No abstract

Purpose of the Study To study the feasibility of blood pressure monitoring and to assess the feasibility of antihypertensive dose adjustment in postpartum women by teleconsultation in COVID 19 pandemic situation. Methods This was a descriptive longitudinal study conducted in the Department of OBGY, GMCH, Aurangabad between the study periods November 2020 to April 2021 with a sample size of 60. The feasibility of blood pressure monitoring in postpartum women by teleconsultation was measured by recruitment and retention through 12 weeks postpartum. The feasibility of anti-hypertensive dose adjustment through teleconsultation was measured by the number of women requiring hospital visit for uncontrolled blood pressure or those with warning signs and symptoms. The data were collected and analyzed. Results The feasibility of blood pressure monitoring in postpartum women by teleconsultation was 95.23%. During follow-up, the antihypertensive drug dose was required to be increased in 3 women. Not a single woman required hospital visit or hospital readmission either due to uncontrolled hypertension or warning signs/symptoms. This indicates that the feasibility of anti-hypertensive dose adjustment by teleconsultation was good. Conclusion We demonstrated feasibility and over all good satisfaction rate of Blood Pressure Monitoring in postpartum women by teleconsultation in COVID 19 pandemic situation and found that teleconsultation is a boon in management for postpartum hypertension to reduce readmissions and decrease maternal morbidity while ensuring social distancing and minimizing viral exposure. We recommend teleconsultation as a quality improvement initiative in maternity care.

Gas gangrene in pregnancy is a rare occurrence although associated with high mortality. We report the case of a patient who developed gas gangrene of abdominal wall post-partum. A 30-year-old G3P2L2 with 6 months of amenorrhea, a neglected ANC with no antenatal visits, a known case of quadriparesis, delivered a preterm male baby. Having a contusion of 20*10cm size on lower abdomen, a blister formed over the same post-partum which had to be debrided. She was treated vigorously with antibiotics and tetanus antitoxin; and appropriate supportive management. Patient’s condition worsened after 36hrs and 46 hrs after admission she went into cardiac arrest. And such we encountered a case in 2019 in modern-day obstetrics, of gas gangrene complicating pregnancy, costing life to both the new-born and parturient. The importance of early suspicion and diagnosis followed by prompt, vigorous treatment cannot be emphasized more.