Pregnancy in Takayasu arteritis - maternal and fetal outcome

Background: Takayasu arteritis is a rare medical disorder of primary vasculitis of unknown etiology. It affects reproductive age women. It is rare disease and associated with serious maternal and fetal complications and long term morbidity.Methods: Retrospective analysis of patients with diagnosed Takayasu arteritis, to know the impact of disease on maternal status and evaluate fetal outcome. The objective of this study was to know the maternal and fetal outcome in pre-diagnosed cases of Takayasu arteritis. The necessity of accurate measurement of pulse and blood pressures in all the limbs in a suspected case of hypertension in antenatal women at any period of gestation and TYPE the disease accordingly. 3. To evaluate the typing of TA on maternal and fetal outcome.Results: All the 4 patients with TA had medical complication like hypertension in the form of chronic hypertension and pre eclampsia that needed good monitoring of BP in all 4 limbs.Conclusions: As the typing of disease increased, more medical and obstetric complications were noticed

Study on HELLP syndrome - maternal and perinatal outcome

Background: HELLP Syndrome is a serious obstetric complication in pregnancy characterised by haemolysis, elevated liver enzymes and low platelet count. Incidence is 0.5-0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia and eclampsia. The aim of the study was to study the incidence, different clinical presentations and diagnosis of HELLP syndrome in Pre eclampsia and Eclampsia and to analyze the severity, complications, maternal and perinatal outcome.Methods: It is a 16 months period retrospective study of 102 cases of preeclampsia and eclampsia admitted in NRIMC and GH in OBGY Department with more than 28 weeks gestation. Of these, 91 cases had preeclampsia and 11 cases had eclampsia. Out of these, 15 cases developed HELLP Syndrome. The available history, clinical data, detailed laboratory investigations were studied and categorized by Mississippi classification for better analysis of complications and outcome in HELLP syndrome.Results: Of 91 cases of Preeclampsia, 12 cases (13.18%) developed HELLP syndrome and out of 11 cases of Eclampsia, 3 cases (27.27%) had HELLP Syndrome. Majority of the cases belonged to 21-25years age group and were mostly from lower Socio economic status. The present study showed 60% maternal morbidity and 6.6% maternal mortality and the perinatal morbidity and mortality was 46.6% each.Conclusions: HELLP Syndrome is a severe variant and a dreadful complication of Preeclampsia and Eclampsia, it needs early diagnosis and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to complications

Pseudoaneurysm of uterine artery: as a cause of secondary post partum haemorrhage

Background: Secondary PPH is rare and life threatening, if the cause is not properly identified. Cases should be subjected for USG doppler to exclude rare entities such as pseudoaneurysm of uterine artery and AV malformations. Pseudoaneurysm of uterine artery is a rare entity to produce secondary PPH, but once identified can be effectively treated, provided facility of uterine artery embolisation is available.Methods: Here in we report 6 cases of secondary post partum haemorrhage where 5 were treated by uterine artery embolization, for recurrent attacks of bleeding following caesarean section with no identifiable cause and referred to our institution. We subjected them for USG doppler study - diagnosed to have pseudo aneurysm in 6 cases and further managed by angiography, followed by uterine artery embolisation.Results: Out of 6 cases, all cases were diagnosed of having pseudoaneurysm of either Right or Left uterine artery. 5 were subjected to uterine artery embolization. Out of the 5 cases, 4 responded well and in one case following coil embolisation as bleeding through collaterals still observed, hysterectomy had to be done. For 6th case because of haemodynamic unstability hysterectomy had to be done.Conclusions: Uterine artery embolization is an effective and reliable method for control of haemorrhage in pseudoaneurysm. One should have doubt about pseudoaneurysm in cases of secondary PPH where the bleeding is recurrent and cause not acertainable and to be referred in time where the facility of uterine artery embolization is available

A clinical and microbiological study of urinary tract infections in diabetes mellitus

Aim & Objective: To study clinical and microbiological profile of urinary tract infections and also to determine antibiotic sensitivity pattern for isolated organisms in patients with diabetes mellitus. Methodology: It was a prospective and observational study. The present study to be conducted on diabetic patients who had pus cells of more than 10 per high power field on complete urine examination who attending general medicine OPD or admitted as in patients in Kamineni hospitals, LB Nagar, Hyderabad. Results: In our study prevalence of culture positive urinary tract infection is 44%. In our study there is higher prevalence of culture positive UTI in females (46%) compared to male patients (44%). In our study age of the patient did not show any association with culture positive UTI. In our study we found that symptoms urgency, frequency, supra pubic pain had significant association with culture positive urinary tract infection. In present study there is no association of culture positive UTI with type of diabetes, duration of diabetes and treatment modality for diabetes. Elevated HbA1c correlates with occurrence of UTI and the predisposition of the diabetic to UTI depends on the degree of glycemic control over a period of weeks to months. Achieving an HbA1c <7.0 percent appears to protect those diabetics who do not have other underlying predisposing factors for UTI. An HbA1c >8.0 percent in patients with diabetes mellitus increase the chance of developing UTI. Leucocytosis, anemia was observed significantly in the culture positive group. Conclusion: In present study there is no association of culture positive UTI with type of diabetes, duration of diabetes and treatment modality for diabete