We report on a 2 1/2-year-old boy with absence of clavicular head of pectoralis major on the left side, ipsilateral upper limb anomalies, and anomalies of the lower limbs such as popliteal webbing, median cleft of right foot, bifid left hallux, syndactyly of toes, and toenail hypoplasia. Other anomalies included undescended testis, hairy nevus in the lumbosacral region, and a pedunculated finger-like tag on the right thigh. The pathogenesis of these associated anomalies cannot be explained on the basis of compromised local blood supply alone. A possible link with the disorganization mutation is discussed.
Introduction
Oligohydramnios has increased incidence of fetal distress, meconium-stained liquor, prolonged labor, low Apgar score, low birth weight, admission to NICU, cord compression, birth asphyxia, and operative interference. The objective of the study was to determine the pregnancy outcome in amniotic fluid index 5 cm or less in term pregnancy.
Materials and Methods
This was a hospital-based cross-sectional study conducted at National Medical College & Teaching Hospital from June 2017 to May 2018. A total of 72 obstetric cases with AFI ≤ 5 cm and 72 cases with AFI > 5 cm with meeting the inclusion criteria were enrolled in the study after taking consent.
Results
Incidence of oligohydramnios was 2.2% out of 4318 deliveries and term oligohydramnios was 1.66%. AFI ≤ 5 cm was associated with increased induction of labor (p < 0.001), caesarean section (p = 0.01)), meconium stained liquor (p = 0.106), Apgar score <7 at 5 minutes (p = 0.001), NICU admission (p = 0.003), neonatal deaths (p = 0.053) were comparable with AFI >5 cm.
Conclusion
Amniotic fluid index ≤ 5 cm at term is an indicator of poor perinatal outcome. Women with AFI ≤ 5 cm can expect a good outcome if they have regular ANC visits and intrapartum monitoring than the AFI > 5 cm.
Background: Hypertensive disorders complicate 5%-10% of all pregnancies and contribute greatly to maternal morbidity and mortality rates. Dangerous hypertension can cause cerebrovascular hemorrhage, hypertensive encephalopathy, and can trigger eclamptic convulsions. Blood pressure (BP) ≥160/110 mmHg in pregnancy requires prompt treatment. Both nifedipine and intravenous (IV) labetalol are effective antihypertensive agents belonging to different pharmacological classes and with different mechanisms of action. This study compares both the drugs. Objective: To compare the efficacy and safety of oral nifedipine versus IV labetalol for control of BP in cases of severe pregnancy-induced hypertension (PIH) with low-dose regimen. Materials and Methods: Pregnant women aged 18-40 years admitted in obstetrics and gynecology department with severe PIH, that is, BP ≥160/110 mmHg were included in this randomized prospective study. Simple randomization was done. A total of 30 patients in group A were given 5 mg oral nifedipine, to be repeated after half an hour if target BP of 150/100 mmHg was not achieved. A total of 30 patients in group B were given IV labetalol 20 mg initially followed by doses of 20, 20, 40, 40, and 80 mg every 20 min, if target BP was not achieved (maximum dose not to exceed 220 mg). The primary outcome variable was time necessary to achieve target BP. The secondary outcome variables were number of doses, cost of drug, need of crossover treatment, and adverse maternal and fetal side effects. Result: Patients receiving oral nifedipine achieved the target BP in 43 ± 16.74 min as compared with 38.67 ± 19.43 min in labetalol group (p = 0.3589). This difference was not significant. No maternal or fetal side effects were observed in both the groups. Labetalol was the costlier drug. Conclusion: Both regimens were equally effective in management of severe PIH with respect to time taken to achieve target BP. The adverse events in mother and baby were also less in view of the lower doses of the two agents used. Oral nifedipine was significantly less costly whereas IV labetalol was preferred in patients who were unable to take drug orally as in immediate postoperative patients and patients with altered sensorium.
Secondary cryptomenorrhea is a rare disorder and results due to adhesion formation postdelivery and puerperal sepsis. We report such a case who presented as amenorrhea and progressive pain in the abdomen postdelivery.
How to cite this article
Amrin S, Mukherjee S, Khan S, Jain U. A Case of Secondary Amenorrhea as a Result of Cervical Atresia Postdelivery. Int J Adv Integ Med Sci 2016;1(2):86-87.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.