Clinical study on feto-maternal outcome in teenage pregnancy in a tertiary care institute

Background: Pregnancies that occur below the age of 20 years are called teenage pregnancies. Teenage pregnancy is a common public health problem worldwide which is detrimental to the health of both the mother and the new-born. This study aims to evaluate the obstetric and perinatal outcomes of teenage pregnancy in the Indian rural and semi urban population. Methods: A retrospective observational study was undertaken in the department of obstetrics and gynecology, Mysore Medical College and Research Institute, Mysore, for a period of one year from August 2021 to September 2022. All the teenage mothers during the study period were included in the study. Data was analysed included various maternal parameters, fetal parameters, and the outcome of pregnancy. Results: Study showed the incidence of teenage pregnancy is 12.6%. About 88.3% were primgravida, 74% were booked cases. 51.6% of the teenage mothers had varying grades of anaemia, 29.09% of teenage mothers had spectra of hypertensive disorders if pregnancy, 27.92% had PROM. Caesarean section rates were 25%, Fetal distress being the most common indication in 47.3% followed by fail induction in 29.8%. Preterm delivery rates were as high as 13.6%. Postpartum complications included postpartum hemorrhage in 2.5%, puerperal pyexia in 1.9%, postpartum eclampsia in 1.38%. Respiratory distress was seen in 17.6% neonates, prematurity in 15.49%, IUGR in 13.6%, 2.99% were stillborn send 3.36% succumbed due to pre-maturity, respiratory distress, and sepsis. Conclusions: From the present study we infer that the prevalence of teenage pregnancy is still high in rural and semi urban population and they suffered from a significant number of complications in pregnancy including anemia pre-eclampsia and preterm labour, neonatal respiratory distress and early onset sepsis. To surmount these problems a multidisciplinary team involving health and social workers, obstetrician and gynaecologist are required to improve adolescent reproductive health.

A study on fetomaternal outcome in eclampsia in a tertiary care institute

Background: Eclampsia is a life threatening emergency that continues to be a major cause of maternal and perinatal mortality. The present study was undertaken to analyse the maternal and fetal outcome in patients of eclampsia and to evaluate various factors influencing this outcome. Methods: A retrospective observational epidemiological study was undertaken in the Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, for a period of three years from January 2020 to December 2022. All women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of pregnancy. Results: The incidence of eclampsia was 7.14% which is relatively high, attributing to the fact that being tertiary care centre many cases are referred. Higher incidence seen in primigravida (72.4%) and low maternal age (48%). Caesarean section was indicated in 50% deliveries indicating immediate action was necessary for better fetomaternal outcome. 58.6% had an uneventful maternal outcome.There was 7.65% maternal mortality most common cause of death was intracranial hemorrhage. 53% were preterm deliveries and 29.4% stillbirths, respiratory distress in the newborn was seen as the major complication (41.9%). Conclusions: In our study, maternal complications were recorded in 41.3% of the patients with a case fatality rate of 7.65%. Respiratory distress, prematurity, growth restriction and low birth weight are the neonatal complications to be anticipated. We infer from our study that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of pregnancy in eclamptic women could improve maternal and fetal outcome

A study on correlation between neuroimaging and maternal outcome in eclampsia

Background: Hypertensive disorders remain among the most significant complications of pregnancy. Neurological complications of eclampsia are a major contributor to morbidity and mortality that is associated with eclampsia. Neuroimaging studies have revolutionized visualization of hypertensive encephalopathy aids in timely intervention and a favorable maternal and perinatal outcome. Aims and Objectives: (1) To study the spectrum of neuroimaging findings in patients with eclampsia. (2) To correlate these findings with the maternal outcome. Materials and Methods: A prospective observational study was undertaken in the Department of Obstetrics and Gynecology, Mysore Medical College and research institute Mysore, for 18 months. All the eclamptic mothers during the study were included in the study. They were studied in terms of neuroimaging and its correlation with maternal outcomes. Results: The incidence of eclampsia was 7.14% which is relatively high, attributed to the fact that being a tertiary care center many cases are referred. Higher incidence was seen in primigravida (72.4%) and lower maternal age of 18–20 years (48%). Cesarean section was indicated in 50% of deliveries indicating immediate action was necessary for better fetomaternal outcome. They presented with varied imminent symptoms such as headache in 20.4%, vomiting in 22.4%, and visual blurring in 22.4%. About 50% presented with altered sensorium. On non-contrast computed tomography brain, 64.3% (63) had normal findings, 17.3% (17) had posterior reversible encephalopathy syndrome (PRES) with a sensitivity of 68.42% and specificity of 85%, whereas on magnetic resonance imaging (MRI) brain, 36.26% had no abnormalities, 40.81% had PRES with a sensitivity of 86.84%, and specificity of 85%. About 58.6% had an uneventful maternal outcome. The others were hemolysis, elevated liver enzymes, and low platelet syndrome seen in 9.18% of patients, acute kidney injury in 6.12%, postpartum hemorrhage seen in 5.1%. The maternal mortality rate was 7.66%, the most common cause of death was intracranial hemorrhage. Conclusion: The common neuroimaging findings in eclampsia are cerebral edema, PRES, cerebral venous thrombosis, infarcts, hemorrhage, and hypertensive leukoencephalopathy. Although some abnormalities seen in neuroimaging studies are incidental and transient without chronic neurologic sequelae, both CT and MRI findings correlate with the clinical presentation and maternal outcome but MRI correlates better compared to CT and can be a better imaging modality in eclampsia patients and is indicated in all patients of eclampsia