Neonatal Outcome of Pregnancies Complicated with Idiopathic Thrombocytopenia.

OBJECTIVE: To determine the neonatal outcome with maternal idiopathic thrombocytopenia. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Obstetrics and Gynecology Department, Liaqat National Hospital, Karachi, from January to June 2017. METHODOLOGY: All 73 pregnant women diagnosed with idiopathic thrombocytopenia (ITP) during the study period were included. All the patients were kept under observation till birth of newborns. Neonates were assessed for thrombocytopenia, classified as mild, moderate and severe thrombocytopenia as outcome on the first post-natal day. RESULTS:  Frequency of neonatal thrombocytopenia in 73 pregnant women complicated by idiopathic thrombocytopenia was 16.44% (12 neonates). Out of 12 cases, three (25%) neonates had mild thrombocytopenia, four (33.33%) neonates had moderate thrombocytopenia and five (41.66%) neonates had severe thrombocytopenia. CONCLUSION: There are considerable chances of neonatal thrombocytopenia when mothers were suffering with idiopathic thrombocytopenia during pregnancy. These findings may be useful for the medical staff to counsel pre-pregnant or pregnant women with ITP as well as care required during delivery. Key Words: Thrombocytopenia, Idiopathic thrombocytopenia, Neonatal ITP, Pre-natal ITP.

Clinical Efficacy Comparison of Saccharomyces Boulardii and Lactic Acid as Probiotics in Acute Pediatric Diarrhea.

OBJECTIVE: To compare the efficacy of Saccharomyces boulardii and lactic acid producing probiotics in addition to usual treatment regimen to cure diarrhea among children (6 months to 5 years of age). STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: Department of Pediatrics, Sheikh Zayed Hospital, Lahore, from February to July 2015. METHODOLOGY: Children suffering from acute diarrhea were orally administered Saccharomyces boulardii and lactic acid producing probiotics for 5 days. The efficacy of administered probiotics was monitored. Patients were given Saccharomyces boulardii and lactic acid producing probiotics randomly to remove the bias. RESULTS: Two hundred patients randomly selected for trials; out of which, 100 were treated with Saccharomyces boulardii while the other 100 were supplemented with lactic acid concomitantly along with conventional diarrhea treatment. Results indicated that Saccharomyces boulardii treatment group has significantly higher efficacy rate (45%) compared to lactic acid producing probiotics (26%). CONCLUSION: This study concluded that Saccharomyces boulardii has a better efficacy compared to lactic acid and may be adopted as a probiotic of choice.

Effectiveness of Per Rectal Misoprostol Versus Intramuscular Oxytocin for Prevention of Primary Postpartum Haemorrhage.

OBJECTIVE: To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). STUDY DESIGN: Randomised controlled trial study. PLACE AND DURATION OF STUDY: Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. METHODOLOGY: Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'. The patients were followed within 24 hours of spontaneous vaginal deliveries. Pads soaked were used to assess the amount of blood loss. RESULTS: A total of 1,678 patients were included in the study. The mean age of patients in group-A was 29.11 years while the mean age of patients in group-B was 29.16 years. One hundred and twenty-three (14.66%) patients in group-A and 120 (14.31%) patients in group-B had PPH. Among the total 1,678 patients, 243 (14.49%) had postpartum haemorrhage among whom 24 (9.88%) had major haemorrhage with a blood loss ≥1000 mL. Among the sub-group (839 patients) administered misoprostol had 123 (14.66%) patients with blood loss greater than 500 mL and the rest 716 patients (85.34%) had blood loss less than 500 mL. The sub-group administered oxytocin have 120 (14.31%) out of 839 patients with postpartum haemorrhage while 719 (85.69%) had blood loss less than 500 mL. CONCLUSION: Active management of 3rd stage of labour with per rectal misoprostol administration was as effective as intramuscular oxytocin. Both were equally effective to reduce PPH and the subsequent need for surgical interventions.