Background: Screening for subclinical hypothyroidism is essential in all pregnant women, especially in the Indian context, as Indian women have increased risk of developing iodine deficiency during pregnancy. Hence this study was undertaken to study the prevalence of subclinical hypothyroidism. Emphasis was put to know the need for universal screening and also the obstetric outcome in terms of perinatal morbidity and mortality and maternal morbidity were assessed.Methods: It was a prospective analytical study. Sample size consisted of 200 pregnant women attending antenatal OPD. Thyroid profile (serum TSH, FT3 and FT4) was done during first visit and in subsequent trimester of each pregnant woman. The results were analyzed taking into consideration recent endocrine society guidelines. Patients with normal thyroid levels were taken as controls. Detailed history taken, physical examination and routine laboratory investigations were done. Patients with SCH were started on Levothyroxine and serial monitoring of TSH done until delivery. The patients were followed up to assess the mode of delivery, maternal and fetal outcome and any associated co-morbidities to serve the secondary objective of the study. Babies of SCH mothers were screened as well to rule out congenital hypothyroidism.Results: Incidence of SCH was found to be 9.5% in the patients studied. Pregnant women with SCH had increased risks of developing anemia (31.5%), preeclampsia (15%), GDM (5%) and prematurity (10%), higher cesarean section rate (36.8%). Neonates of women with SCH had higher incidence poor APGAR score (47.36%), LBW (15%), NICU admission (10%), IUGR (5%). Increased maternal age and more BMI were associated with higher incidence of subclinical hypothyroidism.Conclusions: Prevalence of subclinical hypothyroidism among pregnant women is fairly high among Indians. Screening for subclinical hypothyroidism has to be included as a routine screening test and should be treated accordingly to improve maternal and fetal outcomes.

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BACKGROUND Postpartum haemorrhage is a major cause of mortality and morbidity in pregnant women in developing countries. Caesarean section is associated with increased blood loss. Misoprostol is used as potent uterotonic agent that has been thoroughly studied in the prevention and treatment of PPH after vaginal delivery. However, role of preoperative rectal misoprostol in caesarean section for reducing blood loss is not studied much, hence this study was undertaken. MATERIALS AND METHODS This randomised controlled trial was performed between Jan 2017-July 2017 on 200 high-risk pregnant women coming to labour room of Department of Obstetrics and Gynaecology, Karnataka Institute of Medical Sciences, Hubli, divided into two groups. The Group A (n= 100) received 400 μg of misoprostol. The Group B (n= 100) received 10U IM oxytocin after delivery as per hospital protocol. The primary outcome measures were amount of blood loss and change in haemoglobin level 24 hrs. after surgery. RESULTS The mean intraoperative blood loss was significantly lower in Group A (389 ± 172.56 mL) than Group B (445 ± 180.42 mL). The difference between the preoperative and postoperative haemoglobin value was also significantly lower in the misoprostol group (0.84) than the oxytocin group (1.10) with (p= 0.0300). Admissions to the neonatal intensive care unit were comparable between the two groups. CONCLUSION Preoperative administration of 400 μg rectal misoprostol significantly reduced blood loss compared to oxytocin in caesarean section without significant side effects and it can be used as an alternative to oxytocin.

Background: Cardiac diseases complicate 1-4% of pregnancies in women without pre-existing cardiac abnormalities. Cardiac disease in the pregnant woman can present a challenge to the obstetrician, cardiologist and neonatologist. Peripartum cardiomyopathy (PPCM) is an idiopathic disorder defined as heart failure occurring in women during the last month of pregnancy and up to 5 months postpartum. Aim is to study the burden of the disease, maternal outcome in PPCM.Methods: The present study was conducted among the antenatal women admitted in the department of Obstetrics and Gynecology at KIMS, Hubli with a previously diagnosed cardiac disease or diagnosed after admission during index pregnancy from December 2016 to May 2018. The mothers were followed up till discharge. Maternal outcome was noted as discharged or died.Results: A total of 11 cases of PPCM noted in our study out of which one case was developed before delivery, and 10 cases developed postnatally. Out of ten cases which were developed postnatally, 5 patients died giving around 50% of mortality rate.Conclusions: PPCM affects previously normal healthy women in the last month of pregnancy and up to 5 months after delivery. Careful assessment of risk factors contributing PPCM could help in their prevention. And these patients should be stratified in developing PPCM in future pregnancies through proper tools available.

Background: The association of posterior reversible encephalopathy syndrome with eclampsia has recently received a lot of attention recently. Advances in Imaging has led to better understanding of the pathophysiology of eclampsia. Present study was undertaken to study the clinical characteristics of patients with eclampsia with PRES. Methods: This is a prospective observational study of 50 cases of Eclampsia with PRES in a period of 1 year. Patients admitted with Eclampsia were subjected to neuroimaging with CT or MRI and those with diagnosis of Posterior Reversible Encephalopathy Syndrome were included in the study and clinical profile analyzed. Results: Total of 50 patients were studied in the period of 1 year. The average age of patients was 21.8 years, majority of them residing in rural areas (74%) and 72% were referred cases. Conclusions: PRES is now identified as core component of Eclampsia. More studies are required to compare the outcome of Eclampsia associated with PRES and without PRES.