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Objectives This study measures the prevalence of risk factors among pregnant women and young children aged 12-24 months in a rural community in West Bengal, India. Methods Community health workers (CHWs) enrolled women and children into this 2015 cross-sectional study. Pregnant women were evaluated for underweight, anemia, and abnormal blood pressure. Children were evaluated for underweight, abnormal head and upper arm circumferences, and low scores from the Ages and Stages Questionnaire (ASQ). Data were collected on smartphones and tablets or by paper. Results More than half of the 279 women (59.9%) had a risk factor during pregnancy: 48.7% were anemic, 35.1% had low blood pressure, and 7.5% were underweight. Among the 366 children, 59.3% had a risk factor, including 24.0% with low ASQ scores and 49.7% who had abnormal anthropometric measures. Conclusions for Practice Vulnerable populations, such as pregnant women and young children, needed a greater connection to doctors in this rural community. This study demonstrated the feasibility of CHWs to listen to health concerns and connect underserved populations with health care services. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease (SCD) is a hereditary blood disorder prevalent in tribal regions of India. SCD can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the community-based hospital of SEWA Rural (Kasturba Maternity Hospital) in Jhagadia block, Gujarat. The objective of the study is to compare the pregnancy outcomes among SCD, sickle cell trait and non-SCD admissions. This study also estimated the risk of adverse pregnancy outcomes for SCD admissions.Methods: The data pertains to four and half years from March 2011 to September 2015. The total tribal maternal admissions were 14640, out of which 10519 admissions were deliveries. The admissions were classified as sickle cell disease, sickle cell trait and non-sickle cell disease. The selected pregnancy outcomes and maternal complications were abortion, stillbirth, Caesarean section, haemoglobin levels, blood transfusion, preterm pregnancy, newborn birth weight and other diagnosed morbidities (IUGR, PIH, eclampsia, preterm labour pain). The odds ratios for each risk factor were estimated for sickle cell patients. The odds ratios were adjusted for the respective years.Results: Overall, 1.2% (131 out of 10519) of tribal delivery admissions was sickle cell admissions. Another 15.6% (1645 out of 10519) of tribal delivery admissions have sickle cell trait. The percentage of stillbirth was 9.9% among sickle cell delivery admission compared to 4.2% among non-sickle cell deliveries admissions. Among sickle cell deliveries, 70.2% were low birth weight compared to 43.8% of non-sickle cell patient. Similarly, almost half of the sickle cell deliveries needed the blood transfusion. The 45.0% of sickle cell delivery admissions were pre-term births, compared to 17.3% in non-SCD deliveries. The odds ratio of severe anaemia, stillbirth, blood transfusion, Caesarean section, and low birth weight was significantly higher for sickle cell admissions compared to non-sickle cell admissions.Conclusions: The study exhibited that there is a high risk of adverse pregnancy outcomes for women with SCD. It may also be associated with the poor maternal and neonatal health in these tribal regions. Thus, the study advocates the need for better management of SCD in tribal Gujarat. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia in pregnancy is still a major concern in reducing maternal morbidity and mortality in India particularly in rural population. Haemoglobinopathies are important contributors to anaemia in pregnancy in rural India particularly in tribal population. Beta thalassemia is the commonest type of haemoglobinopathy all over the world. Thalassemia and other haemoglobinopathies are highly prevalent among the tribal communities in West Bengal. Bankura is one of the districts of West Bengal where more tribal population are present. So detection and prevention of thalassemias is one of the major public health problems in this part of the state of West Bengal.Study done by Manna et al4 showed that about 10% of the population is carrier of haemoglobin disorder.This study was taken up to document the recent prevalence status of hemoglobinopathies particularly Thalassemias and coexistence of iron deficiency anaemias Objective: To find out prevalence of haemoglobinopathies and to compare the prevalence of different types of Thalassemias among the antenatal mothers. Materials and Methods: This study was carried out in Bankura Sammilani Medical College (BSMC), Bankura West Bengal among 3500 tribal and non-tribal antenatal mothers. Cation exchange-high performance liquid chromatography (CE-HPLC) is being used for investigation for hemoglobinopathies and thalassemias. Together with a complete blood count, the CE-HPLC is effective in categorizing hemoglobinopathies as traits, homozygous disorders and compound heterozygous disorders. Results: In our study 275 mothers had haemoglobinopathy. The commonest disorder we encountered was Beta Thalassemia trait (57.5%), followed by HbE carrier (36%), homozygous HbE disease (1%), HbS carrier (4%), HbE Beta Thalassemia (1.5%). [ABSTRACT FROM AUTHOR]

Introduction: Women who experienced and survived a severe health condition during pregnancy, childbirth or postpartum are considered as 'near-miss' or severe acute maternal morbidity (SAMM) cases. Women who survive life-threatening conditions arising from complications related to pregnancy and childbirth have many common aspects with those who die of such complications. Aim: To evaluate health-care facility preparedness and performance in reducing severe maternal out comes at all levels of health care. Materials and Methods: The present study was carried out over a period of 12 months under the Department of Community Medicine. The cross-sectional study included all the women (937) attending health-care facilities, at all levels of health care i.e. Primary, Secondary & Tertiary level in Doiwala block of Dehradun district. This study was conducted as per the WHO criteria for 'near-miss' by using probability sampling for random selection of health facilities. All eligible study subjects visiting health-care facilities during the study period were included, i.e. who were pregnant, in labour, or who had delivered or aborted up to 42 days ago. Results: It was found that all women delivering at the THC received oxytocin to prevent postpartum haemorrhage. Treatment of severe post-partum haemorrhage by removal of retained products was significantly associated with levels of health care. Majority (94.73%) women who had eclampsia received magnesium sulfate as primary treatment. Conclusion: Application of WHO 'near-miss' tool indicates good quality of maternal care in rural healthcare setting in Uttarakhand, North India. The women would have otherwise died due to obstetrics complications, had proper care not been provided to them in time. [ABSTRACT FROM AUTHOR]

The study determined the incidence of low birth weight (LBW), small for gestational age (SGA), preterm birth, and perinatal morbidity among Asian Indians (AI) in New Jersey (NJ), as well as identified predictors of SGA. We analyzed birth records for singletons born to mothers identified as AI and non-Hispanic white from 2008 to 2011, obtained from the NJ Department of Health. For AI, rates of LBW and SGA were elevated, rates of preterm birth were similar, and neonatal intensive care unit admission was lower, compared to whites. Factors associated with SGA in AI included nulliparity, anemia, hypertension, placental abruption, and lack of prenatal care. Maternal education, marital status, substance abuse, and timing of prenatal care were associated with SGA in whites, but not in AI. SGA incidence was higher among AI despite preterm rates similar to whites. Anemia was associated with SGA uniquely among AI. [ABSTRACT FROM AUTHOR]

Aims: To evaluate fetal scalp stimulation test (FSST) as an adjunct to intermittent auscultation in diagnosis of intrapartum fetal acidosis and associate result of FSST with cord blood pH and immediate neonatal outcome. Material & Methods: This study was conducted at a tertiary hospital in India. Digital FSST was performed in seven hundred and fifty women in labor with singleton gestation 37 weeks, cephalic presentation and fetal heart abnormalities and/or thick meconium stained amniotic fluid. Intermittent auscultation was used for fetal monitoring during labor. The outcome measure was cord blood pH < 7.20 and neonatal morbidity. Results: The non-reactive FSST is associated with lower umbilical cord blood pH, lower Apgar scores and higher asphyxia related neonatal morbidity (P-value < 0.001). The non-reactive FSST had 41% sensitivity and 84% specificity to detect pH < 7.20. The positive predictive value of FSST for fetal acidosis is 44% and negative predictive value is 83%. The likelihood ratio for acidosis with noncreative FSST is 2.57. Conclusions: Non-reactive FSST is associated with adverse neonatal outcomes. The positive and negative predictive values of FSST to diagnose fetal cord blood pH < 7.20 during labor are 44% & 83%, respectively. [ABSTRACT FROM AUTHOR]

Teenage pregnancy is a global problem and is considered a high-risk group, in spite of conflicting evidence. Our objective was to compare obstetric outcomes of pregnancy in teenagers and older women. This was a retrospective study of case records of pregnancies from August 2000 to July 2001. Girls aged ≤19 years were compared with pregnancy outcomes in older women (19-35 years) in the same hospital. The study took place in the Government General Hospital, Sangli, India, a teaching hospital in rural India, with an annual delivery rate of over 3,500. A total of 386 teenage pregnancies were compared with pregnancies in 3,326 older women. Socioeconomic data, age, number of pregnancies, antenatal care and complications, mode of delivery, and neonatal outcomes were considered. The incidence of teenage pregnancy in the study was 10%. A significant proportion of teenage pregnant mothers were in their first pregnancies. The teenage mothers were nearly three times more at risk of developing anaemia (OR = 2.83, 95% CI = 2.2-3.7, p < 0.0001) and delivering pre-term (OR = 2.97, 95% CI = 2.4-3.7, p < 0.0001). Teenage mothers were twice as likely to develop hypertensive problems in pregnancy (OR = 2.2, 95% CI = 1.5-3.2, p < 0.0001) and were more likely to deliver vaginally with no significant increase in the risk of assisted vaginal delivery or caesarean section. Young mothers were nearly twice at risk of delivering low birth weight babies (OR = 1.8, 95% CI = 1.5-2.2, p < 0.0001) and 50% less likely to have normal birth weight babies (OR = 0.5, 95% CI = 1.2-2.9, p < 0.0001). The outcome of this study showed that teenage pregnancies are still a common occurrence in rural India in spite of various legislations and government programmes and teenage pregnancy is a risk factor for poor obstetric outcome in rural India. Cultural practices, poor socioeconomic conditions, low literacy rate and lack of awareness of the risks are some of the main contributory factors. Early booking, good care during pregnancy and delivery and proper utilisation of contraceptive services can prevent the incidence and complications in this high-risk group. [ABSTRACT FROM AUTHOR]

Healthy body weight on conception and adequate weight gain during pregnancy is important to ensure that the mother and baby remain well. About 30% of women living in South Asia enter pregnancy with severe or moderately severe underweight and do not gain sufficient weight during gestation to allow the fetal growth to proceed unimpeded. In India, out of twenty million babies born every year, about seven million are low birth weight.1 The aim of the present study was to determine the effects of first trimester BMI on pregnancy, labour and fetal outcomes, which will help to identify how significant is the BMI monitoring in antenatal period for preventing complications. Antenatal and intranatal records of 250 primi gravid women were studied over a period of one month for knowing the complications which had occurred to mother and her fetus during antenatal and intranatal period. Statistical analysis was done by using SPSS 11.5 package and relation was found using logistic regression. Complications like gestational diabetes mellitus, gestational hypertension, preterm delivery, meconium stained liquor, low birth weight, small for gestational age and IUGR were found to be more in abnormal first trimester BMI categories. Abnormal first trimester BMI revealed to be associated with severe maternal and neonatal complications. Therefore pregnant women should maintain a normal BMI to achieve a healthy pregnancy outcome. [ABSTRACT FROM AUTHOR]

The article focuses on the seasonal trends in the occurrence of eclampsia in India. It notes that Eclampsia is one of the most serious and potentially catastrophic complications of pregnancy and major cause of maternal and perinatal mortality and morbidity in the nation. It examines the occurrence of eclampsia in the nation's four major seasons including dry cool winter, dry hot summer, and post monsoon. It adds that eclampsia is also associated with cooler temperature or winter cold weather leading to vasospasm and ischaemia thus high incidence is noted in winter season. Meanwhile, several charts and graphs including the nation's season-wise distribution of eclampsia, comparison of study with various authors, and the month-wise distribution of eclampsia are also presented.