Placental mesenchymal dysplasia

Placental Mesenchymal Dysplasia (PMD) is a rarely encountered placental lesion often associated with high fetal mortality and morbidity. We report here a case of PMD with a favourable outcome. The salient features of diagnosis, management and literature review are discussed

Prevalence of ecosapentaenoic acid and docosahexaenoic acid deficiency in pregnant women: a prospective observational study

Background: Docosahexaenoic acid (DHA), ecosapentaenoic acid (EPA) and alpha lineoloic acid (α-LA) are essential fatty acids of the long chain polyunsaturated fatty acid (LC-PUFA) or omega-3 fatty acid. These fatty acids are not synthesized by our body. Diets rich in LC-PUFA reduces the incidence of - preeclampsia, intrauterine growth restriction, preterm delivery, in utero fetal death and placental abruption. Objectives of the study were: to estimate the prevalence of EPA and DHA deficiency in pregnant women by omega-3 index test (O3I), and also to correlate blood levels of EPA and DHA with various socio demographic parameters. Methods: All enrolled subjects were assessed with a pre-defined performa for their demographic and socio-economic characteristics, personal history, obstetric history, body mass index (BMI), education, diet and blood samples were tested for O3I. Results: Result of the study indicated that 98% of pregnant women had EPA and DHA deficiency as indicated by O3I levels. This was regardless of age, parity, BMI, and socio economic status. Women consuming vegetarian diet had statistically significant lower mean and median levels of O3I as compared to the women having a non-vegetarian diet, p value <0.001, 0.004 respectively. In our entire cohort of 150 women, only 2 non-vegetarian women had sufficient O3I. Conclusions: 98% of pregnant women across various socio economic classes had EPA and DHA deficiency as measured by O3I levels. Vegetarians had statistically significant lower levels of O3I as compared to the non-vegetarians

Early versus delayed cord clamping in small for gestational age infants and iron stores at 3 months of age - a randomized controlled trial

Abstract Background Delayed cord clamping is the standard of care in infants not requiring resuscitation; however effects of cord clamping strategies have not been evaluated systematically in small for gestational age (SGA) infants. The primary objective was to compare effects of delayed cord clamping (DCC) and early cord clamping (ECC) on serum ferritin at 3 months in SGA infants born at ≥35 weeks. The secondary objectives were to compare hematological parameters, clinical outcomes in neonatal period and growth at 3 months of age. Methods All eligible infants with fetal growth restriction were randomized to two groups, DCC at 60 s or ECC group in which the cord was clamped immediately after birth. Results Total of 142 infants underwent randomization and subsequently 113 infants underwent definite inclusion. At 3 months, the median (IQR) serum ferritin levels were higher in DCC group, compared to ECC; 86 ng/ml (43.35–134.75) vs 50.5 ng/ml (29.5–83.5), p = 0.01. Fewer infants had iron deficiency in DCC group compared to ECC group; 9 (23.6%) vs 21 (47.7%), p = 0.03 [NNT being 4; 95% CI (2–25)].The proportion of infants with polycythemia was significantly higher in DCC group; 23 (41.81) % vs 12 (20.6%), p = 0.01. There was no difference in proportion of infants with symptomatic polycythemia or those who underwent partial exchange transfusions. Clinical outcomes and mortality were similar. Conclusions DCC improves iron stores in SGA infants ≥35 weeks at 3 months of age without increasing the risk of symptomatic polycythemia, need for partial exchange transfusions or morbidities associated with polycythemia. Trial registration Our trial was retrospectively registered on 29th May 2015 through Clinical trials registry India. Registration number: CTRI 2015/05/005828