Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with jaundice.Methods: 30 antenatal patients with clinical /laboratory evidence of Jaundice were selected for study in period between august 2014 to august 2015.Results: The peak age of incidence in our study was 21-25 years (66.6%) and majority were primigravida (66.6%). All cases were in third trimester of pregnancy, 93.3% were unbooked, 73.3% were term, 60% were of lower socioeconomic status and 73.3% were urban. All patients presented with jaundice at time of admission. Pruritus was most common presenting symptom present in 60% of patients. Other presenting complaints were nausea, high BP, abdominal pain and petechiae. Viral Hepatitis was most important cause of jaundice in this study found in 46.7% of cases. Preeclampsia and ICP were other causes of jaundice in this study. Hepatitis B was the most common cause of acute hepatitis (26.7%) and incidence of hepatitis E was 13.3% in our study. Maternal mortality was found in 1 case of hepatitis E complicated with hepatic encephalopathy and coagulopathy. 2% of these patients developed FHF. All patients were kept in ICU for intensive monitoring. PPH was most common maternal complication in 60% of patients. There was 1 maternal death in our study. Of 30 patients, 12 had spontaneous onset of labour. All delivered vaginally of which 8(26.7%) were preterm of which 2 died, 4(13.3%) were IUFD, 12 (40%) had fetal distress with meconium stained liquor, 5 (16.6%) had PROM, 2 (6.7%) had fetal growth restriction and 2 (6.7%) delivered uneventfully.Conclusions: Jaundice in pregnancy results in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management

Awareness, knowledge and prevention of mother to child transmission of human immunodeficiency virus in pregnant women: a descriptive study

Background: India has the third highest number of estimated people living with HIV in the world. According to the HIV estimations 2012, the estimated number of people living with HIV/AIDS in India was 20.89 lakh, with an estimated adult (15-49 age group) HIV prevalence of 0.27% in 2011. The objective of this study was to evaluate the awareness and knowledge of mother-to-child transmission of HIV and its prevention among pregnant women attending the antenatal clinic.Methods: A cross sectional descriptive study was carried out at the antenatal clinic of Chirayu medical college and hospital, Bhopal, Madhya Pradesh, India from August 2015 to January 2016. Antenatal clinics run with average total attendance of 40 per day. A pretested questionnaire was designed to assess awareness of the women about HIV/AIDS, evaluate their knowledge of possible routes of transmission-particularly mother to child transmission-and measures to prevent vertical transmission from mother to child.Results: Amongst the respondents, 84% had heard of HIV and in 79% of them, the source of information was through mass media. 54.8% were aware of sexual intercourse as a mode of transmission of HIV while 43% knew that sharing sharp objects and infected blood products can spread HIV. 66% of respondents were aware of MTCT and 33.6% heard of antiretroviral therapy as a method of prevention of MTCT. 74% were aware of contracting infection by sexual contact with infected partner. Majority of them (77.4%) were aware of increased risk of contracting HIV/AIDS by sexual relationship with multiple partners. 74% of females were aware that HIV/AIDS is preventable. 59.6% of women were aware of availability of ART of AIDS treatment. 72.5% of study population was aware that use of condom can protect against HIV transmission.Conclusions: Although awareness of HIV and MTCT is increased as compared to previous studies, but to achieve global plan to reduce MTCT by 90% there is still need to promote programs targeting antenatal population with emphasis on MTCT and its various methods of prevention

Study of correlation between perinatal outcome, placental coefficient and feto-placental ratio

Background: Pregnancy and birth are nature’s finest marvel wherein perfect symbiosis between the two individuals protects the little and weak one and also allows the propagation of genetic prototype of the other individual generation after generation. Placenta acts as a mirror which reflects intrauterine status of fetus. Placenta has an undisputed role in foetal development but still is grossly neglected organ which is equal to liver, lung and kidney in function.Methods: Placentae collected from labor rooms and operation theatres were studied for various parameters like weight, surface area, volume, area of calcification and infarction, number of cotyledons etc. Birth weight of babies was also noted, feto-placental weight ratio and placental coefficient was calculated.  Results: Average placental weight being 490.5 gm (range 295-660 gm). Placenta of male baby was found to be slightly heavier as compared to female babies. Birth weight of male babies was also more than female babies. Average placental surface area was found to be 225.5 sq. cm. Mean placental volume was recorded as 450.5 cu. cm. Foeto-placental weight ratio was found to be 5.41:1 irrespective of sex of the baby, 5.61:1 in case of male baby and 5.40:1 for female babies.Conclusion: The placenta is a mirror which reflects intrauterine status of the fetus.

Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with jaundice.Methods: 30 antenatal patients with clinical /laboratory evidence of Jaundice were selected for study in period between august 2014 to august 2015.Results: The peak age of incidence in our study was 21-25 years (66.6%) and majority were primigravida (66.6%). All cases were in third trimester of pregnancy, 93.3% were unbooked, 73.3% were term, 60% were of lower socioeconomic status and 73.3% were urban. All patients presented with jaundice at time of admission. Pruritus was most common presenting symptom present in 60% of patients. Other presenting complaints were nausea, high BP, abdominal pain and petechiae. Viral Hepatitis was most important cause of jaundice in this study found in 46.7% of cases. Preeclampsia and ICP were other causes of jaundice in this study. Hepatitis B was the most common cause of acute hepatitis (26.7%) and incidence of hepatitis E was 13.3% in our study. Maternal mortality was found in 1 case of hepatitis E complicated with hepatic encephalopathy and coagulopathy. 2% of these patients developed FHF. All patients were kept in ICU for intensive monitoring. PPH was most common maternal complication in 60% of patients. There was 1 maternal death in our study. Of 30 patients, 12 had spontaneous onset of labour. All delivered vaginally of which 8(26.7%) were preterm of which 2 died, 4(13.3%) were IUFD, 12 (40%) had fetal distress with meconium stained liquor, 5 (16.6%) had PROM, 2 (6.7%) had fetal growth restriction and 2 (6.7%) delivered uneventfully.Conclusions: Jaundice in pregnancy results in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management