Abhijeet Madhukar Patil ¹, Shreeda Uday Prasade ², Manasi Harish Kathaley ³, Poonal Patil ⁴

Affiliations
1 Associate Professor, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN
3 Professor and Head, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN
4 Assistant Professor, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN

Abstract

Background: Thrombocytopenia is found to complicate pregnancies in India. The major function of platelets is the initiation of haemostasis. Thrombocytopenia can result in spontaneous bleeding from any part of the body. It may be associated with serious bleeding at delivery and may require emergent maternal and neonatal care. Introduction: After anaemia, thrombocytopenia is the most frequently occurring hematologic disorder in pregnancy. It is found to complicate 7% to 8% of pregnancies in India. The major function of platelets is the initiation of haemostasis, and hence, thrombocytopenia can result in spontaneous bleeding from any part of the body. It may be associated with serious bleeding at delivery and may require emergent maternal and neonatal care. Thrombocytopenia is diagnosed if the platelet count 150 × 109/l, caused by increased platelet lysis or reduced inefficient production. Aims & Objectives: To study the maternal and fetal outcome of thrombocytopenia in pregnancy and to study some of the causes of thrombocytopenia in pregnancy. Methodology: Total 113 cases with maternal thrombocytopenia were included in present study after satisfying inclusion and exclusion criteria and followed till delivery. We studied maternal complications gestational age at delivery, indication of induction of labour and method (if required) and mode of delivery, NICU stay were recorded. Results: Majority of the patients i.e. 63 patients (55.8%) were in the age group of 20-25 years. Among 113 cases; primigravida (56 cases, 49.6%) and multigravida (57 cases, 50.4%) were almost equally distributed. Majority of the study population was diagnosed with Gestational thrombocytopenia 50.4% followed by severe pre-eclampsia 22.12%, HELLP syndrome 8.8%, abruption 5.3% antepartum eclampsia and dengue 2.7% each. Maternal mortality was seen in 2 cases (1.8%). Mean birth weight was found to be 2.45 Kgs. of 113 babies, neonatal mortality was seen in 15 cases, NICU admission was indicated in 18 babies and KMC care was needed for 1 baby. Conclusion: The most common cause of thrombocytopenia during pregnancy is Gestational Thrombocytopenia (GT) followed by pre-eclampsia, eclampsia and HELLP syndrome. With platelet counts above 70,000/ μLno prior history of thrombocytopenia the condition is more likely to be GT. The lack of well-defined symptomatology and clinical presentation makes early and accurate diagnosis difficult leading to delay in treatment.

Keywords

Gestational Thrombocytopenia, HELLP Syndrome, Pre-Eclampsia

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Priyanka Prabhakar Nagansure ¹, Kiran Pandharinath Patole ², Abhijeet Madhukar Patil ³

Affiliations
1 Former PG Resident, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Professor and Head, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Associate Professor, Department of Obstetrics and Gynaecology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN

Abstract

Background: Polycystic Ovarian Syndrome (PCOS) accounts for significant healthcare costs, emotional distress and significant impact on quality of life of women. Even though a fairly common problem it is a complex trait with unclear etiology. The present study was conducted to study various clinical presentations in the adolescent girls with polycystic ovarian syndrome having menstrual irregularities. Aims and Objectives: To study the anthropometric measurements among PCOS patients and to find the association of various risk factors. Material and Methods: It was an observational, cross-sectional study conducted in Out-patient department of Obstetrics and Gynecology at a tertiary healthcare center in Maharashtra. This study was conducted amongst the adolescent girls coming to the OPD of Obstetrics and Gynecology with irregular menses. Results: We evaluated the study subjects according to the Rotterdam’s criteria. We observed that 51.96% cases fulfilled two of the three criteria, while 29.13% cases fulfilled all the three criteria from Rotterdam’s criteria for PCOS. Oligomenorrhea was noted among 46.45% subjects, followed by hypomenorrhea among 32.28% cases. Primary amenorrhea was observed among 21.25% cases. Secondary amenorrhea was seen as the presenting symptom in 4.72% cases. Conclusions: Adolescents who had irregular menses and signs of increased androgen secretion should undergo investigations and must be treated. Prompt treatment following early diagnosis of PCOS helps improve quality of life in young adolescent girls.

Keywords

Menstrual Irregularities, Rotterdam’s Criteria, Modified Ferriman-Gallwey Score, PCOS

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