Prediction of adverse effects of preeclampsia

Background: To predict the adverse maternal, perinatal and combined (both maternal and perinatal) outcome in preeclampsia by using various clinical and laboratory variables. Methods: Five hundred fifty women diagnosed with preeclampsia were included and twenty-four women were excluded from the study due to exclusion criteria, six women decline to participate, twenty women were lost to follow up, three women withdrew consent, so a total of 497 women were followed up in the study.Results: Mean age of study population was 26.82±4.48 years. Majority of women with preeclampsia delivered vaginally. Forty-five (9.05%) developed neurological complication. Mean gestational age at delivery (weeks) in patients who developed adverse outcome was 34.58±3.74 weeks and in patients with normal outcome is 38.62±1.59 weeks. Mean birth weight of newborns were 2.1±0.73 kg and 1.85±0.61 kg for newborns with adverse outcomes. Majority of perinatal complication was small for gestational age 267 (54.37%) followed by prematurity 262 (53.36%). Total number of adverse perinatal events was six hundred seventy-seven as multiple neonates had more than one perinatal outcome. In combined (both maternal and perinatal) adverse outcome-374 (75%) developed adverse outcome, 123 (25%) developed normal pregnancy outcome.Conclusion: This study found out simple clinical, biochemical tools for monitoring pregnant women and accurately identifying who was at greatest risk of severe complications. By identifying those women at highest risk of adverse maternal outcomes well before that outcome occurs, transportation and treatment can be targeted to those women most in need. This clinical prediction tool found to be an important contributor as it offers the potential to improve health outcomes of women for a condition that is at the root of a large amount of morbidity and mortality in the developing world

Maternal and perinatal morbidity and mortality in COVID-19 positive obstetric patients with medical disorders in tertiary care hospital in North India

Background: Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 virus experienced mild to moderate respiratory illness. Coronavirus is known to human kind since 1930. It was first discovered in domesticated chicken with symptoms of pulmonary infection. The aim and objective was to study clinical profile of patients presented with medical disorders in COVID-19 positive pregnant women.Methods: Present retrospective COHORT study included 50 COVID-19 positive obstetrics patients. The study was conducted in the department of obstetrics and gynaecology, World college of medical sciences and research, Jhajjar (Haryana). Retrospective review of medical records of all pregnant patients with pre-existing medical disorders or those suspected with medical disorders on the basis of clinical and/or laboratory data from 1 April 2020 through 30 September 2020.Results: Mean age of the women was 27.46±4.16 years with age range of 20-35 years. Mean period of gestation was 33.26±8.35 weeks. A total of 33 (66%) women were found to be COVID-19 positive due to close contact. 29 (58%) women were found to be asymptomatic and 17 (34%) had various other COVID-19 symptoms. In 17 (34%), sore throat was the commonest symptoms followed by cough, myalgia and fatigue, that is, 13 (26%) each. Fever at the time of admission was present in 9 (18%) women and postpartum fever was observed in 4 (8%) women. Mean hospital stay was 9.24±3.25 days. A total of 29 (58%) women underwent caesarean delivery and 21 (42%) had normal vaginal delivery. Mean postoperative hospital stay was 4.48±2.24 days. In 9 women, postoperative complications were seen. A total of 8 babies admitted to NICU due to various complications. Two babies expired during the study period.Conclusions: In the present retrospective COHORT study, the majority of the pregnant women with COVID-19 infection had mild symptoms with no severe illness. Mother-to-child transmission of COVID-19 cannot be ruled out. The impacts of COVID-19 infection on patients with medical disorders during pregnancy were seen