A prospective observational study to evaluate prevalence of asymptomatic bacteriuria in pregnancy

Background: Asymptomatic bacteriuria is under-diagnosed condition in pregnancy. Prompt recognition of asymptomatic bacteriuria and its treatment is necessary as this condition can be associated with adverse maternal and foetal complications. Screening of asymptomatic bacteriuria is easy and replicable and goes a long way in promoting safer maternal and foetal outcomes. The aim of the study was to determine (a) prevalence of asymptomatic bacteriuria in pregnant women attending antenatal care and determine its association with age, parity and socio-economic status, and (b) microbiological patterns of the causative organism.Methods: This was a prospective, observational study that evaluated 200 pregnant women visiting antenatal care in tertiary care hospital, SS Institute of Medical Sciences and Research Centre, Davangere, India. A study was conducted in Department of Obstetrics and Gynecology. Subjects having fever, symptoms of urinary tract infection, underlying co-morbid conditions were excluded from the study. Those willing to give a valid consent with no signs of urinary tract infection were included in the study.Results: The prevalence of asymptomatic bacteriuria was noted to be 19% in our study. The most common organism noted to cause asymptomatic bacteriuria was noted to be E. coli followed by Staphylococcus aureus. The prevalence of asymptomatic bacteriuria was noted to be highest in the second trimester followed by those in first trimester.Conclusions: Asymptomatic bacteriuria is widely prevalent in pregnancy. Pregnant women should be screened every trimester for presence of asymptomatic bacteriuria.

Changing trends in the usage of copper intrauterine contraceptive device: a five year institutional study

Background: Intrauterine contraceptive device is one of the commonest form of long acting contraceptive method (LARC) adapted by reproductive aged women all over the world today. It can be used for 5 to 10 years depending on the type of the device. Aim of the study was to study the institutional rate of copper IUCD usage, rate of removal, side effect profile, indications for removal among women seeking contraception.Methods: The data regarding the usage of various temporary contraceptive methods were obtained from the family planning unit at our institution SSIMS&RC, Davangere from the records between Jan 1, 2012 to Dec 31, 2016 (5 years). A careful detailed study of records was done on the usage of Cu-IUCD.Results: During the five year study period, 3,767 women were provided with various forms of contraceptive methods. Cu-IUCD was the commonest method used by women accounting for 42.11% (1586 users). There was a decline in the rate of usage of Cu-IUCD in 2015-16, with increase in the usage of injectables. 179 women requested for removal in the study period, main reason being desire to become pregnant in 73.18% (131) users. Failure rate in the study period was 0.55%.Conclusions: Cu-IUCD is a safe and effective method of contraception adapted by women of reproductive age. The rate of removal is also low in our study. The decline in the usage of Cu-IUCD during our study period could be attributed to increasing awareness of other methods of LARC

A clinical study of prevalence of gestational diabetes mellitus and associated risk factors at a tertiary care centre in Karnataka, India

Background: Women with GDM are at increased risk for adverse obstetric and perinatal outcome .This study was undertaken to evaluate the prevalence of GDM using Diabetes in pregnancy study group India (DIPSI) criteria and associated risk factors in pregnant women.Methods: Universal screening for GDM was done in 200 pregnant women with estimated gestational age between 14 -18 weeks. They were given 75 gm oral glucose irrespective of meals. Diagnosis of GDM was made if 2 hr plasma glucose was ≥140, If plasma glucose is <140 then the test is repeated at 24-28 weeks. If normal, then the test is repeated at 32 weeks. If plasma glucose is <140 mg at 32 weeks, then they are classified as non –GDM group. Prevalence of risk factors like age ≥25, BMI ≥25, family history of DM, bad obstetric history, history of GDM and macrosomia were studied in GDM and non GDM group and results are statistically analysed.Results: The prevalence in this study was 11.5%. The prevalence was more in women with advanced age, high BMI, positive family history of DM, past history of GDM and macrosomia.Conclusions: The prevalence of GDM was found to be 11.5 % and its association with risk factors found to be significant. DIPSI diagnostic procedure is a simple, cost effective and evidence based test

A rare case report of recurrent ectopic pregnancy

This case presenting a 30-year-old lady, a case of G4A1E2 who presented with history of 1 month of amenorrhoea, followed by bleeding per vaginum 1 week back for 3 days. Presented to hospital with spotting PV and pain abdomen for 2 days. UPT done at home was positive. USG revealed right ovarian complex haemorrhagic cyst and left adnexal ectopic pregnancy near left ovarian fimbriae. Conservative management by Methotrexate and Folinic acid regimen was tried but as there were no signs of resolution on serial ultrasonography reports and serial human chorionic gonadotropin (hCG) levels did not fall as expected, hence decision of laparoscopy/laparotomy was made and salpingectomy was done. Later patient was followed up with serial hCG levels

Study of near miss maternal morbidities at a tertiary hospital

Background: In health care literature NEAR MISS refers to a severe life-threatening condition that did not cause death-but had the potential to do so. But in 2009, WHO came up with a comprehensive criteria for identification of near miss. Present study was undertaken to analyse maternal near miss morbidity (MNMM) cases and associated morbidity in a local setting.Methods: Present study was single-center, prospective, observational study, conducted in maternal near miss cases which met the comprehensive criteria of WHO, admitted during study period and survived.Results: In present study, majority of cases were 20-29 years (78%), multigravida (52%), in third trimester and postpartum (52%), had phenotype as class I MNMM (maternal near miss with healthy infant) (36%), In near miss cases, near miss on arrival were 66% while 34% were near miss after admission, 8% had disorder on admission and became near miss and 26% had no disorder on admission but became near miss (26%).Conclusions: Hypertensive disorders and Hemorrhage and COVID-19 related complications were the leading causes of near miss situations. Previous LSCS and Anemia seem to be risk factors for developing MNMM.