Background: The purpose was to determine whether AFI<5 cm after preterm premature rupture of the membranes (PPROM) is associated with an increased risk of maternal and perinatal morbidity.Methods: We performed a prospective case control study of 161 singleton pregnancies complicated by preterm prelabour rupture of the membranes (PPROM) in whom AFI was assessed. Patients were categorized in two groups on the basis of amniotic fluid index- AFI<5 cm or AFI ≥ 5 cm. Categorical data were tested for significance with the χ2 and Fisher exact tests. All 2-sided p values < 0.05 were considered significant.Results: Both groups were similar with respect to selected demographics, gestational age atrupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to maternal chorio-amnionitis, abruption, mode of delivery, early onset neonatal sepsis and NICU stay. Patients with AFI<5 cm demonstrated greater frequency of C/S delivery for non-reassuring fetal tests.Conclusions: There is no significant difference between obstetric outcome in AFI<5 and AFI> 5 after PPROM between 24- and 37-weeks’ gestation.
Background: The greatest risks to life are in its very beginning. Although a good start in life begins well before birth, it is just before, during, and in the very first hours and days after birth that life is most at risk. This prospective case control study was designed on maternal risk factors for perinatal mortality.Methods: This was a case control study conducted in the Department of Obstetrics and Gynecology and Department of Paediatrics, Medical College Trivandrum for one year period in 2004-2005. The cases were all the fresh and macerated still births and early neonatal death cases during the study period. The controls were chosen as the next delivery entry in the OR register.Results: During this period, the total number of deliveries was 14,796 and there were 431 perinatal deaths. The perinatal mortality rate was 29.12. This was much higher compared to Kerala’s perinatal mortality rate of 10, the reason being that the study is conducted in a tertiary referral hospital with one of the best new born care nurseries and a large number of referrals. The most significant risk factors for perinatal mortality were low socio-economic status, referrals, late registration, prematurity, low birth weight, intra-uterine growth restriction, maternal diseases like gestational hypertension and gestational diabetes and intrapartum complications like abruption.Conclusions: Perinatal mortality rate serves as the most sensitive index of maternal and neonatal care. Good antenatal care and prevention of preterm birth may play a key role in further reduction of PMR.
Introduction Polycystic ovarian syndrome (PCOS) is an endocrine disorder affecting all age groups and presenting with myriad problems like menstrual irregularities, hirsutism, anovulatory infertility, and long-term complications like diabetes, cardiovascular problems, etc. Aim Study was aimed at finding the prevalence, characteristics, and various risk factors of metabolic syndrome (MS) in reproductive age group in our hospital. Materials and methods Using statistical table, a sample size of 131 was calculated and patients were recruited as per inclusion criteria. Polycystic ovarian syndrome was diagnosed by the American Society for Reproductive Medicine (ASRM)/European Society of Human Reproduction and Embryology (ESHRE) criteria. After informed consent, a detailed history was obtained and physical examination was carried out to assess, body weight, height, body mass index (BMI), waist—hip ratio (WHR), and blood pressure (BP). Fasting blood glucose, triglycerides, and high-density lipoprotein (HDL) were measured for each woman Results Prevalence of MS in our study was 45.8%; 26.7% of patients had a combination of increased waist circumference, raised triglycerides, and low HDL; 55.2% of patients had a fasting blood sugar (FBS) levels more than 100 mg%. Age of the patient was a statistically significant risk factor of MS with 100% of patients in the age group of 35 to 39 presenting with MC. Body mass index was also a statistically significant risk factor with 82.6% with BMI > 30 having MC. Other important risk factors include a WHR more than 0.95, presence of diabetes in mother or sister, and presence of acanthosis; 71% of patients with WHR more than 0.95 had MC. Age of menarche, duration of menstrual cycles, and hirsutism showed no significant relationship. Conclusion An outstanding fact that emerged in this study was that 94% of women with PCOS had HDL values <50 mg/dL. And 58% had triglycerides more than 150 mg/dL. Hence, lifestyle modification and early intervention will hopefully spare long-term complication of PCOS. How to cite this article Madusudhanan RR, Nambisan B, Brahmanandan M, Radha S. Study on the Prevalence and Characteristics of Metabolic Syndrome in Women of Reproductive Age Group with Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):341-347.
Background: Near misses are defined as pregnant women with severe-life threatening conditions who nearly die but, with good care or good luck survive. Because near miss situation occurs more frequently than maternal death, more comprehensive and statistically reliable analysis could be conducted to assess the quality of maternal care and to develop evidence-based management protocols. The objectives of this study were to evaluate the determinants of near miss maternal mortality in a tertiary referral Government medical college hospital in Trivandrum, Kerala.Methods: Case control study from a defined delivery population with three randomly selected pregnant women as controls for every case. Study was conducted at Department of Obstetrics and Gynecology, Medical College Hospital Trivandrum, Kerala, India. Study duration was one year. Study population were patients admitted in Obstetrics and Gynecology Department, fulfilling the WHO criteria of near miss.Results: Of the primary determinant factors of near miss in this study, preeclampsia contributed the main role, followed by hemorrhage and eclampsia. During the antenatal period, preeclampsia was the major determinant followed by eclampsia. Hemorrhage was the major determinant in intra op /intra natal cases and next was eclampsia. Postpartum hemorrhage, eclampsia and preeclampsia were the major determinants in post-partum /post op cases. Among the associated indicators assessed, low socioeconomic status, anaemia, high body mass index, referral status, placenta praevia and caesarean section were statistically significant.Conclusions: Detailed analysis of near miss cases helps in identifying risk factors. It helps in formulating preventive strategies, and helps us in tackling the delays in referral process.
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