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To know role of cord arterial blood pH and lactate dehydrogenase levels in neonatal outcome assessment. Methods: Present observational study was conducted in Obstetrics and Gynecology department of a rural tertiary center of Northern India over 6 months (July-January 2019) on 155 term (≥37-≤42 weeks) antenatal women with hypertensive disorders of pregnancy fulfilling inclusion criteria. Immediately after delivery, arterial blood sample was drawn from doubly clamped 10-12 cm long umbilical cord in pre-heparinized insulin syringe, which was sent for pH estimation and 0.5 ml in lithium heparin tube for lactate dehydrogenase levels. One-and 5-min neonatal Apgar score was noted by pediatrician. Cord blood pH and lactate levels were then compared with overall neonatal outcome. Statistical analysis was done using SPSS-22 version. Results: Mean values of umbilical cord arterial pH and LDH was 7.2 ± 0.1 and 449.5 ± 562.9 U/L respectively. Significantly low mean cord blood pH (7.03 ± 0.12) and high LDH levels (939.74 ± 781.75 U/L) were observed in neonates of eclamptic mothers (p = 0.00). Mode of delivery had significant effects on cord blood parameters with significantly low pH and elevated LDH levels seen in neonates delivered by emergency LSCS for fetal distress (p < 0.05). Cord blood LDH levels were more significantly associated with NICU admission, neonatal morbidity and mortality. Cord blood LDH was a better predictor of neonatal outcome with 100% sensitivity and 79.73% specificity. Conclusion: Cord arterial blood lactate dehydrogenase levels were better predictor of overall neonatal outcome.

Objective: To study the efficacy of Diabetes in Pregnancy Study Group India (DIPSI) as a diagnostic tool for gestational diabetes mellitus (GDM). Introduction: A simple, convenient, and patient-friendly method of diagnosing GDM by DIPSI criteria has been questioned by many workers. Hence, this study was undertaken to compare DIPSI to gold standard International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria to determine diagnostic accuracy of DIPSI. Materials and methods: This cross-sectional study was conducted in the department of obstetrics and gynecology in a rural medical college in North India. It included 800 pregnant women with gestational age 24-28 weeks, who underwent plasma glucose (PG) evaluation 2 hours after the challenge of 75 g glucose load irrespective of their fasting state (DIPSI criteria for GDM). After 7 days, standard 75 g OGTT was done in all women irrespective of previous PG value. Blood glucose was tested by glucose oxidase peroxidase method. Accuracy of the DIPSI result was compared with OGTT using cutoffs as per standard criteria for the diagnosis of GDM. Results: Of all 800 cases, 48 cases either did not report for the second visit in time or could not tolerate oral glucose. Of the remaining 752 cases analyzed, 620 cases found to be normal both by DIPSI and IADPSG criteria, 81 patients detected to have GDM by both criteria. In 30 patients, DIPSI detected GDM, but IADPSG criteria values were within normal limit. A total of 21 patients found to be GDM by IADPSG criteria, but DIPSI values were within normal limit. When compared with IADPSG, DIPSI found to have a sensitivity of 79.41%, specificity of 95.39%, positive predictive value of 72.97%, negative predictive value of 96.73%, and diagnostic accuracy of 93.23%. Conclusion: In conclusion, DIPSI method of screening antenatal women for GDM is found to be simple, cost-effective, easy to perform, patientfriendly, and convenient. On comparing results to gold standard IADPSG, DIPSI shows high specificity and acceptable sensitivity. A statistical analysis has shown that if a cutoff value of blood sugar is lowered to 136 from 140, the sensitivity and specificity of DIPSI criteria improve further.

Background: Hypertensive disorder of pregnancy is associated with adverse maternal, perinatal outcome. Objective: To know the perinatal outcome in women with hypertensive disorders of pregnancy. Methods: Present retrospective cohort study was conducted in the Obstetrics and Gynecology department of the rural tertiary center of Northern India over one year (January-December 2018) on 205 antenatal women with hypertensive disorders of pregnancy at gestation ≥28 weeks. All the participants on the basis of diagnosis were divided into four groups: Group 1 Gestational hypertension; Group 2 Pre-eclampsia; Group 3 Eclampsia and Group 4 with Chronic Hypertension. Demographic features, gestational age, the onset of labor, mode of delivery and perinatal outcome including birthweight, Apgar scores, morbidity and mortality were recorded and compared between four groups. Statistical analysis was done using software SPSS 22.0. version. Results: Of 205 participants, 93 had Gestational Hypertension, 68 Pre-eclampsia; 36 Eclampsia, 06 Chronic Hypertension. The mean age of presentation was 24.96±3.535 years. Average gestation at birth for group 1 was 37.91±2.38 weeks, group 2: 36.50±3.312 weeks, group 3: 34.44±4.062 weeks and group 4: 37.97±1.524 weeks. The majority of participants had induced labor especially in preeclampsia and eclampsia groups with a spontaneous vaginal delivery as the most common mode. 1 and 5-minute Apgar scores, birth weight were lower in eclampsia and pre-eclampsia women. Severe disease was associated with the adverse perinatal outcome with maximum neonatal morbidity and mortality in eclampsia and pre-eclampsia group. Conclusion: Hence, hypertensive disorder of pregnancy was associated with adverse perinatal outcome, especially in women with severe disease (Eclampsia and Pre-eclampsia).