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Biomedical subjects

K Vasishta

Publications and source records attributed to K Vasishta.

35 records · Page 2Linked to original sources
PubMed1998

Pregnancy and congenital heart disease--maternal and fetal outcome.

Two hundred and seventy five pregnancies in patients with congenital heart disease during 1980-1996 were analyzed retrospectively. Maternal and perinatal outcome was compared in 251 pregnancies of women with acyanotic and 24 pregnancies of women with cyanotic heart disease. Congenital heart disease was diagnosed during the index pregnancy in 26.1% of patients and the majority (88.4%) were in NYHA classes 1 and 2. Atrial septal defect (27.7%) was the most common lesion in women with acyanotic heart disease and the majority with cyanotic heart disease had Eisenmenger syndrome, 13 of 21 (61.9%). Sixty pregnancies occurred in patients with surgically corrected lesions (acyanotic, 56; cyanotic, 4). The incidences of abortions (8.3%), stillbirths (13.6%) and small for gestational age (SGA) (36.4%) were higher in cyanotic heart disease compared to acyanotic heart disease (stillbirth, 0.8%; SGA, 6.9%). There was a statistically significant difference in mean maternal age, mean gestational age and mean birth-weight in the surgically corrected and noncorrected lesions in both acyanotic and cyanotic heart disease. There was 1 maternal death in a woman with Eisenmenger syndrome.

Adult↗
PubMed1998

Effect of maternal low dose aspirin on neonatal platelet function.

OBJECTIVE: To evaluate the effect of maternal low dose aspirin ingestion in platelet function of newborn. DESIGN: Prospective randomized placebo controlled study. METHODS: 25 neonates born to mothers receiving low dose aspirin and 25 matched neonates with no maternal exposure to aspirin were studied. 2 ml of EDTA and 4.5 ml of citrate blood was collected from umbilical vein using double clamped umbilical stump for hemogram, coagulation profile and platelet functions. RESULTS: The platelet counts (10(9)/l) of study and control groups were 186.4 +/- 22.76 (116-225) and 205.28 +/- 17.34 (176-225), respectively. There was no significant difference in coagulation parameters. Prothrombin time index (PTI) was 86.24 +/- 6.623 and 87 +/- 6.43, respectively in the study and control group while PTTK (sec) was 55.88 +/- 20.54 and 52.12 +/- 11.82 in study and control subjects, respectively. The platelet aggregation studies (platelet function) with various platelet agonists in study and control group did not show any significant difference. Clinically, none of the babies had bleeding. CONCLUSIONS: Use of low dose aspirin in pregnant women was found to be safe and had no adverse effects on platelet functions of newborn.

Aspirin↗
PubMed1996

Pregnancy with epilepsy--a retrospective analysis.

OBJECTIVES: To study the course of epilepsy in pregnancy and to assess the perinatal outcome. METHODS: A retrospective analysis of 219 pregnant patients with epilepsy. The type of epilepsy, drug therapy and seizure frequency were documented. The perinatal outcome of 157 pregnancies with epilepsy was analyzed and compared with that of 471 normal gravidas of similar age and parity. RESULTS: Generalized seizures occurred in 203 patients, partial seizures in 13 patients and complex partial seizures in three patients. One hundred fifty-two patients (69.41%) were on monotherapy. Carbamazepine was the most common drug (56.58%) used. Ninety-five patients (43.38%) had seizures in the current pregnancy, five of whom had status epilepticus. There was no maternal mortality in status epilepticus. There was no difference in perinatal outcome between the study and control groups. The incidence of congenital malformations was higher in the control group (5/476, 1.05%) than in the study group (1/160, 0.63%). The incidence of low-birth-weight babies was higher in the study group in patients with gestational seizures. CONCLUSION: The course of pregnancy and perinatal outcome was not altered by epilepsy. There was no increase in the incidence of congenital malformations with the use of monotherapy.

Adult↗
PubMed1995

Effect of bronchial asthma on the course of pregnancy, labour and perinatal outcome.

The course of pregnancy and labour, and perinatal outcome of 182 pregnancies complicated by bronchial asthma, over a 10-year period were studied. Antiasthmatic medications included oral and/or parenteral beta 2-agonists, theophylline, aminophylline, corticosteroids, and inhaled salbutamol and beclomethasone. A control group of 364 nonasthmatic gravidas was matched for age and parity. In asthmatic gravidas, antenatal complications mean duration of pregnancy (38.5 weeks), mode of delivery, incidence of prematurity (13.2%) and low birth weight (LBW, 19.6%) and perinatal mortality (0.5%) were not significantly different compared to the controls (p > 0.05). However, uncontrolled severe asthma in 15 gravidas who required hospitalization, was associated with significant decrease in mean birth weight (2469 +/- 571 g vs 2842 +/- 494 g; p < 0.05) and a high incidence of LBW neonates (53.3% vs 20.5%; p < 0.01) at mean gestation of 38 weeks. Bronchial asthma during pregnancy, when optimally controlled does not affect the course or pregnancy and labour, and perinatal outcome. However, uncontrolled severe asthma leads to fetal growth retardation.

Adolescent↗
PubMed1995

Tuberculous uteroenterocutaneous fistula--a rare post-caesarean complication.

A case of uteroenterocutaneous fistula which developed after lower segment Caesarean section is described. A total abdominal hysterectomy with removal of a tuboovarian mass with excision of the fistulous tract and repair of a small gut fistula were performed. The tuberculous aetiology of this fistula was established after surgery by a positive endometrial culture of acid fast bacilli and the demonstration of epithelioid granulomas in the surgical specimen. Antituberculosis therapy was started and the postoperative recovery was uneventful. The description of the nature of the fistula, its rarity and its presence in a woman with unimpaired fertility are discussed.

Adult↗
PubMed1994

Perinatal outcome in pregnancies complicated by pulmonary tuberculosis.

OBJECTIVES: To assess the perinatal outcome of pregnancies complicated by active pulmonary tuberculosis. METHODS: The perinatal outcome of 79 gravidas with pulmonary tuberculosis was compared with that of 316 normal gravidas of similar age, parity and socioeconomic status. RESULTS: The mean birthweight of infants (2649 g) born to tuberculous mothers was 215 g less than that of control group (P < 0.001). Pulmonary tuberculosis was associated with an approximate 2-fold increase in prematurity (22.8% vs. 11.1%, P < 0.01), small for gestational age (20.2% vs. 7.9%, P < 0.005) and low birthweight neonates (34.2% vs. 16.5%, P < 0.001), and 6-fold increase in perinatal deaths (10.1% vs. 1.6%, P < 0.001). The adverse perinatal outcome was pronounced in cases with late diagnosis, incomplete and irregular treatment, and advanced pulmonary lesions. CONCLUSIONS: Maternal tuberculosis is a high-risk perinatal condition. The study emphasizes the need for early diagnosis and treatment of tuberculosis, preferably before pregnancy, regular medical supervision and good perinatal care for tuberculous mothers.

Adult↗
PubMed1994

Cortisol response in acute foetal distress.

Thirty neonates born after having acute intrapartum distress (study group) and 30 neonates matched for gestation, born without any clinical evidence of acute foetal distress (control group) were studied. Neonates with congenital malformation were excluded. Samples for cortisol estimation were taken from cord artery, cord vein at birth and from peripheral vein at 6 h of age. At birth maternal venous blood was also taken for cortisol estimation. Cortisol level was estimated by radioimmunoassay. Cord blood pH was measured immediately at birth in all neonates whereas base deficits were estimated in 20 neonates in the study group and 23 neonates in control group. Cortisol levels did not differ significantly in the groups with or without foetal distress. There was no significant correlation between cord blood pH and cord arterial cortisol levels. Significant positive correlation was found between cord arterial cortisol and maternal cortisol levels. We failed to find any significant cortisol response in acute foetal distress.

Acute Disease↗
PubMed1993

Pregnancy in association with mitral valve prolapse.

Mitral valve prolapse (MVP) is considered to be the most common valvular heart lesion in adult females of reproductive age. Our report reviews the obstetrical performance and outcome of 34 pregnancies in 15 women with MVP. In 12 (80%) patients cardiac lesion was suspected due to enigmatic dyspnoea and palpitation during antenatal period. Four mothers required propranolol for cardiac arrhythmias. However, all of them tolerated pregnancy and labour well. Four pregnancies (11.8%) ended in spontaneous abortion and 1 mother had intrauterine fetal death due to severe pregnancy-induced hypertension. There were 25 (73.5%) term and 3 (8.8%) preterm neonates without congenital abnormality. One preterm neonate had tracheo-oesophageal fistula and died 6 hours after corrective surgery. The mean birth weight of 2.8 kg was appropriate for mean gestation of 38.5 weeks when compared to the Institute's reference neonatal weight curve. Infective endocarditis prophylaxis was recommended in cases having mitral regurgitation and complicated delivery. Awareness of this common cardiac lesion, thorough cardiovascular examination during pregnancy, early detection and treatment of cardiac arrhythmias if any, are the essential steps to prevent rare but dreaded maternal complications.

Adult↗
PubMed1993

Induction of labour in pregnancy complicated by cardiac disease.

Twenty one pregnant patients with cardiac disease had induction of labour for various obstetric reasons with a modified oxytocin infusion method. All of them went into labour and delivered within 20 hours. Twenty patients delivered vaginally. Three neonates had birth asphyxia (Apgar score < 7) and 1 of them died on the 4th day from prematurity. No adverse effect of oxytocin infusion on maternal cardiac status was observed and all of the women went home in good condition. Induction of labour with a modified oxytocin infusion is a safe and effective alternative for selected gravidas with cardiac disease where elective delivery is warranted.

Adult↗
PubMed1991

Idiopathic pulmonary fibrosis (IPF) necessitating therapeutic midtrimester abortion: a case report.

A 35-year old multiparous lady was admitted at 19 weeks of pregnancy with rapid onset of dyspnoea which progressed to grade III in 2 months. She was diagnosed as a case of idiopathic pulmonary fibrosis (IPF). She had a vital capacity of 1.25 l, 46.5% of predicted and PaO2 of 60 mmHg at rest, dropping to 35 mmHg on mild exercise testing. She did not respond to prednisolone 40 mg daily given orally for one month. In view of lack of improvement, therapeutic abortion was carried out at 24 weeks by abdominal hysterotomy combined with tubal ligation. Subsequent to termination of pregnancy, her clinical status and pulmonary function improved markedly and she had only grade I dyspnoea 30 months later without corticosteroids. Effect of pregnancy on interstitial lung disorders especially IPF is not yet clear because of extreme rarity of their association. Therapeutic abortion should be seriously considered in patients who cannot increase their oxygen consumption 3 times normal without uncorrectable hypoxaemia.

Abortion, Therapeutic↗
PubMed1991

Study of lupus anticoagulant in pregnant women with recurrent abortion.

The relation between lupus anticoagulant (LA) and repeated abortions was evaluated in a case-controlled study of 50 women with 3 or more unexplained spontaneous abortions compared with 50 control subjects who had 2 or more normal pregnancies and no previous spontaneous abortion or fetal deaths. LA was detected in 5 of 50 cases (10%, 95% confidence limits 1.69% to 18.31%) but in none of the 50 controls. There was an indication that missed abortions may be more frequent in LA positive women. The women who had recurrent abortions but were LA negative had prolonged prothrombin time values (though within normal range) compared to the control group. LA being a treatable cause of idiopathic recurrent abortion should be sought for in women with unexplained fetal losses.

Abortion, Habitual↗
PubMed1990

Correlation between human placental lactogen levels and glucose metabolism in pregnant women with intrauterine growth retardation.

Twenty pregnant women with fetal growth retardation and 20 pregnant women with appropriate for gestational age fetuses (controls) were recruited after the 28th week of gestation. Samples were collected for estimation of serum insulin and human placental lactogen (HPL) levels in the fasting state and a glucose tolerance test was carried out on all the subjects. The results showed the glucose and HPL levels to be significantly lower in the fetal growth retardation group compared to controls. There were no differences in the fasting serum insulin levels in the 2 groups. Fetal growth retardation appears to be linked with the absence of development of the physiological 'diabetogenic' state in the second half of pregnancy. This maternal hypoglycaemic state is associated with low HPL levels and not with raised maternal insulin levels as measured in the fasting state.

Adult↗
PubMed1988

Effect of maternal cardiac disease on perinatal outcome.

Perinatal outcome of 223 pregnancies complicated by maternal cardiac disease, over a 5-year period has been studied. Mean birth-weights of these babies were compared to the Institute's reference neonatal weight curves at different periods of gestation and found lower than the reference. The mean difference of 150 g was statistically significant. The incidence of prematurity, small for gestational age and perinatal mortality was analyzed according to the risk factors i.e. type, duration and severity of symptoms. The perinatal outcome was directly proportional to the severity of symptoms, irrespective of the type and duration of heart disease.

Adult↗