Placenta previa: risk factors, feto-maternal outcome and complications

Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.Methods: All This is a retrospective study of 88 cases of placenta previa, which were admitted under department of obstetrics and gynecology in our institute during July 2017 to June 2019. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by ultrasound examination. Outcome measures prevalence of placenta previa, maternal and neonatal outcomes, and case fatality rate.Results: The total number of deliveries performed during the study period was 16330, of them, 88 cases were placenta previa. Thus, the prevalence of PP was 0.53%. Multiparity was one of the etiological factors in 84.09%, whereas previous LSCS was 47.73%, previous H/O D and E was 14.73%, previous H/O placenta previa was 7.95%. Obstetric hysterectomy was done in 7 (7.95%) patients out of 88 patients. 92.04% of patients delivered with cesarean section and 7.95% patients delivered with normal vaginal delivery. 22 (26.50%) babies out of 83 live born were admitted in NICU.Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta previa remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. Measures to reduce the primary caesarean section rate should be adopted

Comparative study of intra vaginal misoprostol (PGE1) with intracervical dinoprostone (PGE2) gel for induction of labour

Background: Labour is a final consequence of Pregnancy and is inevitable. The timing of labour may vary widely but it will happen sooner or later. The aim of the present research was to study the safety, efficacy and effect of intra vaginal Misoprostol and intra cervical Dinoprostone gel for induction of labour.Methods: 100 patients who required labour of induction were included in this prospective cross-sectional study from September 2017- March 2018. 50 patients of them received 25mcg tablet misoprostol intravaginal and 50 patients of them required 0.5mg intracervical dinoprostone gel and doses were repeated every 6 hourly for up to maximum 6 doses for Misoprostol and 3 doses for Dinoprostone gel.Results: The majority of patients had gestational age above 40 weeks and between 37-40 weeks in PGE2 and PGE1 group respectively. The mean time taken for the onset of labour was less in Misoprostol than in Dinoprostone group (43.22min v/s 1 hr40 min). The mean time taken for induction to active phase of labour (1hr 42min v/s 4hr 10min) and active phase to delivery (3hr 6min v/s 4hr54min) was less in Misoprostol than Dinoprostone group. The mean time required for induction to delivery was less in Misoprostol group (5hr 2min v/s 11hrs). Requirement of oxytocin for augmentation of labour was almost equal in both groups. Caesarean section rate was less in Misoprostol group (10% v/s 22%). Maternal side effects were minimal in either groups and neonatal outcome was good in both the groups.Conclusions: Both Misoprostol and Dinoprostone gel are safe, effective for cervical ripening and induction but Misoprostol is more cost effective and stable at room temperature

Detection of Landmine Signature using SAW-based Polymer-coated Chemical Sensor

The explosive charge within a landmine is the source for a mixture of chemical vapours that form a distinctive chemical signature indicative of a landmine. The concentrations of these compounds in the air over landmines is extremely low (parts-per-trillion or lower), well below the minimum detection limits of most field-portable chemical sensors. This paper describes a portable  surface acoustic wave-based polymer-coated sensor for the detection of hidden explosives. The sensitivity and selectivity of polymer-based sensors depend on several factors including the chemo-selective coating used, the physical properties of the vapour(s) of interest, the selected transducers, and the operating conditions. The polymer-based sensor was calibrated in the  laboratory using the explosive vapour generator. The preliminary results indicated that the carbowax 1000 could be a very good chemical interface to sense low levels of chemical signature of explosive material. Response for 50 ppb of TNT vapours was observed to be 400 Hz for an exposure of 2 min

Pigeonpea hybrids and their production: a manual for researchers

Pigeonpea (Cajanus cajan L. Millsp.) is crowned as poor man’s crop which provides much needed protein to farming families with least inputs.. It is a versatile plant species which can grow successfully in a range of soil types, temperatures and photoperiods. Its deep root system enables it to overcome intermittent drought and other stresses. In India, the crop is grown annually on about 4.04 m (FAO, 2012) ha and the major pigeonpea growing states are Maharashtra, Andhra Pradesh, Karnataka, Madhya Pradesh, Uttar Pradesh, Bihar and Gujarat (Table 1). The high protein pigeonpea dal (decorticated dry splits) is widely consumed across the country in various cuisines. The annual national production of pigeonpea is about 2.56 m tones. This produce, however, is not sufficient to feed the ever growing population of the country, and hence, necessitates huge (500,000 tons) imports of this pulse. In spite of its importance in food security and sincere research efforts, its national productivity could never cross the bar of 800 kg/ha (Fig 1) since independence. Since last 50 years ICAR have been very seriously pursuing the issue of genetic enhancement with huge investments and some outstanding pure line varieties with about 10% more grains over the best local varieties were developed. These achievements, however, were not enough to feed the nation with nutritious food and a major breakthrough in pigeonpea productivity was needed. Intensive national efforts in this direction could not succeed in raising the stagnant productivity level. Recently, an opportunity had come in our way when cytoplasmic nuclear male sterility (CMS) based hybrid pigeonpea technology was developed jointly by International Crops Research Institute for the Semi Arid Tropics (ICRISAT) and Indian Council of Agricultural Research (ICAR). The release of the world’s first commercial hybrid ICPH 2671 by Rajmata Vijayaraje Scindia, Krishi Vishwa Vidyalaya, Gwalior, Madhya Pradesh has already become a milestone in pulse breeding (Saxena et al., 2013). This hybrid has demonstrated huge (>40%) yield advantage in farmers’ fields. This research development has given the breeders an option to break the decades-old yield plateau in pigeonpea. For realizing high yields from hybrids and reap the benefits of this technology, the availability of both quality seed and optimum agronomy are essential. Since in hybrids every year new crossed seeds are required for sowing, the production of large quantities of quality seed is the key for their success. In this book efforts are made to describe various methods of breeding new hybrid combinations and large scale seed production of promising hybrids and their parents..

OBTAINING TEMPERATURE FIELDS AS A FUNCTION OF EFFICIENCY IN TIG WELDING BY NUMERICAL MODELING

The temperature field serves as the basis for predicting levels of residual stress in a welded joint. The aspects related to the mathematical modeling of complex welding procedures were pondered with the FEM: variations in the physical and mechanical properties of the materials as a function of the temperature, the transience and the speed of the welding process, the material phase transformations, the different mechanisms of heat exchange with the environment (convection and radiation), all them associated with a high level of nonlinearity. The heat source used in this analytical model for heat supply was the double ellipsoid model proposed by Goldak (2005), in which a 60 mm x 50 mm and 3 mm rectangular ASTM AH36 steel plate was used for the TIG process simulations. It was made a comparison of temperature fields for three different values of process efficiency (60%, 70% and 80%). The results showed many differences in the temperature fields following changes in the levels of residual stresses which will be determined in further studies

Enhanced Mucosal Antibody Production and Protection against Respiratory Infections Following an Orally Administered Bacterial Extract

Secondary bacterial infections following influenza infection are a pressing problem facing respiratory medicine. Although antibiotic treatment has been highly successful over recent decades, fatalities due to secondary bacterial infections remain one of the leading causes of death associated with influenza. We have assessed whether administration of a bacterial extract alone is sufficient to potentiate immune responses and protect against primary infection with influenza, and secondary infections with either Streptococcus pneumoniae or Klebsiella pneumoniae in mice. We show that oral administration with the bacterial extract, OM-85, leads to a maturation of dendritic cells and B-cells characterized by increases in MHC II, CD86, and CD40, and a reduction in ICOSL. Improved immune responsiveness against influenza virus reduced the threshold of susceptibility to secondary bacterial infections, and thus protected the mice. The protection was associated with enhanced polyclonal B-cell activation and release of antibodies that were effective at neutralizing the virus. Taken together, these data show that oral administration of bacterial extracts provides sufficient mucosal immune stimulation to protect mice against a respiratory tract viral infection and associated sequelae

Measurement of cervical length using transvaginal sonography for prediction of preterm labour

Background: Preterm labour and delivery cause major health burden to the society due to high perinatal morbidities and mortality and long-term health implications and also affects maternal. An effective and objective way for predicting preterm delivery is measurement of cervical length by transvaginal sonography as it allows better quality and accurate visualization of uterine cervix. Cervical length (<25 mm) is good and accurate cervical biometry for prediction of preterm birth. The objective of this study was to measure cervical length by transvaginal sonography for predicting preterm labour and fetal outcome.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology, at SVPIMSR hospital, Ahmedabad from July 2018 to December 2019 in 150 antenatal women to assess cervical changes (cervical length, dilatation of internal OS, funnelling etc.) between 16 to 24 weeks of gestation and these cases followed till delivery and results were analysed.Results:150 antenatal women who fulfilled the selection criteria were studied using transvaginal ultrasound between 16-24 weeks of gestation, out of them 36 (24%) women delivered preterm babies. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) recorded in this study were 80.5%, 94.73%, 82.85% and 93.91% respectively.Conclusion: Transvaginal sonography is the most useful and better, safe, accurate, most effective, less expensive, objective and acceptable technique for assessing cervical length in all antenatal women and predicting the preterm labour when assessed between 16 -24 weeks of gestational age

Fetomaternal outcome in COVID-19 infected pregnant women: a preliminary clinical study

Background: WHO has declared COVID-19 infection a health emergency of international concern on 11th March, 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 differ from those of nonpregnant women and whether it aggravates COVID-19 symptoms and whether antiviral therapy is necessary for COVID-19 infected pregnant women.Methods: This is prospective study of 125 cases based on the compiled clinical data for pregnant women with COVID-19 between 15th April 2020 and 10th June 2020. A laboratory confirmed positive case of COVID-19 infection in pregnant women were included.Results: The most common symptoms at presentation were cough in 61.6% (77/125) and fever in 46.4% (58/125). Other reported symptoms were sore throat in 13.6% (17/125), myalgia in 10.4% (13/125) while 38.4% (48/125) were asymptomatic. There were total 97 deliveries (including 2 twins’ deliveries) among which 3 cases had IUD. Present study reported 96 live births. The incidence of missed abortion was 2.4% (3/125). The incidence of preterm birth before 37 weeks was 8.2% (8/97). Ninety-six (96.9%) of neonates were tested for SARS-CoV-2 viral nucleic acid on nasopharyngeal and pharyngeal samples and 16.67% (16/96) were resulted positive.Conclusions: At present, there is no evidence regarding the greater risk of pregnant women to succumb to COVID-19 infection and experience severe pneumonia. The risks of spontaneous abortion and preterm birth are not increased as reported in this study but shows possibility of vertical transmission when it manifests during the third trimester of pregnancy

A hospital based retrospective study of thyroid disorders on obstetric and perinatal outcomes

Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients