A retrospective study of ectopic pregnancies in a tertiary care hospital

Background: Ectopic pregnancy is a common life threatening emergency in first trimester of pregnancy and it leads to serious maternal morbidity and also can cause mortality. The aim was to study the incidence, clinical presentation, risk factors and the management of patients with ectopic pregnancies admitted in our hospital over three year period.Methods: The present study involves a retrospective analysis of ectopic pregnancies admitted in SRM Medical college hospital for three years from 2012 to 2015.Results: The incidence of ectopic pregnancy in the present study is 1.77%. About 79% of the women were in the age group of 21-30 years. About 79% of patients in present study belonged to low socioeconomic status. In the study ectopic pregnancies were more common among multigravida (78%). 73% of patients had identifiable risk factors of which tubal surgeries were more common (31.15%). Ultrasound was diagnostic of ectopic pregnancy in 85% of patients. 97.26% were tubal ectopic pregnancies and 2.74% were ovarian ectopic pregnancies. Among tubal pregnancies majority of cases were ampullary pregnancies (62%). All patients in the study underwent surgical management.Conclusions: Ectopic pregnancy is still a major challenge in gynaecological practice. Early diagnosis and early referral is the key to successful management. It is better to over diagnose an ectopic pregnancy especially in a rural setup. Most cases present late, making tubal conservation treatment inapplicable. The impact on future fertility can be improved by focusing on primary prevention and early diagnosis before rupture so that conservation treatment can be done

Does mild hyperglycemia in 75gm Glucose Tolerance Test (GTT) affect outcome in pregnant women?

Background: Glucose tolerance in pregnancy is fundamentally linked to fetal growth. The relationship between maternal glycemia and adverse outcomes is a continuous process, with no distinct cut off point for increased risk. The objective of the study is to find out whether mild hyperglycemia in 2 hour 75 gm Glucose Tolerance Test (GTT) affects maternal and perinatal outcome in pregnant women.Methods: This case control study was conducted in SRM Medical College during a 10-month period. Mild hyperglycemia was diagnosed when the - 2hour non- fasting 75gm GTT was between 120-139 mg/dl and Controls were women with 2hour nonfasting 75gm GTT <120mg/dl. Maternal and neonatal parameters were noted and the results were compared.Results: During the study period 142 delivered women had mild hyperglycemia, of which 10 patients on subsequent blood sugar monitoring required insulin for blood sugar control. There was significant family history of diabetes in women with mild hyperglycemia when compared to controls. There was no significant difference in incidence of hypertension, hypothyroidism, preterm delivery and caesarean section between the two groups. LGA (Large for gestational age babies) (p=0.001) and serum triglyceride levels (p=0.04) were significantly more in women with mild hyperglycemia when compared to controls.Conclusions: Mild hyperglycemia during pregnancy should not be ignored and periodic blood sugar monitoring should be done to improve maternal and fetal outcome

Serum Prolactin Levels in Patients with Recently Diagnosed Rheumatoid Arthritis

OBJECTIVES: The role of Prolactin in autoimmune diseases & use of anti Prolactin drugs in disease remission has been described & investigated in several studies. The role of antiprolactin drugs in remission of disease activity have been investigated. The present study was carried out to correlate serum Prolactin levels with disease severity in recently diagnosed Rheumatoid Arthritis patients. MATERIALS and METHODS: A case-control study was carried out in 55 recently diagnosed untreated Rheumatoid factor positive & RF negative Rheumatoid Arthritis patients and 27 age & sex matched apparently healthy individuals. The diagnosis of RA was made using ACR criteria 2010. Serum Prolactin(ELISA), serum Anti CCP (ELISA), RF (Latex agglutination method), TSH(ELISA), ESR (conventional Westergrens method), Serum urea & creatinine were assayed. Disease severity was assessed by DAS (28) formula. Statistical evaluation was done by independent t-test,ANOVA, Pearson correlation coefficient. RESULTS: Serum Prolactin levels in RA patients was significantly higher (33.53±17.9ng/mL) compoared to controls (14.4±5.9) with p value of ˂ 0.001 . A fair correlation was found between disease activity and serum Prolactin levels ( r = 0.345 ; p = 0.01 ). CONCLUSION: Elevated levels of serum prolactin indicates the immunomodulatory role of PRL and its relationship to diseases activity. Use of Anti Prolactin drugs may be of use in patients with hyperprolactinemia