Efficacy of single dose of misoprostol 800μg in the first trimester termination of pregnancy: a cross sectional study

Background: The MTP (Amendment) Act 2021 has allowed termination of pregnancy up to 24 weeks on only certain indications. Decision of two medical practitioners are required for termination beyond 20 weeks. Misoprostol is one drug used for medical termination of pregnancy. It can be used alone in single or multiple doses, or in combination with other drugs. The study was undertaken to determine the efficacy of a single dose of 800 μg of misoprostol in the first trimester pregnancy termination. Methods: It was a cross-sectional study conducted among 124 women in the first trimester who were undergoing termination of pregnancy. After administering 800 μg of misoprostol vaginally, participants were kept under observation for 48 hours. Data were collected and analysed. Results: Around half of the participants (56.4%) expelled the conceptus completely by 12 hours, 78.2% by 48 hours. Seven (5.6%) out of those 27 failed cases were given further doses of misoprostol, while in the remaining 20 (16.1%), surgical intervention was undertaken. Conclusions: The efficacy of a single dose of misoprostol for 1st trimester termination of pregnancy varies widely from study to study, but, the efficacy increases with adding further doses of the same drug or addition of mifepristone. Misoprostol is a safe, cost effective, and reasonable drug for the termination of pregnancy in first trimester

Study of maternal serum lipid profile and apolipoprotein a levels and its correlation with fetal growth restriction

Background: This study was aimed to estimate maternal serum lipid profile and apolipoprotein A levels in pregnancies complicated with FGR and to compare the levels with the levels in normal pregnancies.Methods: A prospective observational study was conducted in Lady Hardinge Medical College, New Delhi, in a study group consisting of 30 pregnant women at gestation 32-34 weeks with ultrasound diagnosed FGR and control group consisting of 30 age and gestation matched uncomplicated pregnant women. Maternal serum lipid profile and apolipoprotein A levels were measured and compared between the two groups.Results: Total serum cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and Apolipoprotein A were significantly lower in FGR group compared to normal controls. Mean±SD of total cholesterol was found to be 199.17±49.06 mg/dl in cases and 244.10±53.17 mg/dl in controls. Mean±SD of triglyceride was 200.53±60.25 mg/dl in cases compared to 304.13±69.12 mg/dl in controls. Mean±SD of LDL-Cholesterol was 98.19±37.91 mg/dl in cases and 127.07±47.84 mg/dl in controls. Mean±SD of VLDL-cholesterol was 40.11±12.05 mg/dl in cases and 60.83±13.82 mg/dl in controls. Mean±SD of Apolipoprotein A was 147.71±16.40 mg/dl in cases compared to 163.30±16.07 mg/dl in controls. HDL-cholesterol did not change significantly as its mean±SD was 60.87±15.18 mg/dl in FGR group and 56.20±16.07 mg/dl in control group.Conclusions: The decreased levels of total cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and apolipoprotein A levels may be used as biochemical marker for detection of FGR

Study of lipid profile in polycystic ovarian syndrome: a case control study in tertiary care hospital

Background: Polycystic ovarian syndrome (PCOS) is one of the most common causes of endocrine dysfunction in women of reproductive age. Dyslipidaemia plays an important role in the development of PCOS. Lipid abnormalities which include elevated low-density lipoprotein and triglyceride levels and reduced high-density lipoprotein levels are often found in women with PCOS and thus they are associated with long-term risk of coronary heart disease. The study aims to estimate lipid profile levels in patients with polycystic ovarian syndrome (PCOS) taken as cases and normal healthy subjects taken as controls. Methods: This is a case control study conducted in the Department of Biochemistry in collaboration with Department of Obstetrics and Gynaecology, RIMS, Imphal. Fasting blood samples were collected from cases and controls and lipid parameters were estimated. Forty-five cases of PCOS patients in the age group of 18-44 years diagnosed according to Rotterdam criteria and forty-five age-matched healthy women with regular menstrual cycle taken as controls were recruited. Results: The mean±SD of age in cases was 26.38±4.85 years and control was 28.23±3.99 years. However, the difference was found to be statistically insignificant. The majority of cases were from urban areas which comprised of 62% and only 55.6% were from rural areas. The mean±SD for cholesterol, TG, LDL were 203.40±54.20 mg/dl, 163.26±69.49 mg/dl, 132.82±50.39 mg/dl respectively and was higher in cases compared to controls and the difference was statistically significant. However, the mean±SD of HDL in cases 24.81±2.31mg/dl was lower as compared to controls and the difference was statistically significant with p<0.05. Conclusions: PCOS is found to be associated with atherogenic lipid profile. Thus, it may be suggested that dietary control and improvement of living style to control dyslipidaemia should be taken up early in PCOS to prevent development of cardiovascular disease

Association of maternal serum triglycerides at term and macrosomia in gestational diabetes mellitus

Background: Aim of the study was to determine association of maternal serum triglycerides (TG) at term and macrosomia in gestational diabetes mellitus (GDM). Methods: A cross sectional study was carried out in the department of obstetrics and gynaecology, RIMS, Manipur. The study was conducted for 2 years duration from September 2019 to August 2021 and 85 singleton term pregnant women with GDM were included. All the patients were subjected to check fasting serum TG, FBS, PPBS. Descriptive statistics like mean, standard deviation and Inferential statistics like Chi-square test was used for comparing study variables between large for gestational age (LGA) and non LGA group. T-test was used to compare the mean values of age, pre-pregnancy BMI, pregnancy weight gain, OGTT, FBS, PPBS, fasting serum TG between LGA and non LGA group. Results: The observed mean TG values in LGA and non LGA group in our study was 262.35±26.08 and 158.18±13.24 mg/dL respectively. The serum TG values in the LGA group mothers was significantly higher when compared to the non LGA group. The mean weight gain in pregnancy 15.17±1.82 and 9.60±1.47 in LGA and non LGA respectively. The mean BMI comparison among LGA and non LGA are 27.7±1.74 and 22.94±1.6 respectively. Conclusions: It is observed that maternal fasting serum TG may be a strong predictor of foetal size irrespective of the glycemic status. Our study clearly pointed out the usefulness of measuring serum TG in GDM pregnancy. In addition to maternal hypertriglyceridemia, pre-pregnancy BMI, excessive weight gain in pregnancy significantly associated with foetal macrosomia in GDM mothers