European Journal of Molecular & Clinical Medicine

Pregnancy and puerperium increases the risk of venous thromboembolism 4- to 5-fold over that in the non-pregnant state. Compared to non-pregnant, pregnant women have a two and a half times increased risk of developing pulmonary embolism. Venous thromboembolism is often fatal. Depending on reports estimate that 10%–30% of patients had mortality within 30 days. The purpose of this study is to estimate the prevalence of thromboembolism in pregnancy and puerperium, risk factors, need for anticoagulants, maternal and fetal outcome in a Govt. Tertiary care center in Chennai.
Materials and Methods: A prospective Descriptive study was conducted in Dept of Obstetrics & Gynaecology, Govt. Kilpauk Medical college, Chennai during February 2019-september 2019 among 200 antenatal and postnatal mothers. Descriptive statistics, Chi Square test were used. A p value of <0.05 was considered statistically significant.
Results: In BMI up to 23 having thromboembolism of 0%, in BMI from 24-29, incidence was thromboembolism of 9.5% and in BMI of 33-36 having thromboembolism of 0%. In patients having BMI between 24-29, risk of thromboembolism was observed high. Hence BMI was considered significant risk factor. One patient developed pulmonary embolism in postnatal period, emergency CTPA done, given LMWH for 3 months & patient revived.
Conclusions: BMI more than 26, multiparity, previous history of surgery, immovability, varicose veins, gestational hypertension, anemia, APLA positive and Eclampsia were the significant risk factors. Since pregnancy is a hyper-coagulable state, by identifying these risk factors and initiating LMWH, we can prevent the complications of DVT. Hence maternal morbidity and mortality can be reduced.

Preterm prelabour rupture of membranes (pPROM) occurs in 2–3% of all pregnancies leading to 30–40% of preterm births. The latent period from membrane rupture to delivery is typically brief after pPROM. The present study undertaken is to identify the risk factors causing pPROM and to study fetal and maternal outcome associated with pPROM.
Materials & Methods: A hospital based prospective study done on 60 patients admitted with pPROM under the Obstetrics and Gynaecology department, at district Hospital during one year period. The onset of complications like fetal distress, fetal heart rate variations, chorioamnionitis were looked for. In cases of fetal jeopardy or any other obstetric complications, labour was cut short by the caesarean section. The babies were followed up in the postnatal period. Neonatal mortality and morbidity were noted. Neonates were monitored for the complications of birth injuries, signs of asphyxia, meconium aspiration and sepsis. Both mother and baby were followed up till their stay in the hospital. Statistical analysis was performed with SPSS statistical software with all the relevant data compiled and entered.
Results: Among the selected cases, pPROM was noted in 6 (10%) mothers in the age group of <20 years, 33 (55%) mothers in the age group of 21-25 years, 14 (23.33%) mothers were in the age group of 26-30 years, and 7 (11.66%) mothers above 30 years of age. Majority of cases belong to socioeconomic status V with a total of 39 cases (65%). Number of multigravida in the study was 22 (36.66%) and primigravida were 38 (63.33%). Out of 60 patients studied, 49 cases (81.66%) were booked and 11 cases (18.33%) were unbooked. Out of 20.58% of neonatal morbidity, complications were maximum in 35-36 weeks group. NICU admissions were more common in 28-31 weeks group. Risk factors were commonly found among 32-34 weeks group with 45%. Out of 13.33% who had latent phase of >3 days, 10% of them were of <34 weeks of gestational age.
Conclusion: We concluded that the most common age group to suffer from pPROM was 21-25 years. There were no risk factors in most of the mothers, but the risk of breech presentation can be avoided by coitus in the later weeks of pregnancy reduces the risk of pPROM. Neonatal care facilities can be improved to manage neonatal emergencies so as to reduce neonatal deaths.

Background: To analyse outcomes of feto-maternal among pregnant hypothyroid women.
Materials & methods: A total 50 subjects were enrolled. Out of the total, 15 subjects were diagnosed with hypothyroidism. Routine hematological parameters and estimation of T3, T4 and TSH was conducted. Estimation for TSH was conducted using the Enhanced Chemiluminescence method. Fetal outcomes include LBW (neonatal birth weight less than 2.5 kg). The data was analysed using SPSS software. The test was considered significant only when the p value is less than 0.05.
Results: 15 subjects with hypothyroidism were enrolled. Of the women with hypothyroidism, 26.6% had anaemia, and the association between occurrence of hypothyroidism and anaemia was statistically significant (p = 0.009). Preeclampsia was observed in 13.4% of women, and the association between occurrence of hypothyroidism and preeclampsia was statistically significant (p = 0.04).
Conclusion: Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism.

To study hypertension induced by pregnancy and neonatal outcomes.
Materials & methods: A total of 200 premature newborns of gestational age (GA) between 20 and 35 weeks and 5 days, born alive were included. In total, 90 infants were born to hypertensive mothers (G1) and 110 to normotensive mothers (G2). The data was recorded. The results were analysed using SPSS software.
Results: The anthropometric measurements of birth weight were significantly lower in G1. Resuscitation in the delivery room and the need to use surfactant and oxygen dependence at 36 weeks of gestational age did not differ between groups.
Conclusion: There was no difference in weight and survival at 18 months of chronological age.

The goal of obstetrics is a pregnancy that results in a healthy infant and a healthy minimally traumatized mother. Much of the art of good obstetric care involves the delicate balance of avoiding cesarean delivery with all its attendant complications. Planned pre-induction cervical ripening and induction of labor has become an established part of modern obstetric practice. Different methods used for the induction of labor in women with an unfavorable bishops score are, mechanical methods such as trans cervical extra-amniotic Foley‘s catheter(FC)insertion, intra cervical balloon catheter and medical methods like vaginal prostaglandin(PGE2) and misoprostol(PGE1)are used for IOL in women with an unfavorable cervix for pre-induction cervical priming. The present prospective study was conducted in a teritiary care hospital after obtaining clearance from institutional ethical committee with no GMC/IEC/140/2019 to compare the efficacy of intra cervical Foleys catheter with Dinoprostone gel (PGE2) in cervical ripening and induction of labor, maternal and neonatal outcome. Maternal outcome compared in terms of pre-induction bishop score and change in bishop score after induction, need for reinstallation and augmentation of labor, the interval between intervention and delivery, mode of delivery, indication for cesarean section, induction delivery interval. Neonatal outcome compared in terms of apgar score at 1min and 5min, perinatal morbidity and mortality. Two hundred antenatal mothers with bishop score<5were randomly allocated to be induced with intracervical foleys catheter (group A) and PGE2 gel (group B). In this study, both Foley’s balloon dilatation and PGE2 gel group had patients of almost similar age group, parity, and gestational age. In the present study, in both the groups (foleys and PGE2 gel groups), post-datism was the commonest indication for induction- 52% and 45%, respectively, followed by pre-eclampsia-19%and 32%. The mean improvement in Bishop score was higher in the PGE2 gel group when compared to the Foley’s. The need for oxytocin augmentation to deliver was higher with Foley’s balloon dilatation when compared to the PGE2 gel group. The mean induction delivery interval in Foley’s group was 13.17hours. The mean induction delivery interval in the PGE2 gel group was 11.43hours. In both the groups, the maternal and fetal outcomes are found to be similar. In both the groups, the rate of normal vaginal and cesarean section delivery was also found to be equal. This study shows that prostaglandin E2 gel is a better and more effective agent than foley’s balloon dilatation in cervical ripening and induction of labour

Aim: The purpose of
this research was to investigate the platelet count in pregnant women. Methods: This cross-sectional study was carried out in the Department of Pathology. Total 100 patients were divided in two groups as Cases and Control. Cases study group includes 50 females with the thrombocytopenia and Control includes 50 females without thrombocytopenia.
Results: The data from the 100 pregnant females were collected and presented as below. The study population was divided in two groups as Cases and Control. Cases study group includes 50 females with the thrombocytopenia and Control includes 50 females without thrombocytopenia. The Most effective age group in which thrombocytopenia seen was between 20 to 25 years. Out of 100 patients with thrombocytopenia, mild preeclampsia was present in 22 cases (44%) and while the rest 28(56%) had Severe Pre eclampsia with thrombocytopenia. In  women with Mild Pre eclampsia Platelet Count ( x 109/L) was 65-277, Severe Pre eclampsia Platelet Count (x109/L) was 27-249 and women without thrombocytopenia had normal Platelet Count .
Conclusion: We concluded that the clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease.

One of the most difficult and dangerous pregnancy problems is acute kidney injury (AKI). We discuss our observations regarding the clinical characteristics and results of 60 patients who had AKI due to pregnancy who were seen throughout the research period. Examining the prevalence, characteristics, and effects of acute kidney injury (AKI) during pregnancy in the Indian population was the aim of this study. Materials and Method: in the study the patients were women who were pregnant with AKI.Patients were examined using demographic data, a detailed history, a clinical examination, and laboratory tests. The main result was a change in maternal renal function, including progression to chronic kidney disease and restoration to normal renal function (CKD). The delivery method, pregnancy-related issues and maternal mortality were all regarded as secondary outcomes. Results: The present study included 60 patients in total, with an average age of 26 years. 41.2% of the individuals were primigravida, and 49.9% had severe anaemia. AKI was primarily brought on by pre-eclampsia and postpartum haemorrhage. During the three-month follow-up period, it was noted that the renal outcome had significantly improved, with 30 patients achieving full renal recovery and remaining patients developing CKD with mild to no recovery. Serum glutamic oxaloacetic transaminase and glutamic pyruvic transaminase levels were increased in all individuals but later recovered to normal. Conclusion: According to our study, women with AKI due to pregnancy frequently experience multi-organ problems and need mechanical ventilation and renal replacement therapy. As a result, managing AKI caused by pregnancy offers a challenge that necessitates an accurate assessment of the contributing factors to enable effective therapy

Introduction: The two most prevalent endocrine conditions that can be seen during pregnancy are thyroid dysfunction and gestational diabetes (GDM). Changes in glucose metabolism and insulin resistance (IR) can both be linked to abnormalities in thyroid function. The study's objective was to ascertain whether pregnant women with gestational diabetes have aberrant thyroid hormone levels.
Material and methods: The medical files of 662 pregnant women who gave birth between 2020 and 2022, separated into two groups: 412 with GDM and 250 with normal glucose tolerance. Using the International Federation of Gynecology and Obstetrics (FIGO) and American Diabetes Association (ADA) standards, a 2-h, 75-g oral glucose tolerance test (OGTT) was used to determine the presence of gestational diabetes mellitus in the study group. TSH, free thyroxine, free triiodothyronine, the FT3:FT4 ratio, fasting plasma glucose, age, and body mass index were all examined in both groups' mean blood concentrations. The Mann-Whitney U-test was used to compare the two groups.
Results: Significantly greater TSH and FT3 concentrations (p 0.0001), lower FT4 concentrations (p 0.0001), and higher FT3:FT4 ratios (p 0.0001) were reported in patients who acquired GDM.
Conclusion: According to the findings of this pilot retrospective series, high-normal to high TSH levels, low-normal to low FT4 levels, and a high FT3:Ft4 ratio may all point to an increased risk of developing GDM.

Pregnancy-related hypertension can alter the outcomes of pregnancy if left unmanaged. The complications associated with pregnancy-related hypertension include pre-eclampsia and eclampsia. Various medicines are available that can avoid these complications and lead to better outcomes of pregnancy. Material and Methods: The study was conducted on 250 patients with pregnancy-induced hypertension (PIH) that were prospectively enrolled over two years at a tertiary healthcare facility. After randomization of the patients into two groups, methyldopa or labetalol was administered to patients. The difference between the two groups was evaluated for the mode of labour, delivery, perinatal mortality, mean birth weight, Apgar score and neonatal intensive care (NICU) admissions. Result: There was no significant difference observed in the mode of labour, delivery, perinatal mortality, mean birth weight, Apgar score and neonatal intensive care (NICU) admissions between the patients undergoing management with methyldopa or labetalol. Conclusion: Overall, labetalol was found to have slightly better and safer outcomes for both the mother and the fetus in comparison to methyldopa.

Thyroid dysfunction is one of the most common endocrine disorders affecting women of reproductive age group including pregnancy. Over the past several years it has been proved that maternal thyroid disorder influences the outcome of the mother and fetus, during and also after pregnancy.
Methods: A total of 385 pregnant women satisfying selection criteria attending the antenatal care during the first trimester were studied. The demographic details were collected and TSH, free thyroxine and free triiodothyronine were estimated.
Results: The present study showed a higher prevalence of thyroid abnormalities which is 33.51% in pregnant women during the first trimester.
Conclusion: The prevalence of thyroid abnormalities was significantly high in women with family history of thyroid abnormalities whereas no statistically significant difference was noted with maternal age and parity. Screening of women in early pregnancy for thyroid disorders is beneficial in preventing adverse fetal and maternal outcome.

Cardiac dysfunction is a predominant complication of hypertensive disease complicating pregnancy especially affecting left ventricular systolic and diastolic function example Ejection fraction, Fractional shortening, E/A ratio, Isovolumetric relaxation time, Deceleration time. These changes usually return to normalcy after delivery by six weeks postpartum in Normotensive patients.
Aim: To study the cardiac function in preeclamptic pregnant women by transthoracic echo in comparison with normal pregnant women in 32-38 weeks of gestation.
Methodology: This is a prospective observational study conducted in government institute of obstetrics and gynaecology hospital Egmore, chennai and government ISO Kasthurba Gandhi hospital chennai in 125 pregnant women and 125 preeclamptic women. The study subjects underwent echo at 32 38 weeks by using parameters such as ejection fraction l, factional shortening isovolumetric relaxation and deceleration time. This study also evaluated bmi, age, gestational age blood pressure and time of delivery. All preeclamptic patients were followed up to 6 weeks postpartum with echocardiography
Results: The average values of the following parameters were high in preeclamptic women as compared to normotensive controls.
BMI in preeclampsia women 28.71 +/- 4.89 and in Normotensive 27.9 +/- 2.9 (with p value 0.13). Fractional shortening was 28.5 +/- 2 in preeclamptic women and in Normotensive 33.26 +/- 1.62 with P value <0.01.
Isovolumetric relaxation time was in 126.02 +/- 58.6 in preeclamptic women and in Normotensive 99.76 +/- 4.66 with P value <0.001.
Deceleration time was in 230.06 +/- 17.23 in preeclamptic women and in Normotensive 203.34 +/- 6.74 with P value<0.001.
All echo values were highly significant.
Conclusion: Echocardiograph was rarely performed on all preeclamptic pregnant patients in developing countries like India. By performing echo on preeclamptic patients we will be able to detect left ventricular dysfunction early, start treatment, prevent complications and reduce morbidity and mortality. This study shows that echocardiography is extreme valuable and should compulsorily be made a part of all antenatal investigations..

Background: To assess effect of body mass index on fetal outcome in pregnancy.
Materials and Methods: One hundred ten first trimester women were selected. Parameters such as BMI, gestational age at delivery (in weeks), birth weight (in kg) APGAR Score, meconium- stained liquor, NICU admission etc. was recoded.
Results: There were 30 underweight, 40 normal and 40 overweight patients. The difference was non- significant (P> 0.05). The mean APGAR score 1t 1 minute in underweight patients was 6.8, in normal was 6.2 and in overweight patients was 6.4. At 5 minutes was 8.9 in underweight, 8.7 in normal and 8.4 in overweight patients. The difference was non- significant (P> 0.05). 11% underweight and 34% overweight required NICU admission. The difference was significant (P< 0.05). 12% underweight and 38% overweight had meconium- stained liquor. The difference was significant (P< 0.05). 76% underweight, 91% normal and 100% overweight had >36 weeks gestational age. 40% underweight, 50% normal and 45% overweight had 2.5- 3 kgs birth weight. Apgar score at 1 min was seen in 90%, 92% and 88%, NICU admission in 11%, 0% and 34% and meconium- stained liquor in 12%, 14% and 38% underweight, normal and overweight babies respectively. The difference was significant (P< 0.05).

Conclusion: Underweight and obese mothers had increased risk of adverse perinatal outcome

Pregnancy induced hypertension is one of the leading medical disorder of pregnancy and contributes significantly to poor maternal and perinatal outcome. The early detection and effective management play a beneficial role in the outcome of pregnancy, both for the mother and the baby. Incidence of Pre-eclampsia is 3-6% of all pregnancies and 1.5 to 2 times higher risk in primigravida.
Materials and Methods: This study was hospital based observational prospective study from September 2020 to August 2022. Total 150 pregnant women included in the study and fetomaternal outcome were noted and statistical analysis done using SPSS-20.
Results: Majority of patients were in age group 21-25 years in both the groups i.e. 44% in study group and 46.7 % in control group. In study group around 58.7% were preterm deliveries. In our study in group A with deranged biomarkers  and group B with normal biomarkers, developed abruption placenta  in 26.7 v/s 2.7%, eclampsia in 18.7% v/s 1.3%, HELLP syndrome in 8% v/s 0%, ARF in  4% v/s0% respectively. In our study perinatal complications developed in group A and group B were IUGR (20% v/s 8%), fetal distress(37.3% v/s 20%),  NICU admission(49.3% v/s 29.3%), MSL (12% v/s 20%)  and IUD (9.3% v/s 1.3%) respectively.
Conclusion:  Hypertensive disorders of pregnancy with deranged hepatic biomarkers are correlated with more adverse maternal and perinatal complications compared to normal hepatic biomarkers. Such cases require more frequent antenatal check-ups with serial ultrasonography.

Heart disease is a major cause of maternal mortality and morbidity during both the
antepartum and postpartum periods. Heart disease occurs less frequently than 1% of the time during pregnancy. Cardiovascular disorders complicate about 1% of all pregnancies.A thorough evaluation of the patient throughout the entire pregnancy may result in the early detection of heart disease. So, the present study was conducted with an aim to assess the effect of heart disease in pregnancy and its outcome.
Methods: This study was a cross-sectional study of the maternal-fetal outcomes of cardiac disease-related pregnancies over the last five years that were followed at tertiary care hospitals in North India. The study was carried out for three months after receiving institutional review board ethical approval. The study comprised pregnant patient files with pre-existing or newly diagnosed heart illness during pregnancy. Maternal age, parity,York Heart Association (NYHA) functional class, and materno-fetal outcome were among the variables that were recorded. The collected data was entered in the MS excel sheet. The variables were presented as frequency and percentages.
Results: In our study, a prevalence of 1.5% of heart disease was observed among pregnant women. Four fifth of pregnant women (80.0%) with heart disease were primigravida.Among enrolled pregnant women four fifth of the women were having rheumatic heart disease (84.2%). Among pregnant women with rheumatic heart disease (RHD), the single valvular lesions were seen in 28.7% of pregnant women (20.3% of mitral stenosis and 5.1% of mitral regurgitation).52.9% of pregnant women were having grade II functional class as per NYHA. Congestive cardiac failure as complication was observed in 15.7% of pregnant women. Among alive neonates, 29.2% of neonates were preterm, and 7.7% of neonates were having IUGR, 15.4% needed NICU admission
Conclusion: In underdeveloped nations, maternal and perinatal morbidity from rheumatic heart disease is high and accounts for a large portion of cardiac disease in pregnancy. When congenital heart disease is treated early in life, morbidity and mortality are reduced.

Diaphragmatic hernias (DH) are known to complicate pregnancy and high mortality rates have been reported due to delay in surgical intervention. The reported mortality rates in presence of strangulation ranged from 22 to 80% and almost one third of the reported cases, did not have any symptoms. A literature review suggests that, out of 43 cases of DH diagnosed during pregnancy, only six cases of right-sided BH have been reported until 2020. Prolonged maternal malnutrition affects the intrauterine growth of the foetus and increases the morbidity and mortality of both the mother and foetus, leading to maternal weight loss, electrolyte imbalances, and vitamin deficiency. In the present case study, 21-year-old primigravida female with right-sided congenital BH was diagnosed during pregnancy, 7 days after the initial presentation of symptoms of acute obstruction. On exploration ischemic bowel was noted and it was associated with foetal loss.

Maternal physiology undergoes a number of transient and persistent changes throughout pregnancy. Nearly all maternal tissues change in some way during pregnancy.The prevalence of IHCP varies significantly across all ethnic groups. In the world, 0.2–2% of pregnant women experience it. Increased risks of post-partum haemorrhage, LSCS, severe pruritus with dyslipidemia, altered coagulation profile, and premature prelabour rupture of membrane are some of the complications associated to IHCP, so this study was conducted with an aim to assess the incidence of intra hepatic cholestasis among pregnant women and to assess the feto-maternal outcome pregnancy complicated by intra hepatic cholestasis.
Methods: After receiving approval from the research and ethical committee of the institute, this hospital-based prospective study was carried out among pregnant women with a diagnosis of intra hepatic cholestasis who were recruited over a period of 2 years in the department of Obstetrics and Gynaecology. A complete hemogram, liver function tests (total and conjugated serum bilirubin), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), serum bile acids, urine routine, and microscopy test were performed on all patients. Ursodeoxycholic acid (UDCA) 10-15 mg/kg/day, with a maximum dose of 300 mg 8 hours a day, was indicated for oral administration to all confirmed patients of IHCP.
Results: The incidence of Intra Hepatic cholestasis among pregnant women was 3.88%.The mean age of pregnant women was 27.11±5.82 years. Around two third of pregnant women (69.0%) were diagnosed with Intra Hepatic cholestasis between 33-36 weeks of gestational age.Three fourth of the pregnant women with Intra Hepatic cholestasis had deranged total bilirubin (76.8%), Aspartate Aminotransferase (79.8%), and Alanine Aminotransferase (73.2%).The Pre-eclampsia and Postpartum haemorrhage were observed as complications among 22.0% and 14.3% of pregnant women with Intra Hepatic cholestasis respectively. The Apgar score at 1 minute and at 5 minutes was <7 in 12.5% and 8.3% of neonates born to pregnant women with Intra Hepatic cholestasis respectively.
Conclusion: Hepatic dysfunction in pregnancy is typically caused by intrahepatic cholestasis. In terms of higher incidence of lower segment caesarean sections and discomfort from pruritus, maternal morbidity has increased

Background: At the onset of Covid-19 pandemic, it was an unknown entity in terms of risk status of the pregnant women for fetomaternal outcome. Both fetus and pregnant women were considered as groups under special concern due to their unique physiological characteristics.
Method: A retrospective study was conducted in department of Obstetrics & Gynaecology along with Paediatrics department in Maharishi Markandeshwar Medical College and Hospital, Solan on pregnant females admitted to the Covid-19 Ward/ ICU over a period from August 2020 till 31st March 2022. Participants were included into 3 waves of pandemic based upon time of presentation and these 3 groups were further studied for the various fetomaternal parameters such as maternal age, symptom status, need for respiratory support, maternal mortality, abortions, still births, gestational age and weight of newborn and other morbidity and mortality in newborns.
Results: A total of 171 pregnant were included in the study, of whom 47, 64 and 60 were seen in 1^st, 2^nd and 3^rd waves respectively. Majority of subjects were asymptomatic in 1^st, 2^nd & 3^rd wave, (p=0.30). Age wise distribution of the patients showed majority subjects in the age group of 20-30 years (p= 0.94). LSCS rates in 3 waves were not different significantly (p = 0.67). Maternal mortality rates and need for respiratory support were in similar proportions in all 3 waves (p=0.71) and (p=0.73) respectively. No significant difference was seen in maternal morbidity and neonatal outcome.
Conclusion: The study showed nosignificant difference between the waves of Covid-19 pandemic in terms of fetomaternal outcome except no maternal mortality in 3^rd wave.

Backgroundandobjectives: Colostrum, the first fluid generated by mothers, is distinct in its nutrient quality and non-nutritive bioactive substances that promote survival and good growth. The research analyzes total proteins, triglycerides, immunoglobulin A, lactose, and calcium in normal colostrum with PIH, GDM, and Anaemia individuals in primigravida to see if there are significant alterations. 
Methods:The research was done on lactating mothers from the Deccan College of Medical Science, Hyderabad, India, with their approval. 80 postpartum women involved in the study, 20 as controls and 60 as instances of PIH, anaemia, and GDM. All cases were examined for protein, triglycerides, IgA, lactose, and calcium. SPSS 17.0 was used to analyse the data. Descriptive results are presented as mean and SD of several groups.
Result:Normal blood pressure (controls) was 120+6.5 mm Hg systolic and 79+3.1 mm Hg diastolic without oedema or proteinuria. Haemoglobin is 10.8+0.7g/dl. PLBS=130.7+7.6 and FBS=949.5. (92+14.6 mg/dl) Normal FBS and PLBS OGTT results. 122.5+7.8 mm Hg systolic, 74+6.8 mm Hg diastolic, 40% (8/20) oedema, 70% proteinuria. PIH, anaemia, and GDM diminish protein (p<0.005). PIH and anaemia had higher triglycerides than GDM (p<0.005). GDM exhibited more IgA than anaemia and PIH. GDM has greater mean lactose levels than anaemia, PIH, and the control group. Lactose levels are similar in anaemia and controls. (p<0.005) Anaemia, PIH, and GDM lower calcium.
Conclusion:Human milk contains number of of bioactive substances that fight infection, inflammation, immunological maturation, organ development, and healthy microbial colonisation. Pregnancy hypertension impacts lactogenesis and colostrum content.  Nutrition impacts milk composition. GDM affects pregnant women, mother and infant. Screening, diagnosing, and treating hyperglycemia are critical for mother and child. Regardless of diet, multivitamins are required throughout lactation. The study can't characterise all bioactive human milk components.

Background: To assess prevalence and risk factors for lower limb varicose veins during pregnancy.
Materials and Methods: 112 pregnant women during prenatal follow-up were enrolled. Varicose disease was clinically identified and classified according to Widmer’s criteria: trunk varicose veins, reticular varicose veins, and telangiectasias; being reclassified according to the criteria of the CEAP clinical classification. Patients without visible or palpable signs of varicose disease were considered as CEAP C0. The results of prevalence and risk factors were recorded.
Results: Age group 18-24 years had 62, 25-31 years had 34 and 32-38 years had 26 patients. The difference was significant (P< 0.05). CEAP C1 e C2 varicose veins were seen in 80 and CEAP C0 in 42. The difference was significant (P< 0.05). Varicose veins type C2 was seen in 22, C1 in 58 and C0 in 32. The difference was significant (P< 0.05). In multivariate analysis, age over 22 years and positive family history, were significant for varicose veins disease (CEAP C2) with odds ratio above 1.
Conclusion: The high prevalence of varicose disease during pregnancy, etiopathogeny and risk factors involved advanced age and positive family history

Background: Physiologically calcium plays a critical role in function of smooth muscle and its deficiency can cause increased blood pressure. Magnesium is a cofactor in several enzymes, cause vasodilatation and helps in neurochemical transmission. Besides magnesium and calcium, hyperuricemia may induce hypertension by impairing nitric oxide generation
Objective: To compare serum calcium, magnesium and uric acid levels in women with pre-eclampsia and normal pregnancy
Methods: Hospital based Comparative Cross sectional study was carried out among 60 (30 pre-eclampsia and 30 normal pregnant women) aged 18-35 years between 20 weeks till term gestation for 18 months. Proteinuria, serum Calcium, Serum Magnesium, and serum Uric acid were measured using standard procedures.
Results: Majority were (40%) 25-29 years, (53.3%) were overweight, 46.6% had 36-38 weeks of gestation. 56.67% were Primi. 60% had severe preeclampsia. Proteinuria was seen in all with 46.67% had 2+. Pulse rate, SBP and DBP were significantly higher among the cases compared to controls.  Serum calcium was significantly lower among preeclampsia women and serum uric acid was significantly higher.  However there was no statistically significant difference between serum magnesium levels among preeclampsia and normal pregnant women. There was no statistically significant difference between pulse rates. Systolic and diastolic blood pressure were significantly higher in severe preeclampsia group. Serum Calcium and magnesium were significantly lower in severe preeclampsia group.
Conclusion: Preeclampsia was found to be associated with low calcium levels and higher serum uric acid levels. But it was not found to be associated with the serum magnesium levels.

Background: The pattern of gestational weight gain (GWG) and pre-pregnancy body mass index (BMI) are indicative of maternal and fetal nutrition during pregnancy and contribute to their later health. However, there is a paucity of studies related to this association from developing countries like India.
Objective: To study early pregnancy body mass index and gestational weight gain in relation to neonatal birth weight.
Methodology: This observational study was conducted on 1031pregnant women, aged 18-35 years, from June 2014-December 2015. Data was collected by a pre-designed questionnaire. Pre-pregnancy BMI and GWG gain at antenatal visits were noted. National health mission (NHM, 2014) guidelines were used to assess weight gain. Neonatal birth weight and gestational age at birth were noted post-delivery. Statistical analysis was performed using R software (Version 3.6.0).
Results: Majority of the women were 21-25 years old (57.81%), nullipara, normal BMI (72.16%) with poor education level (61.69%) and good socio-economic status (31.91%). Neonatal birth weight was within normal range (2.5-2.99 Kg) (41.22%) with maternal GWG within NHM recommendation (71%). A significant association was observed between neonatal birth weight and maternal BMI (P>0.001). A significant difference was observed in weight gain in 1^st and 2^nd trimester between underweight and normal weight subjects (P <0.05). Distribution of neonatal birth weight born to women with 1-4 Kg weight gain during 1^st trimester (P<0.05) and with 3-7 Kg during 2^nd and 3^rd trimester (P<0.001) was significantly different. A significant positive correlation existed between maternal BMI and neonatal birth weight (P<0.001); total GWG and birth weight of neonates for most demographic characters (P <0.05).
Conclusion: Maternal early pregnancy BMI and GWG are positively associated with neonatal birth weight with GWG causing an increase in birth weight.

Introduction: Anemia is one of the commonest medical disorder in pregnancy all over the word. The burden is huge. Several international and national programs are running to reduce this burden.
Aim: The aim of the present study is to know the “Prevalence of Anemia in Pregnancy and its Biosocial connection with other factors at Integral Institute of Medical Sciences Research, Lucknow”, Uttar Pradesh, India. It is a tertiary care centre mainly catering the rural population.
Methodology: It was a prospective study, conducted on pregnant women attending antenatal clinic and admitted in the department of obstetrics and gynecology of Integral Institute of medical Sciences & Research. Study was conducted over a period of 11 months from February 2021 to December 2021. All pregnant women 18 years and above attending antenatal clinic were included in this study. The questionnaires were developed consisted of questions divided into three sections namely : socio-demographic, nutritional and other factors along with menstrual and obstetric history. Data was collected after women received antenatal services or after admission in the ward. Diagnosis of anemia was established after hemoglobin estimation by automated blood count.
Results: The total study subjects were 356 pregnant women. Among them 198 pregnant women (55.61%) suffered with mild, moderate and severe anemia. Among participants, 78.5% of pregnant women were 20-30 years of age group. The high prevalence anemia (96.5%) was among homemakers and daily workers as compared with working females. Among the parity group majority of the participants who suffered with anemia were second gravida (45.45%). The vegetarian group suffered with high prevalence of anemia (61.5%) as compared with the patients on mixed diet.
Conclusion:A very high prevalence of anemia (55.61%) in pregnant women is an indicator of the slow performance of national and international programs towards the desired goal because of various reasons

Background: Pregnancy-related specific dermatoses are skin conditions that develop during pregnancy and go away after delivery. Itching and only secondary skin lesions in the form of excoriations, with or without signs of cholestasis, are the main symptoms of the skin illness known as pruritus gravidarum in gravid women.So, the present study was conducted with an aim to evaluate the prevalence and characteristics of pruritus among pregnant women.
Methods: The present prospective cross-sectional study was conducted among pregnant women in the outpatient (OPD) of the department of Obstetrics and Gynecology for 12 months. Complete dermatological examination was done in all cases to study the physiological and pathological changes of skin. Appropriate investigations were done if required to confirm the diagnosis. A preformed questionnaire was used for data collection to document baseline characteristics pruritis type and pruritis characteristics. The collected data was entered in the Microsoft (MS) Excel Spreadsheet and also, analysis of data carried out using MS Excel Spreadsheet. A p value of <0.05 was considered as statistically significant.
Results: In present 256 pregnant subjects were enrolled. The mean age of study subjects was 27.9±5.6 years.The prevalence of pruritis among enrolled subjects was 18.3%. The most common pruritis type was pruritis gravidarum (12.5%) and least common was pruritic folliculitis (0.8%).No pruritis was observed in the first and second trimester mothers and mothers with 3 or more gravida.In our study, among the subject with pruritis, more than four fifth of the them were having pruritis in the abdomen (89.4%) and chest region (83.0%). Chi-square analysis showed significant association between variables (period of gestation and trimester) with the pruritis (p<0.05).
Conclusion: During pregnancy, pruritus is frequent. While it can be the outcome of physiologic changes associated with pregnancy or diseases peculiar to pregnancy, it might also be an indication of an underlying, unrelated illness process.

Objective:  One of the most common and potential life threatening complications of pregnancy is pregnancy induced hypertension. This cross-sectional study aimed to investigate the relationship between platelet count and pregnancy induced hypertension.
Materials and Methods: This is a present cross-sectional study was carried out in the Department of Medicine and Obstetrics and Gynecology, Maheshwara Medical College & Hospital over a period of 1 year among 60 subjects. The subjects for this cross-sectional study included consecutively - recruited Normotensive (n = 130) serve as a control, Non-Sever Pre-eclamptic (N = 35) and Severe pre-eclamptic (n = 35). All consenting, adult (≥ 18 years) pregnant women who were confirmed to have pregnancy induced hypertension by an Obstetrician constituted the subjects for these subjects.
Results: A total of 200 pregnant women were included in the study. Platelet count and platelet crit levels tend to decrease as pre-eclampsia becomes more severe. In this study, no statistically significant differences were observed between the three groups in age, residence, number of pregnancies (gravidity), number of deliveries (parity), gestational age, and BMI, but there was a significant difference between the three studied groups with regards to SBP, DBP and MAP which increased with severity of preeclampsia (P<0.001). The value of PLT accounts 180(97–352) ×103/μl for pre-eclamptic women and 260(139–445) ×103/μl for normotensive pregnant women (p<0.001).
Conclusion: Platelet indices, including platelet count, mean platelet volume, platelet distribution width, and Platelet crit, have been identified as promising candidate markers for predicting preeclampsia in pregnant women. In the future, a serial examination of these indicators during several trimesters of pregnancy should be conducted.

Background:Iron deficiency is a major public health problem in developed countries. The present study was conducted to assess anaemia during pregnancy as a risk factor for infant iron deficiency.

Introduction: Infertility is a multidimensional health problem with social & economic consequences. Female factor remains the foremost reason (40%-55%) and ovulatory disorders is the most common identifiable female factor. Ovulation induction is one of the most successful treatment of infertility due to anovulation.
Aim: To compare the effects of letrozole and clomiphene citrate (CC) for ovulation induction in women with anovulatory infertility.
Materials And Methods: In this assessor blind randomized controlled trial 80 infertile women with anovulatory infertility were randomized to receive either letrozole or CC for ovulation induction in incremental doses for a maximum of three cycles. Main outcomes studied were endometrial thickness, ovulation rate, pregnancy rate and rate of mono-follicular development. Both the groups were followed by ultrasound until the dominant follicle reached a diameter ≥18 mm, human chorionic gonadotropin (hCG) 10,000 IU was given, and timed intercourse was advised.
Results : The mean age, duration of infertility,  body mass index, and endocrine status in both the groups were similar at baseline. Ovulation occurred in 36 subjects (90.0%) in the letrozole group and 29 (72.5%) in the CC group, with a statistically significant difference between the two groups (P=0.045). Mono-follicular development was seen in 60.0% of ovulatory cycles in letrozole group compared to 22.5 % in clomiphene group (p=0.001).  Pregnancy was achieved in 37.5% women in letrozole group and 25.0% in clomiphene group (p=0.228).  There was no statistically significant difference in endometrial thickness between the two groups at the time of hCG administration (9.71±1.16mm vs. 9.6±1.03 mm with letrozole and clomiphene respectively (p = 0.648).
Conclusion: The effect of letrozole showed a better ovulation rate and monofollicular  development as compared with CC. Letrozole may have a role as a first-line treatment for anovulatory patients with anouvulatory infertility.

Background and Aims: Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of pregnant women. The aim of this study is to examine severity of COVID-19 disease and maternal and foetal outcome among COVID-19 positive pregnant women undergoing caesarean section. Methods: This retrospective observational study was conducted at a tertiary teaching hospital in Karnataka between 1stApril to 31st July 2021, during which 100 COVID-19 positive pregnant women with ASA physical class II, III and IV who have undergone lower segment emergency caesarean section were selected on the basis of simple random sampling method. Results: A total of 100 women who had undergone caesarean section under spinal anaesthesia with positive SARS-CoV-2 PCR tests were assessed. Mean age was 24.45± 4.3 years, eight women were having severe covid-19 infection and overall mortality rate was 5% (5/100) in women and 1 woman had HELPP syndrome and one met with PPH (post-partum haemorrhage). Seven (7%) COVID-19 pregnant women required intensive care in the perioperative period. Eight neonates required NICU admission and had APGAR score less than 7. Fifty-five (55%) women were asymptomatic. While the rate of pneumonia in symptomatic women was 3.6% (8/45), the pneumonia incidence among all SARS-CoV-2 PCR (+) pregnant women was 8% (8/100). Conclusion: In our study, 61% of patients had pulmonary involvement and the mortality rate was 8% among mothers and 1% in neonates.

Background and objectives: Predicting preeclampsia (PE) at 11-14 weeks of gestation is a new concept. Studies integrating multiple factors at 11-14 weeks of pregnancy have been conducted, but an algorithm with a good predictive value has yet to be created. This study aimed to design a methodology combining MAP, Uterine artery Doppler, and PAPPA at 11-14 weeks of pregnancy to predict PE in India. Basically objective is to determine whether higher Mean Arterial Pressure (MAP), increased Uterine Artery Pulsatility Index (UAPI), and low Pregnancy Associated Plasma Protein A (PAPP - A) between weeks 11-14 of pregnancy are linked to the growth of hypertensive diseases in pregnancy.
Method: This is a prospective cohort study. Data were obtained from 200 registered patients attending antenatal OPD in hospitals between 11 and 14 weeks of gestation. MAP, blood pressure, uterine artery Doppler, and serum sample for PAPPA were measured. IBM SPSS Version 22 for Windows was used to analyse the data.
Result: There were a total of 200 women enrolled in the study, and 24 of those women (37.1%) suffered difficulties. At 11-14 weeks of pregnancy, the uterine artery doppler pulsatality index (PI) was found to be an effective screening tool (sensitivity 29%, specificity 90%) for the prediction of pregnancy.
Conclusion: This study revealed that the uterine artery Doppler Pulsatality index is an effective screening approach for women at high risk of developing preeclampsia and related complications during the 11th to 14th week of pregnancy.
 

Background and objectives:
Complications during pregnancy are frequently associated with adverse outcomes for the mother and foetus. These complications may result from preexisting maternal conditions and prior obstetric complications. A higher risk of developing intrauterine growth restriction, Hypertensive disorder is associated with impaired trophoblastic invasion of the maternal spiral arteries. The objective of study is the to predict this complication of hypertensive disorder and IGUR in 1st and 2nd trimester pregnancy by using Doppler study on uterine and umbilical arteries.
Method:
This study on Uterine and umbilical arteries Doppler Ultrasound assessment among pregnant women in 1st and 2nd trimester to predict hypertensive and IUGR disorder, There were a total of 200 women enrolled in the study, same 1st trimester pregnant women continuation with 2nd trimester for Doppler study. Data were obtained from 200 registered patients attending prenatal OPD in hospitals between 1st and 2nd trimester.
Results:
In the present study we found that Uterine artery Doppler RI: 12%, PI: 10 %, S/D: 12 % in first trimester, and Uterine artery Doppler RI: 38%, PI: 34 %, S/D: 38 %, ED Notch: 18 % in 2nd trimester and 15 % of women had raised SBP and DBP Of the total 200 pregnant women.
Conclusion:
Uterine and umbilical artery Doppler has potential. Clinicians would have the chance to stop the condition before it shows clinical symptoms by implementing an ultrasound screening programme in high-risk pregnant mothers.

Background: Pregnancy-related hypertensive disorders, a condition with numerous maternal and foetal consequences, can be avoided. By measuring serum uric acid levels, the condition can be detected early on and its progression can be stopped. In India, the prevalence of PIH varies from 5% to 15%. Fetal growth restriction, low birth weight, spontaneous or iatrogenic premature delivery, respiratory distress syndrome, and admission to neonatal intensive care are all significantly linked to preeclampsia. Preeclampsia prediction may aid in classifying women into high risk groups so that surveillance can be stepped up and preventative treatments can be started.
Aim and Objectives: The purpose of this research is to investigate the role that serum uric acid plays as a predictive factor in hypertensive disorders of pregnancy. The purpose of this study is to determine the function that serum uric acid plays in the determination of hypertensive problems in pregnancy. The purpose of this study is to evaluate the accuracy of blood uric acid as a potential predictive predictor of maternal and foetal problems related with hypertensive diseases of pregnancy.
Methods: Patients with hypertensive disorders of pregnancy who came in for antenatal checkups between 24-32 weeks and had blood pressure readings of more than or equal to 140/90 mmHg but did not have proteinuria were included in a study that was conducted in the department of obstetrics and gynaecology at the Modern government maternity hospital in Petlaburz. The inclusion and exclusion criteria were met by these patients. As part of the standard evaluation, the level of uric acid in the serum was determined for each and every hypertensive patient. Recording was done for both the maternal and perinatal outcomes.
Results: In the current study, 46 (46%) of the 100 women with HDP had elevated serum uric acid levels. Of the 64 women who had pre-eclampsia, 34 (53.1%) had high serum uric acid levels. The median serum uric acid level was 6.2mg/dl, with an SD of 1.8. Numerous maternal and postnatal problems, including eclampsia, abruption of the placenta, HELLP syndrome, and foetal growth restriction, were linked to hyperuricemia in HDP patients.
Conclusion: Patients who have been given a diagnosis of hypertensive disorders of pregnancy and who also have hyperuricemia are at an increased risk for a variety of different maternal and perinatal complications.

Aim: To evaluate Lipid profile of pregnant women during all the three trimesters of pregnancy.
Materials and Methods: This prospective observational cross sectional study was conducted in the Department of Obstetrics and Gynaecology, Rajindra Hospital, Patiala in 1000 women attending antenatal clinic and labor room. Their lipid profile was done and proportion of dyslipidemia during pregnancy was recorded. Samples from all subjects were collected under aseptic precaution; 5 ml of non-fasting venous blood was collected in plain vacutainer from antecubital vein. After the clot retracts the sample was centrifuged at 4000 rpm for 5 min the serum separated and stored at 4°C pending assay for lipid profile. Serum TGs, TC, and HDL cholesterol was analyzed by enzymatic methods with the help of Glaxo kits on ERBA Chem-5 plus semi-auto analyzer in the department of biochemistry, GMC, Rajindra hospital Patiala.
Results:  Out of 1000 patients, 5.6% patients were from <20 years age groups, 31.6% patients were from 20-25 years age groups, 35.7% patients were from 25-30 years age group, 20.9% patients were from 30-35 years age group and 6.2% patients were from >35 years age group. 20.5% patients came from rural area and 79.5% from urban area. The mean cholesterol levels in first second and third trimester were 187.86 mg/dl, 252.36 mg/dl and 294.43 mg/dl respectively showing significant rise in levels of TC with subsequent trimester. The mean TG levels in one, second and third trimester were 142.2 mg/dl, 252.33 mg/dl and 309.97 mg/dl respectively showing a significant rise in levels with subsequent trimester. The mean HDL levels in one, second and third trimester were 53.78 mg/dl, 57.12 mg/dl and 54.07 mg/dl respectively. Levels rise in 2nd trimester and there is significant fall in values between 2nd and 3rd trimester. The mean LDL levels in one, second and third trimester were 105.6 mg/dl, 144.8 mg/dl and 178.4 mg/dl respectively. Values increases with subsequent trimesters. The mean VLDL levels in one, second and third trimester were 28.4 mg/dl, 48.5 mg/dl and 57.6 mg/dl respectively showing significant rise in levels with subsequent trimester. The mean TG/HDL ratio in one, second and third trimester was 0.16 mg/dl, 0.68 mg/dl and 1.73 mg/dl respectively.
Conclusion: After three months of pregnancy, there was a substantial increase in total cholesterol, triglyceride level, HDL, LDL, VLDL and TG/HDL ratio in the serum. Values of HDL rises in 2nd trimester and there is seen a decline in 3rd trimester.

Urinary tract infections (UTI) are the most common bacterial infections during pregnancy.
Untreated UTI can be associated with serious obstetric complications. This cross-sectional
study was carried out to determine the prevalence of UTI among pregnant women. UTI was
diagnosed using mid stream urine (MSU) culture. Using >10’5 colony forming unit per millilitre
as a significant level of bacteriuria, the prevalence was found to be. There was a high
incidence of infection in 21-25 years age group (43.75%). There was also a high incidence of
infection in the third trimester of pregnancy (51.56%) compared to first (17.18%) and second
trimester (31.25%). Multiparty is associated with increased urinary tract infections in pregnancy.
Regarding education 10% were literate and 90 % were illiterate. Prevalence of bacteriuria
was 94% in women who had past history of urinary tract infection.80% were sexually
active. E.coli was the most frequently isolated pathogen. These findings underscores the importance
of screening all pregnant women for significant bacteriuria, so that positive cases
should be treated subsequently with antibiotics in order to reduce the adverse effects on both
maternal and fetal health.

Aim: To investigate the use of ultrasound in diagnosing patients with first trimester bleeding and to prognosis and forecast the outcome of abnormal pregnancies
Methods: The research included all consecutive individuals having a history of vaginal bleeding in the first trimester of pregnancy. Age, obstetric history, menstruation history, and specifics of the current pregnancy such as period of amenorrhea at the time of the first episode of bleeding, quantity and duration of bleeding, discomfort abdomen, and history of expulsion of fleshy mass/clots were all recorded. Transabdominal sonography was performed on all patients using a GE Logiq P5 Pro ultrasound equipment. When transabdominal sonography was unclear or ambiguous, transvaginal sonography (TVS) was used. The presence or absence of a gestational sac, the location of the gestational sac, the size of the gestational age in comparison to the period of amenorrhea, the margins of the gestational sac, the presence or absence of a foetal pole, crown rump length (CRL), cardiac activity, and the presence of fluid in the cul-de-sac were all noted on an ultrasound.
Results: Clinical examination revealed that 74 (74%) of the cases were threatened abortions, 6 (6%) were complete abortions, 4 (4%) were incomplete abortions, and 2 (2%) were missed abortions. Clinically, no blighted ovum or molar pregnancy was suspected. On USG, 55(55%) of 100 cases were classified as threatened abortion, 15(15%) as complete abortion, and 9(9%) as missed abortion and incomplete abortion. There were also 6 (6%) cases of blighted ovum, 3 (3%) cases of ectopic pregnancy, and 2(2%) cases of complete hydatiform mole. The total disparity between clinical and USG diagnosis was present in 61% of cases, and clinical diagnosis was confirmed by USG in 62 cases, indicating clinical diagnosis accuracy of 62%.
Conclusions: We conclude that USG is a helpful and readily accessible technique for evaluating individuals with first trimester vaginal haemorrhage. It is quite precise in pinpointing the root of the bleeding problem and helping the doctor decide what course of action to take. In the algorithm for deciding whether or not to intervene and keep the pregnancy going, ultrasound is a useful input.

Introduction:Unsafe abortions are a serious public health issue in India, involving the expulsion or extraction of the product of conception and causing controversy.Unmet demand exists for a simple, effective early pregnancy termination method that is both accessible and safe. Medical abortion using mifeprostone and misoprostol and surgical abortion using manual vacuum aspiration are two procedures that meet this need.
Materials and Methods:All requirements outlined in the MTP Act of 1972 by the Government of India were followed in this study. On the first day of the medical abortion, the patient was given 200 mg of mifepristone orally. After 48 hours at home, the patient was told to keep using Tab. Misoprostol 800ug vaginally.A 60ml double-valved manual vacuum aspiration syringe was used for MVA. Following the MVA syringe's attachment, the contents were aspirated. Villi on fresh tissue served as proof that the procedure was successful.The aspirated uterine contents were placed on a piece of gauze and examined to determine the gestational sac. Each woman was under observation for at least four hours following the procedure. The vital signs were examined before discharge. Inj. Women with Rh negative blood groups received 300ug of anti-D within 72 hours of the abortion.

Background: The objectives is to Screening of all the antenatal pregnant women for
thyroid dysfunction, To study the maternal and fetal noutcome in pregnancy thyroid
dysfunction, To provide adequate treatment and there by reduce adverse outcome,
Follow up of cases six weeks post partum.
Materials and Methods: Prospective, observational study. 110 patients were included.
The study was conducted at Department of Obstetrics and Gynecology (OBG), Modern
Govt MaternityHopsital, Petlaburz attached to Osmania Medical College, Hyderabad,
Telangana, India during the period from 1st December 2019 to 30th June 2021.Mothers
attending for ante-natal check-up and having either a detected or documented thyroid
dysfunction. An Institutional Ethics Committee approval was obtained. Written
informed consent was obtained from all the study participants. The mothers during
their first visit were included for detailed history, clinical examination and blood
investigations as follows.
Results: No age related influence in the presence of thyroid dysfunction, there was no
statistical significance. it was observed that 68% of abortions were in primigravida, it
was found that with increase in gravida abortion rate was less. the mode od delivery
had no significant variations in both hypo/hyperthyroidism. it was noted that
subclinical hypothyrid and overt hypothroid cases resulted in more preterm deliveries
than hyperthyroid patients.the study showed no significance difference in newborn
thyroxine levels among thyroid dysfunction groups.
Conclusion: The study showed that thyroid dysfunction is more among the pregnant
women. Hypothyroidism is the major thyroid dysfunction among the antenatal women.
The women with thyroid dysfunction had more incidents of adverse outcomes of
pregnancy like increased abortion rates, caesarean deliveries on the mothers and
preterm babies and lbw on the newborn.

Background: Standard assessment of renal function in pregnancy is by measurement of
serum creatinine concentration yet normal gestational ranges have not been established.
The aim of this systematic review was to define the difference in serum creatinine in a
healthy pregnancy compared with concentrations in non-pregnant women to facilitate
identification of abnormal kidney function in pregnancy.
Materials and Methods: The study was performed on 70 pregnant women. Out of which
35 women were pregnancy induced hypertensive and 35 were normal pregnant women.
Results: The result showed significantly high blood pressure (SBP-197.21±21.7 VS
187.28±8.69, DBP 124.36±9.41 VS 99.2±6.28) and Blood urea (42.31 ±7.81 mg% VS
41.30±9.29 mg%), serum creatinine (3.45 ±1.19 mg% VS 3.18±1.38 mg%), serum uric
acid level (9.89±3.16 mg% VS 7.34±0.9 mg%) in pregnancy induced hypertensive
women compares to normal pregnant women. In the present study, in pre-eclampsia,
there is elevation of serum uric acid and serum creatinine elevated values are
statistically significant.
Conclusion: There is a renal derangement of parameters in preeclampsia so it may be
advised to renal function test to confirm involvement of renal dysfunctions.
Measurement of renal function Test could be used as a biochemical indicator in
pregnancy induced hypertensive women.

Background: Preeclampsia isa state of insulin resistance. Insulin resistance features like
Hypertension, hyperinsulinemia, glucose intolerance, and lipid abnormalities are
associated with pregnancy-induced Hypertension.
Aimsandobjectivesofthestudy:
1. Tostudyinsulinresistanceinwomenwith pre-eclampsia.
2. TocompareandevaluatetheroleofmeasuringIR amongwomenwith
preeclampsiaandnormalpregnancy.
Methodology: AProspectiveandobservational one year study conducted in
GovernmentGeneralHospital.Kurnool. Atotalof 50Womenwith
preeclampsiaand50women withnormalpregnancy. Women were instructed for 12hrs
overnight fasting about 2ml of venous blood was collected in a
fluorideethylenediaminetetraacetic acid vial using proper aseptic precautions. Plasma
was separated by centrifugationand usedforestimationof
plasmaglucoseandplasmainsulinlevels. Values are presented as mean ± standard deviation
(SD) and the statistical analysis was done using SPSS 17.0software. Student’s unpaired ttest
was used for comparison of parameters between two groups. The p-value
oflessthan0.05was consideredas statistically significant.

Background:Cardiac disease is an important cause of maternal mortality and morbidity
both in ante partum and postpartum period. The overall incidence of heart disease in
pregnancy is <1%. Objective of present study was to determine maternal outcome in
pregnant women with heart diseases in terms of fetal complication, maternal
complication and Mode of delivery. Aims: The aim of this study is to evaluate the
influence of biological factors inPerinatal Outcome in Heart Disease Complicating
Pregnancy.
Materials and Methods: This study wasconducted between January 2018 to
Decmber2021,ina tertiary care centre, SVIMS, Sri Padmavathi Medical college for
women. It is a retrospective observational study. Sample size is 55.
Results: In the present study, age distribution varied from 20-40 yrs. majority of women
(52.72%) are in the age group 20-25 years, followed by 23.63% in the age group of 26-30
years, 12.72% in the age group 31-35 years and 1.81% in the age group 36-40 years.
90.90% of cases are booked cases and 9.10% of cases are booked cases.
Conclusion: Preconceptional counselling, accurate risk assessment, regular antenatal
checkups,prevention, early recognition and aggressive treatment of complications
during pregnancy are crucial in reducing themorbidity. Surgical correction of the
cardiac lesion prior to pregnancy is associated with better pregnancy outcome.

Background: Asthma attack is the most common respiratory symptom observed and is of great concern. Throughout the world asthma cases are increasing during pregnancy. The major issue is that the control levels of asthma is changing during pregnancy so the management is a little difficult during pregnancy.
Objective: The present study was undertaken to observe the prevalence of asthma and respiratory symptoms during pregnancy.
Materials and methods: 40 pregnant women attending OPD in the hospital were part of the study after obtaining the written informed consent. Confidentiality of the data was maintained. Willing pregnant women were included in the study. Pregnant women with any other complications severe were excluded from the study. Respiratory symptoms were examined during the general physical examination by an expert physician.
Results: The age group of the participants ranges from 22-30 years. 25% of individuals have asthma. 37.5% of individuals have wheeze without cold, 15% of individuals have nasal allergies. 27.5% have shortness of breath. 5% of individuals have a history of smoking. 15% of individuals are currently under the medication for asthma.
Conclusion: The present study results explained that wheezing without cold and shortness of breath are the most common respiratory symptoms during pregnancy. Further detailed studies with a higher sample size are recommended to understand better the respiratory symptoms during pregnancy.

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Background: In pregnancy, anaemia has a significant impact on the health of fetus as
well as that of mother. It is one of the leading causes responsible for maternal and
perinatal morbidity and mortality. The objectives of the study are to find out the effect
of severe anaemia on women in labour affecting maternal and fetal outcome.
Materials and Methods: This a prospective case control study undertaken in the
Department of Obstetrics and Gynaecology, Govt Maternity Hospital, Petlaburz
attached to Osmania Medical College, Hyderabad. The period of study was from 1st
December 2019 to 31st December 2021.There were a total of 160 study subjects, 80 cases
of severe anaemia (Hb<7gm %) and 80 non anaemic controls (Hb≥ 11gm %).
Results: Low socio economic status (86.25%), inadequate antenatal care (38.75%),
multiparity (71.25%) and no iron supplementation (52.5%) were associated with severe
anaemia cases. Microcytic hypochromic anaemia was more prevalent (76.25%),
suggesting nutritional inadequacies as a cause of anaemia. It was seen that the incidence
of preterm labour (22.5%), atonic PPH (2.5%), sub involution of the uterus (2.5%),
CCF (1.25%), abruptio placentae (1.25%) and maternal mortality (1.25%) was more in
cases of severe anaemia than in the control group. Adverse fetal outcome in the form of
preterm birth (22.5%), low birth weight babies (41.25%), IUGR (13.75%), birth
asphyxia (11.25%), and perinatal mortality (11.25%) was more in the anaemic group
than the controls.

Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved his genetic growth potential, regardless of fetal size (1) Worldwide FGR is observed in about 24% of newborns; approximately 30million infants suffer from FGR every year. The burden of FGR is concentrated mainly in Asia which accounts for nearly 75% of all affected infants. National neonatal perinatal database of India reported the incidence of FGR to be 9.65% among hospital born live birth infants. Study was conducted for all cases with clinical/ Sonological term FGR admitted under department of OBG. A detailed history as per questioner will be taken with general physical examination and investigations will be done as per requirement. The accumulated data was evaluated and statistically analyzed. In the present study 70 patients with term gestation with FGR were recruited. Maternal (74.28%) was the commonest cause followed by Idiopathic (11.43) and Placental (10%) and Fetal (4.29%) causes. Among Maternal causes Pre Eclampsia was found to be in 50% cases. Most of the patients (50.7%) required caesarean section. A total of 9 (12.86%) neonate had birth weight of <1.5 kg, 48.6% had Birth weight between 1.6 to 1.9kg, 38.5% had birth weight between 2-2.4kg and 95.8% had asymmetrical FGR, 4.2% were symmetrical. 26 (40%) neonates had morbidity with 17(24.3%) neonatal mortality with Respiratory distress syndrome (41.18%) being most common cause. No Maternal Mortality.

Background:Health & nutritional status of mother during & before pregnancy is
considered to be strongly associated with pregnancy outcomes. Poor nutritional status
& inadequate intake of food in pregnancy not only affect women’s health but also effect
birth weight & development of infant. The present study was conducting to analyse the
outcomes of maternal nutrition on infant's birth weight.
Material and methods: The present cross-sectional study was conducted among 350
pregnant women. Socio-demographic characteristics and obstetrics information of the
pregnant women were collected using pretested questionnaires. Anthropometric
measurements were carried out using appropriate measuring instruments. All statistical
analyses were performed using SPSS version 20. Multiple linear regressions analysis
was also performed to explore independent effects of maternal factors. A p value< 0.05
was considered to be significant.
Results: In this study, the mean weight and height of pregnant women were 63.25kg and
156.32cm, respectively. Overall, the mean pre-pregnancy BMI of the study participants
was 24.43kg/m2. The study also revealed that the mean weight gain of the mothers was
9.45kg, within the weight gain range of 4–16kg. The mean maternal hemoglobin level
was 11.76g/dL. Moreover, the mean total serum cholesterol level of the mothers was
187.32mg/dL. Maternal blood sample analysis also revealed that the mean total serum
protein level was 5.70g/dL, with 81.42% and 18.58% of women having total protein
level less than 6.7 g/dL and between 6.7 and 8.7 g/dL, respectively. In multivariate
linear regression analysis, birth weight was significantly associated with parity,
maternal BMI, weight gain during pregnancy, hemoglobin level.
Conclusion: The present study concluded that birth weight was significantly associated
with parity, maternal BMI, weight gain during pregnancy, hemoglobin level. Therefore,
nutritional status of the pregnant women should be improved to reduce the risk of low
birth weight.

Background: Measurement of serum free T4 concentrations and TSH is helpful in
assessing thyroid function. During the first trimester of pregnancy, free T4 levels
measured by analog immunoassays may be unreliable, as measurements using 2
different assays were not reproducible. The present study was conducted to assess
thyroid functions in early pregnancy.
Materials & Methods:
Results: Age group 18- 21 years had 28, 22-25 years had 25, 26- 29 years had 20 and 30-
33 years had 7 patients. Subclinical hypothyroidism was seen in 20, euthyroidism in 4,
overt hypothyroidismin 8, subclinical hyperthyroidism in 45 and overt hyperthyroidism
in 3. The mean TSH (mIU/l) in subclinical hypothyroidism was 4.31, in euthyroidism
was 1.48, in overt hypothyroidism was 10.32, in subclinical hyperthyroidism was 0.016
and in overt hyperthyroidism was 0.06. The mean FT3(pg/ml) level in subclinical
hypothyroidism, euthyroidism, overt hypothyroidism, subclinical hyperthyroidism and
overt hyperthyroidism was 4.08, 3.94, 1.54, 4.2 and 7.52 respectively. The mean
S.FT4(ng/dl) level in subclinical hypothyroidism, euthyroidism, overt hypothyroidism,
subclinical hyperthyroidism and overt hyperthyroidism was 1.20, 1.28, 0.48, 1.6 and 4.2
respectively.
Conclusion: The high prevalence of thyroid disorders in pregnant women makes it
necessary to screen all the pregnant women in early pregnancy.

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Background: The present study was conducted with the aim of assessing the outcome of pregnancy complicated by fibroid uterus.
Materials & methods: 50 subjects with presence of fibroid uterus were enrolled. Complete demographic details of all the patients were obtained. Assessment of the increase in the size of the fibroid and degeneration and other obstetric complications was done. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. 
Results: Pain abdomen was found to be present in 18 percent of the patients, while spontaneous miscarriage occurred in 6 percent of the patients. Postpartum occurred in 8 percent of the patients while threatened preterm labor occurred in 6 percent of the patients.
Conclusion: Fibroid uterus increases the risk of associated complications.

Background:To determine the number of women with asymptomatic bacteriuria
(Group A) and the number of women with symptomatic bacteriuria (Group B) (Group
B). To identify the most common pathogenic organism in women with asymptomatic
bacteriuria. To compare the outcomes of pregnancies in groups A and B (maternal and
foetal morbidity).
Materials and Methods: Pregnant women visiting the antenatal clinic of the Department
of Obstetrics and Gynecology in Govt Medical College/General Hospital Suryapet for
the first time in 20 weeks to 36 weeks were the subjects of this prospective study.
Results: The study included 250 pregnant women starting at 20 weeks of gestation.
Urine culture and sensitivity testing were performed to check for asymptomatic
bacteriuria. Asymptomatic bacteriuria was found in 8.8 percent of the study population.
E.Coli was the most common pathogen, accounting for 63.63 percent of all cases.
Asymptomatic bacteriuria was associated with increased maternal morbidity (18.18
percent ). Those who did not have asymptomatic bacteriuria had lower morbidity (9.1
percent ). Fetal morbidity was higher (21.4 percent) in kids whose mothers had
asymptomatic bacteriuria than in those whose mothers did not have silent bacteriuria
(9.3 percent ). Preterm labour was the most prevalent maternal morbidity (18.18
percent), while low birth weight was the most common foetal morbidity (18.18 percent ).
There was no maternal or foetal death.

Objective: To study the Feto maternal outcome of Covid-19 in Pregnancy.
Methodology: This is a retrospective study done on 53 pregnant patients who tested positive
for SARS-CoV-2 and were delivered in D. Y. Patil Hospital, Kolhapur from April 2020 to
July 2020. Maternal and fetal characteristics and the outcome of Covid-19 infection in
pregnancy was studied.
Results: Among the 53 patients, 49 patients (92%) were asymptomatic. Remaining presented
with fever, sore throat, cough. 69% were primigravida and 30% were multigravida. 66%
underwent LSCS while 28% were delivered normally. In majority, LSCS was done for
oligohydramnios and fetal distress. All the patients were discharged after negative swab
report and no maternal death was reported. About 32% of neonates required NICU admission
for hyperbilirubinemia, pneumonia and sepsis. There was no neonatal death and none of the
neonates turned out to be positive for covid-19.
Conclusion: The severity of SARS-CoV-2 was seen to be mild to moderate in pregnant
women. Majority of the women infected with coronavirus disease were asymptomatic. The
risk of vertical transmission to the neonate was also found to be low. Oligohydramnios and
fetal distress were commonly seen in the patients, pointing towards the lack of antenatal
follow up visits due to restricted mobility in the covid era.

Background: Elevated levels of maternal serum alpha-fetoprotein are associated with pregnancy complicated by Pre-eclampsia, placental abruption, placental infections, chronic villositis, low birth weight and preterm labor. The present study investigated the possibility that maternal serum alpha-feto-protein can be used to predict the pregnancy outcome as a routine test.
Materials & Methods: 250 patients in the Postgraduate Department of Gynaecology and Obstetrics, Lalla Ded Hospital, Government Medical College Srinagar, over a period of one year were assessed for maternal serum alpha-fetoprotein by human serum by microplate immuno-enzymometric assay by EIA-AFP kit.
Results: Age group 20-23 years had 31, 24-27 years had 80, 28-31 years had 104 and 32-35 years had 35 patients. The mean of the maternal serum alphafeto protein (overall) was 65.32+33.95. The mean of the maternal serum alphafeto protein in pregnancies with normal outcome was 53.47+25.65. The mean of the maternal serum alphafeto protein in pregnancies with adverse outcome was 92.96+34.99. 4 (1.6%) patients out of 250 developed low- lying placenta. 2 out of 4 had raised values of maternal serum alpha-fetoprotein. 6 patients out of 250 had still birth. 4 out of 6 had raised values of maternal serum alpha-fetoprotein. 19 (7.6%) patients out of 250 had low birth weight babies. 18 had raised values of maternal serum alpha-fetoprotein. 12 (4.8%) patients out of 250 had intrauterine growth retardation (IUGR) of babies. 11 had raised values of maternal serum alpha-fetoprotein.
Conclusion: There is no relation between preterm rupture of membranes, low lying placenta and still birth with raised levels of maternal serum alpha-fetoprotein. It is easily done and is cost effective.

Background: Pre-pregnancy obesity is strongly associated with certain pregnancy
complications and perinatal conditions. Placental structure and function are important
for maternal and fetal health both during and after pregnancy. The aim of this study to
evaluate the effect of prelabour body mass index on the mode of delivery.
Materials and Methods: An hospital-based prospective study involving pregnant women
at term (33-37 weeks) admitted to gynaecology ward in district hospital Dholpur,
Rajasthan, India during one-year period. A total of 120 cases in the age group of 18-40
years included in the study. Patients were classified into 3 categories based on their first
trimester BMI. Category I included normal women (BMI 20- 24.9 kg/m2), Category II
included overweight women (BMI 25-29.9 kg/m2) and detailed history and clinical
examination including general physical, obstetrical and systemic examinations.
Category III included obese women (BMI >30 kg/m2). Data were analysed statistically
by Chi-square test of the dependence of variables and a p-value of less than 0.05 was
considered as statistically significant.
Results: Under anthropometric parameters, the differences in mean age, mean weight,
mean height and mean BMI among the three categories women were statistically
significant (p<0.001**), In this study, it was observed that overweight and obese women
were slightly older and short in stature when compared with women with normal BMI.
There was increased incidence of antepartum complications in Category III women as
compared to Category II and Category I women. The difference in the onset of labour
as well as mode of delivery among the three categories was statistically significant
(p<0.05*).
Conclusion: As obesity is a modifiable risk factor all attempts should be made to
maintain a normal BMI in women of childbearing age. Pre–pregnancy counselling,
health programme and appropriate multidisciplinary management should be done.

Pregnancyisatransitoryphysiologicalstatewhichcarriesdifferenthormonalchangesinawoman’sbody.Theseeffectsaregeneralizedandincludingvariousoralchangesaswell.Thereareamanyimportantalterations in the periodontal conditions within the oral cavity. These changes have significant consequences as theyhavebeenknowntocausenegativepregnancyoutcomes.Betterknowledgeaboutthesescenariosamonghealthcare professionals and women would go a long way toward avoiding or minimizing these adverse outcomes.Healtheducationisanimportanttoolincreatingawarenessamongpregnantwomenregardingimprovementoftheiroralhealth.Awarenessamongthehealthprofessionalsandgoodinter-departmentalcollaborationwouldhelptowardamoreefficienttreatmentofthesepregnanciesrelatedconditions

Background &Method: To evaluate the maternal outcomes through ABG index and its
influence on new-borns through Apgar scoring. Role of arterial blood gas values and their
implications to patient management.A total of 130 women with PIH syndrome were treated in
Department of Obstetrics and Gynaecology of IMCHRC, Indore, over a period of 12 months
Result:In this study, 66.10% PIH patients improved by conservative management, whereas
33.88% required ventilatory support of which 5.08% died on mechanical ventilation.
Amongst which maximum patients which succumbed showed decompensated metabolic
acidosis at 0 hr ABG.In this study, the mean pH value, PO2, HCO3 in severe PIH cases were
lower than the mild PIH cases, whereas the mean PCO2 and BE levels in severe PIH cases
were higher than the mild PIH cases. Therefore, with the exerbation of the disease,the
differences of indexes from normal values became larger.

Background: Severe acute maternal morbidity has long-term ill effects on socioeconomic
condition and health of the females including excessive financial burden post-treatment
which may last lifelong to the desertion of females after hysterectomy considering the
inability to reproduce.
Aims: The present clinical trial was carried out to assess the incidence and various causes
leading to SAMM. Also, the trial was aimed at factors associated with the instance of nearmiss
cases or SAMM.
Materials and Methods: 82 SAMM cases and 4 maternal deaths were evaluated based on
the WHO criteria. The data were maternal deaths, demographic data, complications
encountered, gestational age at the time of SAMM, SAMM event time from admission
time, ICU admission, and associated organ failure/dysfunction. The collected data were
subjected to statistical evaluation and the results were formulated.
Results: Maternal death resulted from abdominal pain in 75% (n=3) and breathlessness in
25% (n=1) female. The disorders associated with SAMM were surgical cause,
haemorrhage, hypertension, indirect causes, and medical conditions respectively in 1.21%
(n=1), 32.92% (n=27), 63.41% 9n=52), 2.43% (n=2), and 18.29% (n=15) females. The
etiology of 4 deaths was due to 50% (n=2) deaths each from cardiac and respiratory
etiology in females with the gestational age of 30.10±2.14 weeks and 25.7±1.3 years of age.
Near-miss cases were 34.14% (n=28) due to compromised transport facility.
Conclusion: The present study concludes that severe acute maternal morbidity affects
significant females and is the leading cause of maternal death. The most common factor
associated with SAMM is in the present study was hypertension leading to morbidity
followed by hemorrhage, whereas, leading causes for morbidity were respiratory and
cardiac causes.

Background &Method: The present study was conducted with an aim to study incidence of patients with recurrent pregnancy loss with respect to antenatal patient &to identify the various etiological factorsin the Department of Obstetrics and Gynecology, M.G.M Medical College and M.Y Hospital, Indore. In this period 14564 antenatal patients were admitted both in routine and emergency hours of which 5660 were high risk pregnancies. 89 patients had recurrent pregnancy loss. Of these 62 patients selected. These patients were randomly selected including all age groups, parity, socioeconomic and educational status.

Aim: To determine the demographic profile of pregnant females with COVID-19 infection.
The outcome and prognosis in pregnant women with COVID-19 infection was also
evaluated.
Method and material:The study included 38 pregnant women with COVID-19 infection and
hospital admission for at least 24 hours. Cause of admission was classified as obstetric and
COVID-19-related. All the patients were COVID positive and were referred from other
centres/ hospital to this facility andwas admitted to this hospital for delivery. Primary
outcomes included maternal admission to intensive care unit (ICU), COVID-19 pneumonia,
maternal mortality. The information on socio-demographic factors, pre-gestational chronic
diseases (including cardiac, renal, endocrine, psychiatric, hematologic and autoimmune
disease, cancer and HIV)and mode of delivery was collected.
Results:The mean age of the patients was 28.8±6.2 years. The mode of delivery for
60.5%patients(23) was normal vaginal delivery and lower segmentcaesarean section in
39.5%(15) patients.94.7%(36) patients were asymptomatic in the present study. Maximum
patients in the present studywere hospitalized for 3-5 days.
Conclusion: COVID-19 infection was associated with higher rates of caesarean section in
pregnant women. However, COVID-19 cannot be considered as an indication for
caesareansectiondelivery. Patients with increased age have more days of hospitalization than
younger patient.

GENERALIZED DLE: Patients with generalized discoid lupus erythematosus are at a higher risk of progressing to systemic disease than those with a localized variant. Pregnancy is one of the factors that can trigger lupus erythematosus. There are only one case report published in online search that presented generalized discoid lupus erythematosus in pregnancy. We report a case of 24 year old female patient with 31-32 weeks of gestational age complained blackreddish patches accompanied by fine scales, slightly itchy and a little painful on the forehead,
cheeks, bridge of the nose, chin, ears, neck, chest, stomach, back, upper and lower extremities since ± 2 months before. ANA profile with positive result. The results of histopathologicaland dermoscopyexamination suitable with discoid lupus erythematosus. Results of the internal medicine department revealed a diagnosis of systemic lupus erythematosus. CONCLUSION:Management of DLE aims to improve general condition of patient, control the lesions, prevent of the development of further lesions; fetal growth abnormalities; preterm birth; neonatal lupus and fetal death.

To evaluate the maternal, fetal and neonatal complications in pregnant women with Covid-19 infection. Setting and design: A prospective descriptive study was carried out in Basrah Teaching Hospital, Iraq during the period 15/3/2020 till 1/11/2020. There were 135 infected pregnant women with Covid-19. The maternal information's were obtained included Age, parity, residence, travel history, gestational age at time of diagnosis. The pregnancy measures of interest were evaluated according to the severity of the disease, medical disease, history of antepartum hemorrhage, mode of delivery, type of delivery, post-natal complication and admission to
intensive care unit and maternal death. The neonatal outcomes of interest were fetal weight, neonatal Apgar
score, admission to neonatal intensive care unit and neonatal death. Results: The mild type of the disease was common (41.48%) in comparison to severe conditions (17.77%).

Purpose: To study indicators of central and peripheral hemodynamics in pregnant women with obesity of varying severity at a gestational age of 36-38 weeks.
Materials and Methods: To study hemodynamic parameters (heart rate, SDD, UI, SI, OPSS, CR, LVMI) in pregnant women with obesity of varying severity, 127 pregnant women (I, main group) aged from 23 to 34 years were selected obesity of varying severity with gestational age 36-38 weeks. The second (control) group consisted of 28 pregnant women of the same age and gestational age with normal body weight (body mass index from 19 to 24.9 kg / m2). The groups were identical in age, gestational age, which allowed for an objective and comparative assessment.

There are still many pregnant women and their families who are unable to do early detection of high risk pregnancies. The purpose of this study was to develop a family empowerment model for the early detection ability of high-risk pregnancies.An explanatory survey research with a cross sectional study approach. The study population was the family of pregnant women in the Surabaya area who were taken using the rule of thumb with a sample size of 120 respondents using systematic random sampling. The latent variables in this study are personal factors, cognitive behavior, resource factors, interpersonal, basic values (Fillial Values), commitment, and family ability in early detection of high risk pregnancies, as measured by using a questionnaire. Latent variables that affect family empowerment consist of data analysis using Structural Equation Modeling (SEM) -Partial Least Squares (PLS).The results showed that the family empowerment model for the early detection ability of high-risk pregnancy was a fit model. This refers to the results of the goodness of fit test. Personal factors towards interpersonal (T statistics = 10,301; P = 0,000), interpersonal towards Fillial Value (T statistics = 13,501; P = 0,000), Fillial Value for commitment (T statistics = 9,495; P = 0,000), family commitment to early detection ability of high risk pregnancy (T statistics = 3,840; P = 0,000).The results of this study provide information about family empowerment models in high-risk pregnancies so that they can be used as a reference in preparing midwifery care plans in cases of maternal emergencies for high-risk pregnant women.

Background:Gestational diabetes mellitus (GDM) becomes common cases over the globe. GDM prevalence is counted as 1-3% out of all pregnancies in the west and 90% of them are complicated by diabetes. GDM is related with the increasing of maternal risk and short-time or long-term perinatal complication.GDM incidents in Indonesia are identified around 1,9-3,6% and around 40-60% women, who ever experienced with GDM, on the further observation after labouring will have diabtes melitus or glucose tolerance disorder. This research is aimed to identify the mother’s experience in GDM self-management.
Methods: This research is a qualitative research with phenomenology approach. This research was conducted on October 2018 – June 2019. The data were collected by employing interview that supported by documentation study over 8 mothers who had GDM interview and 3 midwives in charge at the KIA poly service. The data were analyzed by using thematic analysis.
Results: Qualitative analysis resulted five themes that cover nutrition management, education, glucose monitoring, sports and medication. The results showed that pregnancy mother tried to control the eating pattern as suggested by the health-workers. The mothers should conduct routine glucose controlling, perform physical activity, such as regular walk, perform house works or pregnancy workout. The appropriate medication during the pregnancy involves insulin.
Conclusion: This research reveals mothers’ experiences in GDM self-management in terms of lifestyle. The result of the research could be a valuable guidance in developing comprehensive self-management service, by considering more on mother’s self-management. The necessities of more effective GDM counceling is required to ensure clear understanding about principal self-management for pregnant mothers, hence it could help mother in enhancing adaptation and ability in dealing with GDM. Besides, it could increase the alert towards the risks on pregnancy with diabetes mellitus. Hence screening examination on diabetes melitus.
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This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This This This research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 – June 2019. June 2019. 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The da The da ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected by by employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis.Results:Results:Results: Results: Results: Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resulted five themes five themesfive themesfive themes five themesfive themesfive themesfive themes that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy mother tried mother tried mother tried mother tried mother tried mother tried mother tried mother tried mother tried to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating pattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the health pattern as suggested by the health-workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin.Conclusion:Conclusion: Conclusion:Conclusion: Conclusion: Conclusion:Conclusion: This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self -management in termmanagement in term management in term management in termmanagement in termmanagement in termmanagement in term management in termmanagement in term s of lifestyle. of lifestyle. of lifestyle. of lifestyle. of lifestyle. of lifestyle. The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing comprehensive selfcomprehensive self comprehensive self comprehensive selfcomprehensive selfcomprehensive selfcomprehensive selfcomprehensive self comprehensive selfcomprehensive self comprehensive self -management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self -management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear underunderunder understanding about principal self standing about principal selfstanding about principal selfstanding about principal self standing about principal self standing about principal self standing about principal self standing about principal self standing about principal selfstanding about principal selfstanding about principal self standing about principal selfstanding about principal self standing about principal self -management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help management for pregnant mothers, hence it could help mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDMmother in enhancing adaptation and ability dealing with GDM mother in enhancing adaptation and ability dealing with GDM. 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Besides, it could increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with increase the alert towards risks on pregnancy with diabetes mellitus diabetes mellitus diabetes mellitusdiabetes mellitusdiabetes mellitus diabetes mellitus diabetes mellitusdiabetes mellitus. Hence screening Hence screening Hence screening Hence screening Hence screening Hence screening Hence screening Hence screening Hence screening Hence screening examination on xamination on xamination on xamination on xamination on xamination on xamination on xamination on diabetes melitus. diabetes melitus. diabetes melitus.diabetes melitus. diabetes melitus.diabetes melitus.diabetes

Purpose:This study was aimed to analyze the correlation of food security status and household food expenditure to nutritional status on pregnant women.This study was aimed to identify the significant effect of the determinants factor of maternal health and incidence of maternal death.
Research Methodology:This study was an observational study with cross sectional design, Thisstudy was conducted in Province Lampung, Indonesia, in 2020. Population of this research consisted of situation maternal health in provience Lampung. Sampel in this study are report of bacis health and SDGs series: districts/city readiness from 13 districts and 2 cities in Province Lampung. The studied indicators either were evaluated of environtment, health behavior, and health service for ech districts/city. Data was collected and then analyzed using SmartPLS application.
Results:The environment determinant in this study was determined to water quality and sanitation. Health behaviour determinant indicator was assessed by ANC adherence and labor operator while indicator of health service determinants were access of health service, care of maternal complication, health insurance. All of determinants have significant correlation to maternal health by T- value and p value were (T= 2.201 ; p= 0.028), (T= 2.467 ; p= 0.012), (T=2.737 ; p=0.006), respectively dor environment, health behaviour, and health service determinants. Refer to the result above which are schematized in Figure 1, it can be learned that environment, health behavior and health services present strong effets to maternal health.
Conclusion:This study results show clearly there are correlation of variable determinants; environment, health behavior, and health service to affect maternal healthby the pathways.

BACKGROUND: The primary function of amniotic fluid is protection of the growing foetus while providing nutrition. A considerable amount of research has been conducted to evaluate interventions to improve amniotic fluid index and the subsequent impact on foetal growth restriction and oligohydramnios. However, there isn't any conclusive evidence hence this study aims to compare the effect of oral amino acid supplements and intravenous infusions in pregnancies with oligohydramnios and foetal growth restriction. 
AIM: To compare the effect of oral amino acid supplementation vs intravenous amino acid infusion on amniotic fluid index and perinatal outcome in pregnancy complicated by oligohydramnios and foetal growth restriction
OBJECTIVES: To compare the effectiveness of oral amino acid supplementation vs intravenous amino acid infusion in pregnancy having oligohydramnios and foetal growth restriction. To study the increase in amniotic fluid index in pregnancy with foetal weight gain. To study the interval growth rate of baby after two weeks and four weeks of therapy.
MATERIAL AND METHOD: This Semi experimental study will be conducted in Department of Obstetrics and Gynaecology, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha. A total of 104 clinically and sonographically proven cases of foetal growth restriction & Oligohydramnios in third trimester attending antenatal clinic or admitted in wards, fulfilling the exclusion and inclusion criteria will be comprise the study groups. After providing oral supplements or intravenous infusions arbitrarily, repeat ultrasonography will be done after two weeks and four weeks of therapy.
EXPECTED RESULTS: We compare from our results the effect of oral amino acid supplementation vs intravenous amino acid infusion on amniotic fluid index and perinatal outcome in pregnancies complicated by oligohydramnios and foetal growth restriction.

This article details the condition of newborn babies from mothers with epilepsy.
The frequency and nature of epilepsy in children born to mothers with epilepsy are
described. Risk factors for the development of epilepsy in children born to mothers with
epilepsy were determined.

Background: A sudden decline of renal function occurring during pregnancy or postpartum is defined as Pregnancy-related acute kidney injury (PRAKI) includes all the causes not only the obstetric one. The incidence and etiology of PRAKI varies greatly between different regions. Data for the prevalence and prognosis cannot be interpreted without taking into account the geographic and economic context of the country in which they have been obtained. In developed countries, obstetric AKI has become a rare complication of pregnancy. However, in developing countries, AKI remains a frequent and grave complication of pregnancy. Aim: to demonstrate the demographic, clinical and laboratory characteristic of the pregnant women with AKI. Materials and Methods: A Cross-sectional study was carried out among pregnant women who were admitted to obstetrics & gynecology department in collaboration with nephrology unit in internal medicine department during a six months. This study is a part of a large study on the prevalence and outcome of AKI in pregnancy by the same authors in the same center that will be published soon. The demographic, clinical and laboratory data was obtained and analyzed
Results: During the period of the study, a total of 4130 obstetric cases were admitted to the hospital. In total, 33 patients met the diagnostic criteria of pregnancy related acute kidney injury. The mean age of the patients was 29 ± 4.58 years, and gestational age was 31.46 ± 6.34 weeks. Eleven of the 33 women (21%) were primiparous and twelve of them (79%) were multipara. There was a significant findings between the patients who were suffering from hypertensive disorders of pregnancy (Group 1) and who didn’t suffer (Group 2) as regarding low hemoglobin level and low arterial blood pressure and in group 2, while group 1 showed higher uric acid level and low albumin level with a significant finding.

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

Pregnancy-reference levels of Subclinic hypothyroidism (SCH), along with normal level of serum thyroxine, are called high thyroid stimulation hormone level (TSH).
Autoimmune Thyroiditis is also common in patients of subclinical hypothyroidism. Subclinical Hypothyroidism in pregnancy is the cause of some adverse obstetric consequences. Changes in the metabolism of thyroid hormones during pregnancy needs to be kept in mind, while diagnosing thyroid abnormalities. There is a jump in the obstetric and neonatal results, like preterm delivery, miscarriage, fetal growth restriction, preeclampsia, gestational diabetes mellitus, low birth weight, abruptio placentae and poor Apgar scores at birth. Treatment with Cevothyroxine therapy may help reduce some of these adverse effects, however there is restricted evidence to provision it. The behavior of subclinical hypothyroidism should target maternal TSH concentrations of less than 2.5mIU/L. However there is a lack of recommendation for the official starting dose of levothyroxine. So, individualised low doses of levothyroxine can be started and thereafter titred to the maintain the TSH in the target level

The aim of our study was to retrospectively examine the history of childbirth and the quality of primary care for bleeding and evaluate the prescribed rehabilitation measures for women who have suffered postpartum hemorrhage and massive bleeding. The materials and methods of the study were 242 birth histories with postpartum hemorrhage for the last 6 years (2013-2018) in the city maternity hospital of Bukhara. The average age of the patients was 26.7 ± 1.2 years. The obstetric pathology leading to bleeding mainly consists of uterus hypotonia - 143 (59.1) and large fetus - 68 (28.1), and preeclampsia and DIOV are equal amounts - 33 (13.64). Only about 20% of women who had postpartum hemorrhage underwent early rehabilitation in the form of prescribing contraceptives.The aim of the research was to study the effectiveness of modern principles of stopping postpartum obstetric bleeding. From 127 cases of bleeding in 101 women (79.5%) the childbirth were with the operational method. With the development of blood loss was renderedstepwise ways to stop bleeding. During hemostasis of the bleeding, ligatures were imposed on the ovarian arteries and the ascending branch of the uterine artery for ischemicization of the uterus, which was effective in 30 (30%) women, and in 114 (89.7%) women managed to achieve organ-sparing tactics.

Purpose:This study was aimed to analyze the correlation of food security status and household food expenditure to nutritional status on pregnant women.
Research Methodology:This study was an observational study with crossectional design, conducted in PuskesmasWonosobo, Lampung Province, Indonesia on May 2020 - Augustus 2020. All of pregnant women who get Antenatal Care (ANC) on Puskesmas were carried out as samples. Food security status and household food expenditure data were measure by anamnesis and questionnaire. Nutritional status was asses by mid-upper arm circumference (MUAC) of pregnant women. Data was collected and then analyzed using SPSS 21 application.
Results:A total of 53 pregnant women, with age distribution on range of <18 years &>35 years (20 women) and 20-35 years (33 women) were analyzed in this study. Statistical analysis (Chi-Square) show the pregnant womens in malnutrition status with food insecurity were 3 women (75%) while pregnant women in good nutrition status with food insecurity only 3 women (6.1%) (p = 0.003). Correlation between house hold expenditure to nutritional status was analyzed by chi-square test, the result show all of pregnant women in malnutrition status (4 women) have lower house hold expenditure (p = 0.001).
Conclusion:This study clearly shows that more food security and level of household food expenditure will affect on nutritional status of pregnant women.

Objectives: This paper points to verify the influences of motherly exposure the basic air depressions off infant mortality. For further investigation of these relationships, we used vital registry data to retroactively build (2907) deaths occurred between 2009 and 2013 at Children's Medical City Hospital for children younger than one year and (1167) of them less than a month Previous investigates have concerned air contamination in raised mortality and disease, mainly in the aged populace and childish person. Extra in recent times, relations with death in newborns then through several generative reproductive effects have also been registered
The purpose from such study is to analysis the relationship relating revealing to open-air pollution for the period of gestation then infant mortality, airborne contamination is linked to poor pregnancy.
Elevation indication has exposed that population’s physical and mental health be able to be influenced air study by several contaminations.
Then, this investigate
Purposes to examine the correlate between air pollutions (O3, SO2, NO2, CO, Pb, PM2.5 or PM10) and Born prematurely. For the interval period (2009-2013).
Method: Totally Infant mortality information besides child birth information since (first January 2009 to end December 2013) be there recorded Children’s Hospital in Medical City in Baghdad Iraq
And Daily data on air quality from The Iraqi Ministry of Health and the Environment, The reality of the environment report (2010 ...) report on the status of the status of the Iraqi Environment

Abstract. The aim of this study was to examine the impact of obesity in pregnant women in
the development of preeclampsia. All women were divided into 2 groups: the study group
included women with obesity (n=120) and the control group of pregnant women with
physiological course of pregnancy without obesity (n=60).

Pregnancy conceived with assisted reproductive technologies (ART) has a higher risk of maternal and perinatal complications, and the overall risk of adverse outcomes requiring extended obstetric care has not been thoroughly studied. The review is devoted to the actual problem of the health status of children born after IVF. A systematic review of the health indicators of children conceived with IVF after the neonatal period was carried out versus natural, conceived.

Abstract. Insufficient supply of pregnant women with micronutrients leads to the
development of a number of congenital malformations of the fetus. In order to study the
multivitamin-mineral complexes application’s effect on pregnant women during
pregnancy, and on intrauterine fetal growth and development. Was revealed that a
deficiency of bioelements and vitamins in mothers is a common cause of intrauterine
growth retardation, serious violations of organs and systems functioning. So, it is indicates
integrated approach significance in the treatment of microelementosis in pregnant.

Study objective is to study the influence of early pregnancy BMI on neonatal birth weight. To Study the association between gestational weight gain and neonatal birth weight. An observational correlational study, consisting of 1031 pregnant women, with singleton uncomplicated pregnancy, booked at Krishna Institute of Medical Sciences, Karad before 12 weeks of pregnancy, conducted between June 2014 to December 2015. After getting written informed consent from the patient, patients included in the study. Those who developed any complication during the study were excluded. With rising BMI, weight gain in pregnancy is greatly increased. Maternal pregnancy BMI has a positive association with the birth weight of neonatal. Lower BMI is significantly linked to a relatively low weight gain lower birth weight.

Background: In new pandemic, the probable effects of COVID-19 pneumonia on pregnant woman and their infant is one of new critical challenge for health care. Here we presented clinical symptoms, laboratory findings and outcome of COVID-19 pneumonia in pregnant woman. Methods: In a case series study, from 15 Feb to 15 June 2020, all women with RT-PCR COVID-19 who referred to two hospitals (Taleghani and Qods Hospital) affiliated to Arak University of Medical Sciences were selected. The epidemiological and demographic variables, laboratory test and outcomes obtained from patient’s medical records. Results: In this case series, we presented thirteen confirmed COVID-19 pregnant women. Their mean age was 34.6 (S.D.: 5.9) years and the mean gestational age was 32.4 (S.D.: 7.3) weeks. Most of patient didn’t show any maternal complication and intrauterine vertical transmission. The large number of pregnant women had normal HRCT and also in terms of laboratory most of the patients had normal laboratory tests. Amniotic fluids, cord blood, the throat swab of neonate in our pregnant woman with delivery were tested for COVID-19 and all of them were negative. Conclusion: The COVID-19 mothers and their infant didn’t have higher risk for morbidity and mortality and this virus didn’t associate with intrauterine vertical transmission.

This study was undertaken to determine the effectiveness of two anti-hypertensive drugs: oral Nifedipine and oral Labetalol in cases of extreme preeclampsia in terms of their side effect profile, BP regulation, time taken to lower BP, and number of doses required. The objective of the study was to calculate the time required to reduce the blood pressure to the target level of 90 / 100 mmHg diastolic and less than 160mmHg systolic.In the labetalol group the mean SBP before treatment was 158mm of Hg which was reduced to 140 mm of Hg. The decline rate in the labetalol group was 11.77%. This study proved that labetalol reduces the BP more effectively than nifedipine and also has minimal side effects with less frequent dosing schedule as compared to nifedipine thus indicating that labetalol is better than nifedipine in lowering the BP in cases of preeclampsia.