Ushadevi Gopalan

Background: Asymptomatic bacteriuria is defined as bacteriuria where colony count of same species is more than 10 colonies/ml of urine in a clean catch midstream urine sample in an asymptomatic women”. This if left untreated in pregnancy, may progress to pyelonephritis. Due to the physiological and anatomical changes in the genitourinary tract during pregnancy, urinary tract infection is more common in pregnant women. Our aim was to study the effect of asymptomatic bacteriuria on pregnancy outcome and to find the most common organism responsible for asymptomatic bacteriuria in pregnant women. Materials and Methods: This was a prospective observational hospital based study conducted in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital. A total of 85 pregnant women were included in the study. Clean catch mid stream urine sample was collected and cultured. The organism was identified and patient was treated according to the antibiotic sensitivity pattern. Patient was followed up till delivery to look for maternal and fetal outcomes. Results: In our study, the prevalence of ASB in pregnancy was 24.7%. 61.9% were in age group of 18-25 years and 42.9% were 2 gravida. 85.7% were in 3rd trimester. Of the ASB cases 90.5% had term babies and 85.7% had babies with birth weight of >2.5 Kg. Conclusion: It is important to do Urine culture and sensitivity in all pregnant women irrespective of the symptoms and gestational age so as to detect ASB as early as possible and by treating this we can avoid the adverse effects in the mother and the fetus. Keywords : Asymptomatic bacteriuria, Urinary tract infection, Pregnancy outcome.

Introduction: PCOS is one of the common endocrine disorders in women leading to various complications like infertility, menstrual, psychological disturbances and metabolic syndrome. The objectives of this study were to study the clinical and biochemical parameters of metabolic syndrome in women of reproductive age group with PCOS. Materials and Methods: This cross-sectional study was conducted in a tertiary care centre from September 2018 to June 2020. Fifty six women diagnosed with PCOS, underwent clinical and laboratory assessments for the diagnosis of metabolic syndrome, as per international diabetes federation (IDF) criteria. Results: 14.3% subjects had metabolic syndrome. The prevalence of individual components of the metabolic syndrome among PCOS patients were: waist circumference >80cms in 100%, HDL < 50mg> 150mg/dl in 75%, blood pressure >130/85mmhg in 12.5%, fasting plasma glucose > 100 mg /dl in 87.5%. Subjects with metabolic syndrome had significantly higher BMI compared to those without metabolic syndrome (p=0.043). Conclusion: The metabolic syndrome and its individual components, like waist circumference and decreased HDL were found to be more common among PCOS patients in this study. As the risk of MetS increases with age and BMI, early screening and timely interventions like lifestyle changes will prevent metabolic complications like cardiovascular diseases and type II diabetes mellitus. Keywords: Polycystic ovarian syndrome, Metabolic syndrome, Central obesity, Insulin resistance, Hyperandrogenism.

Introduction: Pregnancy is a diabetogenic state which places the mother as well as the foetus at high risk for certain complications even though the woman is neither GDM nor overt diabetic. This study aims at estimation of HbA1c value after 24 weeks of pregnancy and its correlation with the pregnancy outcome. Materials and Methods: The study was done among 60 healthy pregnant women who are between 18-35 years. HbA1c was estimated and they were followed up for assessing pregnancy outcome. Birth weight >90th percentile, primary C-section, neonatal hypoglycaemia, any NICU admissions and neonate’s condition at discharge were assessed. Results: The mean of haemoglobin, OGTT (fasting, 1-hour and 2-hours) and HbA1c were 11.25mg/dL, 81.73mg/dL, 120.75mg/dL, 104.13mg/dL and 5.24% respectively. The trimester specific HbA1c levels in the second and third trimesters in the present study were found to be 5.11% and 5.27% respectively. Among the study subjects 51 (85%) women had term delivery whereas 9 (15%) women had preterm delivery. 42 women (70%) had normal delivery, 1(1.7%) patient had operative vaginal and the remaining 17(28.3%) patients had emergency caesarean section. It was observed that 5(8.3%) subjects had LBW and 55(91.7%) had normal birth weight neonates. Two neonates among the study subjects had NICU admission for other reasons. Conclusion: The results obtained by this study showed low or no significant relationship between HbA1c levels estimation during pregnancy and pregnancy as well as foetal outcome, also adverse pregnancy outcomes have multifactorial influences rather than maternal glycaemic status alone. Keywords: HbA1c, Gestational diabetes mellitus, Pregnancy outcome.

Introduction: Polycystic ovarian syndrome is the most common endocrine and metabolic heterogeneous disorder among reproductive-aged women. Obesity worsens the metabolic, clinical and endocrine features of PCOS, mainly by increasing insulin resistance and hyperinsulinemia: Obesity rates are increasing due to changing lifestyles, including unhealthy food habits. The objective of this study was to characterize the dietary pattern and BMI of PCOS women and to compare it with healthy controls. Materials and Methods: This study was a case-control study. Study Population was women in the age group 15-45 years with complaints s/o PCOS and age matched control group .PCOS cases were diagnosed using Rotterdam criteria and the controls were age matched women without PCOS. All the women were subjected to a detailed history taking and physical examination. The data was entered in Excel sheet and Statistical analysis was done using SPSS version 23. Results: The average age of PCOS cases was 24.64 years. There was a statistically significant increase in history of snacking with ingestion of high caloric and oily food in PCOS cases compared to control women. PCOS women were more overweight and Obese compared to Control women and this difference was also statistically significant. Conclusion: The results of this study suggests with PCOS is associated with an increased intake of food high in calorie and saturated fat and that women who are obese or overweight are more likely to develop PCOS. Lifestyle modifications like healthy diet and regular exercise should be the front line therapy in PCOS women. Keywords: BMI, Dietary Influences, PCOS, Snacking.

Background: Anaemia is the most common manageable problem among pregnant women worldwide, which contribute to maternal and perinatal mortality. The aim is to compare the efficacy, safety and compliance of intravenous ferric carboxymaltose with intravenous iron sucrose in the treatment of iron deficiency anaemia in pregnancy. Materials and Methods: It is a randomized prospective study conducted in department of obstetrics and Gynecology at Shri Sathya Sai Medical College, constituting of 100 pregnant women. 50 pregnant anemic patients were treated with intravenous ferric carboxymaltose and other 50 patients were treated with intravenous iron sucrose. Hemoglobin, packed cell volume and blood indices were measured before and 3 weeks after treatment. The efficacy and safety of both intravenous compounds were studied. Results: Anaemia in pregnancy was more prevalent among 20-24 years of age groups, it is more common in multigravida in 22-28 weeks of gestational age. The mean difference of hemoglobin 3 weeks after treatment was 2.34 g/dl for ferric carboxymaltose and 1.32g/dl for iron sucrose. The other parameters also increased significantly for ferric carboxymaltose than iron sucrose. Conclusions : ferric carboxymaltose is an efficient and better alternative in iron deficiency anaemia in pregnancy with fewer side effects and has the added advantage of single dose regime.   Keywords: Ferric carboxymaltose, Iron sucrose, Intravenous, Haemoblobin, Peripheral smear.

Background: Leiomyoma or uterine fibroid are benign tumours that arise from the smooth muscles of the uterus. The leiomyomas are common gynaecological problem encountered among reproductive age group women. Mifepristone is the commonly used drug in the management of uterine leiomyoma. The objective of the study were to study the efficacy and safety of 10mg and 25mg of Mifepristone in the management of uterine fibroid. Materials and Methods: This is a randomized controlled Trial conducted in tertiary care centre. Hundred women with the diagnosis of uterine fibroid were taken up for the study. Group-A (n=50) were given Mifepristone 10mg and Group-B (n=50) were given Mifepristone 25mg daily for a period of 3 months. Reduction in the size of fibroid were assessed at the end of 3 months. Results: At the end of 3months there was a significant reduction in both menstrual blood loss and fibroid volume in both the groups (p Conclusion: Both Mifepristone 10mg and 25mg had similar clinical outcomes but 10mg had better compliance and lower side effects. Hence, 10mg can be preferred over 25mg in order to bring about effective management of uterine fibroid.   Keywords: Leiomyoma, Menorrhagia, Fibroid volume, Mifepristone.