Gomathy E

Abstract

Introduction: Infertility defines as the inability to conceive naturally after one year of regular unprotected sexual intercourse. The chance to conceive depends on the length of sexual exposure, frequency of coitus and couples age. Only 5% of the couples will conceive after one and half year or two years. Both males and females are equally responsible for the causes. Factors contributing to infertility have included male factors (sperm abnormality), female factors (an ovulation), couple factors (luteal phase defect, poor sperm production) and factors of unknown origin. Infertility has always existed but is now recognized as a global reproductive health problem and as an important component of reproductive health. It is a world wide health concern and affects 8 -15% of couples. The knowledge regarding fertility and biology of reproduction was poor. Many women have little awareness about the fertility period and the risk factors. Aim and Objectives: 1. To assess the knowledge and attitude of infertile couples attending gynecological OPD. 2. To assess the possible risk factors and social consequences towards infertility. Materials and Methods: This is a cross sectional observational study conducted on infertility patients attending to R l Jalappa hospital and research centre from February 2018 to July 2018.we designed a fertility questionnaire for both the partners with questions covering knowledge and attitude towards infertility. Results: Out of 154 couples, prevalence of primary and secondary infertility was 72.1% and 27.9% respectively. The mean duration of infertility was 2.97 years. On scoring their level of knowledge, (n= 80) had inadequate, (n= 68) had moderate knowledge and (n= 6) had adequate knowledge. There was no statistically significant difference in the knowledge in relation to their educational qualification and type of infertility among participants. Keywords: Infertility, Knowledge, Attitude, Misconceptions.

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Abstract

Introduction: Epilepsy is most common major neurological complication encounterd in pregnancy. The etiology of seizures covers a wide range of diseases, vascular insults,infectious sequelae, malignant processes and primary central nervous dysfunction. A wide range of obstetric complications have been reported including spontaneous abortion , preterm labour, stillbirth, neonatal death, hemorrhagic disease of the newborn; low apgar and low birth weight. The incidence of malformations increase from 2.9% in the non drug user group to 3.7% in patient on monotherapy and 6.6% in patients on polytherapy. Objectives: To study the maternal and perinatal outcome in pregnant women with epilepsy on polytherapy. Materials and Methods: This retrospective observational study was conducted in R.L. Jalappa Hospital Kolar India over a period of 6 months (December 2017-june2018). Five pregnant women with epilepsy attending the antenatal clinic or admitted in labour ward in a tertiary care hospital taking two or more antiepileptic drugs were evaluated. Conclusion: Cases included in this study concludes that, despite the increased risks of pregnancy in woman with epilepsy, with appropriate clinical management with newer drugs, more than 90 percent woman with epilepsy can have successful pregnancies and better neonatal outcome. Moreover because of prepregnancy planning, counselling and optimisation of antiepileptic drug regimens and use of preconception folic acid, pregnancy outcome have become better. A higher teratogenic potential was confirmed for traditional antiepileptic drugs, particularly Valproate. Lower rates of congenital malformations were found for levetiracetam(1.7%) than in association with VPA (6.9%). Keywords: Epilepsy, Antiepileptic drugs, Teratogenicity.

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