INTRODUCTIONHypertension in pregnancy constitutes the most common medical complication occurring in 12-22% of all pregnancies of which pre-eclampsia remains the leading cause that complicates 10% of all pregnancies.1,2 It is defined as new onset of elevated blood pressure and proteinuria (BP>/=140/90 and >/= 0.3gm protein in 24 hours urine specimen) after 20 weeks of gestation in a previously normotensive woman. 3,4 It is considered severe if blood pressure and proteinuria are increased substantially (BP>/=160/110 and >5 gm protein in 24 hours urine specimen) or symptoms of end organ damage like thrombocytopenia, altered liver function, oliguria, cerebral or visual disturbances, pulmonary edema and fetal growth restriction are present. 3,4 Eclampsia is defined as the new onset of generalized tonic clonic seizure in a woman with severe preeclampsia. Seizures most commonly occur in the postnatal period in 44% cases, antenatally in 38% and in the intrapartum period in 18%. 5 It was found that 3-5% of first pregnancies and 1% of subsequent pregnancies are complicated by preeclampsia.1 WHO estimated that approximately 60,000 women die each year from pre-eclampsia world-wide. Pre-eclampsia and eclampsia account for 24% of all ABSTRACTBackground: Pre-eclampsia accounts for the majority of referrals in a tertiary care centre as it stands one of the major causes of maternal and perinatal morbidity and mortality. The objective of this study was to study the maternal and fetal outcome in patients with severe pre-eclampsia and eclampsia in a tertiary centre over a period of one year. Methods: Total 150 women with severe eclampsia and eclampsia after 20 weeks of gestation were included. Women with medical complications like anemia, preexisting hypertension, epilepsy, diabetes, vascular or renal disease, multiple gestation, polyhydramnios were excluded. Patients were managed as per existing protocol after proper history, examination and investigations. Anti-hypertensive of choice was alphamethyl-dopa, labetalol and oral nefidipene. Magnesium sulphate was used as anti convulsant. Results: Out of 150 cases of severe pre-eclampsia and eclampsia, majority (69%) were between 20-30 years of age and 47% were primigravida. We had 75 patients with convulsions on admission and 75 with severe pre-eclampsia of whom 11 had convulsions. Headache was most common complaint. Common mode of delivery was caesarean section in 72 (48%) women, majority in view of failed induction or non-progress. Maternal complications were noted in 59% attributed to renal dysfunction, postpartum hemorrhage, DIC, placental abruption, HELLP, pulmonary edema, pulmonary embolism and renal failure. 4 maternal deaths were recorded. Conclusions: Maternal and perinatal complications are more in patients with eclampsia. The incidence of eclampsia can be reduced by better antenatal care, early recognition and prompt treatment of severe pre-eclampsia.

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Introduction:Abruptio placentae (AP) which is a major cause of maternal morbidity and perinatal mortality globally is of serious concern in the developing world. We retrospectively analyzed the AP cases and evaluated its impact on fetal and maternal outcomes.Materials and Methods:The present study was undertaken from September 2007-August 2009 at a tertiary care center attached to medical college; patients of AP were selected from all cases with minimum of 28 weeks of gestation, presenting with antepartum hemorrhage. Patients underwent complete obstetrical investigations and were managed according to maternal and fetal condition.Results:4.4% incidence rate of AP was documented accounting for 318 cases during the study period. Most of cases were unbooked, with an average age of 34.5 years (range, 18-44) and nearly two-third of the patients were from lower socioeconomic class. Anemia was observed in 96% of patients, with 3.5 and 68% incidence of maternal and fetal mortality, respectively.Conclusion:We observed a higher than expected frequency of AP and neonatal mortality in our study population, which is of major concern. We envisage need for mass information regarding the importance of antenatal maternal care and improvement in nutritional status, which may reduce the frequency of maternal and fetal morbidity and mortality associated with AP.

The present cross-sectional descriptive study was conducted to assess the nutritional status, maternal haemoglobin concentration, anthropometric details and its association with neonatal anthropometry. 200 pregnant women aged 18-37 years in the gestational age of 27-41 weeks, without any co-morbidity and having a complete medical record were included in the study. Pregnant women who were in labour in the maternity ward and had visited the tertiary centre in Mumbai for antenatal checkups were enrolled for the study. Predesigned, pretested questionnaire was used to obtain sociodemographic and pregnancy details along with 24-hour dietary recall taken prior to delivery. Maternal and neonatal anthropometry was measured by trained personnel using standardized techniques. Haemoglobin concentration prior to delivery and postpartum, birth weight and length was obtained from the hospital record. Analyses were performed using SPSS software (version 16.0) to determine the effect of nutritional status on birth outcome. P-value <0.05 was considered to be statistically significant. The mean maternal anthropometric details were height-153.13±10.39cm, postpartum weight-57.02±11.57kg, postpartum BMI-24.29±3.54kg/m 2 , haemoglobin concentration prior to delivery-11.19±1.78g/dL and post-partum-9.97±1.68g/dL. The mean neonatal birth weight was 2.77±0.50kg though 22.3% neonates had low birth weight (<2.5kg). The mean neonatal anthropometric details were length-45.72±1.14cm, MUAC-10.48±1.14cm, ponderal index-2.88±0.43g/cm 3 and MUAC/Head circumference-0.31±0.03. However, women (≥28 years) were older (+2.46 years), weighed more both pre-and post-partum and also had a higher interpregnancy interval (+1.3 years) and gravida as compared to women (≤27 years) (p<0.05). Birth outcome was influenced by maternal height, weight, postpartum BMI, haemoglobin levels prior to delivery, gestational age and nutrient intake particularly energy, protein, vitamin C and calcium. Maternal diet prior to pregnancy and during pregnancy along with maternal anthropometry, haemoglobin concentrations prior to delivery and gestational age greatly influences birth outcome. Thus, attention has to be given to nutrition of an adolescent girl by proper nutrition education, pre-pregnancy counseling which will help in better pregnancy outcome.