Study of BMI in pregnancy and its correlation with maternal and perinatal outcome

Background: Maternal nutrition plays an important role in maternal and fetal outcome. The low maternal BMI or Obesity is associated with adverse outcome.Methods: A total 148 primigravida included. BMI was calculated on first visit and in each trimester, all booked patient was followed throughout pregnancy and delivery for any maternal and fetal complications.Results: (66.2%) of patients were with normal BMI, (17.56%) were underweight, (10.13%) were overweight and (6.08%) patients were obese. APH was seen in (11.1%) and (6.7%) cases in BMI grades ‘IV and III’ respectively. PIH was present in total 10 cases, (33.3%) cases belonged to BMI grades IV. Anemia was present in total 51 cases (53.8%) belonged to BMI grade I. Preterm delivery was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. GDM was present in 11 cases and out of them (26.7%) and (44.4%) cases belonged to BMI grade III and IV respectively. PPH was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. In BMI grade I group, (96.2%) babies had birth weight 2.5 (22.2%) cases of fetal macrosomia belonged to BMI grade IV.Conclusions: There is importance of pr-pregnancy counseling in maintaining weight of women during pregnancy to avoid pregnancy maternal and fetal outcomes.

Evaluation of abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women

Background: Abnormal uterine bleeding is defined as any deviation from the normal menstrual cycle this include change in regularity, frequency of menses, duration or amount of bleeding during or in between periods. Objective of present study was to evaluate abnormal uterine bleeding with transvaginal sonography and hysteroscopy in perimenopausal women.Methods: This study is conducted on women presenting to the gynecological OPD with complain of abnormal uterine bleeding in perimenopausal age group. A total of 50 patients were subjected to transvaginal sonography and Diagnostic hysteroscopy.Results: On TVS, out of total 50 patients, 50% patient showed normal endometrial finding. 24% Patient showed Endometrial hyperplasia, 14% Endometrial Polyp, 8% Submucosal fibroid, 4% Adenomyosis. On TVS, out of total 50 patient, 50% patient showed normal endometrial finding. 24% Patient showed endometrial hyperplasia, 14% endometrial Polyp, 8% submucosal fibroid, 4% adenomyosis. Out of total 50 patients, 28 (56%) showed normal endometrial finding.20% cases showed endometrial Hyperplasia, 16% showed endometrial Polyp, 8% showed submucosal fibroid. Sensitivity, specificity, PPV, NPV of endometrial hyperplasia – 81.81%, 92.3%, 75%, 94.73% respectively.Conclusions: Transvaginal sonography has a moderate diagnostic accuracy in detecting endometrial hyperplasia and other intrauterine pathology. TVS is safe, acceptable and easily available & is noninvasive. It should be used as 1st line diagnostic tool in patients with AUB in perimenopausal women. Hysteroscopy has important tool in the diagnosis of various endometrial and intrauterine lesions TVS and hysteroscopy should be employed hand in hand in evaluation of AUB

A Study of Sales Prediction Analysis in a Business Organization using Data Mining Technique

Various studies have been presented on sales prediction using datamining technique.The data mining technique has advantages & disadvantages however datamining techniques are more effective tool for analyzing sales prediction. The main objective of this paper is to give insights about customer’s experience of buying pattern , mining the database and association using sales data

Maternal and fetal outcome in epidural analgesia study

Background: Labour is a highly complex event. Labour may be the most painful experience many women ever encounter. The objective of this study was to study the maternal and fetal outcome in epidural analgesia.Methods: A prospective study was conducted on 60 pregnant women. The study group (n = 60) consist of group A (epidural analgesia, n = 60) and group B (control, n = 30).Results: The maternal and fetal outcome in group A and group B were not statistically significant. Mean duration of first stage of labour (minute) was significantly lower in group A as compared to group B (p value <0.001). The duration of second stage of labour was prolonged in group A as compared to group B (p value 0.0137). The modes of delivery (normal, instrumental delivery, LSCS) were not statistically significant in both the groups. The neonatal outcome (Apgar score at 1 minute and 5 minutes) were statistically similar in both groups (P value = 0.569).Conclusions: Epidural analgesia is safe and effective to relieve the labour pain. It has no adverse maternal and fetal outcome. Patients are very comfortable and happy after epidural analgesia

A comparative study of the effectiveness of placental blood drainage versus no placental blood drainage in active management of third stage of labor at a tertiary care hospital

Background: WHO defines postpartum haemorrhage (PPH) as when blood loss is greater than or equal to 500 ml within 24 hours after birth. When blood loss is greater than or equal to 1000 ml within 24 hourrs, it is called as severe primary postpartum haemorrhage. Placental blood drainage is done by clamping and cutting of umbilical cord after birth of baby followed by unclamping the maternal side of cord so the blood can drain freely into a container.Methods: 200 patients were studied in current research finding. Study group had 100 patients whose placental blood drainage was done and control group had 100 patients whose placental blood drainage was not done. This study was done to analyze the effectiveness of placental blood drainage in reducing blood loss.Results: The duration of third stage of labor was 295.70 seconds in study group and 475.20 seconds in control group. The amount of blood loss in study group was 273.76 ml and 294.92 ml in control group. p value was found to be significant. Incidence of PPH in study group was 1% and 8% in control group.Conclusions: Placenta blood drainage was safe and simple. It is a non invasive method very useful to prevent PPH. It reduces the duration of third stage of labor and reduces amount of blood loss

Prevalence of vitamin D deficiency in patients of hypertensive disorders of pregnancy and normal pregnant women

Background: The aim of this study was to compare vitamin D level in normal pregnant women and patients of hypertensive disorders of pregnancy and to study the prevalence of vitamin D deficiency in patients of hypertensive disorders of pregnancy and normal pregnant women.Methods: 50 women affected by hypertensive disorders of pregnancy and 50 normal pregnant women more than 20 weeks of gestation, admitted to the ward or to labour room in the Obstetrics and Gynaecology Department, of Mahatma Gandhi Medical College and Hospital were enrolled in the study. Assessment of serum 25 hydroxy vitamin D was done by chemiluminescent immunoassay method.Results: Serum vitamin D levels were low in women with hypertensive disorders of pregnancy with mean serum vitamin D level 13.66±7.358 ng/ml as compared to normal normotensive pregnant women 21.14±8.241ng/ml, which is statistically significant (p=0.001). Mean vitamin D level in study population was 17.40±8.634 ng/ml. The prevalence of vitamin D deficiency in hypertensive disorders of pregnancy group was very high 88% compared to 50% in normal normotensive pregnant women group. The difference was statistically significant (p=0.001). vitamin D deficiency was found among 69% in study population.  Conclusions: Vitamin D levels are deficient in patients of hypertensive disorders of pregnancy as compared to normal pregnant women. There is increased prevalence of vitamin D deficiency with hypertensive disorders of pregnancy suggesting that vitamin D deficiency can be a risk factor for the development of hypertensive disorders of pregnancy

Intrapartum amnioinfusion in meconium stained amniotic fluid at term pregnancy

Background: In our country a major cause of perinatal mortality and morbidity is meconium aspiration syndrome (MAS) in new-born. The aim of this study is to assess feto-maternal outcome following intrapartum amnioinfusion in patients with meconium stained amniotic fluid and the rate of ceaserean deliveries following intrapartum amnioinfusion in patients with meconium stained amniotic fluid.Methods: This prospective observational study was conducted on 252 patients with pregnancy at or beyond 37 weeks in active labour with moderate to thick meconium stained amniotic fluid following spontaneous rupture or ARM. In such cases amnioinfusion was performed. Continuous electronic FHR monitoring was performed. Emergency LSCS was done when fetal Bradycardia was recorded or in case of non-progress of labor. Fetomaternal outcome will be noted.Results: In present study most, women had normal vaginal delivery 157 (62.30%) followed by LSCS 93 (36.91%) followed by forceps/vaccum delivery 02 (0.07%). No maternal complication was seen in 230 women (91.26%). Accidenatal hemorrhage was seen in 01 (0.39%) which was managed by emergency LSCS. Out of 252 neonates, 183 asymptomatic neonates at birth, 69 needed resuscitation and in which 52 neonates recovered and shifted back to mother and 17 neonates referred and admitted in NICU for MAS in which 07 were recovered and 10 neonates (3.96%) died due to MAS.Conclusions: Intrapartum amnio infusion in meconium stained amniotic fluid by diluting the meconium and by decreasing the cord compression decreases the incidence of foetal distress and there by decreases the rate of caesarean section, these all leads to decrease the incidence of maternal and perinatal morbidity and mortality

Assessment of maternal and fetal outcome in trial of labor after cesarean

Background: Nowadays, cesarean sections are increasing consistently. Repeat cesarean sections are performed for a large percentage and associated with a higher rate of surgical complications and Long-term morbidities. The trial of labor after cesarean offers an alternative choice. This study carried out to assess the maternal and fetal outcome and to evaluate various parameters as a predictor of success of TOLAC.Methods: This prospective observational study conducted on 150 pregnant women with one previous LSCS who delivered at Mahatma Gandhi hospital, from January 2017 to July 2018. Patient having a singleton pregnancy, cephalic presentation, adequate pelvis size with spontaneous onset of labor were included. Cases were monitored carefully during the labor. Emergency LSCS was done if any indication appeared.Results: 78% of cases delivered safely by the vaginal birth and 22% of cases had an emergency repeat cesarean section (EmRCS). Favorable Bishop Score, active stage of labor and prior vaginal delivery were associated with higher success rate. One (0.66%) case of uterine scar rupture and 2 (1.33%) cases of scar dehiscence noted. No maternal mortality observed. Perinatal mortality occurred in 2 cases (1.33%).Conclusions: Present study shows that appropriate clinical settings and the properly selected group of patients can make the TOLAC safe and effective

A clinical study on maternal and fetal outcome in pregnancy with oligohydromnios

Background: Oligohydramnios is associated with various maternal and fetal complication. It’s correlated fetal complications like FGR, increased risk of meconium aspiration syndrome, Birth asphyxia, low APGAR scores and increased congenital abnormalities in fetus. It’s also associated with maternal morbidities in view of operative interventions for delivery. To study effect of oligohydramnios in mother in form of, operative delivery and progress of labour. To study effect of oligohydramnios in fetus in form of fetal compromise i.e.  FGR, fetal distress, altered APGAR score, need for NICU admission. congenital anomaly and perinatal death.Methods: 50 patients with ≥ 28 weeks POG with oligohydramnios, confirmed by ultrasonographic measurement of AFI using four quadrant technique; were selected randomly after fulfilling inclusion and exclusion criteria.Results: Incidence of oligohydramnios were more found in primigravida (56%) in present study. Most common cause of oligohydramnios was idiopathic (62%) followed by PIH (20%). Most common cause of caesarean was fetal distress (23%) either due to cord compression or FGR. oligohydramnios was related to higher rate of Fetal Growth restriction and NICU admission (24%).Conclusions: Oligohydramnios is very common encounter during pregnancy, Because of its frequent occurrence; it demands intensive fetal monitoring and systemic approach to antepartum and intrapartum fetal surveillance. There is increased risk of intrapartum complication, perinatal morbidity, perinatal mortality; thus, the rate of caesarean increasing day by day.one should always know the fine line between vaginal delivery and caesarean section; move ahead with best option without hampering fetal wellbeing and avoid unnecessary operative morbidity

PREMENSTRUAL SYNDROME.

Aim: The aim of our study was to evaluate the effects of Yoga intervention in females suffering from premenstrual tension and premenstrual syndrome. Settings and Design: 32 recently diagnosed females with premenstrual tension patients were recruited for a randomized controlled trial comparing the effects before and after a Yoga program. Materials and Methods: To evaluate the premenstrual symptoms and severity, a simple scoring system given by WHAQ was used. Symptoms were divided in 3 main categories that were Negative effect, Water retention and Impaired concentration, analyzed before and after the yogic intervention techniques. Statistical Analysis Used: We used analysis of covariance to compare interventions before and after the Yoga practice. Result: 32 females contributed data to the current analysis (n=32). The result suggest a significant decrease in the negative affect category (p=&lt; 0.00001) and i