Background: Preeclampsia (PE) is a hypertension disorder condition occurring in 7-10% of all pregnancies. Preeclampsia if unidentified and left untreated is associated with poor maternal and fetal adverse outcomes. The objective of the present study was to characterize maternal serum selenium levels as a predictor of preeclampsia and to correlate dietary selenium intake with serum selenium levels in first trimester of pregnancyMethods: A retrospective case-control study of 107 pregnant women was conducted over 1.5 years at St. John’s Medical College Hospital. On screening for inclusion criteria, at baseline, information on maternal socio-demography, anthropometry, dietary intake and clinical examination was collected. A venous blood sample at baseline and 2nd or 3rdtrimester of pregnancy was collected for estimation of selenium concentrations. Blood pressure was measured at baseline and followed up during pregnancy to select cases and controls. Pregnant women were termed ‘cases’ based on NHBPEP (National High Blood Pressure Education Program) classification and subsequent 22 women with normal blood pressure controlled for age were termed as ‘controls.Results: No statistically significant differences were observed for baseline characteristics, biochemical parameters and blood pressure at recruitment among cases and controls. Cases had significant lower levels of energy (P=0.032) and micronutrients like zinc (P=0.027), selenium (P=0.022), magnesium (P=0.047) at first trimester. The serum selenium levels were significantly higher in cases as compared to the controls (69.2±13.7 vs. 59.6±12.9; P=0.021) at baseline.Conclusions: Our findings suggest that serum selenium levels may not be an independent predictor of preeclampsia. Assessment of other micronutrients, oxidative stress markers and other complementary elements may be useful in predicting preeclampsia.

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Emergency peripartum hysterectomy (EPH) is a major obstetric procedure, usually performed as a life-saving measure in cases of intractable obstetric hemorrhage. The aim of this study was to determine the incidence, indications and the risk factors and complications of emergency peripartum hysterectomy (EPH). The medical records of 13 patients who had undergone EPH, between January 2012 and December 2018, were reviewed retrospectively. All necessary data was obtained by record review. The mean age of pregnant women was 30 year. There were 13 EPHs out of 15768 deliveries, a rate of 0.82 per 1,000 deliveries. Out of 13 women who underwent EPHs, 8 hysterectomies were performed after cesarean delivery and 5 after vaginal delivery. The most common indication for hysterectomy was abnormal placentation (7/13), followed by atony (4/13), rupture of scared uterus (1/13) and rupture of unscared uterus (1/13). There were two cases of intra-operative bladder injury, we had 1/13 maternal death because of EPH. There were no cases of neonatal mortality. In our series, abnormal placentation was the most common of indication for EPH. The risk factors for EPH were previous CS for abnormal placentation and placental abruption for uterine atony and peripartum hemorrhage. Limiting the number of CS deliveries would bring a significant impact on decreasing the risk of EPH.

and extrahepatic portal venous obstruction (EHPVO).NCPF is a syndrome of unknown etiology, characterized by obliterative portovenopathy leading to portal hypertension, massive splenomegaly and variceal bleed, with preserved liver function. 2 EHPVO is obstruction of the extrahepatic portal vein with or without the involvement of the intrahepatic portal veins, may even involve splenic or superior mesenteric veins. 3 Pregnancy ABSTRACT Background: To study the maternal and fetal outcome of non-cirrhotic portal hypertension (NCPH) in pregnancy. Methods: We retrospectively analyzed ten women with the diagnosis of NCPH in pregnancy. The study was done at St John's Medical College Hospital Bangalore, Karnataka from January 2012 -January 2016. All the necessary data was obtained by record review. Results: The mean age of the pregnant woman was 25.5 years. Among 10 women with the diagnosis of NCPH 4 had Non-cirrhotic portal fibrosis (NCPF) and 6 had Extrahepatic portal venous obstruction (EHPVO). Six patients were diagnosed with NCPH prior to pregnancy; while among the remaining 4 patients, 1 had variceal bleed and the other 3 manifested with splenomegaly during pregnancy which led to the diagnosis of NCPH. All these 4 patients were successfully managed with beta blockers alone without any surgical intervention during pregnancy. Thrombocytopenia and splenomegaly were the most common clinical manifestations which were observed in all 10 patients. Severe thrombocytopenia (platelet <50,000 cells/mm 3 ) was seen in 7 patients who received platelet transfusion. Six (60%) of patients had vaginal delivery, the other 4 underwent cesarean section due to meconium stained liquor and fetal distress in early labor. Hence cesarean delivery was reserved only for obstetric indication. Postpartum hemorrhage was seen in 2 patients managed conservatively, one patient on 3 rd postoperative day developed ascites and pleural effusion requiring pleural tapping and diuretics with successful recovery. There was no maternal mortality during the study period. The fetal/neonatal outcome was good in the present study with 90% of babies with good APGAR score, whereas 1 preterm neonate developed HIE stage 2 requiring prolonged NICU stay. The overall pregnancy outcome was good in the present study. Conclusions: Pregnancies can be allowed and managed successfully in patients with NCPH.

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