Background: High-risk pregnancy refers to any condition in pregnancy that increases risk for morbidity or mortality in mother, fetus and neonate. Globally, nearly 5,29,000 women die due to pregnancy related complications. In India, 20-30% of the pregnant patients contribute to high risk group. This study was conducted to determine different high-risk factors prevalent in antenatal women in Haryana. Objective of this study was to find out prevalence of different high-risk factors in antenatal women.Methods: Data of all antenatal high-risk patients attending OPD during one year was taken from hospital record registers. Maternal characteristics such as age, gravida/parity, gestational age, and gestational age at the time of first visit were noted. High risk factors identified were noted.Results: The records of total 10073 antenatal women were analyzed, 1283 were included in the high-risk group. Most prevalent high-risk factors found were previous cesarean section (31.04%), anaemia (31.02%), malpresentation (12.93%) and thyroid disorders (13.09%).Conclusions: Antenatal surveillance for the high-risk factors complicating pregnancy may prevent or treat most of the complications. Authors should develop strategies for early screening of high-risk pregnancy cases to prevent maternal and perinatal mortality and to improve the maternal and perinatal outcome.
The aim of this study was to evaluate the demographic profile, risk factors, management strategies in women with placenta accrete spectrum and also to see the feto-maternal outcome of these women.
Study design-Prospective AnalysisMethods: This study was conducted in the Department of Obstetrics and Gynaecology, PGIMS, Rohtak, Haryana from January 2017 to December 2018. All the women who were diagnosed as placenta accrete spectrum (PAS) either on ultrasonography, magnetic resonance imaging or intra-operatively were included in the study. Results: During the two year study period, there were 22745 deliveries, out of which 22 patients were diagnosed to have placenta accrete spectrum, therefore, the incidence was 0.09%. The majority (41%) of the women in study belonged to the age group of 30-35 years. Most of the women (77%) were unbooked and 80% were from rural background. None of the women in our study were primiparous. The risk factors for PAS in our study included history of one caesarean section in 11(50%) patients, two caesarean section in 4 (18%) patients and history of three caesarean section in 2 (9%) patients. Co-existing placenta previa was present in 17 (77%) of the women with placenta accrete spectrum. Eight women (36%) had placenta accrete, one (5%) had placenta increta and rest of the 59% were diagnosed as placenta percreta. The maternal complications encountered in the study were post-partum haemorrhage (95%), bladder injury (59%), DIC (9%) and sepsis (5%). Maternal mortality rate was 9%. The most common neonatal complication was prematurity and low birth weight.
Conclusion:The rising rates of caesarean sections is an important factor behind increase in incidence of placenta accrete spectrum. Early diagnosis in antenatal period, timely intervention, multi-disciplinary team approach and adequate arrangement of blood and blood products is a key for successful management of PAS, thereby, reducing maternal and neonatal morbidity and mortality.
The main objective was to evaluate the effectiveness of Neuromuscular exercises (NEMEX) on pain and function in patients with knee osteoarthritis. Pubmed, Cochrane and Pedro and Google Scholar were accessed with eligibility criteria Randomized controlled trials, single blinded controlled trial and Controlled before and after study comparing and assessing the effectiveness of NEMEX in knee osteoarthritis, articles published in English language till 2020 with NEMEX either alone or in conjunction with other interventions (drugs, educational packages) in patients with Knee osteoarthritis. Outcome measures used for meta-analysis were visual analog scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function and the other measures Knee injury osteoarthritis outcome score (KOOS), Knee Index and Knee Adduction Moment (KAM) and Hip Disability and osteoarthritis outcome score (HOOS). The result of the metaanalysis for the included two studies showed statistically significant reduction in pain (VAS) in the NEMEX group as compared to the other group Z = 0.64, p = 0.03, I2 = 79% and no significant reduction in WOMAC scores Z = 0.70, P = 0.64.The study concludes that there was statistically significant improvement in pain (VAS) but no functional improvement (WOMAC) with the NEMEX whether used in isolation or in conjunction with other interventions was seen in the patients with knee OA. However, large numbers of studies are required to generalize the effectiveness of NEMEX in knee osteoarthritis. Implications of the study includes NEMEX can be used as a potential intervention in reducing pain, improving strength and function in knee osteoarthritis patients.
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