There was better overall satisfaction reported by the patients who received FCM treatment.

Background: Care of the critically ill obstetric patients is a unique challenge particularly because of its unpredictability. The outcome in these patients would not only contribute to the assessment of the quality of patient care but would also enhance the risk stratification of pregnant patients in the evaluation of new therapies. This study is intended to review a series of critically ill obstetric patients admitted to our ICU to assess the spectrum of disease, required interventions, and maternal outcome, and to identify conditions associated with maternal death. Methods: This retrospective cohort study was conducted in 16-bed medical and surgical ICU in a 500 bedded tertiary care hospital over a period of 5 years (2009-2013) at Bhubaneswar, Odisha, India. Results: Only 54 obstetric patients were admitted to the ICU which constitutes 2.09% of all ICU admissions, 0.78% of emergency obstetric admissions and 0.9% of the total deliveries. Majority of patients (79.62%) were admitted during postpartum period. The leading obstetric indication for ICU admission was obstetric hemorrhages (29.6%). Ectopic pregnancy was common (7 patients) among the obstetric hemorrhages. In the present study maternal mortality was 16.6%, while 70.3% were improved after treatment. The main cause of maternal death was obstetric haemorrhage (55.5%). ICU interventions during the stay of the patients in terms of mechanical ventilation were used in 72.2% of cases. Other interventions included blood & blood product transfusion in 30 (55.5%), inotropes in 34 (62.9%), antihypertensive in 14 (25.9%), anticonvulsant in 16 (29.6%) & dialysis in 4 (7.4%) cases. Conclusions: The need of ICU management for obstetric conditions is on rising trend. The need for ventilatory or inotropic support may predict poor outcome. An adequate adoption of safe motherhood initiative would reduce obstetric ICU admissions and thereby will also reduce the maternal mortality.

No abstract

Background: Mifepristone is potentially a method of inducing labour in late pregnancy by increasing uterine contractility and by increasing the sensitivity of the uterus to the actions of prostaglandins. Present study was done to portrait the beneficial of mifepristone induction of labour. The objective was to study the effect of mifepristone in induction of labour with the outcome of induction of labour (IOL). Methods: 100 patients (term) were included, after their informed consent. Patients were categorized by BISHOP SCORE at the beginning of induction for comparison of BS, mode of delivery, induction delivery interval (IDI). Women undergoing induction with RU486 (200mg PO) were grouped in one and those with placebo control group into another. Statistical analysis of categorical variables was done. Results: Rate of successful IOL or vaginal delivery was 76% in study group and only 36% in control group. After induction with mifepristone for cervical ripening in study group 76% patient who had cervical score <3 on admission had cervical score improved to>8 within 24 hours, whereas in control group 2% female’s cervical score was>8. Among the babies, 44% in the control group required baby unit admission as compared to 36% in the study group. Conclusions: In the present study, the women who were induced with mifepristone 200 mg per orally showed drastic improvement in cervical score within 24-48 hours and decreased the cesarean rate in the study group and amount of dose requirement of augmentation of labour with Misoprostol or Oxytocin, lesser NICU admission and maternal complication. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000): 35-38