Objectives: To evaluate the safety in labor of epidural analgesia for labor pain relief in severely anemic women.
Methods: Eighty-four consecutive women with hemoglobin less than 6 g/dL were given epidural analgesia after ruling out contraindications. Their obstetric outcome was compared with 84 nonanemic women who were also given labor analgesia in the same way. Preloading in anemic subjects was reduced to half.
Results: There was no increase in any complication in women with severe anemia receiving epidural analgesia. They had longer interval between drug administration and effect of analgesia. The level of analgesia was one root higher than that in non-anemic women.
Conclusion: With adequate precautions epidural analgesia can be safely given for labor to anemic subjects for labor pain relief.
Objectives: To study the seroprevalence of HIV amongst pregnant women and their spouses.
Methods: The study was conducted from January 2004 to December 2005. The pregnant women attending the antenatal clinic for consultation and those coming directly to labor room for delivery (unbooked cases) were counseled for HIV testing, informed consent was obtained and blood samples collected for HIV testing. Seropositive women were questioned regarding their awareness of AIDS, personal habits, blood transfusion, drug abuse, and method of contraception. Spouses of the seropositive pregnant women were also counseled and similarly tested for HIV.
Results: The seroprevalence of HIV was 0.41% and 0.63% in 2004 and 2005 respectively.
Conclusions: There was 53.3% increase in seroprevalence of HIV in pregnant women in 2005.
Objectives: To study and analyze obstetric hysterectomies done over a 2 year period in our teaching hospital, to suggest ways of avoiding them and improving their outcome.
Methods: A prospective study of cases of emergency obstetric hysterectomy was done over a 2 year period.
Results: Thirty obstetric hysterectomies were performed during the study period. There were 8362 deliveries, giving an incidence of 0.35%. The incidence of hysterectomy following vaginal delivery was 0.15% and that of cesarean hysterectomy was1.42%. Forty seven percent of the cases were unbooked. The incidence was highest in the age group of 26-35 years. It was more common in 3rd paras. Postpartum hemorrhage was the commonest indication contributing to 50% of the cases followed by rupture uterus (26.6%). There were three maternal deaths in the study and the fetal outcome was poor in 32%.
Conclusion: Identification of high risk cases, early referral, timely performance of cesarean and resort to procedures like internal iliac artery ligation can reduce the incidence of obstetric hysterectomy.
Objectives: Every year about 18,000 babies are born in India with trisomy 21. With the availability of well established, documented and widely used maternal serum triplemarker screening during midtrimester of pregnancy, every pregnancy can be monitored for the most common aneuploidy like trisomy 21, trisomy 13, and trisomy 18 in addition to open neural tube defects.
Methods: MoM values were derived from 1738 normal pregnant women between 14-20 weeks of gestation who later had full term normal delivery. Two thousand one hundred and eleven women were investigated by triple marker screening between 14-20 weeks of gestation.
Results: Two hundred twenty four women were considered as screen positive for trisomy 21, of which, 105 were further investigated for karyotyping and eight of these had trisomy 21, one each had mosaic trisomy 21, der (14:15) and del (X) (p11). Twentythree women with low hCG MoM were considered as screen negative for trisomy 21 and trisomy 18 but positive for other chromosomal abnormalities like iso (X) (q10) and der (13:14) one each, and two with polyploidy.
Conclusion: The results suggest that triple marker screening is an effective screening program for noninvasive diagnosis of pregnancies with suspected Down syndrome fetus and also detects other chromosomal anomalies.
Objectives: To study the incidence of septic abortion and reasons thereof, besides their socio-demographic profile, abortion providers, procedures used, complications faced, treatment provided, and attitude of patients towards contraception.
Methods: All patients admitted with septic abortion during the period April 2001 and December 2003 were included in the study.
Results: Seventy-five women, averaging 27.9 (±4.9) years, sought abortion for reasons like limiting family (44%), spontaneous bleeding (20%), economic limitation (13.3%), spacing etc from dais (36%), ANMs (16%), nurses (22.6%) and even doctors (22.6%). Instrumentation or crude methods were used on an average of 11.8 days prior to hospital admission for pain in abdomen, distension, fever bleeding etc. Septic shock was seen in nine. Various grades of sepsis/pelvic inflammation were seen in all. In 47 patients (62.6%) who underwent laparotomy, uterine perforation (40%), bowel injury (30.7%), peritonitis with blood/pus or fecal fluid (48%) were the commonest findings. Fourteen deaths (18.7%) occurred.
Conclusions: The study highlighted the high mortality and morbidity associated with illegal abortions by unskilled providers. Unfortunately patients still approach them due to illiteracy, poverty and privacy.
Objectives: To examine the relationship between concentration of zinc in seminal plasma and semen quality.
Methods: Semen samples from one hundred and fourteen male partners of couples who were attending the Obstetrics and Gynecology Department were collected and analyzed for semen quality as per WHO procedure. The seminal plasma concentration of zinc was determined by flame atomic absorption spectroscopy.
Results; The mean zinc levels were lower among azoospermic as compared to oligozoospermic and normospermic groups. A positive correlation was observed between zinc levels and sperm count (r=0.12). Zinc also showed a positive correlation with other seminal indices. Significant correlation was also observed between seminal plasma zinc levels and alpha glucosidase activity.
Conclusions: Zinc levels in seminal plasma and its relationship with other parameters of semen might give useful information regarding male reproductive dysfunction.
