Objectives: To assess efficacy and safety of Bio-Kult Pro-Cyan (BKPro-Cyan), a product containing two strains of Lactobacilli plus cranberry extract, for preventing recurrent UTIs in pre-menopausal adult women. Methods: This was a randomized, double-blind, placebo-controlled pilot study. Subjects received BKPro-Cyan or placebo twice-daily for 26 weeks. The primary endpoint was the proportion of subjects with recurrent UTI at the end of the study. Results: 115 subjects were screened; 90 were enrolled; 81 completed the study. After 26 weeks, a significantly lower number of women experienced recurrent UTIs with BKPro-Cyan compared to placebo (9.1 vs 33.3%; P = 0.0053). BKPro-Cyan produced statistically significant improvements compared to placebo for multiple secondary endpoints, including: greater number of subjects who experienced no UTIs (90 vs 67%; P < 0.05); longer time to first UTI (174 vs 90 days; P = 0.001); shorter duration of active UTI (5 vs 12 days; P = 0.009); Fewer subjects requiring antibiotics (3 vs 11; P < 0.05); and shorter median duration of antibiotic treatment (4 vs 7 days; P = 0.09). Conclusions: BKPro-Cyan was safe and effective for preventing recurrent UTI in pre-menopausal adult women. These findings support the need for further well-designed trials to clarify the benefits that may be achieved.

Background:The objective of this study was to explore the association between striae gravidarum and the risk for perineal tear during childbirth. Methods: Three hundred patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained. Results: Mean age was 25.41 years ranging from 20 -30 years, mean gravidity was 2.27 ranging from 1 -5, mean weight gain was 9.72 Kg ranging from 5 -16 Kgs and average baby birth weight was 2.8 Kg ranging from 2.1 -3.5 Kg. The only predictors of perineal tears that were found to be statistically significant in our study were Severity of striae gravidarum and Episiotomy given or not. In patients with moderate to severe striae there was tear in 105 patients as compared to 45 patients with no or mild striae. 89 patients belonging to no or mild striae group delivered without any perineal tear whereas 61 patients in moderate to severe striae group delivered without perineal tear. It is observed that episiotomy has some protective effect against perineal tear. Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.

Objectives:To study cases of pregnancy with coronavirus disease-2019 (COVID-19) and its clinical outcome. To study evidence of the vertical transmission in pregnant women infected with COVID-19. Materials and methods: A prospective study was performed in BJ Medical College and Civil Hospital, Ahmedabad, one of the biggest designated (1200 beds) COVID hospitals in India. It was carried out from June 2020 to mid-October 2020. A total of 50 pregnant patients who were COVID-19 positive and admitted to the labor room were studied. Results: The mean age of the mothers was 27.40 ± 4.76 years (range: 19-36 years) and mean gravidity was 1.67 ± 1.41 (range: 1-4). The mean gestational age was 38.31 ± 1.67 weeks. The main complaint was fever in 22 (44%), followed by dry cough in 9 (18%), sore throat in 4 (8%), headache in 2 (4%), malaise in 7 (14%), and diarrhea in 2 (4%) patients. Twenty-two (44%) patients showed an elevated C-reactive protein level, 17 (34%) had lymphopenia, 19 (38%) had mild elevation of the D-dimer level, and 16% of the patients had increased interleukin 6 levels. Most of the patients had normal renal function test (RFT) and liver function test (LFT) results. A majority of them (86%) had normal chest X-ray, whereas rest of them (14%) had haziness in bilateral lung fields. Twenty-six (52%) patients underwent C-section, and 23 (46%) delivered vaginally. Four (8%) babies required the admission in the newborn intensive care unit for mild birth asphyxia but were discharged well. Five babies developed physiological jaundice and required single surface phototherapy (SSPT). Forty-eight (96%) out of 50 had negative vaginal swab by reverse transcription polymerase chain reaction (RT-PCR), 48 (96%) did not show any evidence of the virus in the expressed breast milk by RT-PCR. We collected the cord blood sample of 35 patients after delivery which was found to be negative in all (100%). The nasopharyngeal swab of all the babies was negative on the very first day. Day 7 repeat swab was found positive only in one baby. This transmission was mostly via respiratory droplets during intermittent assisted breastfeeding. Most of the cases were having mild disease without acute respiratory distress syndrome (ARDS), which responded to the supportive treatment. Four patients (8%) had severe anemia and required blood transfusion. Conclusion: Most of the cases were having mild disease without ARDS, which responded to supportive treatment. Reassuringly, there was no evidence of poor fetal outcome, intrauterine fetal deaths, or premature deliveries. We did not find any evidence of the virus in the vaginal fluid, cord blood, or breast milk supporting vertical transmission of COVID-19 in the third trimester of pregnancy, even if patient delivered vaginally.

Background: Thrombocytopenia defined as platelet count of less than 1,50,000/cu.mm. Thrombocytopenia is divided according to severity into mild moderate and severe types. Multiple factors are responsible.Methods: This is a retrospective study of one-year period including 120 pregnant patients irrespective of their gestational age at civil hospital Ahmedabad. Etiology of this condition are identified and analyzed.Results: Gestational Thrombocytopenia is the most common etiology. This condition is self-limiting usually.Conclusions: Platelet count estimation should be a routine at first antenatal visit for timely diagnosis and to achieve favorable fetomaternal outcome.

Objectives:The aim of this article is to assess fetomaternal hemorrhage (FMH) and determine its volume and also to study the relation of the amount of FMH to various factors. Materials and methods:This was a prospective study carried out at Ahmedabad Civil Hospital from October 2012 to March 2013. A total of 75 blood samples were collected from RhDnegative mothers during the postnatal period. Sixteen samples were excluded because the fetus blood group was either Rh negative or unknown. The acid elution or Kleihauer-Betke quantitative test was used to measure the amount of FMH. The data were analyzed using Epi Info version 7.Results: With Kleihauer-Betke/acid elution test (KBT), 45.76% of women had fetal whole blood in their blood circulation during a postnatal period varying from 1.2 to 9.6 mL. The test was negative (i.e., no fetal cells were identified) in 54.24% of women. The majority of women had hemorrhage less than 4 mL. None of them had a large FMH. Conclusion:Most of the FMH calculated was <10 mL, which could have been neutralized by lower doses of anti-D immunoglobulin, which have incurred lower costs than the 300-µg dosage. Thus, developing optimized testing and accessing dosing protocols is needed in health care facilities. In the present study, we found no significant relation between the amount of FMH and parity or type of delivery.