Eclampsia: its association with thyroid inadequacy: case of pregnancy in a woman suffering from myxoedema

In discussing eclampsia, it is well to note that people are not even agreed as to what ought to be defined as eclampsia. The reason is not far to seek. So far as we know there is no exact pathological cause agreed upon by everyone as the always present determining lesion.I shall take as my definition "The occurrence of epilepti-form fits during pregnancy, labour or puerperium, with the presence of albumin in the urine"Cases are recorded where no albumin has been present and still classified as eclampsia. It is doubtful if these cases ought not to have come under a different heading, e.g. cases of epilepsy; or the albumin might have been so small in quantity as to be overlooked.n the first part of this thesis I shall deal with the pathological appearances of the different organs in eclampsia, referring incidentally to theories advanced explaining the different lesions.Until recently the kidney received most attention as being the prime factor in eclampsia, but with more recent observations it has become evident that the kidney is only one of the many organs showing changes in this obscure disease.Unfortunately autopsies on subjects dying fro eclampsia have not been very frequently carried out in this country, but from those which have been done, and from reference to others, fairly definite appearances are noted

Dyslipidemia is a persistent problem in puerperium with or without preeclampsia.

Purpose of investigation: To compare serum levels of triglycerides and cholesterol and the dyslipidemic factor (DLF): (triglycerides (mg/dl)/150) X (cholesterol (mg/dl)/200) among puerperal women with or without preeclampsia. Materials and Methods: three groups of puerperal women were formed: group A uncomplicated deliveries, group B deliveries complicated with preeclampsia that had not attended the Obstetric Intensive Care Unit (OICU); and group C puerperal women complicated with preeclampsia and that had attended the OICU. Results: The authors studied a total of 47 puerperal women, 14 without complications, 11 complicated with preeclampsia, and 22 complicated with preeclampsia requiring attention at the OICU. Thirteen (92.8%) puerperal women without complications and 100% of puerperal women complicated with preeclampsia had triglycerides higher than 150 mg/dl at least three days post-delivery. Furthermore, six puerperal women without complications (42.8%), one puerperal woman complicated with preeclampsia (9%), and eight puerperal women complicated with preeclampsia requiring attention at the OICU (36.3%) had levels in crescendo. Conclusions: Hypertriglyceridemia is a persistent problem in puerperal women who suffered preeclampsia and the DLF could be a useful tool to evaluate a mixed lipemic state. Finally, preeclampsia and dyslipidemia might be considered as risk factors to develop chronic endothelial disease (CED)

A one year prospective study of acute renal failure in pregnancy and its maternal and fetal outcome

Background: Pregnancy related acute renal failure is still common in developing countries.  This study is aimed to evaluate the etiological factors responsible for ARF in pregnancy, and, maternal and fetal outcome of this condition. It contributes upto 20-22% of the referrals to higher centers and is associated with high risk of maternal mortality (9 to 55%) in developing countries. Methods: This is a prospective study carried out at M. R. medical college and Basaweshwara teaching hospital, Kalaburagi (Gulbarga), for one year from January 2017 to December 2017. Results: A total of 38 patients were hospitalised with renal failure in pregnancy. Majority of the patients (73.68%) were multigravida. Eclampsia (42.10%) and severe post-partum hemorrhage (21.05%) were the most common causes of acute renal failure in late third trimester and in post-partum period. Edema (65.78%) and oliguria (50%) were the most common presenting complaints. Most cases (73.68%) responded to diuretics and IV fluids. 21.05% required dialysis, 39.47% needed ICU admissions. Maternal mortality amounted to 13.15%. Fetal IUGR (18.42%), preterm delivery (13.15%), fetal distress (10.52%), NICU admissions (15.78%), and still births (7.89%) were noted. Conclusions: Pregnancy related acute renal failure is still high in developing countries. Good antenatal care, correction of anaemia, early diagnosis and management of pre-eclampsia, good transport facilities to shift to tertiary care centers are essential requirements to reduce maternal and fetal mortality and morbidity due to acute renal failure in pregnancy