Evaluation of intravenous iron sucrose therapy for management of moderate to severe anaemia in pregnancy

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to evaluate the response and effectof parenteral iron sucrose complex therapy in iron deficiency anemia in pregnancy.Methods: A prospective observational study was conducted at GMERS Medical College, Dharpur-Patan over a period extending from September 2014 to August 2017. A total of 150 Antenatal women, between 26-32 weeks of pregnancy with hemoglobin between 5-9 gm% were selected for study by purposive sampling. They were given intravenous iron sucrose complex in a dose of 200 mg (2 ampules of 5 ml each) in 100 ml normal saline over a period of 15-20 minutes, on alternate day. Repeat CBC was done after a period of 6 weeks.Results: Age range of the patients was 20 to 34 years. Out of total 150 women, 72 women (48%) were in age group of 20-24 years. 64.6% women had 27-29 weeks of pregnancy. 58 (38.6%) women had <8 gm% of Hb before treatment and 108 (72%) women achieved Hb of 10 gm% after treatment. The mean haemoglobin raised from 7.9±0.92 gm% to 10.3±0.83 gm% (P<0.001) after six weeks of therapy. There was significant rise in MCV levels (from 67.7±5.1 fl to 78.9±6.4fl) (P<0.001). Major side effects or anaphylactic reactions were occurred in none of the women during study period. 93.3% of patients, treated for anemia were delivered at full term, either vaginally (67.3%) or by LSCS (26%). Most of the delivered babies (80%), had birth weight of more than 2.5 kgs.Conclusions: Parentral iron therapy was effective in increasing haemoglobin and other haematological parameters in pregnant women with moderate to severe anaemia

Efficacy of misoprostol over dinoprostone gel as a cervical ripening agent: a comparative study

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. The objective of this study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Dinoprostone gel in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and 100 cases with 0.5 mg intracervical Dinoprostone gel during September 2014 to August 2017 at the department of Obstetrics and Gynaecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 74.8% of the patients were in 21-25 years age groups. 50.4% patients were multigravida. 57.6% patients had more than 37 weeks of pregnancy. 50.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 93% of patients in Dinoprostone group were delivered by vaginal delivery. 60% patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Dinoprostone: 27%, p<0.001). Incidence of thin meconium was 11.3% in Misoprostol group, 9% in Dinoprostone group. In Misoprostol group 3.3 women had fever after induction.Conclusions: Vaginal misoprostol is more efficacious in cervical ripening and for induction of labor than Dinoprostone

Efficacy of misoprostol over Foley’s catheter as a cervical ripening agent: a comparative study

Background: Timely induction of labour could reduce maternal mortality and morbidity as well as assure a delivery of healthy baby. Objective of present study was to evaluate the efficacy of Misoprostol as a cervical ripening agent and its comparison with Foley’s catheter in terms of success rate, safety, side effects and patient compliance.Methods: A total of 250 pregnant women requiring induction of labor were recruited. Out of 250 cases, 150 were induced with 50 microgram Misoprostol and in 100 cases Foley catheter 18 F, was placed through the internal os of the cervix during September 2014 to August 2017 at the department of Obstetrics and Gynecology, GMERS Medical College, Dharpur-Patan. Written and informed consent was taken from the patients. Outcome measures, such as change in Bishop's score, need of augmentation, induction delivery interval; complications like hyperstimulation, fever and meconium passage were compared between two groups. Statistical analysis was performed by Epi Info 7.Results: Age range of the patients was 21 to 35 years. 72.4 % of the patients were in 21-25 years age groups. 54.4% patients were multigravida. 59.2% patients had more than 37 weeks of pregnancy. 46.4% of the patients had premature rupture of membrane as indication of labour. The mean Bishop's score for induction was 3.21 in Misoprostol group. 81.3% patients in Misoprostol group and 88% of patients in Foley’s catheter group were delivered by vaginal delivery. 60 % patients delivered within 6 hours in Misoprostol group. (Misoprostol: 60%, Foley’s catheter: 9%, p<0.001) Incidence of thin meconium was 11.3% in Misoprostol group, 9 % in Foley’s catheter group. In Misoprostol group 3.3 women had fever after induction while it was 6% in Foley’s catheter group.Conclusions: The results of the present study confirm that vaginal misoprostol is more effective than Foleys catheter in pre-induction cervical ripening

Impact of educational intervention regarding anaemia and its preventive measures among pregnant women: an interventional study

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to assess knowledge of pregnant women regarding anaemia and its preventive measures before and after educational interventional training.Methods: The present study was an interventional study undertaken in purposively selected pregnant women attending the out patient Department of Obstetrics and Gynecology Department of GMERS Medical College, Gandhinagar During the month of October 2017. Total 100 pregnant women were included after written informed consent. Baseline knowledge of pregnant women regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Single educational interventional training for 45 minutes was given to selected pregnant women. Post– intervention knowledge of pregnant women for the same was assessed after training. Thus, collected data was analyzed /using Epi info 7.Results: Baseline knowledge of the pregnant women regarding causes, signs and symptoms of anemia and dietary sources of iron was 21%, 23% and 40% respectively which was significantly increased to 64%, 66% and 72% respectively after the intervention. Baseline knowledge of the pregnant women regarding factors which inhibit and increase iron absorption was 25% and 4% respectively which was significantly increased to 55% and 41 % respectively after the intervention. Baseline knowledge of the pregnant women regarding treatment of anaemia was 30% which was significantly increased to 79 % after the intervention.Conclusions: There was significant improvement in the knowledge regarding anaemia and its preventive measures among pregnant women after our single educational session

Assessment of knowledge regarding anaemia and its preventive measures among lactating mothers of North Gujarat region, India

Background: Anaemia in pregnancy and lactation period has detrimental effects on maternal and child health. Objective of this study was to assess knowledge of lactating mothers regarding anaemia and its preventive measures before and after educational intervention.Methods: The interventional study conducted in purposively selected lactating mothers attending the outpatient department of obstetrics and gynecology. Hospital ethical committee permission was obtained. After taking informed consent 100 lactating mothers were selected by systemic random sampling methods. Knowledge of lactating mothers regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Health education for 30 minutes was given to selected lactating mothers. Knowledge of pregnant women for the same was assessed after health education. Thus, collected data was analyzed using Epi info 7.Results: Awareness among lactating mothers regarding causes, signs and symptoms of anemia and dietary sources of iron was 41%, 26% and 5% respectively which was significantly increased to 73%, 56% and 42% respectively after health education. Awareness among lactating mothers regarding factors which inhibit and increase iron absorption was 31% and 22% respectively which was significantly increased to 80% and 65% respectively after health education. Out of 100 lactating mothers only 24% were aware regarding treatment of anemia.Conclusions: Lack of awareness among lactating mothers regarding anemia and its preventive measure should be addressed by health education during hospital visits