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Background: Pregnancy induced hypertensive (PIH) disorders are a significant cause of adverse maternal and fetal outcomes, especially in developing areas of the world. Objective of this study to compare the maternal and fetal outcomes of PIH patients with normotensive control in central India Materials & Methods: This is a prospective study conducted in the department obstetrics and Gynaecology, GRMC, Gwalior, India. 122 women with PIH admitted for delivery were included in the study. Outcomes of PIH were assessed in terms of feto-maternal complications. All the quantitative data were statistically analyzed by chi-quire test and P-value. Results: Majority (56.6%) of the study subjects were between 21 to 25 years, mostly from rural areas (55.7%) and belonged to lower socio-economic status (74.5%). The highest proportion of them (73.7%) had >37 wk of gestational age and also primigravida (74.5%). Anaemia and edema was significantly associated with PIH patients. LSCS, IUGR and PROM were more common in PIH group, whereas GDM, BOH and decreased foetal movement were common in control group. LBW babies, me conium Stained Liquor, maternal and foetal mortality were significantly higher in PIH. Conclusions: Pregnancy-related hypertensive disorders are common and adversely impact maternal and fetal outcomes. Efforts should be made at both the community and hospital levels to increase awareness regarding PIH and reduce its associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

The choice and regimen of anticoagulation therapy in pregnant women with mechanical valve prostheses have always been a daunting task. It is a delicate balance that takes into consideration the risk of thromboembolic complications in the mother and the risk of potential Warfarin embryopathy to the foetus. Medical practice in a low socioeconomic setting also has the peculiar challenge of financial constraints on the part of the patients and difficulties in monitoring the efficacy of anticoagulation therapy. We report our experience in managing two pregnant women with mechanical valve prostheses and review the existing literature on this complex but interesting subject.

The choice and regimen of anticoagulation therapy in pregnant women with mechanical valve prostheses have always been a daunting task. It is a delicate balance that takes into consideration the risk of thromboembolic complications in the mother and the risk of potential Warfarin embryopathy to the foetus. Medical practice in a low socioeconomic setting also has the peculiar challenge of financial constraints on the part of the patients and difficulties in monitoring the efficacy of anticoagulation therapy. We report our experience in managing two pregnant women with mechanical valve prostheses and review the existing literature on this complex but interesting subject. [ABSTRACT FROM AUTHOR]

Background the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. Methods a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012. In total, 1400 women were recruited and randomly allocated to either the experimental group ( n =700, 446 completed the protocol) who delivered in hands-and-knees position and the control group ( n =700, 440 completed the protocol) who delivered in supine position. Women who could not maintain the randomised position during the second stage of labour were allowed to withdraw from the study. The primary maternal outcome measured was rate of episiotomy. Secondary outcomes included degree of perineum laceration, rate of emergency caesarean section, rate of shoulder dystocia, and duration of labour, postpartum bleeding, neonatal Apgar score, and the rate of neonatal asphyxia. Because outcome data were only collected for women who gave birth in the randomised position, per-protocol analyses were used to compare groups. The primary outcome, episiotomy, was also compared between groups using logistic regression adjusting for maternal age，gestational age at birth, whether the woman was primiparous, the process of second stage of labour and birthweight. Findings as compared with the control group, the experimental group had lower rates of episiotomy and second-degree perineum laceration (including episiotomy), and higher rates of intact perineum and first-degree perineum laceration, with a longer duration of second stage of labour. No significant differences were found in the amount of postpartum bleeding, shoulder dystocia, neonatal asphyxia and neonatal Apgar scores at 1 minute and 5 minutes. Adjusted for maternal age, gestational age, parity, duration of second stage of labour and birth weight, the hands-and-knees position reduced the need for episiotomy (OR=0.024, p <0.001). Conclusions this study provided evidence that women who could maintain the hands-and-knees position during the second stage of labour had lower rates of episiotomy and second-degree perineum laceration (including episiotomy). Both midwives and obstetricians are suggested to learn the skills to assist women with delivery in this position. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of threatened miscarriage on obstetric complications during pregnancy and early postpartum period. Methods: In this case–control study, hospital records of 12 050 first-trimester patients between January 2011 and December 2012 at the Research and Educational Hospital in Ankara, Turkey, were used. Of the 12 050 patients, 481 threatened miscarriage patients were evaluated. The control group was formed by age- and body mass index-matched cases without first trimester bleeding. Abortion, intrauterine foetal demise, preterm birth, preeclampsia, antenatal haematoma, uterine atony placental abruption and low birth-weights were compared between the study and the control group. Results: When compared with the control group, the risk of having a preterm birth (p = 0.014; OR: 1.95; 95% CI: 1.15–3.24), low-birth-weight infant (p = 0.001; OR: 2.33; 95% CI: 1.45–3.83) and abortion (p = 0.00; OR: 2.55; 95% CI: 1.62–3.91) increased in cases of threatened miscarriage. However, the risk of uterine atony was decreased (p = 0.006; OR: 0.09; 95% CI: 0.12–0.7) in the threatened miscarriage group when compared with the control group. Threatened miscarriage did not increase the risk of placenta praevia, placental abruption or intrauterine foetal demise. Conclusion: Increased complications after threatened miscarriage is probably due to the persistence of a triggering mechanism. As preterm birth and abortion rate increased, whilst uterine atony rate decreased, one of the mechanisms causing threatened miscarriage might be increased uterine contractility. [ABSTRACT FROM AUTHOR]