Pregnancy-induced Diabetes Mellitus Research Articles

Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair

Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index >25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p < 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p < 0.01 and p < 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.

The effects of stillbirth and abortion on the next pregnancy: a longitudinal study

BackgroundAbortion and stillbirths are the common obstetrics condition in Ethiopia and their effect on the next pregnancy was not well identified in resource limited settings. The aim of the study was to assess the effect of stillbirth and abortion on the next pregnancy.MethodsA prospective cohort study design was implemented. The study was conducted in Mecha demographic surveillance and field research center catchment areas. The data were collected from January 2015 to March 2019. Epi-info software was used to calculate the sample size. The systematic random sampling technique was used to select stillbirth and abortion women. Poison regression was used to identify the predictors of MCH service utilization; descriptive statistics were used to identify the prevalence of blood borne pathogens. The Kaplan Meier survival curve was used to estimate survival to pregnancy and pregnancy related medical disorders.Results1091 stillbirth and 3,026 abortion women were followed. Hepatitis B was present in 6% of abortion and 3.2% of stillbirth women. Hepatitis C was diagnosed in 4.7% of abortion and 0.3% of stillbirth women. HIV was detected in 3% of abortion and 0.8% of stillbirth women. MCH service utilization was determined by knowledge of contraceptives [IRR 1.29, 95% CI 1.18–1.42], tertiary education [IRR 4.29, 95% CI 3.72–4.96], secondary education. [IRR 3.14, 95% CI 2.73–3.61], married women [IRR 2.08, 95% CI 1.84–2.34], family size [IRR 0.67, 95% CI 1.001–1.01], the median time of pregnancy after stillbirth and abortion were 12 months. Ante-partum hemorrhage was observed in 23.1% of pregnant mothers with a past history of abortion cases and post-partum hemorrhage was observed in 25.6% of pregnant mothers with a past history of abortion. PREGNANCY INDUCED DIABETES MELLITUS was observed 14.3% of pregnant mothers with a past history of stillbirth and pregnancy-induced hypertension were observed in 9.2% of mothers with a past history of stillbirth.ConclusionObstetric hemorrhage was the common complications of abortion women while Pregnancy-induced diabetic Mellitus and pregnancy-induced hypertension were the most common complications of stillbirth for the next pregnancy.

English

BACKGROUND Neonatal thrombocytopenia is one of the most common haematological abnormalities in neonates occurring in 1 to 2 % of healthy term neonates. Various risk factors like sepsis, prematurity, and birth asphyxia are known to be associated with this condition. Maternal factors also predispose to this condition. Early detection and appropriate management is of utmost importance to prevent complications. The aim of the study is to evaluate the predisposing factors for neonatal thrombocytopenia in a teaching hospital. METHODS This was a cross sectional observational study done in the Department of Peadiatrics, MediCiti Institute of Medical Sciences, Medchal, Telangana, for a duration of one year i.e., from January 2019 to December 2019. A total of 60 neonates with thrombocytopenia were studied for onset of thrombocytopenia, severity based on platelet counts, aetiology and for contributing maternal factors. RESULTS Early onset thrombocytopenia (< 3 days of age) was seen in 46.6 % (28 / 60) and late onset thrombocytopenia (3 - 28 days) in 53.3 % (32 / 60). The most common cause for neonatal thrombocytopenia was neonatal sepsis 30 % (10 / 60), followed by birth asphyxia. Common maternal predisposing factors were pregnancyinduced hypertension and pregnancy-induced diabetes mellitus. CONCLUSIONS Neonatal thrombocytopenia is one of the most common clinical problems in neonates. It can be of early or late onset type and has fetal and maternal predisposing factors. Neonatal sepsis is one of the most common cause for neonatal thrombocytopenia followed by birth asphyxia which is a preventable cause. Early diagnosis and thorough evaluation are needed to prevent complications. KEYWORDS Neonatal Thrombocytopenia, Neonatal Sepsis