Background Cardiac disease in pregnancy is a major contributor to maternal mortality in high, middle and low-income countries. Availability of data on outcomes of pregnancy in women with heart disease is important for planning resources to reduce maternal mortality. Prospective data on outcomes and risk predictors of mortality in pregnant women with heart disease (PWWHD) from low- and middle-income countries are scarce. Methods The Tamil Nadu Pregnancy and Heart Disease Registry (TNPHDR) is a prospective, multicentric and multidisciplinary registry of PWWHD from 29 participating sites including both public and private sectors, across the state of Tamil Nadu in India. The TNPHDR is aimed to provide data on incidence of maternal and fetal outcomes, adverse outcome predictors, applicability of the modified World Health Organization (mWHO) classification of maternal cardiovascular risk and the International risk scoring systems (ZAHARA and CARPREG I & II) in Indian population and identify possible gaps in the existing management of PWWHD. Pregnancy and heart teams will be formed in all participating sites. Baseline demographic, clinical, laboratory and imaging parameters, data on counselling received, antenatal triage and management, peripartum management and postpartum care will be collected from 2500 eligible participants as part of the TNPHDR. Participants will be followed up at one, three and six-months after delivery/termination of pregnancy to document study outcomes. Predictors of maternal and foetal outcome will be identified. Discussion The TNPHDR will be the first representative registry from low- and middle-income countries aimed at providing crucial information on pregnancy outcomes and risk predictors in PWWHD. The results of TNPHDR could help to formulate steps for improved care and to generate a customised and practical guideline for managing pregnancy in women with heart disease in limited resource settings. Trial registration The TNPHDR is registered under Clinical Trials Registry-India (CTRI/2020/01/022736).

Background: The aim of this study was to study the prevalence of GDM in a tertiary care centre based on 75 gm OGCT and to analyse the socio demographic and clinical profile of GDM using 75 gm OGCT in a tertiary care centre.Methods: This study was conducted in the antenatal OPD of Tirunelveli Medical College Hospital from October 2014 to July 2015, a period of 10 months on 300 antenatal women. The mothers were screened using 75gm 2-hour OGCT once during each trimester and the results analysed.Results: The prevalence of GDM in this study was 3.4%. Out of this 47-50% of women with GDM were of the age group 26-30 years. 6% of the women had BMI of >25 kg/m2. The incidence of GDM was found to be high in multigravidas and 70% belonged to class V socioeconomic status. Using the 75 gm OGTT 20%, 40% and 40% were diagnosed during the I, II and III trimesters respectively. 90% of the women delivered at term and total caesarean section rate was 30.6%. Mean birth weight of the babies was 2.9 kg. 70% of the diagnosed GDM women were treated using Medical Nutrition Therapy (MNT).Conclusions: 75gm OGCT recommended by WHO can be used to detect significant number of cases of GDM.

Background: Asymptomatic bacteriuria is defined as greater than 100,000 organisms in the urine of a person who lacks symptoms. The objective of present study was to find out the prevalence of asymptomatic bacteriuria (ASB) in women attending the antenatal OPD in a tertiary care centre and to study the effect of screening and treatment on maternal and fetal outcome.Methods: The study was conducted at OG Department, Tirunelveli Medical College Hospital over a period of ten months from March 2014 to Dec. 2014. Antenatal women at 12-16 weeks were screened by collecting clean catch midstream urine samples and doing routine urine analysis, culture/sensitivity and colony count. Treatment was given to all bacteriaurics with oral cephalexin and for persistent cases with Inj. gentamycin. Repeat culture was done at second and third trimesters.Results: In this study, the incidence of ASB was found to be 10.8%. It was more common among primi gravida (13.98%) and the incidence was found to be high in low socio economic groups (12.4%). In present study E. coli was 88.88%, Klebsiella 7.4% and Staphylococcus aureus 3.7%. Anemia was found in 37.04% of bacteriurics, preeclampsia in 7.4%, preterm delivery in 14.82% and low birth weight in 18.5% of bacteriurics.Conclusions: Treatment of ASB during pregnancy at the first antenatal visit decreases the incidence of preeclampsia, premature delivery, low-birth weight and perinatal mortality.