An Observational study to assess the prevalence of Vitamin D deficiency in Indian women

Aim: The aim of this study to encounter the gravity of the vitamin D deficiency problem throughout India so that the physicians take necessary caution and care in the diagnosis and treatment of Vitamin Ddeficiency.Methods:This was a prospective study conducted in a government teaching hospital located in Patna, Bihar, India from March 2018 to February 2020. The prevalence of vitamin D deficiency in our study the level of vitamin D was done in 840 women, irrespective of the clinical features by the method of electrochemiluminescence. Sunshine exposure was calculated as hours of exposure/day X% of body surface area exposed. Results:In the present study 840 women attending the clinic were taken for the consideration and the vitamin D level were done in them. The prevalence of vitamin D deficiency (level <20 ng/ml) was 68.24% among women with age <30 years and it was 56.97% among women with age >30years. The prevalence of vitamin D deficiency was 90.19% among illiterate women and it was 41.60% among literate women. Prevalence of vitamin D deficiency was 71.09% among non working women and 38.06% among working women.Conclusion:To reduce the prevalence of Vitamin D deficiency in India it is very important that the public and private sector work very closely with each other such as the cut off level for the vitamin D deficiency level should be revised in according to the need of the people of India as the high prevalence of vitamin D deficiency in our study could be the resultof our being over concerned and the internationally set up criteria for its deficiency. Keywords: Indian women, Prevalence, Vitamin D

To determine the prevalence of vitamin D among pregnant women and its impact on feto- maternal outcome

Background: Vitamin D deficiency is widely prevalent in all parts of the world. Pregnant women and neonates are highly vulnerable to vitamin D deficiency. The aim of our study was to determine the prevalence of vitamin D among pregnant women and its impact on feto maternal outcome. Methods: This was an observational study conducted in a government teaching  hospital located in Patna,Bihar, India fromJanuary 2019 to March 2020. Total 100 pregnant women aged 18-40 years old with gestational age >28 weeks were included in this study. Blood sample was taken during routine blood collection at the first prenatal check-up. Reliable serum vitamin D was measured in the extra blood sample using an enzyme immunoassay method. Results: 100 pregnant women with aged 18-40 year participate in the study. Among study subjects 44% were multigravidae and 56% were primigravidae. All women recruited for the study were >32 weeks gestation. It was found that 52% had insufficient Serum 25(OH) D concentrations and 16% were deficient for Vitamin D.The lowest 25(OH) D concentrations (insufficient levels) were found in those with only 1-2 hours of sun exposure (60%), and 50% had deficient levels. Highest concentrations (12.5%) were found in those with 2-4 hours of sun exposure. It was found that 67% of women studied took regular calcium supplementation throughout pregnancy.There were no significant association between 25(OH) D concentrations and maternal outcome. While 89% with normal vitamin D levels had no complications, 81.25% with deficient levels were uncomplicated. However, among women with hypovitaminosis D, 20.19% developed PIH, 19.71% had pre term birth & 3.84% developed GDM. Conclusion: Treatment of vitamin D deficient women and vitamin D supplementation is safe and is recommended for all women who are pregnant or breastfeeding. Keywords: Vitamin D, Pregnancy, Low birth weight, Preeclampsia, Preterm, GDM

Quantitative sonoelastography of the uterine cervix in predicting successful outcome of induction of labour

Objectives: The aim of the study was to evaluate the stiffness of cervix and determine its significance in predicting successful outcome of induction of labour. The primary objective was to determine the differences in elastography indices of different areas of cervix between the outcome groups of successful and failed induction of labour. A secondary objective was to find out the correlation of these elastography indices with Bishop’s score and cervical length. Methods: This was a prospective, observational study conducted over a period of 6 months on pregnant women admitted in the labour room for induction of labour. Establishment of adequate regular uterine contractions – at least three contractions lasting 40–45 s in a 10-min period – was taken as end point for successful outcome of induction of labour. Even after 24 h of initiation of induction of labour, regular, adequate and painful uterine contractions were not established, then induction of labour was described as having failed. Prior to induction, cervical length measurement, Bishop’s scoring and elastographic evaluation of the cervix were done by stress–strain elastography. A colour map was produced from purple to red and a five-step scale – the elastography index – was used to describe the various parts of the cervix. The differences between elastography indices of different parts of cervix were estimated using Mann–Whitney U test. Correlation of the indices with cervical length and Bishop’s score was determined by Spearman’s correlation coefficient. Results: A total of 64 women were included in the study. A significant difference ( p  < 0.001) was found in the elastography index of internal os between the two outcome groups of success (1.76 ± 0.64) and failure (0.54 ± 0.18). However, the elastography index of central cervical canal, external os, anterior lip and posterior lips did not differ significantly across the outcome groups. A significant positive correlation was found between elastography index of internal os and cervical length (Spearman’s correlation coefficient, r  = 0.441, p  < 0.001) and between elastography index of external os and cervical length ( r  = 0.347, p  = 0.005), whereas a negative correlation was seen between elastography index of external os and Bishop’s score ( r  = −0.270, p  = 0.031). Conclusion: Elastography index of internal os can be used to predict outcome of induction of labour. Cervical elastography is a promising new technique for cervical consistency assessment. Further larger studies are required to determine some cut-off point for elastography index of internal os in prediction of outcome of induction of labour and to strongly establish the usefulness of cervical elastography for pregnancy management, preventing preterm delivery and establishment of cut-off points to determine successful induction