Online ISSN: 2515-8260

Keywords : pregnant women


Maternal and Perinatal Outcome in Emergency Obstetric Referrals in a Tertiary Care Centre.

Dr. Prashant Bhingare , Dr. Shrinivas Gadappa , Dr. Aishwarya Nichani , Dr. Nikahat Mansuri

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 563-572

Aim & Objective:  to study Maternal and Perinatal Outcome in Emergency Obstetric Referrals in a Tertiary Care Centre.
Material & Methods:  This Prospective observation study was conducted in Labour room , Department of Obstetrics and Gynaecology tertiary care hospital during 1st October 2019 to 30th September 2021.
Inclusion criteria: All cases referred from Government or Private hospitals, who are having referral letter and who deliver in our institute and are willing to participate in the study. In present study we have enrolled 1297 cases during two years.
Observations & Results:  Out of 1297 pregnant women, maximum Pregnant women i.e. 557(43.0%) referred were from the 21 To 25 years of Age-group. The mean age of pregnant women was 26.93±7.37 years. Most Common reason of delay in decision taking‑by relatives in 1060(81.7%) of pregnant women, 121(9.3%) of pregnant women were reported in delay in transportation. Majority of 420(32.4%) of pregnant women were having referral place was District Hospital. Majority of the Pregnant women i.e., 784(60.4%) were referred because there was lack of trained health professional in the referral unit followed by non-availability of ICU and ventilator i.e. 289(22.3%).60(4.7%) of pregnant women observed near miss and 14(1.1%) of pregnant women reported mortality. 324(24.9%) of babies had had Apgar Score of less 7. 303(23.5%) babies had NICU admission, 21(1.6%) were having early neonatal death and 57(4.3%) of babies were still birth.
Conclusion: Timely referral is crucial for a satisfactory maternal and fetal outcome. Health education and awareness by mass media and non-government organisations can improve the health and social status of women in rural areas. Health education and awareness by mass media and nongovernment organisations can improve the health and social status of women in rural areas.

PREVALENCE OF CARPAL TUNNEL SYNDROME IN PREGNANT WOMEN IN A TERTIARY CARE TEACHING HOSPITAL IN CENTRAL INDIA

Dr. Vipin Garg, Dr. Parul Trichal, Dr. Vijerdra Damor, Dr. Pradeep Dubey, Dr. Roma Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 664-672

Background: Carpal tunnel syndrome (CTS) is a most common type of upper limb compression neuropathies. Carpal tunnel syndrome is common during pregnancy and the symptoms are mostly high in the third trimester. Various physiological and electro diagnostic tests are used to detect carpal tunnel syndrome in this stage. Aim: this study was aimed to find the prevalence of carpal tunnel syndrome among pregnant women.
Materials & Methods: A cross-sectional study was carried out in the department of orthopedics in Gajara Raja Medical College, Gwalior, India. Pregnant women presenting with sign and symptoms of CTS were enrolled in our study.
Results: Among 300 pregnant women, prevalence of CTS was 24 (8%). Majority of the women (66%) were found in third trimester of pregnancy. 37.4% pregnant women were 26-30 years age group, 54% was primiparous and 65.3% women were obese category. Physiologic tests (Phalen’s Test, Tinel’s sign and Carpal Compression Test) used for diagnosis of CTS.
Conclusion: Prevalence of carpal tunnel syndrome was higher among pregnant women mainly in third trimester.

Effectiveness of pre-conceptional counselling in preventing adverse maternal and fetal outcomes among pregnant women with Systemic Lupus Erythematosus: A prospective observational study

Neelima Varaganti, Anantha Lakshmi Porla, Himabindu Sangabatula, Visweswara Rao Guthi .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1749-1756

Background: Systemic lupus erythematosus (SLE) is an idiopathic, chronic autoimmune inflammatory disease with a high prevalence in females of reproductive age group. In the past, SLE patients were advised not to become pregnancy because of poor maternal and fetal outcomes. But nowadays the scenario has been changed because of pre-conceptional counselling and intense surveillance of disease during and after pregnancy. To study the effectiveness of pre-conceptional counselling in preventing adverse maternal and fetal outcomes among pregnant women with Systemic Lupus Erythematosus.
Materials and methods: It is a prospective observational study conducted among 32 women who were diagnosed with SLE and confirmed for pregnancy. Among these 32 women, 14 women have received pre-conceptional counselling and remaining 18 women did not receive pre-conceptional counselling prospectively. Maternal and fetal outcomes includes incidence of pre-eclampsia, lupus flare,f etal losses, fetal growth restrictions(FGR),preterm labor, neonatal lupus and oligohydramnios.
Results: Total of 32 SLE pregnancies were studied. The incidence of SLE in this hospital was 0.79 per 1000 pregnancies (32 out of 40032). 14 (43.7%) of women received pre-conceptional counselling,18 (56.2%) did not receive pre-conceptional counselling. Among women who received PCC 5(35.7%) cases developed late onset pre-eclampsia without severe features,3(21.4%)fetal wastage, 3 (21.4%) cases were pre term labour and 3 (21.4%) cases were diagnosed as FGR. Among women who did not receive PCC 9 (50%)cases developed pre-eclampsia, 9 (50%)fetal wastages 6 (33.3%) cases were pre term labour and 6 (33.3%) cases FGR were diagnosed.
Conclusions: Adverse maternal and fetal outcomes like preeclampsia, pre term labor, FGR, lupus flare and fetal wastage were high among women who did not receive pre-conceptional counselling compared to women received. Pre-conceptional counselling decreases the adverse outcome of the disease to large extent.

A CROSS-SECTIONAL STUDY OF ANEMIA IN THE THIRD TRIMESTEROF PREGNANT WOMEN IN GOVT GENERAL HOSPITAL & COLLEGE, NIZAMABAD

Dr. D. Anupama, Dr. G. Aparna, Dr. Saroja Adapa, Dr. B. V. Surendra .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 465-471

Background: In pregnancy, anemia is a common disorder and is associatedwith an increased risk ofmaternal, fetal, and neonatalmorbidity and mortality. The present study was conducted to determine the prevalence and risk factors of anemia among III Trimester pregnant women attending OBG department, Government medical college &general hospital, Nizamabad.
Methods: A hospital based cross sectional study was conducted on 392 III Trimester pregnant women attending antenatal care at Governmentmedicalcollege&general hospital, Nizamabad from October 2020 to March 2021. Data on socio-demographic and clinical characteristics of the study participants were collected using a questionnaire and medical records. The haemoglobin was measured using an automated cell counter method and those with hemoglobin level less than 11 g/dl were considered as anaemic.
Results: The overall prevalence of anemiain our study was found to be 192 (48.9%).The age of the patients ranged from 18 to 35 years. out of all anaemic pregnant women about 100 were mildly anemic, 82 were moderate anaemic &10 were severe anaemic. Iron folic acid supplementation, antenatal care visit were significantly associated with the prevalence of anemia.
Conclusion: There is a high prevalence of anemiain III trimester pregnant woman attending tertiary care hospital in Nizamabad.Iron supplementation and health education to create awareness about the importance of antenatal care are recommended to reduce anemia.

A Cross-Sectional Study to Assess the Sociodemographic Characteristics and Early Pregnancy Behaviors among Pregnant Women with Heart Disease

Lynette Fernandes, Manjusha Jindal, Meenakshi, Professor,Ajey Jha

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9937-9944

Background:Cardiac diseases complicate about 1% of pregnancies in women.
Pregnancy is a natural stress test and the cardiovascular system must undergo major
changes to its structure to sustain tremendous increases in blood volume. According to
the National Centre for Health Statistics, almost half of adults aged 20 and older have at
least one risk factor for cardiovascular disease. Detailed assessment of patient
throughout pregnancy may lead to initial discovery of heart diseases. Hence, the present
study was conducted at Tertiary Care Hospital to study the prevalence of heart diseases
in pregnancy, and is to assess the Sociodemographic Characteristics and Early
Pregnancy Behaviors among Pregnant Women with Heart Disease.
Materials and Methods: This prospective, hospital-based study was done in the
Department of Obstetrics and Gynecology of a Teaching Institute of Goa from the 1stof
June 2012 to 31stof May 2014 and included all the pregnant women or puerperia with
heart disease who delivered during that time period. A written consent was obtained
from all participants and they were fully informed about the study. Clinical history was
gathered after admission, and patient-specific and pertinent information was acquired
through interviews in a structured data collection schedule. In addition to all routine
antenatal investigations, electrocardiography and echocardiography were performed.
Collected data was tabulated on a Microsoft Excel sheet and analyzed using simple
descriptive statistics like percentage, ratio and proportion.
Results: Out of total 10230 admissions in our hospital in year, 102 of women had
pregnancy complicated by diagnosed heart diseases (1.0%). In present study, most of
patients were having NYHA grade of 1 (67.6%) and 2 (26.5%). Two fifth of patients
(21.6%) were illiterate. Most of admitted patients were from rural area (67.6%). One
third of patients were having SES of class III (30.4%). In present study, 85.3% of
subjects have registered for the ANC care. Only one third of subjects had four or more
ANC visits (29.4%). Smoking and alcohol consumption during pregnancy was noticed
in 2.9% and 6.9% of patients. In our study out of 102 patients, there was one maternal
death in this study.
Conclusion: The incidence of heart disease in pregnancy was 1 % and most of the cases
were NYHA Grade 1 (67.6%) or grade II (26.5%). Most of admitted patients were from
rural area (67.6%). Only one third of subjects had four or more ANC visits (29.4%).
Therefore, educating the patient about heart disease and its complications reduces
maternal and perinatal mortality.

PSYCHOLOGICAL MORBIDITY IN PREGNANCY DURING COVID-19 LOCKDOWN

Dr.Saima Sadiq,Dr. Rajesh Chandel,Dr.Heena Mir,Dr. Anil Mehta, Dr Sonali Sharma,Dr Rouf Gul6,Mr.Pawan kumar,Mr. Ravi kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 46-53

AIM: Study aimed to assess the burden of psychological morbidity due to lockdown in
the pregnant females.
MATERIAL AND METHODS: It was an observational study conducted in the
department of obstetrics &gynecology, GMC Kathua during the covid lockdown period
from June 2020 to August 2020. 100 antenatal patients attending OPD were included
in the study after excluding those with hypertension, diabetes, heart disease, bleeding
pv,IUGR,oligohydramnios,threatened preterm labour, known psychiatric illness or
taking psychotropic medication, prior sleep disorder. The patients were assessed using a
questionnairewhich was framed using various scales such as PHQ-9 for Depression,
GAD7 for anxiety, Perceived Stress Scale and Insomnia severity index , in addition to
incorporating various sociodemographic and obstetrical details.The arbitrary division
of PHQ‑ 9 scores into ratings of minimal (0–4),mild (5–9), and moderate to severe
depression (≥10) suggested by Reddy et al. was used in this study. Cutoff points of 5, 10,
and 15 were interpreted as representing mild, moderate, and severe levels of anxiety on
the Generalized Anxiety Disorder-7 (GAD-7). Insomnia severity index scored on a fivepoint
Likert’s scale (0 = no problem to 4 = very severe problem). Score of 0–7 depicted
absence of insomnia, 8–14 showedsubthreshold insomnia, 15–21 represented moderate,
and 22–28 showed severe insomnia.

Stem cell management is truly a primary bio-insurance for the well-being of babies- A study on Indian pregnant women

Swati Chaudhary, Dr. Supriti Agrawal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3403-3418

Background: In recent years, Non-communicable diseases (NCDs) have been shown
in developed countries to have an increasingly important impact on their health status
worldwide. The NCDs are the world's leading cause of death and a significant threat
to public health in developing countries. Almost 71 per cent of deaths worldwide are
individually responsible for non-communicable diseases including cardiovascular
diseases, stroke, cancer, diabetes and chronic condition. Almost three-fourths patients
with non-communicable diseases have died before the age of 70 and 82% of 16 million
prematurely deaths are in small and average countries are due to NCDs as per the
WHO report 2018. India is undergoing rapid transitions with increase in Noncommunicable
diseases (NCDs), that are resulting into significant rise in morbidity
and mortality in Urban and rural populations.47% of the patients in India are bearing
the treatment cost (Out of Pocket) themselves. Stem cell therapy is becoming the
crucial line of treatment for these diseases. In fact, from last two decades, Stem cells
derived from cord blood were used for treatment of blood disorders, immune systems
and metabolic diseases as an alternative to bone marrow transplants. In 2016, Noncommunicable
diseases (NCDs) control initiative was implemented by the Indian
government to educate about the use of stem cells to treat non-communicable diseases.
Doctors and biotech companies are helping to educate pregnant women to encourage
the use of stem cells so they can decide to store their child's cord blood as needed for
future use. Henceforth, this paper aims for understanding the attitude of Indian
pregnant women for the storage and usage of stem cell that would be a critical bioinsurance
for baby’s well –being

Direction of Earthquake Disaster Mitigation Policy for Pregnant Mothers based on Local Wisdom

Erpita Yanti; Siti Fatimah; Abdul Razak; Yessy Aprihatin

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2189-2196

Various efforts and policies on earthquake mitigation have been carried out by the Government of Pariaman City, but not for pregnant women. Therefore, the direction of the earthquake disaster mitigation policy for pregnant women based on local wisdom is drawn up. This research is analyzed using the Analytical Hierarchy Process (AHP) with Policymaking using human resources, maternal and child health, and local wisdom as criteria used in determining policy. The results of priority policies based on local wisdom are as follows: 1) Socialization and preservation of knowledge; 2) determining safe evacuation routes for pregnant women with the assistance of special teams; 3) Improvement of facilities and infrastructure needed by mothers pregnant and child; 4) trauma healing for religiously-based pregnant women; 5) Compilation of Standard Operational Procedures (SOP); 6) Establishment of monitoring groups for pregnant women; 7) Improved coordination between related institutions and program integration in one command; and 8) Security escort in the delivery and distribution of aid facilities, infrastructure, and logistics based on mutual assistance. The eight (8) policies, making cooperation and kinship the basis for implementation, strengthening the role of Ninik Mamak and Bundo Kanduang as a driving figure, and for promotion and socialization of local wisdom.