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Wani, Reena J.
- "The Best Medicine in the World is a Mother's Hug!"
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Authors
Affiliations
1 Dept. of Obstetrics & Gynaecology HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN
1 Dept. of Obstetrics & Gynaecology HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN
Source
The Indian Practitioner, Vol 69, No 5 (2016), Pagination: 7-8Abstract
No Abstract.- "Go Placidly Amid the Noise and Haste, and Remember what Peace there may be in Silence. As Far as Possible, without Surrender be on Good Terms with all Persons. Speak your Truth Quietly and Clearly; and Listen to Others, even the Dull and the Ignorant; they too have their Story"
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Authors
Affiliations
1 HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN
1 HBT Medical College & Dr R N Cooper Municipal Hospital, Juhu, Mumbai, IN
Source
The Indian Practitioner, Vol 70, No 6 (2017), Pagination: 7-8Abstract
This is the opening stanza of a piece of timeless writing, a poem I first heard from my English teacher in school, and one which I have used as a motivational piece for my students and my own children. Desiderata is a Latin word for "things desired" and this poem gives us many important messages for what we may want in life in this fast-moving and materialistic world today.- COVID-19 and Women’s Health–Conception to Delivery
Abstract Views :215 |
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Authors
Affiliations
1 Professor Addl & Head of Unit, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN
2 S Registrar, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN
1 Professor Addl & Head of Unit, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN
2 S Registrar, Obstetrics & Gynecology, HBT Medical College & Dr. R .N. Cooper Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 73, No 5 (2020), Pagination: 48-54Abstract
The COVID-19 pandemic is the biggest threat in living memory to the human race. The Global havoc unleashed by the COVID-19 pandemic is unprecedented. As we complete more than 45 days since it was declared a pandemic, we review the available literature from across the world about everything related to COVID-19 and women’s health, from conception to delivery. We present guidelines for antenatal care, testing, and precautions for health care workers [HCW]. Special emphasis is given on intrapartum care for COVID positive and suspected cases. We also present an algorithm for HCW exposed to possible cases.Keywords
COVID-19 and Pregnancy, Obstetric Positive Case, Screening Guidelines, PPE.References
- ASRM. Patient Management and Clinical Recommendations During the Coronavirus[COVID-19] Pandemic. Available from: https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforce.pdf
- Coronavirus [COVID-19] infection and pregnancy [Internet]. Royal College of Obstetricians & Gynaecologists. [cited 2020Apr24]. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-24-guidancef-or-maternal-medicine.pdf
- Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395[10226]:809–15.
- Guidance for Management of Pregnant Women in COVID-19 Pandemic [Internet]. [cited 2020Apr24]. Available from:https://icmr.nic.in/sites/default/files/upload_documents/Guidance_for_Management_of_Pregnant_Women_in_COVID19_Pandemic_12042020.pdf
- Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395[10226]:809–15.
- Coronavirus [COVID-19] infection and pregnancy [Internet]. Royal College of Obstetricians & Gynaecologists. [cited 2020Apr24]. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/
- Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, Xia S, Zhou W. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational Pediatrics. 2020;9[1]:51–60.
- Zeng H. Antibodies in Infants Born to Mothers With COVID-19 [Internet]. JAMA. 2020 [cited 2020Apr24]. Available from: https://jamanetwork.com/journals/jama/fullarticle/2763854
- Dong L. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn [Internet]. JAMA. 2020 [cited 2020Apr24]. Available from: https://jamanetwork.com/journals/jama/fullarticle/2763853
- Zhang Z Wang C Gao CC. Neonatal coronavirus expert confirmed at 30 hours of birth: vertical transmission from mother to infant. Available from: http://www.cnr.cn/hubei/yuanchuang/20200205/t20200205_524961963.shtml
- Niu Y Yue H. Wuhan Tongji Hospital diagnoses first case of neonatal infection with new coronavirus. Available from: http://society.people.com.cn/n1/2020/0205/c1008-31572959.html
- Indian Council Of Medical Research, Department Of Health Research. Strategy for COVID19 testing in India [Version 4, dated 09/04/2020] Available from:https://icmr.nic.in/sites/default/files/upload_documents/Strategey_for_COVID19_ Test_v4_09042020.pdf
- WHO Risk assessment and management of exposure of health care workers in the context of COVID-19: Interim guidance. Available from: https://apps.who.int/iris/bitstream/handle/10665/331496/WHO-2019-nCov-HCW_risk_assessment-2020.2-eng.pdf
- RCOG. Coronavirus [COVID-19] Infection in Pregnancy. Information for healthcare professionals Version 7: Published Thursday 9 April 2020. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-17-coronavirus-covid-19-infection-inpregnancy.pdf
- https://www.who.int/news-room/q-a-detail/q-a-oncovid19-pregnancy-childbirth-and-breastfeeding https://www.cdc.gov/coronavirus/2019-ncov/need-extraprecautions/pregnancy-breastfeeding.html?CDC_ AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fpregnancybreastfeeding.html
- https://www.cdc.gov/ coronavi rus/ 2019-ncov/ need-extra-precautions/pregnancy-breastfeeding.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fpregnancy-breastfeeding.html
- CDC. Coronavirus Disease 2019 [COVID-19]. Interim Operational Considerations for Public Health Management of Healthcare Workers Exposed to or Infected with COVID-19: non-US Healthcare Settings. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/nonussettings/public-health-management-hcw-exposed.html#figure.
- Fighting Fungi
Abstract Views :196 |
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Authors
Affiliations
1 Junior resident (JR2) in Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
2 Professor (Addl) and Unit Head, Obstetrics & Gynecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
1 Junior resident (JR2) in Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
2 Professor (Addl) and Unit Head, Obstetrics & Gynecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 6 (2021), Pagination: 27-29Abstract
Fungi are one of the major Kingdoms on this planet which, like all other life forms, ‘adapt to survive’. The human-fungus interaction is vast, with mycology being a major subset of microbiology and infectious diseases. This article attempts to be a neutral perspective: it not only describes how we fight off fungal infections by preventive and curative methods, but also how the fungi fight for survival in the available habitat that is largely controlled by humans. Two diseases are focused on, ringworm and mucormycosis. While the former is a troublemaker since time immemorial, mucormycosis has recently taken the limelight as an opportunistic infection in COVID-19 patients. The direct increase in the population of immunocompromised individuals is this pandemic may be due to an intensive use of steroids for treatment. The article also emphasises the need for early detection by a comprehensive diagnostic intervention (histopathology, direct microscopic examination, culture, (1,3)-β-D-glucan, galactomannan, and PCR-based assays) to ensure effective treatments and also highlights the preventive measures which can be taken to save lives. It is prudent to know the risk factors, the types of invasive mycosis, the strengths and limitations of diagnostic methods, clinical settings, and the need for standard or individualized treatment for mucormycosis in COVID-19 patientsKeywords
Fungus, tinea, ringworm, mucormycetes, mucormycosis, black fungusReferences
- Fungus, Merriam-Webster Dictionary [Internet], © 2021 Merriam-Webster, Incorporated. 2021 May 20. [cited 2021 June 15] Available from: https://www.merriam-webster. com/dictionary/fungus
- Ringworm (body), Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) [Internet]. 2021 Feb 26. [cited 2021 June 15] Available from: https://www.cdc.gov/fungal/diseases/ringworm/definition. html
- Ringworm (body), Mayo Clinic [Internet], © 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). 2019 Sep 13. [cited 2021 June 15]. Available from: https:// www.mayoclinic.org/diseases-conditions/ringworm-body/ symptoms-causes/syc-20353780
- Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005 Sep 1;41(5):634-53.
- Mucormycosis, Fungal Diseases, Centers for Disease Control and Prevention [Internet]. 2021 Jan 14. [cited 2021 June 15]. Available from: https://www.cdc.gov/fungal/diseases/mucormycosis/definition.html
- Song G, Liang G, Liu W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia. 2020 Jul 31:1-8.
- Guidelines for handling the Mucormycosis cases, Commisioner Health Services and Mission Director, National Health Mission, Maharashtra, Mumbai. Circular no. 11327-527/2021 dated 18.05.2021.
- Mucormycosis, Fungal Diseases, Centers for Disease Control and Prevention [Internet]. 2019 May 28. [cited 2021 June 15]. Available from: https://www.cdc.gov/fungal/diseases/mucormycosis/risk-prevention.html
- Lederberg J. Infectious history. Science. 2000 Apr 14;288(5464):287-93.
- Challenges and Concerns in Setup of COVID Vaccination Centre : Experience from 2 Centres in Mumbai
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Authors
Affiliations
1 Dept of Community Medicine, TNMC & BYL Nair Ch Hospital, Mumbai, IN
2 HBT Medical College & Dr RN Cooper Municipal Hospital, Mumbai, IN
3 TNMC & BYL Nair Ch Hospital, Mumbai, IN
1 Dept of Community Medicine, TNMC & BYL Nair Ch Hospital, Mumbai, IN
2 HBT Medical College & Dr RN Cooper Municipal Hospital, Mumbai, IN
3 TNMC & BYL Nair Ch Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 74, No 4 (2021), Pagination: 18-23Abstract
Since the beginning of COVID-19 pandemic and Lockdown on March 2020 till date, measures like hand hygiene, social distancing and testing have worked only partially to contain the cases and deaths. Cooper Hospital, Mumbai, was one of the 10 nodal centres identified by Prime Minister’s Office in January 2021 to launch the Nationwide Vaccination drive, along with other public hospitals in Mumbai. We aim to highlight the challenges of vaccination setup and procedures in initial phases and discuss concerns/effect on our department workforce and workplan. We reviewed the patterns, procedures and problems faced by our vaccination centre from January 15th till March 15th (2 months). We also looked into setup at another centre in Mumbai. Over 37,000 vaccine doses have been administrated in our center alone by March end, and issues were analysed in detail with special reference to logistics & department work. Adverse Events Following Immunization (AEFI) were very few. We found that anxiety about side effects, concerns about choice of vaccine and long-term effects were the major impediments to vaccination. Although vaccination is not the final answer, it is an important tool to improve our response to the pandemic. Restructuring available infrastructure is essential in pandemic situations. Proper procedure, counselling and choice in the way forward in this crisis.Keywords
COVID Vaccine, Covishield, Vaccination.References
- World Health Organization [Internet]. COVID-19 -India Situation. [Cited 2021 March]. Available from: https://covid19.who.int/region/searo/country/in
- Ministry of Health and Family Welfare. All preparations are on track for COVID-19 vaccine roll-out from 16th January 2021: Health Secretary. pib.gov.in [Internet]. [Cited 2021 April 8]. Available from: https://www.pib.gov.in/PressReleasePage.aspx?PRID=1688036
- Sinha D. Covid 19 vaccination and challenges in India: Ahead of world’s largest vaccine drive, medical experts explain what to expect. Financial Express. [Internet]. 2021 Jan 14 [Cited 2021 April 8].Available from: https://www.financialexpress.com/lifestyle/health/covid-19-vaccination-and-challenges-in-india-ahead-of-worlds-largest-vaccine-drive-medical-experts-explain-what-to-expect/2170852/
- Violence against Women and COVID Pandemic – Double the Trouble!
Abstract Views :112 |
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Authors
Affiliations
1 HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
2 Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
3 University of Notre Dame vGPE Program, IN
1 HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
2 Community Medicine, TNMC & BYL Nair Hospital, Mumbai, IN
3 University of Notre Dame vGPE Program, IN
Source
The Indian Practitioner, Vol 74, No 8 (2021), Pagination: 7-11Abstract
Violence against women remains terribly pervasive and affects 1 in 3 (roughly 736 million) women across their lifetime. This violence can be from an intimate or non-intimate partner and have been fairly unchanged over that last decade since the onset of the COVID-19 pandemic, there has been emerging data from front line workers that violence of all forms against women and girls has intensified. Addressing this shadow pandemic is a health care crisis of global proportions, but of special significance in the patriarchal Indian scenario and needs to be prioritized amidst the COVID care issues. The first step forward is awareness, followed by access and availability of services. This cannot be achieved overnight but by a step-wise approach. There is an urgent need to adapt our approach, integrate these issues into our health care systems so that survivors can access appropriate medical and social services.Keywords
Domestic Violence, Sexual Violence, COVID-19, Shadow Pandemic.References
- who.int [Internet]. World Health Organization; c2021 [cited 2021 Jul 26]. Available from: https://www.who.int/news/item/09-03-2021-devastatingly-pervasive-1-in-3-women-globally-experience-violence.
- The Shadow Pandemic: Violence against women during COVID-19 [Internet]. UN Women. [cited 2021 Jul 26]. Available from: https://www.unwomen.org/en/news/in-focus/in-focus-gender-equality-in-covid-19-response/violence-against-women-during-covid-19.
- Press release: UN Women raises awareness of the shadow pandemic of violence against women during COVID-19 [Internet]. UN Women. 2020 [cited 2021 Jul 26]. Available from: https://www.unwomen.org/en/news/stories/2020/5/press-release-the-shadow-pandemic-of-violence-against-women-during-covid-19.
- unodc.org [Internet]. United Nations; c2020 [cited 2020 Jul 26]. Available from: https://www.unodc.org/documents/Advocacy-Section/EssentialServices-Infographic-COVID-FIN_WEB_VERSION.
- National Family Health Survey. Fact Sheet: Women age 20-24 years married before age 18 years (%), 2019-20. [cited 2021 Jul 26]. Available from http://rchiips.org/nfhs/fact-sheet_NFHS-5.shtml.
- Seth P. As COVID-19 Raged, the Shadow Pandemic of Domestic Violence Swept Across the Globe [Internet]. The Wire. 2021 [cited 2021 Jul 26]. Available from: https://thewire.in/women/covid-19-domestic-violence-hdr-2020
- Schneider D., Harknett K., McLanahan S. Intimate partner violence in the great recession. Demography. 2016;53(2):471–505.
- EPW Engage. 2020. COVID-19, Domestic Abuse and Violence: Where Do Indian Women Stand? [Internet]. [cited 2021 Jul 26]. Available from: https://www.epw.in/engage/article/covid-19-domestic-abuse-and-violence-where-do.
- Nikore M. With Covid-19, comes the “Shadow Pandemic”: How the surge of domestic violence gripped India’s women in 2020 [Internet]. Times of India Blog. 2020 [cited 2021 Jul 26]. Available from: https://timesofindia.indiatimes.com/blogs/irrational-economics/with-covid-19-comes-the-shadow-pandemic-how-the-surge-of-domestic-violence-gripped-indias-women-in-2020/
- A digital cry for help: Big data study in Asia-Pacific provides key signposts to violence against women amid COVID-19 [Internet]. United Nations Population Fund. 2021 [cited 2021 Jul 26]. Available from: https://www.unfpa.org/news/digital-cry-help-big-data-study-asia-pacific-provides-key-sign-posts-violence-against-women
- Singh PK. Act now to address the shadow pandemic of violence against women [Internet]. World Health Organization. World Health Organization; 2020 [cited 2021 Jul 26]. Available from: https://www.who.int/southeastasia/news/detail/25-11-2020-act-now-to-address-the-shadow-pandemic-of-violence-against-women
- The Shadow Pandemic in Latin America: The Impact of COVID-19 on Gender-Based Violence [Internet]. Wilson Center. 2020 [cited 2021 Jul 26]. Available from: https://www.wilsoncenter.org/video/shadow-pandemic-latin-america-impact-covid-19-gender-based-violence
- Davies G, Guenfoud I, Jovanovic D. [Internet]. ABC News. ABC News Network; 2021 [cited 2021 Jul 26]. Available from: https://abcnews.go.com/International/shadow-pandemic-domestic-abuse-reports-soar-europes-coronavirus/story?id=76325386
- Dhokia T, Wani R, Jalvee R, Paprikar S. “Sexual Assault: Current Scenario at a Referral Center in Mumbai”, International Journal of Science and Research (IJSR), Volume 7 Issue 12, December 2018, 1308 – 1310.
- Sharma A, Borah SB. Covid-19 and Domestic Violence: an Indirect Path to Social and Economic Crisis. J Fam Viol (2020). https://doi.org/10.1007/s10896-020-00188-8
- Campbell AM, Hicks RA, Thompson SL, Wiehe SE. Characteristics of intimate partner violence incidents and the environments in which they occur: Victim reports to responding law enforcement officers. Journal of Interpersonal Violence, 0886260517704230 (2017).
- Katz J, Moore, J. Bystander education training for campus sexual assault prevention: An initial meta-analysis. Violence and Victims, 28(6), 1054–1067 (2013).
- Rodriguez MA, McLoughlin E, Nah G, Campbell JC. Mandatory reporting of domestic violence injuries to the police: What do emergency department patients think? Jama, 286(5), 580–583 (2001).
- Felson RB, Messner SF, Hoskin AW, Deane G. Reasons for reporting and not reporting domestic violence to the police. Criminology, 40(3), 617–648 (2002).
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- Choi GY, Byoun SJ. Domestic violence against migrant women in South Korea: Addressing the needs of a uniquely situated victim population in domestic violence policy. International Social Work, 57(6), 645–660 (2014).
- Dominelli L, Campling J. Anti oppressive social work theory and practice: Macmillan international higher education (2002).
- Successful Lactation in the Modern World : Is it Possible?
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Authors
Affiliations
1 Dept of Community Medicine, LTMMC and GH, Sion, Mumbai, IN
2 Dept of Obstetrics & Gynaecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
1 Dept of Community Medicine, LTMMC and GH, Sion, Mumbai, IN
2 Dept of Obstetrics & Gynaecology, HBT Medical College & Dr RN Cooper Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 75, No 8 (2022), Pagination: 7-11Abstract
Breastfeeding is a natural act, but it is also a learned behaviour. This year’s theme for World Breastfeeding Week 2022 is ‘Step up for breastfeeding: Educate and support.’ Organizations like Mumbai Breastfeeding Promotion Committee (MBPC) Mumbai Obstetric & Gynecological Society (MOGS) and Federation of Obstetrics & Gynecologic Societies of India (FOGSI) have been holding activities, webinars and competitions to focus on this important topic. This has been a wonderful way to partner with neonatologists, pediatricians, community medicine and mother support groups. The aim of all these activities is to highlight the physiological importance of breastfeeding, promote exclusive breastfeeding, and make the general population aware about its multiple benefits. This article provides a few key points for practicing physicians to impart knowledge of the evidence-based advantages of breastfeeding to their patients, friends and relatives.Keywords
Breastfeeding, Mother, Infant, Newborn, Lactation, MBPC, COVID, HIV.References
- Campbell S. Core Curriculum for Interdisciplinary Lactation Care: Jones and Bartlett Learning. 2019:4-6.
- Park K. Textbook of Preventive and Social Medicine. 25th Edition: Banarasidas Bhanot Publishers, 2019:614.
- National Family Health Survey (NFHS-4). 2015-2016. Indian ministry of Health and Family Welfare. International Institute for Population Sciences.
- National Family Health Survey (NFHS-5). 2015-2016. Indian ministry of Health and Family Welfare. International Institute for Population Sciences.
- UNICEF. Breastfeeding: a mother’s gift, for every child. UNICEF; 2018. Accessed on 2022 Aug 11. Available from: https://www.unicef.org/media/48046/file/UNICEF_Breastfeeding_A_Mothers_Gift_for_Every_Child.pdf
- Lutter CK, Lutter R. F et al and early childhood undernutrition, mortality, and lifelong health. Science. 2012;337(6101):1495-9.
- Horta BL, Victora CG. A systematic review on the benefits of breastfeeding on diarrhoea and pneumonia mortality. World Health Organization. 2013.
- Tiruneh GT, Shiferaw CB, Worku A. Effectiveness and cost-effectiveness of home-based postpartum care on neonatal mortality and exclusive breastfeeding practice in low-and-middle-income countries: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2019;19(1):1-9.
- Lubbe W, Botha E, Niela-Vilen H, Reimers P. Breastfeeding during the COVID-19 pandemic–a literature review for clinical practice. International Breastfeeding Journal. 2020;15(1):1-9.
- BPNI. COVID-19 and Breastfeeding Update. 2020 May. Accessed on 2022 Aug 11. Available from https://www.bp-ni.org/wp-content/uploads/2020/05/Update-on-COVID-19-and-Breastfeeding.pdf
- World Health Organization 2020. Breastfeeding and COVID-19: Scientific brief. 2020 June. Accessed on 2022 Aug 11. Available from https://apps.who.int/iris/handle/10665/332639
- Yadav P, Wani RJ, Shirodkar S. Impact of Changed HIVTesting Strategy in PPTCT Programme at Tertiary Hospital. Indian Jnl of Applied Research.2021;11(4).DOI : 10.36106/ijar.
- Sickle Cell Disease and Pregnancy
Abstract Views :56 |
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Authors
Reena J. Wani
1,
Mahin Bhatt
2
Affiliations
1 Professor and Head, Department of Obstetrics and Gynaecology, H. B. T. Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN
2 Research Associate, H. B. T. Medical College, and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN
1 Professor and Head, Department of Obstetrics and Gynaecology, H. B. T. Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN
2 Research Associate, H. B. T. Medical College, and Dr. R. N. Cooper Municipal General Hospital, Mumbai., IN
Source
The Indian Practitioner, Vol 76, No 6 (2023), Pagination: 29-32Abstract
Sickle cell disease is caused by a mutation in the beta-globin gene, leading to the formation of abnormal haemoglobin and various complications. Managing this condition during pregnancy requires a collaborative approach, involving close follow-up, patient education, and active patient involvement. The process begins with pre-conception genetic counselling and assessing the patient’s baseline health. If the disease is uncontrolled or if the patient has kidney disease, hypertension, or frequent vaso-occlusive crises, pregnancy may need to be delayed or alternative reproductive options considered. The use of hydroxyurea during pregnancy is a subject of debate and is determined on a case-by-case basis. High-dose folic acid supplementation is recommended before and during pregnancy. Medications should be carefully reviewed, and any potentially harmful drugs to the fetus should be discontinued. Low-dose aspirin and adequate hydration are used to prevent hypertensive and vaso-occlusive crises, respectively. Severe anaemia may require a blood transfusion, but haemoglobin levels are maintained below 10g/dl to prevent increased blood viscosity. Vaginal delivery can be safely performed with appropriate measures such as hydration, warmth, and nasal oxygen. Cesarean sections are reserved for obstetric indications.Keywords
Sickle Cell Disease, Pregnancy, Vaso-occlusive crises, Anemia, Hydroxyurea, Delivery.References
- Jain D, Atmapoojya P, Colah R, Lodha P. Sickle Cell Disease and Pregnancy. Mediterr J Hematol Infect Dis. 2019;11(1): e2019040. doi: 10.4084/MJHID.2019.040.
- Esoh K, Wonkam A. Evolutionary history of sickle-cell mutation: implications for global genetic medi-cine. Hum Mol Genet. 2021Sep 1;30(R1): R119-R128. doi: 10.1093/ hmg/ddab004.
- Royal College of Obstetrics and Gynaecology. Management of Sickle Cell Disease in Pregnancy, Green-top GuidelineNo. 61, July 2011.
- Oppong SA, Asare EV, Olayemi E, et al. Multidisciplinary care results in similar maternal and perinatal mortality rates for women with and without SCD in a low-resource setting. Am J Hematol. 2019Feb;94(2): 223-223. doi: 10.1002/ajh.25356.
- Asare EV, Olayemi E, Boafor T, et al.Implementation of multidisciplinary care reduces maternal mor-tality in women with sickle cell disease living in low-resource setting. Am J Hematol. 2017Sep;92(9): 872-878. doi: 10.1002/ajh.24790.
- Asare EV, Olayemi E, Boafor T, et al. Third trimester and early postpartum period of pregnancy have the greatest risk for ACS in women with SCD. Am J Hematol. 2019 Sep;94(9): E328-E331. doi: 10.1002/ajh.25643.
- Early ML, Eke AC, Gemmill A, et al. Severe Maternal Morbidity and Mortality in Sickle Cell Disease in the National Inpatient Sample, 2012-2018. JAMA Netw Open. 2023Feb 1;6(2): e2254552. doi: 10.1001/ jamanetworkopen.2022.54552.
- Standards for the Clinical Care of Adults with Sickle Cell Disease in the UK. Pregnancy, contraception, and fertility. 2008. p.59.
- Buckner TW, Key NS. Venous thrombosis in blacks. Circulation. 2012Feb 14;125(6): 837-9.doi: 10.1161/ CIRCULATIONAHA.111.073098.
- Bates SM, Rajasekhar A, Middeldorp S, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2018Nov 27; 2(22): 3317–3359.
- Savitt TL, Goldberg MF. Herrick’s 1910 case report of sickle cell anemia. The rest of the story. JAMA. 1989Jan 13;261(2):266-271. doi: 10.1001/jama.261.2.266. PMID: 2642320.
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- Charache S, Terrin ML, Moore RD, Dover GJ, Barton FB, Eckert SV, et al. (May 1995). “Effect of hy-droxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia”. The New England Journal of Medicine. 332 (20): 1317–1322. doi:10.1056/NEJM199505183322001. PMID 7715639.
- Steinberg MH, Barton F, Castro O, Pegelow CH, Ballas SK, Kutlar A, et al. (April 2003). “Effect of hy-droxyurea on mortality and morbidity in adult sickle cell anemia: risks and benefits up to 9 years of treatment”. JAMA. 289 (13): 1645–1651. doi:10.1001/jama.289.13.1645. PMID 12672732.
- Schmalzer, E. A., Lee, J. O., Brown, A. K., Usami, S., & Chien, S. (1987). Viscosity of mixtures of sickle and normal red cells at varying hematocrit levels. Implications for transfusion. Transfusion, 27(3), 228–233. https://doi.org/1 0.1046/j.1537-2995.1987.27387235626.