Objective: To explore the correlation between uric acid levels and feto-maternal outcomes in women with hypertensive disorders of pregnancy. Study Design: Comparative cross-sectional study. Place and Duration of Study: Obstetrics & Gynaecology Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2021. Methodology: In this cross-sectional study, 90 pregnant women with hypertensive disorders having greater than 26 weeks of gestation were included after seeking Ethical Committee approval. Selected parameters were noted on a structured proforma. Results: Among the participants, 38(42.2%) had pregnancy-induced hypertension, 32(35.5%) had pre-eclampsia, 13(14.5%) had chronic hypertension with pre-eclampsia, and 7(7.8%) had eclampsia. Mean Uric acid levels ranged between 363.66±50.45 μmol/L and 451.86±120.62μmol/L, with a significant difference between PIH and eclampsia (p<0.001). Mode of delivery was avaginal, primary cesarean section, and repeat cesarean section in 31(34.4%), 38(42.2%), and 21(23.4%) patients, respectively(p<0.001). Liquor was meconium stained in 49(54.4%) while clear in 41(45.6%) births, with (p<0.001). Early neonatal deaths6(6.7%) participants had significantly higher uric acid levels than no NICU admission 22(24.4%). In maternal outcomes, 83 patients (92.2%) required routine post-operative care, while 7(7.8 %) went to the intensive care unit. Uric acid levels had a negative correlation with gestational age. Conclusion: Maternal uric acid levels differ significantly in different hypertensive disorders of pregnancy and affect the mode of delivery and neonatal outcomes.
Objective: To find the appropriate timings for intervention in women with intrahepatic cholestasis of pregnancy. Study Design: Prospective observational study. Place and Duration of Study: Gynaecology and Obstetrics Department Combined Military Hospital Okara, from Oct 2019 to Nov 2020. Methodology: Patients between 34-40 weeks of gestation with intrahepatic cholestasis were included in the study. With clinical and biochemical findings patients were monitored and conventional treatment was given. Intervention by delivery was done when required. Maternal and fetal outcome were followed. Results: Out of 380 patients with pruritus between 34-40 weeks of gestation, intrahepatic cholestasis was found in 53 patients. Most of the patients 27 (51%) were delivered at 37-completed weeks. At 35-weeks of gestation 6 (11%) patients were delivered, at 36-weeks 8 (15%) patients were delivered, while 2% patients delivered at 39 and 40 weeks of gestation. The number of intrauterine deaths was 1 at 34 weeks of gestation and 2 at 35 weeks of gestation. Transient tachypnea of newborn was observed in 23% neonates. Respiratory Distress Syndrome was observed in 6 (12%) newborns. Neonatal sepsis was observed in 5 and hyperbilirubinaemia was observed in 4 (8%) neonates. Conclusion: Patients with intrahepatic cholestasis should be preferably delivered between 37 to 38 weeks for a better foetal outcome.
Objective: To find the association of preterm delivery with metabolic syndrome in females presenting in a tertiary care hospital.Study Design: Cohort study.Place and Duration of Study: Department of Obstetrics & Gynecology, Combined Military Hospital Kharian, from May 2020 to Oct 2020.Methodology: A total of 150 females fulfilling inclusion criteria were enrolled in the study which were divided into two equal groups ‘A’ and ‘B’. Group ‘A’ was with metabolic syndrome and group ‘B’ without it. These females were followed in OPD till active labor, assessed and followed till delivery of fetus. If delivery occurred before 37 weeks, then preterm delivery was labeled. All this information was recorded on a pre-designed proforma.Results: The risk for preterm delivery was 2.18 times higher in group ‘A’ as compared to group ‘B’. (Relative Risk = 2.18, CI (95%) 1.1529 - 4.12).Conclusion: There is a strong association of preterm delivery with metabolic syndrome in females.
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