Background: Care of the critically ill obstetric patients is a unique challenge particularly because of its unpredictability. The outcome in these patients would not only contribute to the assessment of the quality of patient care but would also enhance the risk stratification of pregnant patients in the evaluation of new therapies. This study is intended to review a series of critically ill obstetric patients admitted to our ICU to assess the spectrum of disease, required interventions, and maternal outcome, and to identify conditions associated with maternal death. Methods: This retrospective cohort study was conducted in 16-bed medical and surgical ICU in a 500 bedded tertiary care hospital over a period of 5 years (2009-2013) at Bhubaneswar, Odisha, India. Results: Only 54 obstetric patients were admitted to the ICU which constitutes 2.09% of all ICU admissions, 0.78% of emergency obstetric admissions and 0.9% of the total deliveries. Majority of patients (79.62%) were admitted during postpartum period. The leading obstetric indication for ICU admission was obstetric hemorrhages (29.6%). Ectopic pregnancy was common (7 patients) among the obstetric hemorrhages. In the present study maternal mortality was 16.6%, while 70.3% were improved after treatment. The main cause of maternal death was obstetric haemorrhage (55.5%). ICU interventions during the stay of the patients in terms of mechanical ventilation were used in 72.2% of cases. Other interventions included blood & blood product transfusion in 30 (55.5%), inotropes in 34 (62.9%), antihypertensive in 14 (25.9%), anticonvulsant in 16 (29.6%) & dialysis in 4 (7.4%) cases. Conclusions: The need of ICU management for obstetric conditions is on rising trend. The need for ventilatory or inotropic support may predict poor outcome. An adequate adoption of safe motherhood initiative would reduce obstetric ICU admissions and thereby will also reduce the maternal mortality.

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Background: Ovarian androgen production can be promoted by insulin resistance which leads to reproductive abnormalities in Polycystic Ovarian Syndrome (PCOS). A wide variety of female tissues can synthesize and secrete Prostate Specific Antigen (PSA). Androgens may take part a significant role in PSA secretion in PCOS. As insulin resistance stimulates androgen production, the baseline value of PSA may decline by insulin sensitising agents in PCOS. Present study is an attempt to measure the function of PSA as a marker of androgen excess in PCOS and to assess the role of insulin sensitising agent metformin in altering PSA level in PCOS.Methods: The study was undertaken to assess the insulin resistance, testosterone and PSA level in 45 women diagnosed as PCOS and 45 healthy controls. Alteration of insulin resistance, serum testosterone and PSA levels by metformin was also analysed.Results: A significant increase in testosterone, PSA level and insulin resistance was observed in PCOS cases when compared with control (p<0.001). When metformin was given for 4 months, improvement in insulin resistance and testosterone level was found in cases, but PSA values observed no change. Correlation was not found linking insulin resistance with PSA level prior to and after therapy.Conclusions: Serum PSA level could be detected in high significant concentration in PCOS women. Various researches explain that insulin resistance and BMI may perhaps control serum PSA level, but our result demonstrate no effect of insulin sensitising agent on serum PSA value.

There are several physiological changes in the body of the pregnant women. Otological, rhinological, and laryngological changes are quite often seen in pregnancy. Most of the otorhinolaryngological manifestations during pregnancy are benign and reverse during the postpartum period and few do not. These changes in pregnancy are mainly due to alteration of the sex hormones in the female body which returns to a normal level once the pregnancy period over. There should be clear understanding between the otolaryngologists and obstetrician for improving the quality of life of the pregnant women by avoiding the drugs for controlling otorhinolaryngological symptoms, especially in the first trimester. It is important to have clinical knowledge in all clinicians regarding the manifestation of otorhinolaryngological manifestations and treatment options with precautions considering effects on the mother and fetus during pregnancy. Here, this review article discusses the alteration in body physiology, clinical manifestations, and current treatment practice of the ear, nose, and throat manifestations during pregnancy. Electronic search of the SCOPUS, Medline, and PubMed databases was done. The search items in the database included pregnancy, otorhinolaryngological manifestations, gravidarum, gestational epistaxis, gestational rhinitis, hearing loss, and vestibular manifestations in pregnancy. All literature was searched for and reviewed by two authors independently. Search results were then cross-examined, and any differences were settled by consensus.