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Mishra Vineet V.,The Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Goyal Preeti A.,The Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Aggarwal Rohina S.,The Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Choudhary S.,The Institute of Kidney Diseases and Research Center and Institute of Transplantation science | And 3 more authors.
Journal of Obstetrics and Gynecology of India | Year: 2016

Background: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries. Aims: The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome. Study Design: A prospective cross-sectional study. Methods: This prospective study was conducted between January 2013 and May 2014. In total 570 women with AKI were referred to the Kidney Institute during this period, out of which 52 patients with obstetrics AKI were included in this study. Results: Incidence of obstetric AKI was 9.12 %. Their age varied from 19 to 34 years, with an average of 26.2 years. About 42(80.8 %) patients had not received antenatal care. The main causes of AKI were obstetric hemorrhage (38.46 %) and puerperal sepsis (15.38 %). The outcome was favorable with complete renal function recovery in 55.76 % patients. Four (7.69 %) patients became dialysis dependent. Maternal mortality was 32.69 %. Conclusion: Obstetric AKI is a critical situation in developing countries. Lack of antenatal care (80.8 %) is a major contributing factor for obstetric-related complications leading to renal failure. Obstetric hemorrhage (38.46 %) is the most common cause of obstetric AKI. Late referral in 18 (34.61 %), puerperal sepsis in six (33.33 %), obstetric hemorrhage in five (27.77 %) and combined sepsis and hemorrhage in five (27.77 %) are the common contributing factors leading to its unfavorable outcomes as maternal morbidity and mortality. Hence, a multidisciplinary approach is warranted to prevent such an avoidable complication. © 2016 Federation of Obstetric & Gynecological Societies of India


Mishra V.V.,the Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Nawal R.,the Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Aggarwal R.S.,the Institute of Kidney Diseases and Research Center and Institute of Transplantation science | Choudhary S.,the Institute of Kidney Diseases and Research Center and Institute of Transplantation science | And 3 more authors.
Journal of Obstetrics and Gynecology of India | Year: 2016

Objective: To evaluate salpingoscopic tubal mucosal grading and to find out correlation between laparoscopic external tubal appearance and salpingoscopic mucosal appearance. Design: Prospective observational study. Intervention: Salpingoscopy and laparoscopy. Materials and Methods: Thirty-seven infertile women between 21 and 40 years of age group who attended infertility clinic at IKDRC, Ahmedabad, from May 2015 to August 2015, were enrolled in the study. Laparoscopic tubal morphology was classified as regular, convoluted and hydrosalpinx. Salpingoscopic findings were graded (Grade I–Grade V) according to Brosens classification. Results: Laparoscopic appearance of tube was regular in 18 (48 %), convoluted in 17 (45.94 %), and hydrosalpinx in 2 (5.4 %) women. Salpingoscopic findings were graded as Grade I in 14 (37.83 %), Grade II in 10 (27.02 %), Grade III in 8 (21.62 %), Grade IV in 3 (8.10 %), and Grade V in 2 (5.4 %) women. Discordance between laparoscopic and salpingoscopic findings, i.e. regular appearance on laparoscopy and Grade III–Grade V appearance on salpingoscopy, was found in 38.88 % women. Conclusion: Laparoscopy alone might not be sufficient to predict tubal integrity and salpingoscopic endotubal grading may help in infertility treatment selection decisions. Early counselling towards IVF-ET can be encouraged in cases with higher grade. © 2016 Federation of Obstetric & Gynecological Societies of India


PubMed | The Institute of Kidney Diseases and Research Center and Institute of Transplantation science
Type: Journal Article | Journal: Journal of obstetrics and gynaecology of India | Year: 2016

Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries.The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome.A prospective cross-sectional study.This prospective study was conducted between January 2013 and May 2014. In total 570 women with AKI were referred to the Kidney Institute during this period, out of which 52 patients with obstetrics AKI were included in this study.Incidence of obstetric AKI was 9.12%. Their age varied from 19 to 34years, with an average of 26.2years. About 42(80.8%) patients had not received antenatal care. The main causes of AKI were obstetric hemorrhage (38.46%) and puerperal sepsis (15.38%). The outcome was favorable with complete renal function recovery in 55.76% patients. Four (7.69%) patients became dialysis dependent. Maternal mortality was 32.69%.Obstetric AKI is a critical situation in developing countries. Lack of antenatal care (80.8%) is a major contributing factor for obstetric-related complications leading to renal failure. Obstetric hemorrhage (38.46%) is the most common cause of obstetric AKI. Late referral in 18 (34.61%), puerperal sepsis in six (33.33%), obstetric hemorrhage in five (27.77%) and combined sepsis and hemorrhage in five (27.77%) are the common contributing factors leading to its unfavorable outcomes as maternal morbidity and mortality. Hence, a multidisciplinary approach is warranted to prevent such an avoidable complication.

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