Indian Journal of Obstetrics and Gynecology

Background:- Fever in pregnancy is a common clinical problem worldwide. The risk to the mother and fetus is significantly increased in pregnancy complicated by infection and fever.

Aim and objective:- To determine etiological spectrum of febrile illnesses in pregnancy and its association with maternal & fetal outcomes.

Methodology :- Prospective observational study was conducted in the Department of obstetrics and gynecology in a tertiary care center in western Maharashtra. A total 105 pregnant women reported with fever during the study periods, out of which 37 were followed up longitudinally till delivery and were included in the study analysis.

Results:- In the present study, Fever of unknown origin(32.43%), Dengue(24.32%), COVID-19 (24.32%), Urinary tract infections(16.21%) Malaria(2.7%) were the common cause of febrile illness. Out of 37 pregnant women with febrile illness, 31 (83.8%) had live births, 5 (13.5%) had intrauterine death (IUD) and there was one case of abortion. In 10 (27%) patients, there was a requirement for NICU admission. It was observed that more is the number of febrile episodes higher is the chance of neonatal morbidity and mortality.

Conclusion :- High grade fever with multiple febrile episodes due to any underlying etiology in pregnancy is harmful to the fetal-maternal health.

Background: Hypertensive disorders of pregnancy are among the most common medical problems in pregnancy with an incidence of between 5-10%.1 The incidence varies amongst different hospitals, regions and countries. Hypertensive disorders in pregnancy are a major cause of maternal and perinatal morbidity and mortality worldwide.

Methods: This prospective observational study was conducted by the department of OBG at Sri Muthu Kumaran medical college hospital and research institute, Shikkaraya puram Chennai from December 2019 to May 2020.

Results: Out of 100 subjects enrolled into the study, Primigravidas constituted for 66% of pregnancies and multigravidas constituted for 34% of pregnancies. Maximum cases 60 (60%) were in the age of 25-30 yrs followed by 22 (22%) in the age group <20 years. The mean age of the patients was 24.57(SD 6.54) years. Caesarean was the most common mode of delivery constituting for 70% of deliveries wheres as vaginal delivery constituted for 30% of cases.
 

Background: Multiple pregnancy is defined as pregnancy with 2 or more fetuses. It is termed as twins for 2 fetuses, triplets for 3 fetuses, Quadruplets for 4 fetuses, Quintuplets for 5 fetuses, Sextuplets for 6 fetuses and Septuplets for 7 fetuses and so on. The incidence of multiple pregnancies varies significantly. In several overview studies (since the early 1970) it was found that natural twinning rates were less than 8 twin births per 1000 births in East Asia and Oceania, 9-16 per 1000 births in Europe, USA and India and 17 and more per 1000 births in African countries.

Methods: This prospective observational study was conducted by the department of OBG at Sri muthukumaran medical college hospital and research institute, Shikkarayapuram, Chennai from December 2019 to May 2020.

Results: Primigravidas constituted for 43% of pregnancies and multigravidas constituted for 57% of pregnancies. The maximum cases 42 (42%) were in the age of 25-29 yrs followed by 31(31%) in the age group 21-24 years. The mean age of the patients was 26.87 (SD 9.67) years. The discordant growth constituted for 12% of pregnancies in both monochorionic and dichorionic twins where as it was absent in 88% of cases.

Pregnancy induced hypertension (PIH) is a type of hypertension that occurs during pregnancy, affecting 6-10% of pregnancies. The study aimed to evaluate the role of Beta Human Chorionic Gonadotropin (β-hCG) levels in second trimester in predicting the on set of pre-eclampsia. The study population included 120 pregnant women in their second trimester who were normotensive and non-proteinuric, selected using consecutive sampling. The blood pressure of the participants was monitored, and the occurrence of pre-eclampsia, method of delivery, gestational age, and fetal outcome were documented. The level of Beta HCG was measured using the ELISA method, and the results were statistically analyzed. Among a total of 120 pregnant women were analyzed, with 21.5% having hypertension in pregnancy. The results showed a relationship between maternal serum β-hCG levels and the development of Pregnancy Induced Hypertension (PIH), but the sensitivity was only 25% with a specificity of 75.93%. The study found that β-hCG MOM levels alone are not a highly reliable predictor for PIH, with the model having limited ability to differentiate between women who develop PIH and those who don't. The study also showed a strong statistical association between gestational age and NICU admission as potential risk factors for the development of PIH. In conclusion, β-hCG levels may have some utility in predicting PIH, but further studies are needed to determine the most effective markers and understand the underlying mechanisms.