Background: Hypertension in pregnancy is a global problem and complicates approximately 10-17% of pregnancies. The incidence of PIH in India ranges from 5% to 15%. Uric acid is a marker of oxidative stress, tissue injury and renal dysfunction and therefore might be helpful in the prediction of complications of PE. Literature on serum uric acid as a predictor of complications of PE is conflicting. The present is intended to study uric acid as an important biomarker in hypertension in pregnancy. Methods: This was prospective observational analytical case control study of 180 individuals done at JSS Hospital, Mysore, India from January 2015 to July 2016. Results: A positive correlation was observed between rise in uric acid and severity of hypertension in pregnancy (p <0.01). Hypertensive mothers with uric acid levels >6.0mg/dl shows 100% maternal deaths, 79.4% with eclampsia and 71.9% with preterm delivery. Conclusions: A positive correlation was observed between rise in uric acid and severity of hypertension in pregnancy. Hyperuricemia in patients with hypertensive disorders of pregnancy is a strong risk factor for several maternal and perinatal complications.
The ten-group Robson classification has been praised for its simplicity, robustness, reproducibility, and flexibility 8 and has been recommended for both the monitoring ABSTRACT Background: With caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates. Methods: This was a cross sectional study for a period of 6 months at a tertiary care hospital in a rural area in Karnataka, South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group. Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 50.3% of the total Caesareans. Followed by Group 1 and 10. A Groups 6, 4, 8 and 9 by themselves did not contribute much but within their groups had a 100% C-section rate. Conclusions: Robson 10-group classification provides easy way in collecting information about Caesarean section rate which obtains good insight into certain birth groups. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute CSection rates.
Background: Pregnancy induced hypertension (PIH) is a global problem with a 5-15% incidence rate in India and complicating 10-17% of all pregnancies. These are multisystem disorders and lead to a lot of cellular death. LDH is an intracellular enzyme and its level is increased in these women due to cellular death. So, serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. The objective of the study was to correlate the severity of the disease, maternal and perinatal outcome with Lactic Dehydrogenase (LDH) levels in serum in patients of preeclampsia and eclampsia.Methods: A prospective comparative study was conducted in the department of Obstetrics and Gynecology, JSS Medical Hospital, Mysore.Results: LDH levels were significantly elevated in women with preeclampsia and eclampsia (<0.001). Higher LDH levels had significant correlation with high blood pressure (P <0.10) as well as poor maternal and perinatal outcome.Conclusions: High serum LDH levels correlate well with the severity of the disease and poor outcomes in patients of preeclampsia and eclampsia.
Background: SLE is an autoimmune disease most frequently found in women of child bearing age and may coexist with pregnancy. Its multisystem involvement and therapeutic interventions pose a high risk for both the mother and the foetus. Disease flares in pregnancy pose challenges with respect to distinguishing physiologic changes related to pregnancy from disease related manifestations. The present study analyzes the fetomaternal outcome of pregnant women with SLE.Methods: An analysis of fetomaternal outcome of pregnant women with SLE during April 2015 to May 2016 at JSS hospital.Results: During the period from April 2016 to May 2016, 3773 deliveries were conducted in the department. Eleven pregnant women with SLE were followed up during this period, giving an incidence of 0.29/1000 deliveries. A high rate of lupus flare during pregnancy was found in the current study. Even among women in remission for more than six months before pregnancy, the rate of lupus flare was not low (27%). Also other complications seen were pre-eclampsia 54.54%, HELLP syndrome in 9.09% , PPH in 50%, polyserositis seen in 9.09% and one maternal death was seen (9.09%). No neonate suffered from heart-blocker however there was 75 % NICU admissions among live borns.Conclusions: Advancing technology and better understanding of the maternal-foetal relationship in lupus have improved outcomes in lupus pregnancies over the last decade. The multisystem nature of the disease, the severity of the organ involvement needs to be assessed and a multidisciplinary approach is required for its diagnosis and successful management.
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