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Objective: First trimester aneuploidy screening (FTAS) has become an integral part of antenatal care in most of centers in India. The serum markers used for FTAS are pregnancy-associated plasma protein A (PAPP-A) and beta human chorionic gonadotropin. In the present study, we aimed to assess the role of PAPP-A in specific adverse fetal maternal events. To analyze pregnancy outcomes with low maternal PAPP-A (≤5th percentile) at the FTAS screening test in southern India, and them compared with a control group of >5th percentile value. Materials and Methods: A total of 1800 consecutive pregnancies in the first trimester were followed up with PAPP-A levels. The study group consisted 108 subjects, which was compared with a matched control group of 288 subjects. The outcomes considered were spontaneous abortions, fetal anomalies, preterm delivery (PTD), hypertension in pregnancy, intrauterine growth restriction, gestational diabetes, mode of delivery, and birthweight. Results: For our grouped data, the 5th percentile value for PAPP-A was 0.49 multiple of medians, (incidence-6%). The incidence of fetal major anomalies was higher in the study group [odds ratio (OR): 1.87]. The incidence of minor anomalies, gestational diabetes, and hypertensive disorders was higher in the study group but not statistically significant. The total rate of PTDs (OR:2.1), small-for-gestation-age fetuses (OR:2.3), and low birthweight babies (OR- 2.12) was significantly higher in the study group. We found positive likelihood ratio of 1.4 for PTD, 2 for

Objective To assess incidence of spontaneous preterm births and determine biochemical and obstetric risk factors for spontaneous pre-term births in a cohort of antenatal women visiting a secondary care hospital. Methods A prospective cohort study was designed to include 1420 pregnant women coming for antenatal care at a secondary care hospital. The cohort was followed throughout pregnancy and relevant history, obstetric and ultrasonographic examination and biochemical investigations was carried out in 2nd (20-24 weeks period of gestation) and 3rd trimester (28-32 weeks period of gestation). Outcome of delivery was noted for all the subjects. Results A total of 1133 women were recruited. Among the 1071 respondents, 11 had abortions, 93.1% delivered at term while 5.9% had preterm deliveries. Preterm deliveries were noted among 6.5% women with short stature, 13.3% with cervical length Conclusions The incidence of preterm births (5.9%) was low in the present cohort. Oligohydramnios and Intrauterine Growth Retardation (IUGR) were identified as significant risk factors for preterm births. Conventional risk factors like short cervix, short stature and biochemical inflammatory markers were not identified as predictors of prematurity. Lower levels of salivary estriol identified among women at risk of preterm births demonstrates the utility of the test as a non-invasive investigation for early identification of preterm births.

Congenital pulmonary airway malformation (CPAM) is a rare developmental lung abnormality. It is also referred as a congenital cystic adenomatoid malformation. The exact etiology is not known yet. The majority of cases are detected during targeted prenatal scan or within 2 years of the birth. Here, we report a case of CPAM type II diagnosed at 23 weeks of gestation, the key diagnostic features of which were mediastinal shift and lung lesion. The fetus had transient polyhydramnios and pericardial effusion. Glucocorticoids were administered for threatened preterm labor and CPAM. Healthy neonate was delivered at term without any immediate neonatal complications.How to cite this articleBhat SK, Nambiar R, Nayak D, Shah KH. Prenatal Diagnosis and Postnatal Management of Congenital Pulmonary Airway Malformation. Int J Infertil Fetal Med 2017;8(2):89-92.

Fetal intra-abdominal umbilical vein varix (FIUVV) is a rare pathology and suggests an enlargement of the umbilical vein. Prenatal diagnosis is done through meticulous ultrasound imaging. Management variables are the diameter of varix, presence or absence of turbulent flow, and fetal anomalies. Color and power Doppler ultrasound helps in diagnosis and follow-up and has a critical role in decision-making for intervention. Clinical guidelines for management are not clear. The adverse fetal outcome is usually associated with multiple malformations, turbulent flow, and thrombotic varix. This case study presents the prenatal diagnosis, obstetric management, and neonatal development of a fetus, diagnosed with FIUVV along with a brief review of the literature.

Background. Although most pregnant women experience spontaneous labour at term, induction of labour is indicated whenever continuation of pregnancy is detrimental to either the fetus or the mother. Objectives . To study the factors associated with the successful induction of labour and to compare the maternal and fetal outcomes between induced and spontaneous labour . Methods. We conducted a prospective observational and comparative study from September 2015 to December 2016 at Dr TMA Pai Hospital – a secondary level hospital at Manipal Academy of Higher Education (MAHE). Women with a singleton pregnancy, live fetus, vertex presentation and gestational age (GA) >36 weeks were included in the study, and those with antepartum haemorrhage, scarred uterus, anomalous fetus and intrauterine fetal demise were excluded. Results. Out of 1 575 deliveries during the study period, 550 were induced (34%). A total of 300 inductions fulfilled the inclusion criteria and formed the study group. Multiparity, body mass index (BMI) 38 weeks were factors associated with successful induction. Among the components of the Bishop score, dilatation was a better predictor of vaginal delivery ( p

Objectives: The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes. Methods: A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI). Results: Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent’s intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height

Background. In the light of the rise in prevalence of gestational diabetes mellitus (GDM) and the importance of early suspicion and prompt diagnosis, different regions have reported different risk factors. This warrants multiple regional studies in sub-populations and diverse geographic areas to quantify determinants of GDM. Objective. To determine risk factors of GDM. Methods. A case-control study was conducted in a tertiary care maternity hospital in coastal South India based on pregnancy records of all those women diagnosed with GDM who received in-patient care between January 2018 and December 2018. There were 131 cases pairmatched for age in the ratio of 1:1 with 131 controls. Results. Women from rural areas and those with a monthly income ≤INR20 000, body mass index (BMI) >23 kg/m2 , polyhydramnios (a trend), pregnancy-induced hypertension (a trend), oligohydramnios (a trend) and a gap between pregnancies of 23 kg/m2 and a spacing gap of

Introduction: Thyroid disorders are among the most common endocrine disorders affecting pregnant women. About 2 to 3% of pregnant women are affected by subclinical hypothyroidism and about 0.3%-0.5% by overt hypothyroidism. Thyroid autoantibodies are found in 5-15% of women in childbearing age and have been associated with adverse pregnancy outcomes. Aim: To compare the pregnancy outcomes in thyroid peroxidase antibody positive and thyroid peroxidase antibody negative hypothyroid women. Materials and Methods: This was a retrospective study done in Dr TMA Pai Hospital, Udupi, Karnataka, India from January 2015 to December 2016. All singleton pregnant women with hypothyroidism were included and multiple pregnancy, pre-existing hypertensive or diabetic pregnancies were excluded. Serum Thyroid Stimulating Hormone (TSH) levels were estimated during booking visit for all pregnant women and if >2.5μIU/ml, free T3, T4, and Thyroid Peroxidase Antibody (TPO-Ab) levels were done. Data were retrieved from the hospital records and divided into TPO-Ab negative and TPO-Ab positive groups. The analysis was done using SAS v9.3. Chi-square test and Fisher- Exact test were used for testing equality of proportions. The p-value

Nephrotic Syndrome (NS), a unique renal disease complex associated with heavy proteinuria (protein excretion >3.5 gm/day), hypoalbuminemia (

Introduction: Routinely performed aneuploidy screen takes into account free beta human chorionic gonadotrophins (β-hCG), Pregnancy Associated Plasma Protein-A (PAPP-A), nuchal translucency, and various maternal characteristics. Incidental finding of extreme level of PAPP-A can generate anxiety. Association of low PAPP-A has been established with chromosomal anomalies and adverse pregnancy outcome. The effect of high PAPP-A on feto-maternal outcome has not been widely studied. Aim: The aim of the study was to analyse pregnancy outcome in the group with high maternal PAPP-A, that is >95th centile at the first trimester aneuploidy screen test. Materials and Methods: The prospective observational study was conducted at Dr. TMA Pai hospital, affiliated to Manipal Academy of Higher Education, Manipal. Each patient visiting antenatal OPD was counselled for first trimester aneuploidy screening during the study period of two years (November 2015 to November 2017). All patients who were registered for delivery at the hospital were taken into the study. Blood samples were taken at 11-13+6 weeks of pregnancy. A total of 1500 consecutive pregnancies having first trimester screening were followed up with PAPP-A levels, expressed in Multiple of Medians (MoM). The study group was formed by patients with PAPP-A of more than 95th centile. Only euploid foetuses were considered for the analysis. The pregnancy outcomes were determined in PAPP-A levels of >95th percentiles (3.11 MoM and more) with respect to threatened abortion, preterm delivery, foetal malformations, hypertension in pregnancy, gestational diabetes and growth abnormalities. It was compared with matched control group of PAPP-A between 5th to 95th centile (PAPP-A >0.49 to 3.10). Statistical analysis was performed using Statistical Package for Social Science (SPSS) software version 16 and p-value

AhMITE1 is an active miniature inverted repeat transposable element (MITE) in peanut (Arachis hypogaea L). Its transpositional activity from a particular (FST1-linked) site within the peanut genome was checked using AhMITE1-specifc PCR, which used a forward primer annealing to the 5′-flanking sequence and a reverse primer binding to AhMITE1. It was found that transposition activation was induced by stresses such as ethyl methane sulfonate (EMS), gamma irradiation, environmental conditions, and tissue culture. Excision and insertion of AhMITE1 at this particular site among the mutants led to gross morphological changes resembling alternate subspecies or botanical types. Analysis of South American landraces revealed the presence of AhMITE1 at the site among most of the spp. fastigiata types, whereas the element was predominantly missing from spp. hypogaea types, indicating its strong association. Four accessions of the primitive allotetraploid, A. monticola were devoid of AhMITE1 at the site, indicating only recent activation of the element, possibly because of the “genomic shock” resulting from hybridization followed by allopolyploidization.

Omega-3 fatty acids (ω-3 FAs) are essential fatty acids with diverse biological effects in human health and disease. Reduced cardiovascular morbidity and mortality is a well-established benefit of their intake. Dietary supplementation may also benefit patients with dyslipidaemia, atherosclerosis, hypertension, diabetes mellitus, metabolic syndrome, obesity, inflammatory diseases, neurological/ neuropsychiatric disorders and eye diseases. Consumption of ω-3 FAs during pregnancy reduces the risk of premature birth and improves intellectual development of the fetus. Fish, fish oils and some vegetable oils are rich sources of ω-3 FAs. According to the UK Scientific Advisory Committee on Nutrition guidelines (2004), a healthy adult should consume a minimum of two portions of fish a week to obtain the health benefit. This review outlines the health implications, dietary sources, deficiency states and recommended allowances of ω-3 FAs in relation to human nutrition.

Hypoparathyroidism is an uncommon endocrine deficiency characterised by low serum calcium, absent or inappropriately low parathyroid hormone and normal or high serum phosphorus levels. Parathyroid hormone is essential for calcium homoeostasis. Pregnancy and lactation are known for increased calcium requirement. They cause calcium stress as well as alter its metabolism. Hence, many abnormalities are expected in hypoparathyroidism during pregnancy and lactation. We report a case of pregnancy in postsurgical hypoparathyroidism, which is rarely encountered in antenatal clinics. We describe our clinical, biochemical and therapeutic experience of pregnancy and lactation in this patient with hypoparathyroidism.