scholarly journals DILEMMAS IN MANAGEMENT OF PREGNANT PATIENTS WITH MECHANICAL PROSTHETIC VALVES IN RURALAND SEMI-URBAN NORTH INDIAN POPULATION AT A TERTIARY CARE INSTITUTION.

2020 ◽  
pp. 44-45
Author(s):  
Amrit Gupta ◽  
Varuna Varma ◽  
Indrani Ghosh ◽  
Nirmal Kumar Gupta ◽  
Neeraj Kumar
Keyword(s):  
Pregnant Women ◽  
Heart Valves ◽  
Economic Status ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Mechanical Heart Valves ◽  
Successful Outcome ◽  
Congenital Defects ◽  
Care Hospital ◽  
In Pregnancy

Pregnancy is a prothrombotic stage, and in women with mechanical heart valves, anticoagulation is a challenge to attain an optimal outcome in mother and fetus. The use of combinations coumadin derivatives and various heparins is still in inconclusive stage due to various socioeconomic and demographic situation. In developing countries due to the cost of surgery, and compliance with lifelong anticoagulation there is contradiction for efficient outcome. Hence a safe protocol is necessary for implementation. Objectives: To evaluate the most effective, practical and uniform “Anticoagulation Regimen” suited to rural and semi-urban Indian pregnant women with mechanical heart valves with low socio-economic status and to observe its impact on the pregnancy outcomes. Methodology: Retrospective observational cohort study carried out at tertiary institute, between July 2006 to June 2015. 69 women became pregnant during the period from 2006 to 2015 on 1 or multiple occasions. 21(30.43%) pregnancies ended in early abortions and 46 (66.7%) pregnancies were continued. Anticoagulation protocol that was followed in these women was H-A-H protocol. These pregnancies were managed by obstetric team of tertiary care hospital under same consultant. Outcome measures were analyzed. Data was expressed as mean with standard deviation or frequency with percentage as appropriate. Results: Of 292 women, who underwent valve replacement surgery, 69 pregnancies were reported during this period on 1 or multiple occasions. 46 women had successful deliveries and rest 23 had single or multiple pregnancy failure. Incidence of stillbirth in those who delivered successfully was lower (2.89%). Fetal morbidity was 37.68% and none of the pregnant women had valve thrombosis. In 46 women majority had successful outcome except 6(13.04%) children out of 46 who developed anticoagulation related congenital defects. This was mainly seen in those women who presented late in pregnancy. Conclusion: Our Experience showed that Heparin-Acitrome-Heparin protocol is effective and safe in pregnancy than heparin alone, or acitrome alone regimen. The fetal outcome was good, maternal compliance was better and this protocol is widely recommended.

scholarly journals Knowledge and Practices of Pregnant Women regarding Oral Health in A Tertiary Care Hospital in Nepal

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Neha Gupta ◽  
Manisha Chhetry
Keyword(s):  
Oral Health ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Health ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Institutional Review ◽  
In Pregnancy

Introduction: Poor dental hygiene has been associated with various perinatal complications in studiesdone worldwide but few studies in Nepal have explored the knowledge of pregnant ladies regardingdental hygiene. The aim of the study was to know the knowledge and practices of pregnant womenregarding oral health in a tertiary care center in Nepal. Methods: A qualitative study was carried out in Nobel Medical College and Teaching Hospital fromJanuary 15, 2018 to June 15, 2018 after approval from the Institutional Review Committee of NobelMedical College. Convenience sampling was done. Fifty pregnant women admitted in antenatalward were interviewed regarding their knowledge of dental care in pregnancy, the common dentalproblems they faced and the treatment taken. A predesigned proforma was used and results wereanalyzed using SPSS version 17. Results: Twenty two (44%) patients reported dental problems during pregnancy. Bleeding gumswas seen in 7 (14%) and toothache in 7 (14%) were commonly reported dental problems. Forty seven(94%) patients acknowledged that routine dental care was needed for health, only 6 (12%) wereaware that poor dental health could affect baby weight. Oral health not seen as priority in 24 (48%)was the main barrier to seeking dental care in pregnancy followed by costs of treatment in 18 (36%)and safety concerns in pregnancy in 8 (16%) cases. Conclusions: Though dental problems were a common occurrence in pregnancy, utilization ofservices was low for the same. The participants reported significant barriers to obtaining dental careincluding lack of knowledge about the importance of maternal oral health and the treatment costs.

scholarly journals A RETROSPECTIVE STUDY ON PREVALANCE OF ANEMIA IN PREGNANCY IN A TERITIARY CARE HOSPITAL

2021 ◽  
pp. 106-108
Author(s):  
SYEDA ZAINEB KUBRA HUSSAINI ◽  
BUSHRA SHEREEN ◽  
SIRISHA D ◽  
MADHAVI E ◽  
HARI PRIYA E ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Iron Therapy ◽  
Care Hospital ◽  
Oral Iron Therapy ◽  
Moderate Anemia ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Objective: To study about prevalence in anemia among the antenatal women, its clinical features, and access the severity and its treatment response. Methods: A hospital-based retrospective study on the prevalence of anemia among the antenatal women in tertiary care hospital for 6 months duration in gynecology and obstetrics department. In evaluating pregnant women with anemia, it is essential to do a complete history and physical examination, as well as complete blood count with indices and a blood smear examination. Based on these findings, other test such as ferritin and serum or red cell folate may be ordered. Because of normal physiologic changes in pregnancy that effect the hematocrit, indices, and some other parameters, diagnosing true anemia, as well as the etiology of anemia, is challenging. Results and Discussion: In this retrospective study, the prevalence of Anemia in pregnancy in a tertiary care hospital was evaluated and determined in fifty patients. The most common age group was between 21 and 25 years i.e., (21 patients) 42%. Among 50 patients, majority of them, i.e., 35 patients (70%) were treated with Injection. Iron Sucrose (200 mg). In this study, increase in prevalence were seen majorly in the third trimester, i.e., 25 patients (50%) of which 22 patients (88%) were with moderate anemia with 7.9 gm/dl average hemoglobin (Hb) percentage and 3 patients (12%) were with mild anemia with 9.3 gm/dl average Hb percentage. Conclusion: The plan of management for anemia complicating pregnancy depends on the type of anemia. Oral iron therapy is the route of choice in women with mild to moderate anemia and for severe anemia in pregnant women <30 weeks of gestation. The rise of Hb with parenteral iron therapy is almost the same (avg: 1gm/dl/week) as that of oral iron therapy.

scholarly journals A study on prevalence of anemia in pregnancy in South India

2019 ◽  
Vol 9 (1) ◽  
pp. 34
Author(s):  
Sarala V. ◽  
Ushadevi Gopalan
Keyword(s):  
Pregnant Women ◽  
Economic Status ◽  
Tertiary Care ◽  
Structured Interview ◽  
Deficiency Anemia ◽  
Major Health Problem ◽  
Socio Economic Status ◽  
Anemia In Pregnancy ◽  
Prevalence Of Anemia ◽  
In Pregnancy

Background: Anemia in pregnancy is a major health problem worldwide, especially in developing countries like India. Maternal and fetal outcomes are poor in pregnant patients with anemia. The most important cause of anemia is iron deficiency anemia which can be prevented by early oral iron supplementation.Methods: This cross-sectional study was conducted in the department of obstetrics and gynecology of our tertiary care teaching institution for a period of one year. 1290 pregnant women coming to the antenatal OPD were screened for anemia and 490 women. Patients who were not anemic were excluded. 800 patients were enrolled in the study. Each patient was interviewed using a structured interview schedule and the data obtained was analyzed.Results: The percentage of anemia in pregnant women was 62% in our study of which 40% were mildly anemic, 55% were moderately anemic and 5% were severely anemic. Maximum number of anemic women -mild, moderate and severe was seen in the age group 20-24 years. Mild and severe anemia was seen more in the secondary educated women. Maximum percentage of anemia was seen in the lower socio-economic status followed by middle and was lowest in the higher socio-economic status group. Prevalence of anemia was almost equal in primigravida and multigravidas (around 50%) but 80% of severely anemic patients were multigravida. Almost 68% took iron and folic acid tablets regularly.Conclusions: Treating anemia in pregnant women will go a long way in improving maternal and fetal outcome. Hence a future healthy younger generation can be produced. Iron tablets can be distributed at school to young girls to prevent anemia in future women.

scholarly journals Prevalence of thyroid dysfunctions in pregnant women: a prospective study in a tertiary care hospital in Maharashtra, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3211
Author(s):  
Vaishali R. Korde ◽  
Sharin P. Barse ◽  
Jaya S. Barla
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Total Sample ◽  
Adverse Outcomes ◽  
Sample Population ◽  
Care Hospital ◽  
A Prospective Study ◽  
In Pregnancy

Background: Thyroid dysfunction is known to be the commonest endocrinological disorder in pregnancy. A range of adverse outcomes in pregnant women and the fetus have been reported. These can be prevented if the thyroid dysfunction is diagnosed and treated as early as possible. There are limited studies conducted on the prevalence of thyroid dysfunction in pregnancy in India. Hence, this study was conducted for assessment of the prevalence of thyroid dysfunction in pregnancy.Methods: The present study is a prospective study conducted in the Department of Obstetrics and Gynecology, MIMER Medical College and Hospital, Talegaon, Dabhade, Maharashtra. The total sample population comprised of 705 pregnant women with uncomplicated singleton intra-uterine pregnancy. All participants were screened by estimation for serum TSH in first trimester.Results: The prevalence of thyroid dysfunction in the present study is 13.9%. Of this, prevalence of hypothyroidism is 12.76% and that of hyperthyroidism is 1.13%.Conclusions: With this study, we conclude that there is high prevalence of thyroid dysfunction in pregnancy even in rural population. Thus, a universal screening helps in early diagnosis and preventing the aftermaths of thyroid dysfunction in pregnancy.

scholarly journals The effect of warfarin dosage on maternal and fetal outcomes in pregnant women with prosthetic heart valves

2011 ◽  
Vol 4 (1) ◽  
pp. 24-27 ◽  
Author(s):  
P Soma-Pillay ◽  
Z Nene ◽  
T M Mathivha ◽  
A P Macdonald
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Maternal Death ◽  
Heart Valves ◽  
Warfarin Dose ◽  
Mechanical Heart Valves ◽  
Prosthetic Heart Valves ◽  
Warfarin Dosage ◽  
Valve Thrombosis ◽  
In Pregnancy

There are several challenges in the management of pregnant women with mechanical heart valves. Pregnancy increases the risk of thromboembolism and there is currently no consensus on the safest anticoagulation method during pregnancy. The objective of the study was to determine the correlation between the warfarin dose and pregnancy outcome in pregnant women with prosthetic heart valves. Warfarin in pregnancy was associated with a low risk of valve thrombosis or maternal death. The risk for fetal abnormalities was not related to the maternal warfarin dosage. However, the risk for stillbirth was significantly increased with increasing doses of warfarin.

scholarly journals An illustration of delays in Mucormycosis: A case Study

2021 ◽  
Vol 33 (3) ◽  
pp. 515-518
Author(s):  
Neelam Anupama Toppo ◽  
Aditya Thakur ◽  
Deepali Soni ◽  
Priyanka Dubey ◽  
Sapna Tiwari
Keyword(s):  
Fungal Infection ◽  
Blood Sugar ◽  
Economic Status ◽  
Tertiary Care ◽  
Successful Outcome ◽  
Care Hospital ◽  
Health Service Provider ◽  
Case File ◽  
Local Trauma ◽  
Three Delays

Background: Mucormycosis is an opportunistic fungal infection with a high fatality rate and is the third most common fungal infection that is invasive in nature, next to candidiasis and aspergillosis. It is attributed to the poor socio-economic status and triggered by the local trauma due to unhygienic setup or poor health care. The pathway of pathogenesis is not clearly understood in immunocompetent patients and therefore becomes a matter of great concern.Aim& Objective: To explore the pathway of  mucormycosis in a case of post SARS-CoV-2 infection Settings and Design: Tertiary Care hospital of Jabalpur DistrictMethods and Material: Interview with the case and care taker and case file review.Results: We could conclude this as a case of rhino- orbital mucormycosis attributed to uncontrolled blood sugar during treatment of SARS-CoV-2 infection,  three delays that have occurred during the disease progression like ignorance from health service provider, late diagnosis, non compliance to the advice given by health facility,  poor oral and nasal hygiene and no use of distilled water in humidifier. Conclusions: The early diagnosis, prompt Treatment , surgical intervention , proper blood sugar monitoring and rational use of steroids are important steps of successful outcome of the disease.

scholarly journals Dengue infections during pregnancy: case series from a tertiary care hospital in Sri Lanka

2010 ◽  
Vol 4 (11) ◽  
pp. 767-775 ◽  
Author(s):  
Sampath Kariyawasam ◽  
Hemantha Senanayake
Keyword(s):  
Sri Lanka ◽  
Pregnant Women ◽  
Clinical Laboratory ◽  
Multiorgan Failure ◽  
Demographic Data ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
In Pregnancy

Introduction: Dengue is the most important mosquito-borne disease in Sri Lanka, leading to more than 340 deaths during the last outbreak (≈35,000 reported cases) starting in mid April 2009. The predominant dengue virus serotypes during the last few years have been DENV-2 and DENV-3. Dengue infection in pregnancy carries the risk of hemorrhage for both the mother and the newborn. Other risks include premature birth, fetal death, and vertical transmission. We report clinical and laboratory findings and outcomes in pregnant women hospitalized with dengue infection during pregnancy. Methodology: Clinical, laboratory, maternal/fetal outcomes and demographic data were collected from patients with confirmed dengue infections during pregnancy treated at De Soysa Maternity Hospital, Sri Lanka from 1 May 2009 to 31 December 2009. Results:  Fifteen seropositive dengue infected pregnant women were diagnosed in the period. Multiorgan failure leading to intrauterine fetal and maternal death occurred in one case of dengue hemorrhagic fever (DHF) IV. One patient with DHF III had a miscarriage at the 24th week of gestation. Perinatal outcomes of the other cases were satisfactory. One woman developed dengue myocarditis but recovered with supportive treatments. No cases of perinatal transmission to the neonate occurred. Conclusion: Dengue in pregnancy requires early diagnosis and treatment. A high index of clinical suspicion is essential in any pregnant woman with fever during epidemic. Further studies are mandatory as evidence-based data in the management of dengue specific for pregnancy are sparse.

FETOMATERNAL OUTCOME OF PREGNANCY WITH HEART DISEASE IN A TERTIARY CARE HOSPITAL OF KOLKATA IN EASTERN INDIA

2021 ◽  
pp. 21-23
Author(s):  
Kajal Kumar Patra ◽  
Dipnarayan Sarkar ◽  
Sukhamoy Saha
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Age Group ◽  
Normal Delivery ◽  
Heart Disease In Pregnancy ◽  
In Pregnancy

BACKGROUND: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India. METHODS: This study was a prospective observational study conducted in the IPGMER & SSKM Hospital, Kolkata, West Bengal from December 2020 to February 2021. 36 Pregnant women with heart disease were taken as study group. Multiple pregnancy and any other medical disorder like GDM, PIH, were excluded from study. Fetomaternal outcome, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared. Template was generated in MS excel sheet and analysis was done on SPSS software. RESULTS: Among 36 patients 14 (38.89%) patients belonged to age group 25-29 years and 2 (5.56) belonged to age group <20 years. 13 (36.11%) patients belonged to lower middle class and 17 (47.22%) belong to lower class. 19 (52.78%) patients were P and 9 (25%) were P parity group. 20 (55.56%) belong to gravida G1. 10 (27.78%) 0+0 1+0 patients had CHD and RHD. 20 (55.56%) were normal delivery. 13 (36.11%) of babies were underweight. Maternal death were 2 (5.56%). CONCLUSIONS: Feto-maternal outcome can be improved appreciably by antenatal care, early diagnosis and management.

scholarly journals Fetomaternal outcome in women with heart disease in urban population in a tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 3684
Author(s):  
Preeti Sharma ◽  
Renuka Malik
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Mortality ◽  
Delivery Mode ◽  
Care Hospital ◽  
Heart Disease In Pregnancy ◽  
In Pregnancy

Background: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India.Methods: This study was a prospective observational study conducted in the department of obstetrics and gynaecology at PGIMER & Dr. RML hospital from Nov 2015 to March 2017. 35 Pregnant women with heart disease were taken as study group and 35 low risk pregnant patients were taken as control. Multiple pregnancy and any other medical disorder like GDM, PIH, IHCP and thyroid disorders were excluded from study. Fetomaternal outcome in terms of POG at delivery, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared between these two groups.Results: Vaginal delivery is still the common mode of delivery. Preterm delivery, prematurity, ICU admission, low birth weight is more common in pregnancy with heart disease than in normal pregnancy.Conclusions: Although maternal mortality and fetal mortality is reduced, pregnancy with heart disease still carries substantial risk to mother and child.

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