The pattern of variations in the first trimester fetal heart rate in Indian population: a pilot study

Background: Fetal heart rate is an indicator of fetal viability. During third trimester and labour the normal range of fetal heart rate is between 110-160 bpm as recommended by the international guidelines. Unlike this, the first trimester embryonic heart rate does not lie in the same range. During the first trimester the normal embryonic heart rate varies between each week of gestation, as determined by a few western studies. Indian studies on the same are not available. Objective of this study was to determine the trend of the fetal heart rate in first trimester of pregnancy in South Indian women.Methods: Transvaginal scan was done in 51 pregnant women with singleton pregnancy attending the antenatal clinic in a medical college hospital. Crown rump length and fetal heart rate were measured and plotted on a graph. Also, the fetal heart rate at different gestational age of our study was compared with the fetal heart rates at the same gestational age from the studies in the western population.Results: The range of fetal heart rate at different weeks of gestation was comparable to the heart rate variations as seen in the western population. The maximum heart rates at 9 weeks of gestation in our study was higher than the heart rate in the western population.Conclusions: Possibility of variation in the fetal heart rates in the first trimester in different populations cannot be ruled out until confirmed by studies with large sample size

Assessing the knowledge on periconceptional use of folic acid among women visiting a tertiary care hospital in South India

Background: Periconceptional folic acid supplementation is an essential element for the prevention of neural tube defects. Neural tubes defects are congenital malformations affecting the brain and spinal cord associated with substantial mortality, morbidity, disability, and psychological impact. Mere awareness about its use and benefits can prevent a major proportion of these complications. Hence the present study is designed to assess the knowledge of use of periconceptional folic acid among women.Methods: This was a descriptive cross-sectional study conducted at Kempegowda institute of medical sciences, Bengaluru. 250 women attending the outpatient department, consenting to participate in the study were assessed about their knowledge on periconceptional use of folic acid by a self-designed questionnaire and the responses were analysed.Results: Out of 250 women, 194 (77.6%) were aware of folic acid. Among the 194 women 151 (77.83%) had learnt about it only after the diagnosis of pregnancy. The major source of information were health care providers in 182 (93.8%) women. The knowledge that it prevented neural tube defects was known to 79 out of 194 women. However only 18 (9.27%) women took folic acid periconceptionally.Conclusions: Among the study population the level of knowledge on periconceptional use of folic acid was low. The major source of information about the use of folic acid was from health care workers during early pregnancy. Periodic health education, awareness programs, periconceptional counselling at individual level can help in optimizing the intake and preventing the burden of neural tube defects