Regular Antenatal Checkup Research Articles

Observing the Maternal Complications and Fetal Morbidity and Mortality of Preterm Birth

Introduction: Preterm labor is one of the clinical events that can change a normal pregnancy into a high-risk one for both the mother and the fetus. Preterm labors are thought to be caused by a combination of factors, including decidual bleeding and uterine deformation. Aim of the Study: The aim of the study was to observe the maternal complications of preterm birth. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Chittagong Medical College Hospital, Bangladesh. The study duration was 6 months, from January to June of 2015. Purposive sampling method was used to select a total of 100 women from those admitted at the study hospital for deliveries according to inclusion and exclusion criteria. Result: Most of the patients were from the third decade of life. Majority (61.0%) patients had multi para. Majority (39.0%) patients were gestational age 34 weeks. More than half (53.0%) had infection, among which urinary tract infection were the most common. Neonatal death was 61%, and most common cause of neonatal death was septicemia, followed by respiratory distress syndrome. Conclusion: Most of the patients were in 3rd decade of life, and did not receive regular antenatal check-up. Infection and pre-eclampsia were the most common maternal complications, while respiratory distress syndrome was the most common perinatal morbidity. Septicemia and respiratory distress syndrome were the most common cause of perinatal death.

Breast feeding practice in a selected peri urban area of Bangladesh

Background: Exclusive breastfeeding (EBF) offers optimum growth and development up to first six month of life. In Bangladesh, 55% of children less than 6 months of age are exclusively breastfed according to BDHS 2014.the aim of the study is to assess the exclusive breast feeding practice and associated factors among children in peri- urban area of Bangladesh. Methods: This is a cross sectional observational study conducted at Jhalkuri under Narayanganj districts during the period of July to December 2014. Total 109 mothers having infants aged 6-12 months interviewed and included in this study. Results: It was found that only 26(24%) mother went for regular antenatal checkup and remaining 83 (76%) had irregular antenatal check up. But none of them got breastfeeding advice during antenatal visit. Knowledge about breast milk as first food in 44(40%) mother. Mother informed to breast feeding exclusively upto six months only 53 (48%).Breastfeeding was initiated with in 1 hour of birth in 42(39%) cases and 67 (61%) cases after 1hour of birth. Exclusive breastfeeding (EBF) was found in 43 (40%) children. Among them 34 (79%) were children of housewife mothers. Mixed feeding (breast milk plus formula/ cow’s milk) was given to 52 children among them 25 (49%) were the children of housewife mothers. Only formula milk was given to 14 children of them 5(35%) were the children of housewife mothers. Exclusive breast milk was not given by 26(39%) mothers due to job or other occupation whereas 40(61%) mother did not give EBF due to insufficient breast milk. Conclusion: In the study rate of exclusive breast feeding was 40%. This is lower compare to national level. This study also showed that frequency of exclusive breast feeding practice was lower in working mothers than housewife mothers. This study also showed that the speculation of not getting sufficient milk was one of the main reasons for not giving exclusive breastfeeding. Bangladesh J Medicine 2022; 33: 274-279

Maternal & Fetal Outcome of Preterm Premature Rupture of the Membranes in Secondary Level Hospital in Bangladesh

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.

Factors Associated with Stillbirth in aTertiary Care Hospital

Background: Stillbirth is a disastrous event faced by the obstetrician. Each stillbirth is a tragedy having devastating implications for mothers, their families and the health personnel. Globally it remains a significant public health issue, particularly in developing countries like Bangladesh. An understanding of the risk factors associated with stillbirth will facilitate optimum quality of maternal and child health services; which leads to reduce the burden of death. Objective: To determine the factors associated with stillbirth in a tertiary care hospital. Methodology: A descriptive type of cross sectional study was conducted in the department of Obstetrics and Gynecology of Shaheed Suhrawardy Medical College Hospital from 1st January 2019 to 31th December 2019. Total 32 pregnant women who had stillbirth occurred during the study period were included in this study. Non probability purposive sampling technique was followed as per inclusion and exclusion criteria. Result: Total stillbirth reported were 32 (3.37% of total births). Maximum cases were primigravida (65.62%) with illiterate (71.87%), low socio-echonomic status (68.75%) and lack of Ante natal care(56.25%). Main causes of stillbirth were hypertensive disorders(15.6%), labour abnormalities(6.25%), other medical disorders(9.37%), infections(3.12%), Antepartum haemorrhage (12.5%), prematurity (12.5%), cord accidents(3.12%), IUGR(6.25%),birth asphyxia (6.25%) and post maturity(6.25%). Conclusion: Hypertension and other medical disorders, Antepartum haemorrhage, labour abnormalities, prematurity, post maturity, IUGR and birth asphyxia were identified as the highest risks for stillbirth which can be reduced by early recognition of the problem with regular antenatal check-up, colour Doppler ultrasound to diagnose fetal growth restriction and cord abnormalities, anomaly scan, intrapartum use of CTG to know fetal distress and use of partograph to prevent prolongation of second stage of labour and timely obstetric intervention will help in reduction of stillbirth. J Shaheed Suhrawardy Med Coll 2021; 13(1): 15-19

A study of abnormal liver function in pregnancy and its correlation with fetomaternal outcome in a teaching hospital of Kolkata in Eastern India

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyzes the causes and fetomaternal outcome in pregnancies and suggests measures to reduce morbidity and mortality. Aims and Objectives: This study aims to analyze the maternal and fetal outcome in pregnancy complicated with abnormal liver function test. Materials and Methods: This was hospital-based observational prospective study conducted at NRS Medical College and Hospital from March 2020 to August 2021. Total 144 pregnant women with abnormal liver function were included in the study. Template was generated and analysis was done on SPSS software. Results: Among 144 pregnant women 44.4% patients were 21–25 years of age. About 79.2% patients had <2 serum bilirubin, 13.9% patients had 2–5 serum bilirubin, 2.8% patients had abruption, 11.8% patients had convulsion, and 9.3% patients had fetal bradycardia. About 13.9% patients had acute kidney injury, 22.2% patients had BT, 9.7% patients had hemolysis, elevated liver enzymes and low platelets, 15.3% patients had postpartum hemorrhage, and 3.8% patients had maternal death. In our study, 34.7% patients had pre-eclampsia and 11.8% patients had eclampsia. Conclusion: Abnormal liver function during pregnancy is associated with adverse events for both the mother and the fetus. Regular antenatal check-up, screening, and diagnosing liver disorder can save the lives of many mothers and fetus.

Burden and pattern of congenital anomalies in newborns in a tertiary care hospital

Background: Anomaly is defined as a significant morphological or anatomic variation in the phenotype from the standard reference population. Objectives of current study was to investigate the incidence and pattern of congenital anomalies in the hospital delivered neonates, JNMCH, AMU, Aligarh.Methods: All the newborns delivered during the study period from October 2019 to November 2021 at JNMC, AMU, Aligarh were thoroughly examined and assessed for the presence of any congenital anomalies. Neonatal and maternal parameters were recorded in a predesigned proforma. Relevant investigations in the form of X-ray, ultrasonography and echocardiography were carried out in case of any suspected anomaly.Results: Out of the total 10932 neonates delivered during the study period, 197 babies had congenital malformations including 166 live births and 31 still births with an incidence of 1.8%. Musculoskeletal system was the most commonly system involved and congenital talipes equinovarus was the single most common malformation. Higher incidence of malformation was seen to be associated with still birth, prematurity, male gender and low birth weight babies.Conclusions: Regular antenatal checkups and anomaly scans can detect congenital malformations early. Pre conceptional counselling about maternal age at conception and birth order may help in preventing malformations associated with syndromes such as Down’s and Edward syndrome. Peri conceptional folate supplementation can prevent CNS malformations such as Neural tube defects significantly. Early diagnosis and treatment of maternal disease conditions like anemia, preeclampsia, hypertension and diabetes may affect occurrence of malformations.

Analysis of Medical and Social Causes of Obstructed Labour

Background: Obstructed labour is one of the major causes of maternal mortality (8%) in Bangladesh. It is also responsible for high rate of maternal and fetal morbidity. If we can identify the medical and social causes of obstructed labour in our country it may be helpful to find out the way to prevent this disease. Objectives: This study was to find out the medical and social causes of obstructed labour in our country. It also finds out the cause of delay in seeking care.Material & Methods:This study is a prospective observational study has been done in Dhaka Medical College Hospital, Dhaka from August 2004 to December 2005. One hundred patients who were admitted with obstructed labour during study period were included in this study.Results:In this study prevalence of obstructed labour was 3.59%. Among the patients who were admitted with obstructed labour 52% were within 20 to 25 years of age, 55% were primigravida, only 30% were on regular antenatal checkup. The medical causes of obstructed labour were cephalopelvic disproportion in 30%, malposition and malpresntation in 69% and cervical fibroid in 1 %. In this study 72% of study population had monthly income below 3,000 BTD, 27% had 3,001 – 5,000 BDT and only 1 % had above 5,000 BDT. Among them 8% patient had crossed the primary level of education and 35% were illiterate. The patients who were admitted with obstructed labour could not utilize the health facility in time and they had to go for trial of home delivery first. In 25% cases their husband and family members did not agree to bring them to hospital, 31.3% was because of ignorance, 14% was due to economic constraints, 13.3% wanted to avoid operative delivery, 9.4 % patient herself did not agree to come to hospital because it would disrupt house hold work and the rest 7% could not come due to long distance between home and health center and tertiary hospital. Modes of delivery were LSCS in 85%, craniotomy in 9% and evisceration in 4%. Maternal outcome was WF in 7% and puerperial sepsis in 18%. Perinatal death was 45%, MMR was 3% due to obstructed labour.Conclusions:SThe causes of obstructed labour are not only due to medical causes but also have social causes. The social causes depend on the socio-economic status and the level of education.

MATERNAL CHARACTERISTICS, FETO-MATERNAL OUTCOME AND SEASONAL VARIATION IN PRE-ECLAMPSIA WITH SEVERE FEATURES AND ECLAMPSIA

Aims&objectives:- To study prevalence of pre-eclampsia, co-relation of severe pre-eclampsia and eclampsia with maternal characteristics,feto-maternal outcome,seasonal variation and sex of the fetus, if any. Materials&Methoods- It was prospective observational study, carried out in obstetrics and gynecology department, MMIMSR, Mullana, Ambala, a tertiary care rural hospital in North India, from 1st June,2020 to 31st December,2020. Maternal characteristics, risk factors, sex of fetus, adverse maternal and fetal outcomes were recorded and data analyzed. Retrospective analysis of patients with severe pre-eclampsia and eclampsia, for a period of 3 years from January,2018 to December,2020 was done to see seasonal variation. Results:- A total of 1275 births were recorded from 1st June,2020 to 31st Dec,2020. 114 women were diagnosed with Hypertensive disorders of pregnancy with a prevalence of 8.94%. An increased incidence(75%) of severe pre-eclampsia/eclampsia in unbooked patients was seen. 87.5% patients were less than 30 years. 55% patients were primigravida. Severe preeclampsia-eclampsia was more in rural population(80%) with low literacy level(45%) and low socio-economic status(70%). Signicantly increased incidence(72.5%) of pre-eclampsia in women with dark complexion. 52.5% cases were seen in BMI range of 30.0-34.9. 42.5% patients presented before 34 weeks, 47.5% beyond 34 weeks and 10% within 48 hours post-partum. Singleton pregnancy was seen in 92.5% cases. Anemia was contributing factor in 42.5% and. 12.5% had APS. Caesarean rate was very high. Increased risk of severe pre-eclampsia has been observed while carrying a male fetus(67.5%). Patients with severe pre-eclampsia had increased risk of eclampsia(27.5%) and placental abruption(17.5%). FGR seen in 20%, with oligohydramnios in 15% cases. ICU admission with ventilator support needed by 10% while 5% had maternal deaths. Fetal complications, like pre-maturity seen in 50%, NICU admission required in 57.5% and intra-uterine death in 27.5%. Peak incidence recorded in summers(June-July). Conclusion-Unbooked/referred-in pregnancy, illiteracy, low socio-economic status, undiagnosed maternal risk factors, anemia pose a challenge for early diagnosis and management of severe pre-eclampsia&eclampsia. Severe disease is usually early onset, more in dark complexion with male fetus in-utero with peak incidence in summer. Regular antenatal check-up with diagnosis of high-risk factors in rst trimester, to implement preventive measures should be universal guideline.

Maternal and Perinatal Outcome in Placenta Previa: One Year Study in Enam Medical College Hospital

Introduction: Placenta previa is a key risk factor for obstetric hemorrhage particularly occurs in women with a previous uterine scar. It can be defined as an embedding of the placenta in the lower uterine segment, overlying or approaching the internal cervical os. One-third of all cases of APH caused due to placenta previa. Aim of the study: To assess the maternal complications and perinatal outcomes of patients with placenta previa by analyzing its obstetrical factors. Methods: This study is a cross-sectional observational study conducted at the Department of Obstetrics and Gynae, in Enam Medical College and Hospital, Savar, Bangladesh. The study was conducted for the duration of 1 year between January 21 to December 21. The sample size for this study was 109. Result: The most respondents 81(74.3%) were from the age group 25-29 years, 17(16%) were booked and 92(84%) were unbooked. 27(25%) were primi and 82(75%) were multi-para. Pain abdomen was present in only 2(1.8%) cases and absent in most 107(98.2%) cases. LSCS was done in 79(72%) patients and vaginal delivery was done in 30(28%) cases. Type 2b in most of the cases 50(45.9%). Blood transfusion was needed in 20(18.3%) and post hemorrhage was seen in 12(11%). APGAR at birth was 8-10 in 69(63.35) cases, 5-7 in 27(24.8%) cases and <5 in 13(11.9%) cases. Conclusion: Placenta previa is the main cause of maternal and perinatal morbidity and mortality. Maternal and fetal outcome can be improved by regular antenatal check-up, early diagnosis of case. Management should be done in tertiary care center with neonatal management facility.

Neonatal outcome in hypertensive disorders of pregnancy in tertiary care centre

Hypertensive disorders of pregnancy, contribute to significant neonatal mortality and morbidity, with complications ranging from prematurity, low birth weight and respiratory morbidities.This study is a observational study done in tertiary care hospital in Cuttack, Odisha during the period December 2018 to November 2020. Mothers, aged 18 to 36 years, beyond 20 weeks of pregnancy with hypertensive disorders complicating pregnancy admitted, with booked pregnancy and regular antenatal check-up were included in the study. Those with underlying chronic diseases like chronic diabetes mellitus, chronic renal failure, chronic hypertension, heart disease, twin or multiple pregnancy and polyhydramnios were excluded. The neonates born followed and outcomes noted. Data analysed using SPSS 26 and results expressed in percentage and comparison across the groups done using Chi Square test / Fisher's Exact Test as appropriate.: Among 150 mothers, majority were suffering from severe preeclampsia (36%) followed by gestational hypertension (27.3%), with most (66.7%) being a term pregnancy. 20.9% were stillbirths and 34% needed NICU admission for various complications. The most common neonatal complication noted was intrauterine growth retardation. A significant association noted between the severity of hypertension and maturity (p<0.001), birth weight (p=0.001), delivery outcome (p=0.001) and neonatal complications (p=0.009). The delivery outcome, gestational age and birth weight, along with neonatal complications had a significant association with increasing severity of the hypertension. Thus, there is urgent necessity for strict protocols to screen, early detection and efficient management of these disorders in pregnant women, in order to ensure a safe outcome for both mother and newborn.

Fatal case of classic Potter’s syndrome: a case report

Potter’s syndrome is a rare complication of oligohydramnios, incidence varies from 1 in every 2,000 to 5,000 fetuses with an average of 1 in 4,000. It is reported in 0.2-0.4% of autopsies in dead new-born who die immediately after birth. Potter’s syndrome primarily affects male fetuses (2:1) and is characterized by pulmonary hypoplasia and renal failure. Here, we are presented a case of classic Potter’s syndrome with fatal outcome. The baby was a live preterm male, born to a 28 years old multigravida, out of a non-consanguineous marriage via caesarean section. There was absolutely no liquor at the time of delivery. The baby did not cry immediately after birth and required resuscitation followed by mechanical ventilation. Multiple congenital anomalies suggestive of Potter’s syndrome were noted including facial features such as low set ears with overturned helix, slanting eyes, redundant fold of skin beneath the cheeks, prominent epicanthal fold, receding chin, flattened broad ear, flat nasal bridge, parrot beak appearance of nose and triangular facies. Chest X-ray showed small volume lung fields suggestive of pulmonary hypoplasia, and both kidneys were absent on ultrasonography indicating bilateral renal agenesis. At 15 min of life, baby developed tachypnea and severe chest retractions and succumbed after 1 hour of birth due to respiratory insufficiency. This case report emphasizes upon the importance of regular antenatal check-ups in every patient as it picks up the suspicious cases, leading to further workup and diagnosis, resulting in a timely decision regarding management.

A Five Year Study on Maternal Mortality in The Maternity Ward of Government General Hospital, Siddhartha Medical College, Vijayawada

Introduction: Maternal health is important for the development of any country in terms of increasing equity and reducing poverty and is important in their own right and is central to solving economic, social and developmental challenges. Hence, maternal mortality is the key indicator of health and socio economic status and development of a community and the whole national system. Aim: To study the factors responsible for maternal mortality and to analyse the causes and trends in maternal mortality. Materials and Methods: A retrospective study on maternal deaths that occurred in the maternity ward of Government General Hospital, Siddhartha Medical College, Vijayawada during the period of five years from January 2017 to December 2021. Covid related deaths excluded. Results: Total 137 maternal deaths occurred during the study period. 121 maternal deaths (88.32%) were unbooked cases, 16 (11.67%) were booked cases. 58 women (42.33%) were primiparous, 76 (55.47%) were multiparous and 3 (2.18%) were grand multiparous. 76 women (55.47%) were of 20-24 years age, 38 women (27.73%)were of 25-29 years age. Maternal deaths due to direct causes were 89 (65.92%) and due to indirect causes were 47 (34.07%). Hypertensive disorders complicating pregnancy was the leading cause of death followed by hemorrhage in pregnancy. 105 (76.64%) maternal deaths occurred after delivery, 14 deaths (10.21%) during 3rd trimester of gestation. Type 1 delay (20.74%), type 2 delay (57.7%) type 3 (21.48%) delays contributed to the maternal deaths. Conclusion: Health education regarding adolescent health, pregnancy, abortion and contraception. Regular antenatal checkup, early identification of risk factors, awareness, timely intervention and referral to higher institute, proper intra natal and post natal care, multispecial team management in high risk cases are needed to reduce the maternal mortality.

ROLE OF SERUM URIC ACID AS A PREDICTOR OF PREECLAMPSIA IN FIRST TRIMESTER

Background: preeclampsia is a unique multisystem disorder of pregnancy leading to increased Maternal mortality in India accounting for 9 % of all maternal deaths.The search for an ideal predictive test for preeclampsia still remains a major challenge for obstetrians. Early diagnosis and management improves maternal and fetal outcome. Objectives: 1)To detect raised levels of serum uric acid during first trimester for early diagnosis and management. 2) To determine the diagnostic efficiency of uric acid as a predictive marker for severity of Preeclampsia. Methods And Methodology: Our study is a prospective cohort study including 200 pregnants attending for regular antenatal checkups in first trimester at our out patient Department during October 2020 to july 2021. After obtaining Informed consent,the selected pregnants were investigated for serum uric acid levels by auto analyser along with other routine blood investigations.These pregnants were regularly followed up once in 4 weeks for 28 weeks then once in two weeks till their delivery for healthy mother and healthy baby outcome. Results: In study, serum uric acid analysis in first trimester for 200 pregnants revealed 92 pregnants had levels >4.2 mg/dl of which 59 were normotensive and 33 pregnants were pre eclamptic. Remaining 108 pregnants had levels <4.2mg/dl. In my study risk for both maternal and fetal complications assessed with serum uric acid levels was P value is 0.0001 which is statistically significant Serum uric acid test Positive (n=92)>4.2 mg/dl Negative (n=108) <4.2mg/dl Preeclampsia frequency Percentage frequency Percentage Absent 59 64 99 91.7 Mild 16 17.4 6 5.6 Severe 16 16.3 3 2.8 Eclampsia 02 2.2 0 0 Conclusion: Assessment of elevated serum uric acid in first trimester was associated with later preeclampsia. Thus serum uric acid estimation is a cost effective,convenient predictor for determination of severity of Pre eclampsia.

Fetal anomalies in gestational diabetes mellitus and risk of fetal anomalies in relation to pre-conceptional blood sugar and glycosylated hemoglobin.

The risk of fetal anomalies (FAs) is increased in infants of diabetic mothers. FAs are closely related to the glycosylated hemoglobin (HbA1c) level in pregnancy. To detect the prevalence of FAs in women with gestational diabetes mellitus (GDM). 157 pregnant women with GDM were included in this study, and data from 151 women were analyzed. Beyond the regular antenatal check-up, the HbA1c was checked monthly during the antenatal follow-up. Collected data after delivery were analyzed to detect the prevalence of FAs in women with GDM and the risk of FAs in relation to the pre-conceptional blood sugar and HbA1c. The FAs were recorded in 8.6% (13) of the 151 women with GDM. The recorded FAs were cardiovascular [2.6% (4)], musculoskeletal [1.3% (2)], urogenital [1.3% (2)], gastrointestinal [1.3% (2)], facial [0.7% (1)], central nervous system [0.7% (1)], and multiple FAs [0.7% (1)]. The uncontrolled pre-conceptional blood sugar significantly increased RR [RR 2.2 (95%CI: 1.7-2.9); P < 0.001], and odds of FAs [OR 17.05 (95%CI: 2.2-134.9); P = 0.007] in women with GDM. In addition, the HbA1c ≥6.5 significantly increased RR [RR 2.8 (95% CI: 2.1-3.8); P < 0.001], and odds of FAs [OR 24.8 (95% CI: 3.1-196.7); P = 0.002] in women with GDM. In this study, the prevalence of FAs in women with GDM was 8.6%. Uncontrolled pre-conceptional blood sugar and HbA1c ≥6.5 in the first trimester significantly increased the relative risk and the odds of FAs.

Comparative Study of Knowledge of Urban and Rural Mothers about Neonatal Care

Abstract Objectives: The purpose of this study is to assess and compare the knowledge about the neonatal care among the mothers in urban and rural area in district Ajmer province of Rajasthan Materials and methods: Comparative randomized descriptive study was conducted among mothers who willingly gave consent to participate in the study. A structured questionnaire were framed and mothers were interviewed, the answers were recorded. To judge the knowledge score of the mothers closed ended questions having four alternatives were also framed. One mark was allocated for correct response. Results: Among 5800 deliveries, 400 mothers (205 mothers were Urban and 195 mothers were from Rural area) were randomly selected. Mothers with Antenatal check-up had knowledge score of 61% compared to 24% who had no regular antenatal checkup. Knowledge about “Exclusive Breastfeeding” was 84.39% and 68.20% urban mothers and rural mothers and regarding adequacy was 73.17% in Urban and 44.61% in rural mothers. Knowledge about Hygiene was 89.75% and 53.33% in Urban and rural mothers. Skin care and baby bath was 28.29% and 18.46% in Urban and Rural mothers respectively. Knowledge about danger signs was 81.95% and 60% in Urban and Rural mothers respectively. Knowledge regarding immunization at birth was 70.7% and 35.89% in Urban and Rural mothers respectively. Conclusions: Main factors affecting the knowledge score of the mothers about neonatal care were Educational status and Antenatal checkup. Knowledge about adequacy of breastfeeding, Immunization at birth, Danger signs, Temperature maintenance and hygiene was less in rural mothers as compared to urban mothers.

Determinants of Low Birth Weight in a Tertiary Care Hospital in Eastern India

Introduction: In developing countries like India, low birth weight is a major public health issue. It is a leading cause of disease and mortality in infants. Low birth weight can be avoided by identifying at-risk pregnant women and taking the necessary precautions.&#x0D; Methods: From January to June 2019, a facility based retrospective case control study was conducted among pregnant women who gave birth at the hospitals. The information was gathered from the antenatal care files and the delivery room register and records. SPSS version 24.0 was used to process the data. To find an independent predictor of low birth weight, researchers used binary and multiple bivariate logistic regressions.&#x0D; Result: An aggregate of 450 neonatal birth records were reviewed in this study of which 150 were low birth weight babies and 300 were of normal birth weight. The mean ± SD and median [IQR] for birth weight of case group was [2.0±0.4kg, 2.2[1.8-2.4] kg] and that for control [3.1±0.4kg, 3.0[2.7-3.3] kg] respectively.&#x0D; Conclusion: Preterm delivery, mothers with hypothyroidism have an increased chance of having low birth weight babies whereas mothers with regular antenatal check-up and mothers with primary and secondary education have a lesser possibility of having low birth weight babies.

A known case of myocardial infarction and its outcome in pregnancy

Acute myocardial infarction (AMI) is rare in women of child- bearing age during pregnancy. Its prevalence is 1/10,000–30,000. A 32-year-old primigravida, with a history of acute MI 1 year ago, presented to us with regular antenatal checkups and was followed up to term. She was asymptomatic throughout her pregnancy. Electrocardiogram, two-dimensional echocardiogram, cardiology opinion, and preanesthetic evaluation were done. Under strict maternal and fetal monitoring, the mother went into spontaneous labor and delivered by vacuum-assisted vaginal delivery. Both the mother and the baby were stable and healthy. She was asymptomatic in her postpartum period and was discharged on postnatal day 8.

Management of Psychiatric Disorders during the Perinatal Period.

Management of Psychiatric Disorders during the Perinatal Period.

Prevalence of anaemia in pregnant women among rural population of Kurhani block, Muzaffarpur district Bihar: A cross-sectional Primary Health Center based study

Anaemia is a major public problem which is a matter of great concern for developing countries. In India, about 63% of women of aged between15 to 49 years are anaemic. Anaemia has severe consequences on the growing child and pregnant women. In this study, pregnant women in the age range 18- 45 years who consulted the Kurhani PHC of Muzaffarpur district for regular antenatal check-up were recruited. The participants were grouped on the basis of age. The blood samples from the recruited subjects were collected and a complete blood profile was done. The median age of the pregnant women participants was 25 years. Among 345 participants, 95% of the participants were of the age group 18 - 30 years. A total of 156 (45%) pregnant women were found anaemic with 72 (20.03%) having mild anaemia, 76 (22.87%) with moderate anaemia and 8 (2.31%) were severely anaemic. The findings from this study reveal the status of anaemia among the pregnant women of the local population; which will be used to design further epidemiological studies, and will pave the ways to explore the various aspects of anaemia in pregnancy; thus contribute to fulfill the mandate of the setup of Model Rural Health Research Unit at Kurhani-Muzaffarpur, Bihar.

Maternal Outcome in Patients of Cardiac Disease in Pregnancy at Tertiary Care Centre

Background: Heart disease complicates at least 1% of pregnancies. There are two groups of cardiac disease in women of childbearing age: Congenital and acquired heart disease. Acquired heart disease includes rheumatic heart disease (RHD), cardiomyopathies and ischemic heart disease. Cardiac disease is usually secondary to streptococcal infections. Material and methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology at Rural Medical College, Loni between the period of July 2020 to November 2021. A total of 52 pregnant women with cardiac disease were admitted during the study period. Data was collected from previous hospital records. Results: A total 52 pregnant women with cardiac disease were included in the study. Total number of deliveries during this period was 13806. The incidence of cardiac disease was found to be 0.37%. Present study showed that the predominant lesion Rheumatic Heart Disease seen in 41 patients comprising 78.84% of patients of cardiac disease visiting our hospital. Conclusion: In our study, it is observed that in patients with pre-existing heart disease were associated with small for gestational age babies. Cardiac disease complicating pregnancy is a high risk situation which needs attention and thorough work-up. Maternal and neonatal morbidity and mortality can be reduced by regular antenatal checkups and early detection of cardiac disease. Joint management by an obstetrician, cardiologist and physician with co-operation of the patient to the fullest will result in achieving optimum maternal and fetal outcome.