Background: This study was done to assess the lung volumes by spirometry in all the three trimesters in antenatal mothers and to observe the effect of pulmonary function abnormality in mode of delivery and birth weight of babies.Methods: Our study included 100 antenatal mothers attending antenatal clinic in Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu during the period of Jan 2017 to Dec 2017. It was a prospective observational study. Mothers were subjected to detailed physical and clinical examination. Basic investigations were done. Considering test by spirometry. The changes in the lung volumes were noted according to gestational age. The effect of pulmonary function abnormality in the mode of delivery and birth weight was observed.Results: One hundred antenatal mothers selected randomly were evaluated for the lung volumes by using spirometry. Out of the 100 cases, 17 belonged to I trimester, 46 belonged to II trimester and 37 belonged to III trimester. We noted a significant reduction in FVC in II and III trimester. This reduction was little more in II trimester. There was significant reduction in FEV1 in II trimester. The reduction in FEV1 and FVC did not influence the mode of delivery but it significantly affected the birth weight of babies. FEV1/FVC reduction had no influence in the mode of delivery and birth weight of babies.Conclusions: The present study highlighted that there was reduction in lung volumes in II and III trimester of pregnancy and it influenced the birth weight of babies. Hence it becomes essential to pay special attention to pulmonary functions during antenatal period.
Gestational trophoblastic disease occurs in less than 1 per 1200 pregnancies. The spectrum of this disease ranges from benign hydatidiform mole to trophoblastic malignancy (placental-site trophoblastic tumor and choriocarcinoma). Benign gestational trophoblastic disease generally occurs in women of reproductive age and is extremely rare in postmenopausal women. We report a case of a 54-year-old postmenopausal woman who underwent an emergency total abdominal hysterectomy due to uncontrollable vaginal bleeding associated with an increased serum β-human chorionic gonadotropin level. The resected uterus contained an endometrial, cystic, grapelike tumor. Microscopic examination demonstrated hydropic degenerated villi with a circumferential trophoblastic cell proliferation and moderate atypia, consistent with a complete hydatidiform mole. Only isolated cases of hydatiform mole in elderly women have been reported in literature. But there still remains a risk of developing gestational trophoblastic disease in the elderly and it should always be included in the differential diagnosis of postmenopausal bleed.
Background: Gestational diabetes mellitus is defined as carbohydrate intolerance with its onset or first recognition during present pregnancy. Objective of present study was to compare screening accuracy of ADA and WHO criteria for screening of gestational DM.Methods: This is a prospective comparative study using ADA and WHO criteria for the screening of GDM. Our objective was to study the implication of implementing the ADA guidelines and WHO guidelines for screening and diagnosis of GDM in 200 antenatal patients at Government Mohankumaramangalam Medical College, Salem during a period of one year from July 2015 to June 2016. All antenatal women attending AN OP between 24-28 weeks of gestation are subjected to fasting blood glucose measurement followed by an oral OGTT using 75 gms of glucose load. Venous blood samples are collected at the end of 1hr and 2hr. The ADA and WHO criteria were applied separately for each subject to diagnose GDMResults: As per ADA criteria presence of any one of either, Fasting blood sugar- 92 mg (5.1 mmol/L),1 hour postprandial-180mg (10.00mmol/L), 2 hour postprandial: 153 mg (8.5 mmol/L) was used for the diagnosis of GDM.As per WHO criteria presence of any one of either, Fasting blood sugar- 126mg/dl (7 mmol/dl) or 2 hour postprandial- 140 mg/dl (7.8 mmol/dl) for diagnosis of GDM. The 2hr value has the statistical significance in the diagnosis of GDM. The 1hr value done in ADA criteria does not have statistical significance when compared to 2hr value.Conclusions: Universal screening for GDM is necessary to diagnose Gestational Diabetes Mellitus. Universal screening may not be feasible in resource poor settings, but it definitely improves the pregnancy outcomes considering the high prevalence of gestational diabetes in India.
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