BackgroundThe objective of this study was to compare the efficacy, safety and tolerability of intravenous iron sucrose with that of oral ferrous fumarate in iron deficiency anemia during 14 to 34 weeks of pregnancy.MethodsA randomized controlled trial was performed involving 112 patients attending the antenatal clinic at Shri B.M.Patil Medical college Hospital, Bijapur from October 2011 to August 2012,with hemoglobin levels between 70-110 g/L and serum ferritin of < 15 ng/ml.In the intravenous group,200 mg of iron sucrose was administered in 100 ml 0.9% sodium chloride per day. Participants in the oral group were given 200 mg of ferrous fumarate per day. The primary outcome measures for the trial, haemoglobin and serum ferritin levels were measured after 4 weeks. Statistical significance was assessed using Student’s t-test.ResultsThe change in haemoglobin in women receiving intravenous iron was higher than with oral ferrous fumarate 22 ± 11.5 g/L vs 12 ± 9 g/L (p < 0.0001).Similarly the change of serum ferritin was significantly higher in women receiving intravenous iron compared to oral iron.55% participants in the intravenous group had an improvement in haemoglobin more than 20 g/L compared to only 11% of the oral therapy group.48% of patients in I.V group showed increase in ferritin level between 51 to 100 ng/ml in comparison to only 3.5% in oral group.Intravenous iron sucrose is an effective in correction of anemia in pregnancy or iron store depletion.ConclusionIntravenous iron sucrose is more effective than 200 mg a day ferrous fumarate in increasing maternal iron stores.Trial registrationThe trial registration number is CTRI/2016/12/007552 registered in Clinical Trial Registry India on 8/12/2016. It is a retrospectively registered trial.

Objective The aim of the study is to obtain insights on the short and long-term safety and effectiveness of isoxsuprine hydrochloride as a tocolytic agent in the management of PTL. Study Design In this prospective, single-center, noncomparative study, patients (with preterm labor at gestational age of 24–37 weeks) were administered intravenous (IV) infusion of 40-mg isoxsuprine hydrochloride until uterine quiescence, followed by intramuscular (IM) injection of isoxsuprine hydrochloride 10 mg/4-hourly for first 24 hours and maintained with retard 40-mg sustained release capsule (two times a day) till the time of delivery or 37 completed weeks of pregnancy. Results All patients (n = 50) achieved successful tocolysis in 24 hours and 48 hours postadministration of isoxsuprine hydrochloride (IV/IM/oral). Mean (±SD) gestation age at the time of delivery was 39.8 ± 2.1 weeks, with latency period of 58.5 ± 18.7 days. Pregnancy outcomes were normal in all the patients and no congenital anomaly/fetal infection was reported. Mean (±SD) fetal birth weight was 2.7 ± 0.3 kg; mean (±SD) Apgar score at 1 and 5 minutes were 7.5 ± 0.6 and 9.2 ± 0.4, respectively. Maternal tachycardia and vomiting (8.0% each) were the commonly reported adverse drug reactions, which were resolved with dose adjustment. Conclusion Isoxsuprine was found to be an effective and well-tolerated tocolytic agent in arresting PTL, in turn resulting in the overall improvement in maternal and perinatal outcomes.

Oral Nifedipine is cheaper and effective alternative which has fewer and less serious side effects as compared to I.V. Ritodrine for suppression of the preterm labor.

Introduction Prevalence of malaria in pregnancy is 1.4%. A high index of suspicion is most important in the diagnosis of malaria and should be differentiated from other complications like eclampsia, intrauterine sepsis. Case Report Gravida 3 para 2 living 1 (G3P2L1) with 28 weeks gestation was referred with high blood pressure (BP), severe anemia. She was afebrile, severe pallor +, pedal edema +, pulse rate (PR)—110/ min, BP—140/80 mm Hg, per abdomen (P/A)— Ut 28 to 30 weeks size relaxed with fetal heart sounds (FHS) regular. Hemoglobin (HB) 5.3 gm%, platelet count 80,000. After 3 days, patient threw one convulsion. Low dose MgSO4 regime given. Peripheral smear (PS) for malarial parasite (MP) vivax positive and injection quinine 1200 mg in 10% dextrose started. She was induced and delivered. Discussion In pregnancy malaria is more common, more atypical, more severe and more fatal. Once diagnosed treatment should be started immediately and pregnant woman should be given full doses of antimalarials. Both eclampsia and malaria are to be treated. How to cite this article Jaju PB, Bhavi SB. Convulsions: Eclampsia or Malaria or Both! J South Asian Feder Obst Gynae 2015;7(3):245-246.