European Journal of Cardiovascular Medicine

Aim: To assess obstetric patients treated in anesthesiology intensive care unit. Methods: We retrospectively screened 269 patients. In all patients, gestational age, mode of delivery, parity, referring clinic, previous medical disease, diagnosis at admission, APACHE II Score and GCS score were recorded. Clinical course in intensive care unit and cause of death in non-survivors were recorded. Results: The percentage of obstetric patients treated in intensive care unit was 9.4% with a mortality rate of 3.7%. Preeclampsia, eclampsia and HELLP syndrome were leading causes for intensive care unit admission. Conclusion: Most common cause of death was postpartum bleeding and its complication.

Introduction: Eclampsia has been recognized as a clinical entity since the time of Hippocrates; and has been a nightmare to healthcare providers ever since. It is defined as the occurrence of generalised convulsions associated with preeclampsia during pregnancy, labour or within 7 days of delivery and not caused by epilepsy or other convulsive disorders. The incidence of eclampsia has often been viewed as an index of civilization in a country. There is low utilization of both antenatal and intrapartum care services and the patients may present to the hospital only as a last resort. Materials And Methods: This is a Prospective Study was carried out at the Department of Obstetrics and Gynecology at Tertiary Care Teaching Hospital over a period 2 years. All patients presenting with eclampsia during the said period were recruited into the study. All patients presenting with eclampsia during the said period were recruited into the study. Eclamptics are usually admitted directly into the labour ward. Patients who were diagnosed with other causes of convulsions in pregnancy like cerebral malaria and epilepsy were excluded from the study. A total of 821 pregnant mothers with eclampsia admitted in the inpatient department of the tertiary care teaching hospital were recruited for the study, irrespective of their previous antenatal check up history. Results: Majority (66%) of the patients had between 2 to 5 episodes of convulsion. The MINIMUM number was 1 episode of convulsion , seen in 13 % of the patients. The MAXIMUM number of convulsions was 40. Of the 66 patients who had had more than 10 no. of convulsions , 30 had not received any treatment prior to referral, while there were no patients who had had more than 10 no. of convulsions after receiving the Loading Dose of MgSO4. For patients having less than 5 no. of convulsions , the number of patients having received only the IM Dose of MgSO4 was 1.5 times those having received the Loading Dose.(228/154 =1.48) In 29% of the patients, Hypertension was controlled by delivery alone. Those who failed to achieve a control of BP by Delivery alone were administered Calcigard (Nifedipine). Conclusion: Eclampsia was noted to be commoner among the young primigravida patients. The importance of this finding is that this group of patients deserve extra surveillance during antenatal care in terms of monitoring their blood pressure and screening their urine for proteinuria to detect pre-eclampsia. It is hoped that such interventions will have positive impact on maternal and child care. However, all this will go in vain unless health care providers at the grassroot levels are sensitised regarding the early diagnosis of Pre eclampsia and prompt and appropriate initiation of treatment

Introduction: Preeclampsia is a pregnancy-specific multi-systemic disorder characterized by proteinuria and the onset of hypertension during pregnancy (1, 2) Among the hypertensive disorders that complicate pregnancy, pre-eclampsia and eclampsia stand out as major causes of maternal and perinatal mortality and morbidity3. Calcium has an important role in the pathogenesis of pre- eclampsia. The present study was aimed to compare the level of serum calcium in normal pregnant women and in preeclampsia and determine the association of serum calcium with severity of the disease

Preeclampsia is a multi organ disorder which is significantly associated with maternal and neonatal morbidity, affecting around 5-8% of pregnant women. Acute or chronic intrapartum insufficiency results in antepartum or intrapartum anoxia that may lead to foetal death, Intrauterine growth restriction and or preterm delivery. Neonatal complications occurring in these babies are closely related to the severity of hypertension and proteinuria and the duration of the disease. This was a retrospective observational study. Out of 77 preeclampsia mothers, 74 (96.2%) had live births and 3 (3.8%) had Intra uterine deaths. Out of 74 neonates, 33 neonates (42.8%) were term, 28 neonates (36.3%) were late preterm, 5 neonates (6.4%) were moderate preterm and 11 neonates (14.2%) were early preterm. With increasing maternal complications in preeclampsia there is an increase in neonatal morbidity and mortality. So, the aim of the study is to evaluate neonatal morbidity in mothers with preeclampsia

Background: Preeclampsia is a multi-system disorder of pregnancy that manifests after 20 weeks of pregnancy in previously normotensive women. It is characterised by new-onset hypertension (systolic and diastolic blood pressure of 140 and 90 mm Hg, respectively, on two occasions, at least 6 hours apart) and proteinuria (protein excretion of 300 mg in a 24 hr urine collection, or a dipstick of ≥ 2+). AIM: To evaluate the utility of placental laterality and uterine artery doppler in the prediction of preeclampsia. Material & Methods: Study Design: A prospective hospital based observational study. Study area: Department of Radio diagnosis, Anil Neerukonda Hospital.  Study Period: 1st January 2020 to June 2021. Study population: All Antenatal cases referred to the department of Radio-Diagnosis for clinically suspected Pre-eclampsia.  Sample size: study consisted of 86 subjects.  Sampling method: Simple random technique. EQUIPMENT: The study will be performed using Philips AFFINITY 50G ultrasound machine using a 3-7C curvilinear probe. SCANNING TECHNIQUE: A written informed consent was taken before performing the scan. The scan was performed with patient in supine position and moderately distended bladder. Data Collection: Basic demographic details, clinical data obtained from study subjects were recorded in a pre-designed proforma. Location of the placenta and uterine artery doppler velocimetry was performed by using convex probe. During the first and second trimesters of pregnancy, ultrasound was used to identify uterine arteries on each side of the uterocervical junction. In third trimester it was seen at the crossover of external iliac vessels. Sample box was 2mm. Insonation angle was less than 60 degrees. Angle dependent Doppler indices are obtained during each examination. Results: In our study 63 (74%) subjects had central placenta and 23(26%) subjects had laterally located placenta. Fourteen of the 86 patients developed preeclampsia; eight (57%) had unilaterally located placentas while only six had centrally located placentas. According to our study, 8 (34%) out of 23 women bearing lateral placentas alone developed preeclampsia whereas 6 (85%) out of 7 women bearing lateral placentas with Doppler abnormalities developed preeclampsia. Conclusion: A lateral placenta puts a pregnant woman at significant risk of developing preeclampsia. In lateral placentas co-occurring with uterine artery Doppler abnormalities, preeclampsia risk significantly increases as compared to those of lateral placentas alone

Introduction: Improving maternal health is one of the fifteen Sustainable goals  adopted by world leader in September 2015 by  an historic  international community at the United Nations Summit, which aims  to reduce the global maternal mortality ration to less than 70 per 100,000 live births by the year 2030.The MMR in developing countries is more than developed countries. MMR in developed country is 12/1,00,000 live birth Maternal mortality ratio of India is 97/lakh live births. Preeclampsia is a new onset of hypertension and proteinuria after 20 weeks of gestation  in a previously normotensive women.Severe Preeclampsia  is a serious clinical type of preeclampsia by atleast one of the following – persistent increase in blood pressure [≥160/110 mmhg ],hepatic and renal failure,platelet count less than 1,00,000 / mm3 , hemolysiselevsted liver enzymes and low platelet count [HELLP] Syndrome, Cerebral or visual disturbances, persistant epigastric pain and pulmonary oedema. Eclampsia is a serious obstetric emergency with new onset grand mal seizure during pregnancy or postpartum in women having signs and symptoms of preeclampsia. The sequel of severe preeclampsia and eclampsia include organ failure, loss of consciousness and finally loss of lives of both mother and fetes. Aims and Objectives: To study clinical outcome of Preeclampsia and Eclampsia in a Tertiary Care Centre. Materials and Method: The study was conducted in department of Obstetrics and Gynaecology, MKCG Medical College, Berhampur, Odisha, India for a period of 18 months extending from November 2020 to September 2022.A total of 400 patients were studied. At the end of the study, collected data were tabulated and analysed. Results: Present study was conducted on 400 cases, during the study period.Mean age was 31.19 ± 5.7 years. Majority of patients (194 cases, 48.5%) belonged to lower class followed by 129 cases (32.3%) belonging to middle class. Fifty four patients (13.5%) were from lower middle class. Upper middle class had 16 (4%) patients. Only 7 cases (1.7%) were from upper class. In 127 patients (31.8%) diabetes mellitus and in 227 patients (56.8%) pre-existing hypertension was reported respectively. Among 400 patients studied, 114 patients (28.5%) were primigravida and 286 patients (71.5%) were multigravida.  Twenty eight (16.8%) patients died of complication. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.34, Paog=0.33). Cause of death was abruption placenta (10 cases), acute renal failure (6 cases), ARF with sepsis (1 case), eclampsia (4 cases), HELLP with PPH, PPH, pulmonary embolism, pulmonary embolism with PPH and wound infection (1 case each) and sepsis (2 cases). Out of 59 patients suffering from eclampsia, 4 (1%) patients died and 24 (6%) patients with pre-eclampsia died. Association of occurrence of eclampsia was robustly associated with patient mortality (P<0.0001).Two hundred and sixteen neonates (54%) had low birth weight while 279 (69.8%) were cases of intra uterine growth retardation. Preterm birth, birth asphyxia and NICU admission was seen in 175 (43.8%), 168 (42%) and 270 (67.5%) respectively. Eighty nine (22.3%) neonates died after birth while 52 (13%). Mean maternal age of deceased and survived neonates in present study was 31.51±5.6 years and 31.1±5.8 years respectively. Mean values for age of gestation of deceased and survived patients were 31.29±1.4 weeks and 31.59±2.2 weeks respectively. Both age and age of gestation of patients were not significantly distributed across maternal mortality (Page=0.56, Paog=0.24).  Conclusion: Preeclampsia and eclampsia tends to threaten maternal health and fetal viability adding to maternal and neonatal mortality and morbidity.There is high frequency of preeclampsia and eclampsia in our setting and the consequences are alarmingly high. There is need for patients education in recognizing the warning symptoms of the disease before intrauterine demise of fetus occurs or mother develops one of the grave complications, Antenatal care, treatment of anemia  and educating the women on significance of symptoms will go a long way in improving maternal and perinatal morbidity and mortality.Presence of NICU  with effective neonatal care will improve the fetal outcome.

Material & Methods: Study Design: Hospital based prospective observational study.Study area:Department of Obstetrics & Gynecology, Mayo institute of Medical Sciences,Barabanki, Uttar Pradesh.Study Period:April 2022 toMarch 2023. Study population:All patients presenting with jaundice to Department of Obstetrics & Gynecologyin antepartum or intrapartum period.Sample size: Study consisted a total of 55 subjects.Sampling Technique:  Simple Random technique. Results: In 29% (n=16) of cases, jaundice is due to obstetric cholestasis, who are mostly presented with pruritis and abnormal LFT’s in their third trimester, In 27% (n=15)it is due to HELLP syndrome which is associated with preeclampsia in 14%, In 12.7%(n=7) cases jaundice is due to sickle cell anemia and Hepatitis B each, haemolytic anemia due to blood transfusion is seen in 5.45% (3), in 3.6%(n=2) cases cause is AFLP who presented with hepatic encephalopathy and hypoglycemia , cirrhosis is the cause of jaundice in 3.6%(n=2) who presented in their first and second trimester,1.8%(n=1) cases are due to malaria, cholelithiasis and autoimmune hepatitis each. So in nearly half of the cases the cause of jaundice is pregnancy specific causes. Conclusion:Jaundice in pregnancy is a dreadful condition resulting in high maternal and fetal mortality. Even though the blood bank facilities has increased, due to their advanced disease state at admission few patients could not be survived. So early referrals are helpful.Team effort is needed in the management of jaundice , team should constitute obstetrician , physician, gastroenterologist, anaesthetist and neonatologist, so that identification and treatment throughout antepartum, intrapartum and postpartum period prevent and reduce maternal and perinatal morbidity and mortality.

Background: One form of hypertension in pregnancy is preeclampsia, which is characterized by blood pressure ≥ 140/90 mm of Hg and protein in urine at gestational age after 20 weeks. Preeclampsia is a global problem affecting 2-8% of pregnancies, and an estimated 8.3 million pregnant women experience preeclampsia every year.  In this review we will look at potential biomarkers and its correlation with uterine artery Doppler for early prediction and diagnosis of preeclampsia. Aim: To investigate the role of placental growth factor, and uterine artery diastolic notch to predict the early onset of preeclampsia. Materials And Methods: A hospital based prospective study conducted on 100 normotensive, non- proteinuric antenatal women less than 20 weeks of gestation were recruited. At 12-16 weeks, PLGF level was estimated from stored serum samples of all cases ad Doppler assessment of uterine circulation for uterine artery indices were done. These women were again rescanned at 24 weeks of gestation by transabdominal USG and further followed up clinically for development of preeclampsia. Methods used for the detection of PLGF is ELISA kit ad Uterine artery Doppler velocimetry was done by transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer Results: In this study,the median PLGF levels being significantly lower in pre-eclampsia cases (15 pg/ml) compared to normal (20.0pg/ml) with sensitivity being 90% and specificity being 23.4%, positive predictive value of 15.5% and negative predictive value of 93.8%. When Uterine arteries notch and RI >0.65 taken together increases sensitivity by 85.71%, 84.62% specificity and negative predictive value by 98.25%.  We found 52.3% sensitivity rate and 84.62% specificity with  70.51% of Negative predictive value regarding Uterine arteries PI  at >0.9573 with Optimal Cut off.  Conclusion: The combined measurement of maternal serum PlGF concentrations and The uterine artery notching, high Resistance Index and Pulsatility Index in uterine artery Doppler waveform at <20 weeks has shown as best screening test for early prediction of preeclampsia.

Background: Eclampsia is a serious medical condition that affects women during pregnancy. Symptoms of eclampsia appear in pregnancy as a condition known as pre-eclampsia, (condition follows a high blood pressure), the condition can go undetected until it develops into eclampsia. This can create additional complications during pregnancy. Each case of eclampsia is unique, and the pregnant woman may share few or no characteristics with other women who develop the condition. Pregnancy histories, Patient age, Family history, Obesity, High blood pressure are major high risk factors for preeclampsia and eclampsia will vary from patient to patient. Materials and methods:The present study was carried out in the Department of Biochemistry, Rama Medical College and Research centre over a period of 1 year. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders – such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease – were excluded from the study. Result:The result showed significantly high blood pressure (SBP-165.81±20.9 VS 125.69±7.24, DBP 109.74±10.41 VS 80.8±5.15) and Blood urea (31.48±2.33mg/dl VS 6.28+/-1.9mg/dl), serum creatinine (0.67±0.52mg/dl VS 0.67±0.03mg/dl), serum uric acid level (6.28±1.9 mg/dl VS 9.48±2.33mg/dl) in pregnancy induced hypertensive women compares to normal pregnant women. In the present study, in PIH, there is elevation of serum uric acid and serum creatinine elevated values are statistically significant. Conclusion:This study concluded that PIH showed significant elevation in the urea, uric acid, and Creatinine levels compared to normal pregnant women, although all parameters’ values for both groups were in the reference values for non-pregnancy.

Purpose: To study the fundus changes in Pregnancy Induced Hypertension (PIH). Methods: It is a hospital based prospective observational study of 100 women with diagnosed PIH. Fundus was examined by direct and indirect ophthalmoscope at bedside. Result: PIH was more common in primigravida (58%); maximum in below 25 years (54%) and in >36 weeks of gestational age (59%). Retinal changes were noted in 45 patients (45%) in which grade I hypertensive retinopathy was 37.7% and grade IV was 24.44%.  Retinal changes were significantly associated with BP (systolic and diastolic), proteinuria and severity of preeclampsia and eclampsia. Most of the changes in the fundus resolved within one week of delivery. Conclusion: All the patients of PIH should be examined by an ophthalmologist for proper management.

Hypertensive disorders in pregnancy, encompassing conditions like gestational hypertension and preeclampsia, significantly impact maternal and fetal health. Understanding their incidence and associated risk factors is vital for improving prenatal care. Objectives: This study aims to determine the incidence of hypertensive disorders among pregnant women and identify key demographic and health-related factors associated with these conditions. Methods: Design: Cross-sectional study. Setting: Obstetric outpatient Department. Participants: 250 pregnant women, ranging from 18 to 45 years, at various stages of gestation. Data Collection: Medical histories, blood pressure measurements, and relevant biochemical markers were collected. Statistical Analysis: Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. Results: Incidence: The incidence of hypertensive disorders was found in a specific percentage of the participants. Risk Factors: Key risk factors such as age, BMI, and medical history were significantly associated with the development of hypertensive disorders. Demographics: The study also revealed demographic trends, such as a higher incidence in certain age groups or pre-existing conditions. Conclusion: This study highlights a significant incidence of hypertensive disorders in pregnant women, underscoring the need for targeted prenatal screening and management strategies. The identification of key risk factors can aid healthcare providers in developing personalized care plans.

Background:  Aim: To study the perinatal morbidity & mortality in twin gestations  according to chorionicity. Methodology: A prospective study was carried out in all twin pregnancy women of second and third trimesters in department of Obstetrics and Gynaecology in Government maternity hospital from date of approval of scientific and ethical committee to one year. Every patient is asked about history regarding age, parity, gravida, family history of twinning, regarding conception whether conceived spontaneously or used any ART. Results: Among 200 twin pregnancies, Primigravidas constituted for 43% of pregnancies and multigravidas constituted for 57% of pregnancies. The most common age being 25 to 29 years in both mono and dichorionic pregnancies. Most of the cases 83% belong to spontaneous conception,15% were induced by drugs and 2% of cases were induced by IUI. Positive family history was present in 13% of twin pregnancies compared to no family history in 87% of twins. 124 cases were (62%) were dichorionic diamniotic where as 68cases (34%) were monochorionic diamniotic where as 8 cases (4%) were monochorionic and monoamniotic. Gestational hypertension was one of the important maternal risk factor noted in my case which was present in 8% of cases where as preeclampsia was the most commonest maternal risk factor which was present in 25% of cases. Pre term complicating twin pregnancies was present in 44% where as preterm PPROM was present in 17% of cases. There was a stastical significance of preterm and preterm PPROM between monochorionic and dichorionic pregnancies. The maximum deliveries were conducted during 34 – 36 weeks and gestational age more than 37 weeks. Among the monochorionic pregnancies, 47% delivered at a gestational age of 31 -33 weeks where as in dichorionic pregnancies 54% of delivery was at more than 37 weeks. The most common causes for neonatal morbidity was RDS which was present in 80% of MC and 20% of DC where as hypoglycemia was present in 1.6 % of DC pregnancies. Neonatal mortality was found in 15cases(19.73%) in MCDA and MCMA where as 9 cases (8%) of DC. The significance in difference between the two groups was found significant. Conclusion: The present study concluded that Monochorionic-Monoamniotic twins should always be delivered by cesarean section to avoid umbilical cord complications for the non- presenting twin at the time of the first twin's delivery. A woman carrying Dichorionic-Diamniotic or Monochorionic- Diamniotic twins is a good candidate for a vaginal birth.

: Introduction: Inferences from most of the studies are limited by the fact that elevated serum Triglycerides were found after the diagnosis of Preeclampsia.  Therefore, this study is done to see if there is any significant elevation of Triglycerides prior to the development of Preeclampsia. Aims: To Find out the Significance of the Association of Early Maternal Hypertriglyceridemia in the Development of Preeclampsia. Materials and methods: It is Prospective Observational study in Department of Obstetrics & Gynaecology in Pregnant women in the early second trimester between 13 - 20 weeks registered for antenatal checkup. Total 300 pregnant women attending the antenatal clinic. 20 patients were lost during the follow up.  Demographic data like age, socioeconomic status and obstetric history along with relevant medical history was recorded on predesigned and pretested proforma. A detailed history, general physical examination including BMI, obstetric examination was done. Results: In this study, out of 280 patients, there is significant correlation between TGL levels and Risk of Preeclampsia. The distribution of patients who developed Preeclampsia is more or less the same with screening in early second trimester. The association between TGL levels and Development of Preeclampsia is statistically significant among the Gestational age group 13- 16 weeks (P=0.013) and 17- 20 weeks (P= 0.000059). The association between TGL levels and Development of Preeclampsia is statistically significant among the age group 21- 29 years (P=0.001) and > 30 years (P= 0.01). The association between TGL levels and Development of Preeclampsia is statistically significant among the Primigravida (P=0.000003) and Multigravida (P= 0.036913). There is significant association between the Triglyceride levels and risk of Preeclampsia among the Primigravida and Multigravida but the Incidence of Primigravida (11.2%) having Preeclampsia as compared to Multigravida (5.1%) is more in this particular study. The association between TGL levels and Development of Preeclampsia is statistically significant among the BMI 18.5 – 24.5 (P=0.001655) and >24.5 – 29.5 (P= 0.009368). Conclusion: The present study shows a consistent positive association between elevated maternal Triglycerides and the risk of Preeclampsia. Therefore, the level of maternal Triglycerides can be used as a screening test in the early second trimester to predict development of Preeclampsia.

Introduction: Hypertension is a significant health concern for pregnant women, potentially leading to adverse maternal and fetal outcomes. This study aims to investigate the maternal and fetal consequences in pregnancies complicated by preexisting hypertension. Objectives: To evaluate the maternal and fetal outcomes in pregnant women with preexisting hypertension. Methods: Study Design: Prospective cohort study. Setting: Two tertiary care hospitals. Participants: 200 pregnant women with a confirmed diagnosis of preexisting hypertension. Data Collection: Data were collected on maternal age, hypertension severity, medication use, prenatal care, and lifestyle factors. Fetal outcomes included gestational age at delivery, birth weight, and incidence of congenital anomalies or distress. Statistical Analysis: Descriptive statistics, chi-square tests for categorical variables, and t-tests or ANOVA for continuous variables. Results: The study found significant associations between the severity of hypertension and maternal complications such as preeclampsia, gestational diabetes, and preterm labor. There was a higher incidence of low birth weight, preterm birth, and neonatal intensive care unit (NICU) admissions in the hypertensive group compared to national averages. Results were statistically significant with p-values <0.05. Conclusions: Preexisting hypertension in pregnant women is strongly associated with adverse maternal and fetal outcomes. Early intervention and careful management of hypertension during pregnancy are crucial to improve health outcomes for both mother and child.

Background: Polycystic Ovary Syndrome (PCOS) affects up to 20% of women of reproductive age globally, with chronic inflammation implicated in infertility and adverse pregnancy outcomes. Objective: To investigate the role of inflammatory pathways in PCOS-related infertility and pregnancy complications, highlighting their contribution to altered reproductive and metabolic health. Methods: A one-year observational study was conducted at Akash Institute of Medical Sciences and Research Center, Bangalore, involving 150 women diagnosed with PCOS. Participants underwent clinical assessments, hormonal profiling, and inflammatory marker evaluation, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Statistical analysis involved correlation coefficients and multivariate regression to explore associations between inflammatory markers and clinical outcomes. Results: Elevated levels of CRP (mean: 6.2 ± 1.3 mg/L), IL-6 (mean: 3.8 ± 0.9 pg/mL), and TNF-α (mean: 12.4 ± 2.1 pg/mL) were observed in 78% of participants. Among infertile women (56%), inflammatory markers were significantly higher (CRP: +18%; IL-6: +22%; TNF-α: +25%) compared to fertile counterparts (p < 0.01). Pregnancy complications, including gestational diabetes (34%) and preeclampsia (18%), showed positive associations with inflammatory marker levels (p < 0.05). Multivariate analysis revealed CRP as the strongest predictor of adverse outcomes (β = 0.42, p < 0.001). Conclusions: This study underscores the pivotal role of inflammatory pathways in PCOS-related infertility and pregnancy complications, advocating for targeted anti-inflammatory interventions to improve clinical outcomes.

Introduction: In the realm of obstetrics, the intricate interplay between maternal health and perinatal outcomes continues to captivate researchers worldwide. Among the multifaceted conditions affecting pregnancy, pre-eclampsia stands as a significant concern, characterized by hypertension and proteinuria after 20 weeks of gestation. This study endeavours to delve into a promising avenue: the association between serum uric acid levels and perinatal outcomes in women grappling with pre-eclampsia. Pre-eclampsia remains a significant challenge in obstetrics, with its potential to impact both maternal and foetal health profoundly. Amidst the array of biomarkers under scrutiny, serum uric acid levels have emerged as a promising candidate for understanding the pathophysiology of this condition. Materials And Methods: This is a Prospective and Observational Study was conducted in the Department of Obstetrics and Gynaecology, Medical College Kolkata from December 2022 to April 2024. Pregnant women diagnosed with Pre-eclampsia in their third trimesters are being included in this study. Pregnant women with Pre-eclampsia who are current smokers, alcoholic and those with diabetes mellitus,thyroid disorders and renal dysfunction were excluded. Patients with chronic diseases like APLA Syndrome and heart diseases were also excluded. All patients with Pre-eclampsia in their third trimesters were asked to test their Serum Uric Acid levels at their third trimesters of pregnancy. These patients were then followed up till delivery and the presence/absence of maternal complications and perinatal outcome were observed. The association between serum uric acid levels and perinatal outcome was then assessed. Results: In our study 11 pre-eclamptic females (9.56%) were ≤20 years of age, 16 (13.91%) were between 21 to 25 years of age, 41(35.65%) were between 26 to 30 years of age, 39(33.91%) were between 31 to 35 years of age and 8(6.95%) were≥ 36 years of age.  In our study, out of 115 participants, 3 (2.60%) had uric acid levels ≤4 milligrams per decilitre, 22(19.13%) had uric acid levels between 4.1 to 6.0 milligrams per decilitre ,61 (53.0%) had uric acid levels between 6.1 to 7.9 milligrams per decilitre and 29 (25.2%) had uric acid levels ≥ 8 milligrams per decilitre. In our study, we calculated the association of Blood Pressure at delivery with serum uric acid levels. It was found to be statistically significant (p value is 0.0035). Data are expressed as percentage. Test applied: Fisher's exact test. The row/column association is statistically significant. The relative risk is 1.833. 95% confidence interval is between 1.116 to 3.011. Conclusion: Hence, from our results, we can surmise that serum uric acid levels have a significant association with perinatal outcome in women with pre-eclampsia and hence, can be used as prognostic marker to predict development of complications in these pre-eclamptic females.

Background: The most common significant health concern during pregnancy is hypertension, which remains a vital factor in both maternal and fetal morbidity and mortality. Preeclampsia is a pregnancy-related hypertensive disorder that occurs after twenty weeks of gestation and involves multiple systems.

Objectives:

1) To study maternal outcome in severe pre- eclampsia & eclampsia.

2) To study perinatal outcome in severe pre- eclampsia & eclampsia.

3) To enumerate variable factors associated with maternal and perinatal morbidity and mortality.

Material & Methods: Study Design:  Prospective Observational Study.  Study area: Department of Obstetrics & Gynecology, GGH, GMC, KADAPA.  Study Period: 1 year. (March 2023 – April 2024). Study population: 100 Pregnant women admitted with severe PE and eclampsia. Sample size: Study consisted a total of 100 subjects. Sampling Technique:  Convenience Sampling technique. Results: In this study 22% of cases had no proteinuria, 25 % of the cases had trace amounts of protein in urine, among them only 2% developed HELLP. Among 77% of the cases with proteinuria, 13% developed HELLP and there was significant association between proteinuria and HELLP i.e as severity of proteinuria increases chances of HELLP increases. Conclusion: Severe preeclampsia leads to higher risks of life-threatening complications, preterm delivery, and IUGR, with maternal mortality observed in multigravida cases. Early detection and proper management, including evidence-based protocols, are crucial to reducing morbidity and mortality. Effective secondary and tertiary prevention improves outcomes for both mother and neonate.

Background: Hypertensive disorders during pregnancy, including gestational hypertension and preeclampsia, are significant contributors to maternal and fetal morbidity and mortality. Emerging evidence suggests that alterations in serum magnesium and lipid profiles may play a role in the pathophysiology of these conditions. Objective: To evaluate and compare serum magnesium levels and lipid profiles among normotensive pregnant women and those with hypertensive disorders of pregnancy (HDP). Methods: A prospective case-control study was conducted involving 100 pregnant women beyond 32 weeks of gestation. Fifty women diagnosed with HDP formed the case group, while fifty normotensive pregnant women served as controls. Fasting blood samples were analyzed for serum magnesium, total cholesterol, triglycerides, HDL-C, LDL-C, and VLDL-C. Statistical analysis was performed using SPSS version 25. Results: Women with HDP exhibited significantly lower serum magnesium levels and higher levels of total cholesterol, triglycerides, LDL-C, and VLDL-C compared to controls. HDL-C levels were notably lower in the HDP group. These findings suggest a correlation between dysregulated mineral and lipid metabolism and the development of hypertensive disorders during pregnancy. Conclusion: Monitoring serum magnesium and lipid profiles in pregnant women may aid in the early detection and management of hypertensive disorders, potentially improving maternal and fetal outcomes.

Background: In Preeclampsia and IUGR, the problem begins in the placenta itself. Normally cytotrophoblastic cells of the chorionic villi invades into the decidua basal is which further invades the spiral arterioles and superficial myometrium leading to progressive dilatation of the vessels and thereby reducing the uterine artery resistance and maintaining the perfusion of placenta along with the fetus. Aims: This study is undertaken to evaluate the association between Uterine Artery Resistance Index (R.I.) performed between 10-14 weeks of gestation to predict Intra Uterine Growth Restriction and Pre-eclampsia at later stages in pregnancy. Materials & Methods: Prospective Cohort study. 150 antenatal patients were included in the study done from December 2021 to November 2022. The age of the women varies between 19-33 years. Result: In our study, diastolic notch was present in both uterine arteries in 81 patients (54.0%), present in one artery in 28 patients (18.7%), and absent in both arteries in 41 patients (27.3%). This distribution was statistically significant, with a p-value of < .00001.  Conclusion: First-trimester uterine artery Doppler resistance index (RI) is a valuable predictive tool for identifying pregnancies at risk for intrauterine growth restriction (IUGR) and pre-eclampsia. Elevated RI values are significantly associated with impaired placental perfusion, which contributes to these adverse outcomes. Early identification through Doppler screening enables closer surveillance and timely interventions, potentially improving maternal and fetal outcomes.

Background: The complex range of conditions known as pregnancy-related hypertensive diseases has a significant negative impact on people's health in both developed and developing countries worldwide.  They play a significant role in maternal and infant mortality and morbidity.  Five to ten percent of pregnancies worldwide are affected by hypertension diseases. Aims: To Assess The Role Of Pigf At 11-14 Weeks In Early Prediction Of Pre-Eclampsia. Materials & Methods: The DARBHANGA MEDICAL COLLEGE AND HOSPITAL. This hospital is a tertiary care referral centre in eastern India. Prospective observational study and total sample size 100 patients Result: In our study, among patients with pre-eclampsia, 6 patients (17.14%) had normal values (>1.16), while 26 patients (40%) had abnormal values (<1.16). This difference was statistically significant (p = 0.01), indicating a potential association between abnormal values and pre-eclampsia. Conclusion: Pregnancy-related hypertensive diseases are a complicated group of problems that have a significant negative impact on people's health in both developed and developing countries worldwide.  They are a major contributor to maternal and infant mortality and morbidity.  Around the world, hypertension disorders affect five to ten percent of pregnancies.

Background: Preeclampsia is a transient but potentially dangerouscomplication of pregnancy. Most current assumption regarding the pathophysiologic mechanisms of preeclampsia point to trophoblastic dysfunction. Aim: The present study was conducted to evaluate the relationship between serum total testosterone (TT) with mean arterial blood pressure and risk of cardiovascular disease in patients withpreeclampsia. Methods: A case-control study designed with fifty preeclamptic patients that randomly selected from gynecology ward were studied for estimation of serum TT. Serum TT determined by means of chemiluminescent immunoassay methodbase Immulite 1000 analyzer.  Results: The statistical analysis of study group of preeclampsia compared with normotensive control group, showed significant (p< 0.001)increase in serum TT concentrations in patients with preeclampsia. Positive and highly significant correlation (r = 0.528, P < 0.001) was observed between serum TT compared with mean blood pressure in preeclampsia. Conclusion: The concentrations of the potent total testosterone were significantly higher in women with preeclampsia than in normotensive women with similar gestational and maternal ages. This change may indicate a role of the testosterone in the pathogenesis of preeclampsia.The present study found a significant association between serum TT and mean blood pressure as a risk factor for cardiovascular disease (CVD) and trophoblastic dysfunction in preeclampsia.

Background: Emerging evidence highlights the critical role of the maternal microbiome in modulating immune, metabolic, and hormonal functions during pregnancy. Alterations in microbial communities may contribute to adverse pregnancy outcomes such as preeclampsia, preterm birth, gestational diabetes mellitus (GDM), and intrauterine growth restriction (IUGR). This longitudinal study investigates the association between maternal microbiome composition and pregnancy outcomes across the three trimesters. Materials and Methods: A prospective cohort of 120 pregnant women aged 20–35 years was recruited at <12 weeks gestation and followed through delivery. Vaginal, oral, and fecal microbiome samples were collected at each trimester. 16S rRNA gene sequencing was used for microbial profiling. Pregnancy outcomes assessed included gestational age at delivery, incidence of GDM, hypertensive disorders, and neonatal birth weight. Alpha and beta diversity indices were calculated, and associations with outcomes were analyzed using multivariate regression models. Results: Out of 120 participants, 112 completed the study. Women who developed preeclampsia (n=14) showed significantly lower vaginal microbial diversity in the second trimester (Shannon index mean: 2.1±0.4) compared to normotensive women (3.5±0.6; p<0.001). Higher relative abundance of Prevotella and Gardnerella in the vaginal microbiome was significantly associated with preterm birth (n=11; OR=2.8, 95% CI: 1.4–5.6). Gut microbial dysbiosis characterized by a lower Firmicutes/Bacteroidetes ratio was observed in GDM cases (n=16) during the third trimester (p=0.02). No significant changes were observed in oral microbiome patterns across groups. Conclusion: This study underscores the dynamic nature of the maternal microbiome and its potential predictive value for pregnancy complications. Specific microbial shifts, particularly in the vaginal and gut environments, are associated with adverse outcomes such as preeclampsia, preterm birth, and GDM. Monitoring maternal microbiome profiles may serve as a non-invasive tool for early identification of at-risk pregnancies and inform targeted interventions.

Background: Preeclampsia is a pregnancy-specific hypertensive disorder associated with significant maternal and fetal morbidity. Homocysteine, a sulfur-containing amino acid, has been implicated in endothelial dysfunction and vascular pathology. This study aimed to evaluate and compare serum homocysteine levels in preeclamptic and normotensive pregnant women and correlate these levels with disease severity and outcomes. Methods: This prospective case-control study was conducted at Chalmeda Anand Rao Institute of Medical Sciences, Telangana, from September 2022 to February 2024. A total of 80 pregnant women between 26–40 weeks of gestation were enrolled, including 40 preeclamptic (cases) and 40 normotensives (controls). Detailed clinical evaluation, blood pressure measurement, and biochemical investigations including serum homocysteine estimation were performed. Maternal and fetal outcomes were recorded. Statistical analyses included t-tests, chi-square tests, and Pearson correlation. Results: The mean serum homocysteine level was significantly higher in the preeclamptic group (15.52 ± 4.80 µmol/L) compared to controls (10.42 ± 3.64 µmol/L, p < 0.001). Hyperhomocysteinemia (>15 µmol/L) was observed in 65% of cases and 10% of controls. A strong positive correlation was noted between homocysteine levels and systolic (r = 0.512) and diastolic blood pressure (r = 0.482). Adverse maternal and fetal outcomes, including preterm delivery, low birth weight, increased NICU admissions, and maternal complications, were more prevalent in the preeclamptic group. Conclusion: Elevated serum homocysteine levels are significantly associated with preeclampsia and correlate with disease severity and adverse outcomes. Homocysteine may serve as a potential biochemical marker for early identification and risk stratification of preeclampsia.

Background: Hypertensive emergencies in pregnancy, especially severe preeclampsia and eclampsia, are critical contributors to maternal and fetal morbidity. Prompt control of blood pressure is essential to prevent complications. In developing countries like India, where maternal deaths due to preeclampsia are still unacceptably high, evaluating cost-effective and practical protocols for hypertensive emergencies becomes essential. This study compares the efficacy of intravenous labetalol and oral nifedipine in achieving rapid BP control in pregnant women presenting with hypertensive emergencies. Materials and Methods: This is a Prospective, comparative, randomized study conducted in the Department of Obstetrics and Gynecology at a tertiary care hospital over 12 months involving 100 pregnant women with hypertensive emergencies was conducted. Group A received intravenous labetalol; Group B received oral nifedipine. Both groups were monitored for time to achieve target BP, maternal side effects, and fetal outcomes. Data analyzed using SPSS v20. Mean, SD, t-tests, and chi-square used. P < 0.05 was considered significant. Results: Group A (IV labetalol) showed faster BP control (mean time: 25 ± 8 min) compared to Group B (nifedipine: 35 ± 10 min). Adverse effects were minimal in both groups. Perinatal outcomes were comparable. Conclusion: Intravenous labetalol offers faster blood pressure control with fewer maternal side effects in hypertensive emergencies of pregnancy, though both labetalol and nifedipine are safe and effective. Drug choice can be guided by clinical setting, availability, and patient-specific factors.