30th, June 2018
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Editorial

The impact of quince paste on menorrhagia

A study published recently in the International Journal of Pharmaceutical Sciences and Research evaluated the effect of quince paste on uterine bleeding in patients with menorrhagia. Quince (Cydonia oblonga) is a member of the genus Cydonia in the family Rosaceae. Quince tree grows in most regions of Europe, the Mediterranean, North Africa and Asia. Quince contains tannins, polysaccharides, glycosides, carotenoids, pectin, coumarin, flavonoids, malic acid, vitamins B and C and pro vitamin A.

This study was a clinical trial of before-after pilot study among 35 patients aged 18-50 years suffering from menorrhagia. Patients were prescribed a tea spoonful of quince paste after each meal for two months. ..... read more

Practice Updates

Anti-inflammatory effects of coconut oil: Potential to treat nipple soreness

The coconut palm (Cocos nucifera) is a member of family Arecaceae (palm family).1 Virgin coconut oil (VCO) has several potential therapeutic benefits. VCO has anticancer, antimicrobial, analgesic, antipyretic, and anti-inflammatory properties.2 It is known to relieve the symptoms of skin disorders by moisturizing and soothing the skin..... read more

Sesame oil to relieve body aches and pains

Sesame oil is obtained from the Sesamum indicum L. plant. It belongs to the Pedaliaceae family. Sesame oil is used in traditional medicine for its antioxidant, anti-inflammatory and anti-bacterial effects. Sesame oil has traditionally been used to relieve pain associated with joints, teeth, premenstrual syndrome, scrapes and cuts.1 Sesame oil contains sesamin, sesamolin and sesaminol lignan fractions that play significant roles in its oxidative stability and antioxidative activity..... read more

Recent Updates

Potential use of ceragenins in treating vulvovaginal candidiasis

Vulvovaginal candidiasis (VVC) is the second most common cause of vaginitis after bacterial vaginosis and affects millions of women globally every year. VVC is most commonly caused by Candida albicans, followed by other species of Candida such as C. glabrata and C. parapsilosis. In a recent study, out of 100 clinical isolates of Candida spp. obtained from patients with VVC, 84 were identified as C. albicans. The remaining isolates were non-albicans Candida strains..... read more

High-risk factors for suppurative mastitis among breastfeeding women

Acute mastitis is a commonly encountered among postpartum lactating women. A study, published in Medical Science Monitor, assessed the high-risk factors for suppurative mastitis (SM) in breastfeeding women. In all, 262 non-SM patients and 63 SM patients were retrospectively recruited and high-risk factors for SM during lactation were determined on the basis of assessment of admission time after acute mastitis, galactostasis, primipara or pluripara, nipple injuries, antibiotic treatment course, and diabetes..... read more

Exercise frequency and maternal mental health

A study longitudinally evaluated the bidirectional association between exercise and maternal mental health symptoms during the perinatal period, and included adjustment for both depression and antidepressant treatment. Data were collected across pregnancy (first and third trimesters) and postpartum (6 and 12 months) for 258 women from a pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Women's weekly exercise frequency was found to fall during pregnancy, returning to first trimester levels by 12 months postpartum..... read more

Estrogen, migraine, and vascular risk.

A new article published in Neurological Sciences discussed that females have higher propensity for migraine and the course of its symptoms is influenced by life stages, vis, presence of menstrual cycle, pregnancy, puerperium, menopause, and the use of hormone therapy, such as hormonal contraception and hormone replacement therapy. The authors stated that hormonal changes are among common migraine triggers, especially, a sudden estrogen drop. Estrogens can modulate neuronal excitability, through serotonin, norepinephrine, dopamine,.... read more

Role of vaginal pH in determining Trichomonas vaginalis infection in reproductive age women

There is a close association between Trichomonas vaginalis (TV) infection and bacterial vaginosis (BV). Evidence indicates that the association is stronger with intermediate Nugent score than BV. The present study aimed to assess the association of TV infection with BV and with intermediate Nugent score. This was a cross-sectional hospital-based study involving 1110 non-pregnant women from Odisha state, India, aged between 18 and 45 years. Vaginal swabs were obtained for diagnosis of BV by Nugent score (NS) criteria and TV by PCR analysis.... read more

Breastfeeding affects sleep in postpartum period

A study published recently in the Journal of UOEH evaluated the effects of breastfeeding on the sleep of mothers in the postpartum period. Two questionnaires, including a self-created questionnaire for a survey of breastfeeding, and the OSA sleep inventory MA version for sleeping mothers, were used for the evaluation. The investigation was performed twice, at 5-8 days and at one month after childbirth. No significant difference could be found in sleep between labor histories and delivery methods, however; the exclusive breastfeeding group exhibited a higher score for recovery and sleep length in the night during hospitalization.... read more

Interactive Session

                                                               QUIZ

A 23-year-old married woman presents to you since she has had unprotected intercourse with her partner and does not want a pregnancy. She had unprotected intercourse 28 hours ago and 3 days before that. Her LMP was 12 days ago and has a regular cycle; she bleeds for 3-4 days every 28 days. She has a history of epilepsy and is being treated for that. What emergency contraception method would you advise her, keeping in mind her medical history?

Answer Now

Case Explained

Intrapartum HELLP Syndrome Associated with Mild Pre-eclampsia: A Case Report

Abstract

Pre-eclampsia can lead to a dreaded obstetric emergency, HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, in a few cases leading to hemolysis, thrombocytopenia and liver enzymes dysfunction. It can occur mostly in third trimester of pregnancy and sometimes during postnatal period. We report a case of mild pre-eclampsia which was complicated with intrapartum HELLP syndrome. A 35-year-old pregnant woman with mild pre-eclampsia at 36 weeks of gestation was admitted to our hospital with labor pain. A cesarean section was performed, due to excessive bleeding per vagina during labor. A prompt diagnosis and appropriate management helped us to reduce morbidity and mortality related to HELLP syndrome.

Keywords : Pregnancy-induced hypertension, pre-eclampsia, HELLP syndrome

Introduction

HELLP syndrome is a life-threatening complication of pregnancy characterized by hemolysis, elevated liver enzymes and low platelets. It is usually considered to be a variant or complication of pre-eclampsia. However, in 20% of cases it may occur without pre-eclampsia during antenatal or intrapartum period. HELLP is a multisystemic disorder, leading to generalized vasospasm, microthrombi formation and coagulation defects. Clinical features include severe headache, malaise, nausea and vomiting, pain around upper abdomen and pedal edema. In about 20% of all women, disseminated intravascular coagulation (DIC) is also seen with HELLP syndrome.

CASE REPORT

A 35-year-old pregnant woman, primigravida, was admitted in emergency to our hospital in the 36th week of gestation, with mild pregnancy- induced hypertension (PIH). Her antenatal check- ups were infrequent but normal. On admission, her blood pressure was 140/90 mmHg (after 2 hours; 170/100 mmHg). Urine albumin was trace. Capsule nifedipine 5 mg was given orally. Prophylactic injection magnesium sulfate (MgSO4) was started. Her cervix was 2 cm dilated, 25% effaced. Augmentation of labor was done with oxytocin. All laboratory findings including hematological, biochemical and coagulation profile, were within their normal limits (Table 1). Three hours after her admission, cervical dilatation was 3-4 cm and 50-60% effaced, bleeding per vagina started with passage of clots. Artificial rupture of membrane was done to rule out abruptio placenta, liquor was clear. In view of excessive bleeding per vaginum, cesarean section was done under spinal anesthesia.

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