Maternal and fetal outcomes in pregnant women with hyperemesis gravidarum

Background: Hyperemesis gravidarum (HG) is associated with maternal weight loss, nutritional deficiencies, fluid and electrolyte abnormalities, which may lead to adverse fetal and maternal outcomes. The purpose of this study was to evaluate the relationship of hyperemesis gravidarum to maternal and foetal outcomes.Methods: A hospital-based prospective observational study was carried out. All patients with singleton pregnancy diagnosed as / history of hyperemesis gravidarum the current pregnancy was included in the study. The pregnant women with multiple pregnancy, molar pregnancy, presence of pre-gestational diabetes, pre-gestational hypertension, and other causes of nausea such as appendicitis and pyelonephritis were excluded from the study.Results: 36 pregnant women with prevalence rate of 3.28% have been found to be suffering from HG. Almost half (17, 47.22%) of the pregnant women with HG had age less than 25 years. The significant association (p-value: 0.0099) has been found between parity and smoking with HG. HG was significantly associated with low birth weight (p-value: 0.0133); small for gestational age (SGA) (p-value: 0.0316); APGAR score < 7 after 1 minute (p-value: 0.0060); and APGAR score <7 after 5 minutes (p-value: 0.0006). There is no association found between mode of delivery, gestational diabetes, and pregnancy-induced hypertension with HG.Conclusions: HG can adversely affect fetal as well as maternal, though not significant, pregnancy outcomes

Perinatal outcomes and intrahepatic cholestasis of pregnancy: a prospective study

Background: Women with intrahepatic cholestasis of pregnancy (ICP) have an increased risk for postpartum haemorrhage, dyslipidaemia, preterm labour and operative interference. Fetus in ICP has been associated with an increased incidence of preterm labour, preterm prelabour rupture of membrane, fetal distress, abnormal CTG, meconium staining, spontaneous intrauterine death. The present study was done to evaluate the perinatal outcomes – maternal outcomes and fetal outcomes of ICP.Methods: This was a prospective observational study carried out in a tertiary care teaching hospital. Total 1100 pregnant women were screened during the study period. Patients with ICP were identified in maternity care units after eliciting history about itching. Pregnancies with pregnancy induced hypertension and other liver diseases in pregnancy were excluded.Results: 62 pregnant women with prevalence rate of 5.64% have been found to be suffering from ICP. The most frequently affected (22, 35.48%) age-group with ICP were belong to age > 35 years. A majority of pregnant women with intrahepatic cholestasis of pregnancy was of multipara. ICP was highly significantly associated with small for gestational age (SGA, p-value: 0.0003); abnormal cardiotocography (CTG, p-value: 0.0002); and meconium stained liquor (p-value: 0.0001). Caesarean section as mode of delivery found significantly associated (p-value: 0.0033) with ICP. Insomnia (p-value: 0.0045); dyslipidemia (p-value: 0.0011); and postpartum haemorrhage (p-value: 0.0122) were also found significantly with ICP.Conclusions: ICP can adversely affect fetal as well as maternal pregnancy outcomes. Maternal outcomes have good prognosis, but fetal outcomes can be improved by timely and effective intervention