Maternal and perinatal outcome in pregnancy following recurrent pregnancy loss

BACKGROUND: Miscarriages occur in 12-15% of all clinically recognized pregnancies. However early loss of a pregnancy causes great distress to couples and undermines their confidence in achieving future reproductive outcomes. Recurrent miscarriages occur in 1% of women. Despite their rarity, the effects of recurrent miscarriages on subsequent reproductive outcomes have dominated the literature. AIM OF THE STUDY: The aim of our study is to estimate the risk of the Preterm delivery, low birth weight, IUGR, recurrence of abortion, still birth, IUD, PROM or any other adverse outcome in women with history of recurrent pregnancy loss. MATERIALS AND METHODS: This prospective study was carried out in the Department of obstetrics and gynecology, Thanjavur Medical College and Hospital, Thanjavur during the period of June 2016 to June 2017. The maternal and perinatal outcome of 200 pregnant women with history of RPL (cases) were compared with 200 primigravidae (controls) whose pregnancy got terminated subsequent the patients in case group. RESULTS: The incidence of preterm delivery (17.9%), Recurrence of abortion (12%) and PROM (14%), ceserean section (44%), low birth weight (36.4%) were found to be high in women with recurrent pregnancy loss. There is no statistically significant increase in the rate of IUGR, APH, still birth, IUD. CONCLUSION: Experience of one or more previous miscarriages can increase the risk in a subsequent pregnancy. This suggests the need for greater vigilance during the antenatal period of these women for early detection of any complications

Correlation between first trimester uric acid level and subsequent development of gestational diabetes mellitus

Background: The aim of the study was to correlate between first trimester uric acid level and its association with subsequent development of gestational diabetes mellitus.Methods: This is a prospective study conducted at Govt. Raja Mirasudar Hospital attached to Thanjavur Medical College, Thanjavur over a period of one year from September 2015. A total of one hundred and eighty seven ante natal women less than 14 weeks of gestational age who attended the outpatient antenatal department were included in this study. Serum uric acid estimation was done in women with 3.6 mg/dl and 2 with serum uric acid <3.6 mg/dl developed GDM. This shows development of GDM increases with increase in uric acid concentration.Conclusions: Though our study results suggest that serum uric acid level estimation in first trimester can be used as a marker to predict GDM in pregnant women, large scale studies are required before it can be recommended as a routine first trimester screening test for prediction of gestational diabetes mellitus

Implications of combined endocrinopathy of diabetes mellitus and hypothyroidism on pregnancy

Background: Hypothyroidism and diabetes are the endocrine disorders commonly observed in pregnancy and each has been associated with adverse maternal and fetal outcomes. Our objective was to study the implications of combined endocrinopathy of hypothyroidism and DM on pregnancy and its outcome.Methods: This prospective cohort study included 150 pregnant women with singleton gestation and who were screened for and diagnosed with DM and /or hypothyroidism. They were then divided into 3 groups: 1) Diabetes (n=69) 2) Hypothyroidism (n = 53) 3) DM and hypothyroidism (n=28). Perinatal and neonatal characteristics were compared among the 3 groups and statistically analysed.Results: Women with both DM and hypothyroidism had higher rates of first trimester abortions, preeclampsia, polyhydramnios, placental abruption, preterm deliveries, caesarean sections, postpartum haemorrhage and intrauterine fetal deaths when compared to other groups. On the contrary, rates of labour induction, fetal macrosomia and LBW new-borns were not statistically significant among the groups.Conclusions: Women with both DM and hypothyroidism are at high risk of developing perinatal complications and need intense surveillance for the same during their pregnancy for better outcome. Pregnant women diagnosed with one of these endocrinopathies should be screened for the other

Implications of combined endocrinopathy of diabetes mellitus and hypothyroidism on pregnancy

Background: Hypothyroidism and diabetes are the endocrine disorders commonly observed in pregnancy and each has been associated with adverse maternal and fetal outcomes. Our objective was to study the implications of combined endocrinopathy of hypothyroidism and DM on pregnancy and its outcome.Methods: This prospective cohort study included 150 pregnant women with singleton gestation and who were screened for and diagnosed with DM and /or hypothyroidism. They were then divided into 3 groups: 1) Diabetes (n=69) 2) Hypothyroidism (n = 53) 3) DM and hypothyroidism (n=28). Perinatal and neonatal characteristics were compared among the 3 groups and statistically analysed.Results: Women with both DM and hypothyroidism had higher rates of first trimester abortions, preeclampsia, polyhydramnios, placental abruption, preterm deliveries, caesarean sections, postpartum haemorrhage and intrauterine fetal deaths when compared to other groups. On the contrary, rates of labour induction, fetal macrosomia and LBW new-borns were not statistically significant among the groups.Conclusions: Women with both DM and hypothyroidism are at high risk of developing perinatal complications and need intense surveillance for the same during their pregnancy for better outcome. Pregnant women diagnosed with one of these endocrinopathies should be screened for the other