Background: To analyze the requirement of High Dependency Unit (HDU) and Intensive care Unit (ICU) in an obstetric population in terms of utilization rate, indications for admission, interventions required and gestational outcome. Methods: Retrospective observational study was carried out from October 2016 to September 2017 in Kasturba Hospital, Mother and Child Health Wing, Mahatma Gandhi Institute of Medical Sciences Sewagram placed in rural central India. Data related to indications for HDU/ICU admission, interventions required, length of stay and outcomes were collected, and results were analyzed. Results: Our obstetric HDU utilization rate was 11.2 per 1000 deliveries. Out of total 57 subjects 48 had no prior antenatal care. Majority (68.42%) were admitted in HDU with only obstetric reasons, while 31.57% required HDU for pre-existing medical diseases. The major obstetric indications were septicemia (35.08%) & PPH (29.08%) and hypertension was observed in 21.05% of women. Other less common causes included post-surgical acute kidney injury, APH, chorioamnionitis and pyelonephritis. Half of the women with pre-existing medical disease had cardiovascular problems. Patients with medical diseases had more pre-term labor (10 vs. 5; P ≤ 0.05), respiratory failure (9 vs. 2; P ≤ 0.05), cardiac failure (7 vs. 1; P ≤ 0.05), duration of stay more than 10 days (15 vs. 6; P ≤ 0.05), fetal growth restriction (6 vs. 3; P ≤ 0.05) and prolonged recovery time. Maternal mortality among these critically ill women was 12.28% and fetal mortality was 17.54%. Conclusion: Establishment of well managed high dependency and intensive care unit in health care facilities dealing with high volumes of high-risk maternity cases reduces the maternal mortality significantly and results in improved maternal outcomes.

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Background: Maternal Anemia is a global health problem with adverse implications on materno-fetal outcome. Various socio-demographic and obstetric factors affect prevalence of anemia.Methods: A hospital based, cross-sectional, observational study was carried out among pregnant women seeking antenatal care at Kasturba Hospital of MGIMS, Sewagram, a rural tertiary care institute in central India. Information was collected about demographic variables, age, gravidity, parity, literacy, area of residence and socioeconomic status. Hemoglobin levels in first trimester and pre delivery were measured by coulter and correlated with socio-demographic and obstetric factors.Results: Among 500 pregnant women of first trimester, 249 (49.8%) had anemia, 154 (30.8%) mild, 86 (17.2%) moderate and 9 (1.8%) severe anemia. More women with anemia were of lesser age, resided in rural area, belonged to middle and lower economic class, lived with joint families and had less than 12 years of formal education.Conclusions: Anemia is prevalent in pregnant women in this geographic region of central India. Age, higher gravidity, higher parity, rural residence, low socioeconomic status and less than 12 years of formal education, are risk factors. Appropriate age at marriage, small family norm, education of girl child, anemia prevention strategy in adolescent girls and financial empowerment of women are suggested strategies for prevention of anemia and improved maternofetal outcome.

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Background: Low pre-pregnancy BMI is considered a marker for minimal nutrient reserves, fetal growth restriction and adverse pregnancy outcome. This study was conducted to evaluate the influence of pre pregnancy BMI on fetal growth parameters.Methods: A hospital based, cross-sectional, observational study was conducted among pregnant women seeking antenatal care at Kasturba Hospital, Sewagram, a rural institute in central India. Maternal pre-pregnancy BMI was calculated and correlated with new born birth weight, birth length, chest circumference, head circumference, arm circumference and ponderal index.Results: Among 500 pregnant women of first trimester, the maternal mean Pre-pregnancy weight, height and Prepregnancy BMI were 47 ± 5.77 kg, 154.43 ± 5.39 cm and 19.78 ± 2.56 kg/m 2 respectively. The mean Pre-pregnancy BMI in the LBW group was 19.25 ± 1.68 kg as compared to 19.98 ± 2.60kg in normal birth weight group with a statistically significant difference (z=3.75, P=0.001, z =25.15, P=0.000). Positive correlation was found between pre pregnancy maternal weight, and BMI with neonatal weight, neonatal length, chest circumference, head circumference and arm circumference. The association was negative with neonatal ponderal index. Mean neonatal length, ponderal index, chest circumference, head circumference a mid-arm circumference were statistically significantly associated with pre-pregnancy BMI.