Prevalence, Pregnancy Outcomes and Treatment Modalities of Immune Thrombocytopenia Mothers Over 5-years in a Tertiary Health Care Hospital in South India | Chapter 15 | Achievements and Challenges of Medicine and Medical Science Vol. 11

Background: It has been proposed that thrombocytopenia is the most common haematological abnormality in pregnancy after anaemia. The incidence of severe immune thrombocytopenia (ITP) in pregnancy has been difficult to report because of the rarity of the disease. Treating pregnancy associated with ITP can be difficult.

Objective: The objectives were to determine the prevalence, pregnancy outcomes, and treatment modalities of ITP mothers over five years in a tertiary health care hospital in South India.

Methods: Our study was a retrospective record study, which looked into various aspects of obstetrical outcomes and complications in ITP mothers. Records of the in-patient medical record department (MRD) folders of patients with ITP who delivered at St. Johns Medical Hospital, Bangalore were studied. Patients with acute and chronic ITP were included as per the Vicenza consensus conference and the criteria for differentiating primary from secondary forms of ITP was followed, with consideration of a new entity of ITP associated with the presence of antiphospholipid antibodies.

Results: The study identified 53 patients with ITP with a mean age of 25.6+4.6 years, age of diagnosis of ITP at 21.1+5.9 years and gestational age of 36.2+3 weeks. In our study 17 (32%) were acute and 36 (67.1%) were chronic ITP. In our study, 39.6% had a history of at least one prior pregnancy loss. Patients with ITP at 35-37 weeks were induced with PGE1 (35.7%) in comparison to those with PGE2 (p≤0.001). Post-partum haemorrage (PPH) was seen in 7.5% of the pregnancies and all four were mothers with chronic ITP. Severe preeclampsia in ITP mothers was seen in 2 (66.7%).  All the findings showed that there is no reliable maternal parameter to predict the susceptibility and the need for intervention in mothers with life-threatening thrombocytopenia and the complications it poses to the foetus. Hence, constant vigilance is required to establish a safe pregnancy outcome in mothers with ITP.

Conclusions: Chronic ITP in pregnancy poses more risks to mother and foetus as seen with the higher chance of PPH etc. Mothers with ITP should be screened antenatally as the chances of anomalies are high in the foetus.

 

Author (s) Details

 

Shashikala Karanth
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bangalore, Karnataka, India.

 

Christy Vijay
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bangalore, Karnataka, India.

 

Chaitanya Harita
Department of Medicine, St. John’s Medical College and Hospital, Bangalore, Karnataka, India.

 

Jaya S. Mol
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bangalore, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v11/3758

Hypothyroidism in Mother and Child during Pregnancy and Its Effect on Fetomaternal Outcome | Chapter 5 | Research Developments in Medicine and Medical Science Vol. 2

 This practical, cross-sectional study aimed to study predominance of hypothyroidism in pregnant mom and autoimmunity among them.  The fetomaternal consequence of the study population is also intentional. Study population contained 142 pregnant mothers in 3rd term of pregnancy. fT4, TSH concentration were calculated from maternal antitoxin and cord blood. TPO agent for negating the effect of an infection or poison was estimated in maternal antitoxin. Maternal pregnancy effects were measured in terms of antepartum and postpartum bleed, as well as anaemia. The APGAR score and the baby's birth burden were used to assess before birth outcome. Prevalence of hypothyroidism was 28.87%, but Prevalence of thyroid autoimmunity was 18%. The incidence of unfavorable maternal outcome was establish to be statistically meaningful in hypothyroid state for maternal anaemia (Hb% <10mg/dl) [odds percentage 2.32, p value = 0.0096].  Adverse foetal outcome was raise to be statistically meaningful in hypothyroid state for the following parameters: Low birth burden (<2.5 kg) [odd ratio 2.37, p profit= 0.026], Low APGAR score [odd percentage 14.25, p value < 0.0001].

Author(s) Details:

Soma Gupta,
Department of Biochemistry, NRS Medical College, Kolkata, India.

Sanchayan Sinha,
Department of Biochemistry, College of Medicine and Sagore Dutta Medical College, Kolkata (Previously Attached as Junior Resident, Department of Biochemistry, NRS Medical College, Kolkata), India.

Please see the link here: https://stm.bookpi.org/RDMMS-V2/article/view/9956

Urinary Uric Acid to Urinary Creatinine Ratio- A Very Promising Biochemical Marker for Perinatal Asphyxia!!! | Chapter 17 | Recent Developments in Medicine and Medical Research Vol. 4

 Background: Perinatal asphyxia is one of the most common disorders in newborns, and it contributes significantly to neonatal morbidity and mortality. It's a well-known and important cause of avoidable cerebral damage. Predicting the result of prenatal asphyxia is crucial, but it's also a nightmare. The Apgar score has a limited significance in forecasting immediate outcomes, such as HIE, and observational error in APGAR can lead to long-term neurological consequences. The biochemical parameters, on the other hand, can be trusted. Asphyxia diagnosis and grading can be difficult, especially if crucial information is not available at the time of delivery. The goal of this study was to see if the urine uric acid/creatinine ratio (UA/Cr) could be used as a non-invasive marker for prenatal hypoxia and if its absolute value might be linked to the severity of the condition.

1. To establish the Urinary Uric Acid to Urinary Creatinine Ratio as a perinatal asphyxia marker.

2. To establish the ratio of urinary uric acid to urinary creatinine as a measure of prenatal hypoxia severity.

3. To establish a cut-off value for the ratio of urinary uric acid to urinary creatinine in order to detect foetal asphyxia.

Methods: This prospective case control study was conducted at the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences between November 2017 and May 2019. It included 42 asphyxiated and 42 non-asphyxiated newborns. All of the neonates who were enrolled underwent a thorough examination and history. Urine samples were sent in to be tested for uric acid and creatinine. The results were noted, and a statistical analysis was performed.

The uric acid to creatinine ratio in the urine is a non-invasive, early, and simple biochemical measure of birth hypoxia that biochemically supports severity grading and clinical diagnosis by the APGAR score.

Conclusions: The urinary uric acid and creatinine ratio can be used to diagnose asphyxial injury quickly and accurately, as well as determine its severity and likelihood for short-term morbidity or fatality.

Author(S) Details

Siddharth
Department of Pediatrics, SRMS IMS, Bareilly, Uttar Pradesh, India.

Preeti Lata Rai
Department of Pediatrics, SRMS IMS, Bareilly, Uttar Pradesh, India.

P. L. Prasad
Department of Pediatrics, SRMS IMS, Bareilly, Uttar Pradesh, India.

View Book:- https://stm.bookpi.org/RDMMR-V4/article/view/4182