Background: Active tuberculosis is a multiorgan disease caused by primary infection or as a re-activation of latent tuberculosis. The studies comparing maternal and fetal outcome in antenatal women with extrapulmonary tuberculosis and pulmonary tuberculosis is scanty therefore, in current study we outline and identify the demographic and clinical characteristics of pulmonary tuberculosis and extrapulmonary tuberculosis and comparing fetal and maternal outcome in pulmonary and extrapulmonary tuberculosis. The maternal complications and fetal complications of pulmonary tuberculosis were analysed compare with extra pulmonary tuberculosis.Methods: This was prospective observational study done in tertiary care centre over a period 1.5 year from January 2019 to June 2020. Institute ethical committee approval was obtained. Pregnant women in the age group of 18-42 years diagnosed with tuberculosis in antenatal period were included in our study for comparing fetal and maternal outcomes. They were evaluated for their symptom including clinical examination, microbiological, radiological and biochemical testing. We excluded those antenatal women with tuberculosis and adequately treated and cured and those women with tuberculosis who did not delivered during study period.Results: Most common complication associated with pulmonary tuberculosis was intrauterine growth restriction whereas in extrapulmonary preterm labour most common complication. Perinatal outcome worse in extrapulmonary tuberculosis as compared to pulmonary tuberculosis.Conclusions: Pregnancy with tuberculosis worsen the outcome of both mother and fetus. Our study depicted perinatal outcome is worse in Extrapulmonary TB than pulmonary TB. Atypical presentation of the Extrapulmonary TB may constitute diagnostic and therapeutic challenges thus a high clinical suspicion is needed.

No abstract

Background: To study the fetal and maternal outcome in preterm labor cases.Methods: It was Prospective, single centered, observational study. All women with preterm labor in the study period i.e. from September 2018 to March 2020 were included in the study i.e. 100 patients.Results: Out of 100 subjects, majority of mothers 65(65%) were in age group of 21-30 years followed by 23 (23%) in age group of ≤20 years. Majority 52 (52%) of study subjects were primigravida followed by 28 (28%) having parity 1. Only one case had parity 4. Majority 36 (36%) of study subjects were in lower class followed by 28 (28%) cases in lower middle class. 23 (23%) cases in middle class and 6 (6%) were in upper class. Maximum 61 (61%) cases were unbooked cases and rest 39 (39%) cases were booked. Out of 90 babies who were <2500 grams, maximum 57 (63.33%) were low birth weight (less than 2.5 kg) followed by 22 (24.44%) being VLBW babies. 10 cases were ≥2.5 kg, which are not LBW babies according to WHO Classification of low birth weight. Majority 34 (47.22%) stayed for 1-10 days followed by 17 (23.61%) babies for 11-20 days. Also 15 (20.83%) babies stayed for 21-30 days.Conclusions: Compared with term infants, preterm infants are at high risk of overall morbidity and mortality. Clinical suspicion, early detection and correction of risk factors, institutional delivery and good neonatal care back up facilities can improve the outcome of preterm labour and decrease the maternal complications as well.

BACKGROUND Pregnancy-associated cardio circulatory changes-primarily, increase in heart rate, stroke volume, and cardiac output, as well as reduction in systemic vascular resistance, may threaten maternal outcome; which in turn has foetal and neonatal implications. We wanted to assess the impact of heart disease during pregnancy, study the neonatal outcomes of pregnancies in women with heart disease and identify predictors of adverse neonatal outcomes. METHODS Data of all pregnant women with documented heart disease who were admitted in a rural tertiary centre in Kerala over a period of 3 years was collected. Patients undergoing medical termination of pregnancy were excluded from the study. The neonatal outcomes of pregnancies in 100 women with heart disease, were evaluated. RESULTS In 100 mothers with heart disease, neonatal adverse events complicated 35% of pregnancies. In 31% cases, the babies were small for gestational age. There were 10 cases with Respiratory Distress Syndrome, 7 preterm babies and 6 cases with low APGAR scores. The live birth rate for pregnancies that continued beyond 20 weeks was 96%. NYHA class is a statistically significant predictor of neonatal events (p value 0.001). 14 out of 28 pregnancies with left heart obstruction had a neonatal complication, which was statistically significant (p value 0.050). Previous history of cardiac events was present in 9 cases and 88.9% of these patients developed a neonatal event (p value 0.000). The requirement of cardiac medications was also a significant predictor of neonatal events (p values-0.004). CONCLUSIONS The management of pregnant woman with heart disease requires a multidisciplinary team work for a good outcome. Early risk stratification, good antenatal care and early recognition of complications are important measures to improve the prognosis in these women.

No abstract