Objective: To determine clinical characteristics, obstetrics and perinatal outcome of coronavirus disease 2019 infection in pregnant women. Method: The cross-sectional study was conducted at the Department of Obstetrics and Gynaecology of the Ruth Pfau Civil Hospital, Karachi, and Dow University of Health Sciences, Karachi, from August 2020 to July 2021, and comprised pregnant women with suspicion of coronavirus disease 2019 infection, who underwent recommended testing, and were found to be positive. Oral swabs for the presence of infection were also taken from the neonate within 24 hours of delivery. Data was analysed using Stata 11. Results: There were 41 women with a mean age of 27±5 years, a mean gestational age of 35±3 weeks, and mean parity 1.2±1.01. Of them, 3(7.3%) women died. Medical complications found along with coronavirus disease 2019 infection were pregnancy-induced hypertension 2(4.8%), eclampsia 4(11%) and diabetes mellitus 2(4.8%). Fever was the most common symptom seen in 12(30%) women, followed by cough 7(20%) and shortness of breath 6(14%). Majority 32(82%) of the women underwent caesarean section. The most common maternal complication was postpartum haemorrhage 6(20%). Also, 36(86%) women required intensive care unit stay for a mean 5±9 days. Conclusion: Fever, followed by cough and breathlessness, were the most common clinical features. Most common maternal and foetal complication was postpartum haemorrhage and low birth weight, respectively. Key Words: COVID-19, Pregnancy, Maternal outcome, Perinatal, Outcome.

Objective: To assess the nutritional knowledge of pregnant women about food intake during pregnancy and to find out association between education level and nutritional knowledge.Methods: It was a cross-sectional study performed in Obstetrics and gynaecology outpatient department of private tertiary care centre Liaquat College of Medicine and Density and Darul-Sehat hospital from June 2016 to December 2016. The study was conducted among pregnant ladies who visited the antenatal clinics where they were interviewed regarding food intake and nutritional requirement in pregnancy using a pretested questionnaire. Their knowledge was then score into good, average and poor and then relation with educational level was calculated.Results: A total of 372 pregnant women with age range of 17-38 years and mean age of 27.45 ± 7.24 years were anticipated. The result showed that majority of the patients (213/372) 57% have some knowledge about increase requirement of food intake in pregnancy and (189/372) 50% had knowledge of increased iron intake. Limited knowledge of pregnant women regarding increase in water requirement is surprising. The misconceptions of hot and cold properties of food still exist in our society with a fear of abortion and contribute to avoidance of some important nutrition from diet during pregnancy.Those with education level of graduation were more knowledgeable and study also pointed towards direct association with socioeconomic status.Conclusion: The awareness regarding the increase intake of food and iron supplementation is sub optimal in our community and need better augmented campaigns and awareness programs. However there is strong co relation between educational level and information.

Objective: To investigate the relationship of serum homocysteine, folic acid, and vitamin-B12 levels with recurrent pregnancy loss (RPL). Methods: A case-control study was conducted in the Department of Gynecology and Obstetrics, Dr. Ruth Pfau Civil Hospital, Karachi from July 2021 to June 2022. Total 124 participants were recruited from gynecology outpatient department after taking informed consent. The participants included 62 females with two or more consecutive unexplained RPLs and 62 healthy women having at least two successful deliveries without any pregnancy loss. Serum folic acid and vitamin-B12 levels were measured by chemiluminescent method and serum homocysteine was measured by enzyme-linked immunosorbent assay (ELISA). Comparison of quantitative variables with RPL cases and control was done by Mann-Whitney U-test (for non-normally distributed data) and independent sample t-test (for normally distributed data), while Pearson’s chi-square test was used for the association of qualitative variables with RPL cases and control. Correlation of homocysteine with vitamin-B12 and folic acid was assessed in RPL cases. Results: The median age of the study population was 27 (IQR 25-32) years. The median body mass index (BMI) was 26.25 (IQR 22-29) kg/m2. Cases had significantly lower serum folic acid (p-value=0.022), while vitamin-B12 was decreased in cases as compared to controls (p-value=0.295). Mean concentration of serum homocysteine was higher in RPL cases as compared to controls (p-value=0.094). There was significant association of serum vitamin B12 (p-value=0.001) and folic acid levels (p-value=0.004) with RPL. The homocysteine was not significantly correlated with vitamin-B12 (r=0.124, p=0.338) and folic acid (r=0.067, p=0.606) in the RPL group. Conclusion: Reduced level of serum folic acid and vitamin B12 was significantly associated with RPL cases, while homocysteine was marginally raised however the difference was not significant. Folic acid and vitamin B12 supplementation before next pregnancy in RPL patients is likely to be beneficial in improving pregnancy outcomes. doi: https://doi.org/10.12669/pjms.39.5.7432 How to cite this: Afaq E, Ali A, Jamil R, Waseem HF. Association of plasma folic acid, vitamin-B12 and homocysteine with recurrent pregnancy loss. “A case control study”. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7432 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.