Urvashi Verma

The study of maternal and perinatal outcome in prolonged pregnancy

Background: Prolonged pregnancy or post-dated pregnancy is that pregnancy which has exceeded duration considered to be upper limit of normal pregnancy that is above 40 completed weeks or 280 days from the first day of last menstrual period. The objective was to evaluate the maternal and perinatal outcome of post-dated pregnancy. Methods: A prospective case control study was conducted on antenatal women for 18 months period from May 2014- October 2015 admitted to the Obstetrics and Gynecology Department, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The study group was comprised of antenatal women having pregnancy beyond 40 weeks, and the control group was represented with antenatal women between 37-40 weeks admitted for delivery during this period. Results: The prevalence of post-dated pregnancy was found to be 17.6% and of post-term was 5.69%. Among post-dated subjects LSCS rate was 56.50% and in term (37-40 weeks) patient it was 34.18%. The NICU admission for birth asphyxia was 6.09% among term (37-40 weeks) patients and 17.6% in post-dated pregnancies. Conclusions: Any pregnancy that crosses expected date of delivery, Foetal well-being must be assessed and induction of labour should be considered to decrease the risk of perinatal morbidity and mortality.

To evaluate the efficacy and safety of single dose intravenous iron carboxymaltose verses multidose iron sucrose in post-partum cases of severe iron deficiency anemia

Background: Iron deficiency is the most common nutritional deficiency worldwide. Anemia is the most common treatable, direct/indirect cause of maternal and neonatal morbidity and mortality in developing countries like India. Methods: 100 cases with iron deficiency anemia in post-partum patient were selected from postpartum wards and assigned in two groups of 50 each. In group A iron carboxymaltose injection administered by intravenous infusion up to a maximum single dose of 20 ml of iron carboxymaltose injection (1000 mg of iron). In group B Iron sucrose was given as 200mg elemental iron (2 ampules of 5 ml) in 100ml of 0.9% normal saline infusion over 1 5 min alternate days up to 5 days. All patients were monitored for rise in hemoglobin level and any adverse effect at 2 weeks, 4 weeks, 8 weeks and 12 weeks of iron therapy. Results: In group A mean Hemoglobin level rise is 3.95 g/dl and in group B it is 3.32 g/dl at 4 weeks of initial therapy. In group A 100% cases achieved target hemoglobin at 12 weeks after therapy while in group B 98% cases achieved target hemoglobin at 12 weeks after therapy. In group A 12% cases have grade 1 adverse reaction while in group B 20% cases have adverse reaction. Conclusions: Administration of intravenous iron has a good clinical result, with minimum adverse reactions. Thus we can conclude that intravenous ferric carboxymaltose therapy is safe, convenient, more effective and faster acting than intravenous iron sucrose for treatment of severe iron deficiency anemia in postpartum patient.