Pregnancy with pancytopenia: an observational study

Background: Pancytopenia is the reduction in all three major cellular elements of blood; hence it is the simultaneous presence of anaemia, leukopenia and thrombocytopenia. Pancytopenia is associated with many maternal and foetal complications during pregnancy like maternal sepsis, postpartum haemorrhage, pre-eclampsia and preterm labour, IUGR and intrauterine foetal demise.Methods: The study was conducted at BLDE (Deemed to be) University, Shri B. M. Patil Medical College Hospital and Research Centre. It’s an observational study done from November 2019-April 2020. The participants enrolled in the study were subjected for further clinical and laboratory evaluation and followed for feto-maternal outcome.Results: The incidence of pancytopenia with pregnancy in this study was 3% and all the patients were vegetarian by diet along with vitamin B12 and folic acid deficiency. They were associated with different maternal and foetal complications.Conclusions: Proper dietary counselling and well-balanced dietary plans even with plant originate food can prevent the micronutrients deficiency and avoid the deleterious consequences like pancytopenia

A study of hypertensive disorders of pregnancy and the fetal outcome in a tertiary care hospital: a prospective study

Background: Pregnancy induced hypertension is one of the major causes of feto maternal morbidity and mortality in pregnancy. The exact cause of PIH is unknown certain factors are known to increase the risk of PIH such as risk factor includes that young women with first pregnancy.Methods: The objective of this study was to assess the socio-demographic and clinico-pathological profile of the patients with hypertensive disorders of pregnancy and its associated fetal outcomes. A prospective study was conducted in department of obstetrics and gynecology Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura Karnataka from 15th July to 15th December 2018. All women admitted to labour ward with diagnosis of hypertensive disorders of pregnancy were included in the study after ruling out the exclusion criteria and thorough history, examination and laboratory evaluation were done and followed till delivery.Results: A total of 123 pregnant women with hypertensive disorder of pregnancy were enrolled in the study. Most of the participants were in the age group of 20 to 30 years. The PIH was seen mostly in primigravida, lower socioeconomic status and with lower educational levels. Emergency LSCS is the most common mode of delivery.Conclusions: The hypertensive disorder in pregnancy affects the majorly younger age group. It is most commonly seen in low socio-economic and uneducated population. Hence, there should be provided with proper antenatal care, early detection of hypertensive disorders for better feto-maternal outcome

Antenatal dexamethasone for early preterm birth in low-resource countries

BACKGROUND: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain. METHODS: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo. The primary outcomes were neonatal death alone, stillbirth or neonatal death, and possible maternal bacterial infection; neonatal death alone and stillbirth or neonatal death were evaluated with superiority analyses, and possible maternal bacterial infection was evaluated with a noninferiority analysis with the use of a prespecified margin of 1.25 on the relative scale. RESULTS: A total of 2852 women (and their 3070 fetuses) from 29 secondary- and tertiary-level hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan underwent randomization. The trial was stopped for benefit at the second interim analysis. Neonatal death occurred in 278 of 1417 infants (19.6%) in the dexamethasone group and in 331 of 1406 infants (23.5%) in the placebo group (relative risk, 0.84; 95% confidence interval [CI], 0.72 to 0.97; P=0.03). Stillbirth or neonatal death occurred in 393 of 1532 fetuses and infants (25.7%) and in 444 of 1519 fetuses and infants (29.2%), respectively (relative risk, 0.88; 95% CI, 0.78 to 0.99; P=0.04); the incidence of possible maternal bacterial infection was 4.8% and 6.3%, respectively (relative risk, 0.76; 95% CI, 0.56 to 1.03). There was no significant between-group difference in the incidence of adverse events. CONCLUSIONS: Among women in low-resource countries who were at risk for early preterm birth, the use of dexamethasone resulted in significantly lower risks of neonatal death alone and stillbirth or neonatal death than the use of placebo, without an increase in the incidence of possible maternal bacterial infection.Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Vogel, Joshua P.. Organizacion Mundial de la Salud; ArgentinaFil: Piaggio, Gilda. Organizacion Mundial de la Salud; ArgentinaFil: Nguyen, My-Huong. Organizacion Mundial de la Salud; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Metin Gülmezoglu, A.. Organizacion Mundial de la Salud; ArgentinaFil: Bahl, Rajiv. Organizacion Mundial de la Salud; ArgentinaFil: Rao, Suman P.N.. Organizacion Mundial de la Salud; ArgentinaFil: de Costa, Ayesha. Organizacion Mundial de la Salud; ArgentinaFil: Gupta, Shuchita. Organizacion Mundial de la Salud; ArgentinaFil: Shahidullah, Mohammod. No especifíca;Fil: Chowdhury, Saleha B.. No especifíca;Fil: Ara, Gulshan. No especifíca;Fil: Akter, Shaheen. No especifíca;Fil: Akhter, Nasreen. No especifíca;Fil: Dey, Probhat R.. No especifíca;Fil: Abdus Sabur, M.. No especifíca;Fil: Azad, Mohammad T.. No especifíca;Fil: Choudhury, Shahana F.. No especifíca;Fil: Matin, M.A.. No especifíca;Fil: Goudar, Shivaprasad S.. No especifíca;Fil: Dhaded, Sangappa M.. No especifíca;Fil: Metgud, Mrityunjay C.. No especifíca;Fil: Pujar, Yeshita V.. No especifíca;Fil: Somannavar, Manjunath S.. No especifíca;Fil: Vernekar, Sunil S.. No especifíca;Fil: Herekar, Veena R.. No especifíca;Fil: Bidri, Shailaja R.. No especifíca;Fil: Mathapati, Sangamesh S.. No especifíca;Fil: Patil, Preeti G.. No especifíca;Fil: Patil, Mallanagouda M.. No especifíca;Fil: Gudadinni, Muttappa R.. No especifíca;Fil: Bijapure, Hidaytullah R.. No especifíca;Fil: Mallapur, Ashalata A.. No especifíca;Fil: Katageri, Geetanjali M.. No especifíca;Fil: Chikkamath, Sumangala B.. No especifíca;Fil: Yelamali, Bhuvaneshwari C.. No especifíca;Fil: Pol, Ramesh R.. No especifíca;Fil: Misra, Sujata S.. No especifíca;Fil: Das, Leena. No especifíca