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

Congenital anomalies in a tertiary care hospital in North East region, India

Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross sectional study done at Regional Institute of Medical Sciences, Imphal over period of 3 years from January 2015 to December 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, and gestational age, sex of the baby, outcome and sex of the baby.Results: Total numbers of congenital anomalies were 257 babies out of 29879 births giving the incidence of 0.86%. Most common congenital anomalies in this study are musculoskeletal followed by craniospinal, genitourinary, cardiovascular and gastrointestinal. It was more common in preterm babies and parity 1-3, more common in 21-30 years of maternal age. Consanguinity was seen in 7 out of 257 patients.Conclusions: Congenital malformations are a major cause of still births and infant mortality. Targeted scan should be done at 18-20 week to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available mode of treatmen

Thyroid dysfunction in preeclampsia and related fetomaternal outcomes

Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia