chaitra sathyanarayana - Academia.edu (original) (raw)

Papers by chaitra sathyanarayana

International journal of reproduction, contraception, obstetrics and gynecology, 2016

Adequate and accessible antenatal care, early diagnosis and management of preeclampsia are necess... more Adequate and accessible antenatal care, early diagnosis and management of preeclampsia are necessary to reduce the incidence of eclampsia. But in majority of cases,

Asian Journal of Medical Sciences, Apr 1, 2022

Induction of labor is a crucial and customary clinical procedure in obstetrics. It is arguably on... more Induction of labor is a crucial and customary clinical procedure in obstetrics. It is arguably one of the most abused procedures. Cervical ripening determines the success of delivery. The availability of newer oxytocics and induction techniques which are simpler and also more predictable has significantly modified our traditionally conservative attitude toward induction of labor. Aims and Objectives: The objective of this study was to determine the effectiveness of Foleys catheter against prostaglandin E2 (PGE2) gel for pre-induction cervical ripening. Materials and Methods: Women attending hospital for induction of labor, with a Bishop's score <6, were allocated randomly to Foley's group (Group F) and PGE2 gel group (Group P). Fifty women were allocated to Foley's group (Group F) and 50 were allocated to gel group (Group P). The Foley's group had a number 18 Foley catheter inserted into cervix, bulb inflated and placed on traction. Further augmentation was done, after Foleys extrusion or 6 h after gel, either with PGE2 gel or oxytocin solution depending on Bishops score. Results: The Foley's group had significantly higher change in Bishop's score (3.12 vs. 2.66, P=0.04). The Foleys group required lesser number of further doses of gel as compared to gel group. No differences were found between the two groups with respect to induction to delivery interval, mode of delivery, non-reassuring fetal heart rate patterns, or baby weight. Conclusion: Foleys catheter was associated with greater change in Bishops score as compared to intracervical PGE2 gel. It was not associated with any side effect during induction process.

Journal of Evidence Based Medicine and Healthcare, Mar 2, 2016

Acute surgical pathology may be overlooked in pregnancy. Despite advances in medical technology, ... more Acute surgical pathology may be overlooked in pregnancy. Despite advances in medical technology, preoperative diagnosis of potentially grave pathologies of the gastrointestinal tract (GIT) is often delayed due to overlap with symptoms of pregnancy non-specific elevation of some laboratory parameters due to pregnancy and a dilemma for obstetricians and surgeons in ordering radiological imaging modalities given the risk associated with fetal exposure to ionizing radiation and contrast. AIMS The aim of this study is to analyse the cases of gastrointestinal tract problems encountered in pregnancy so that increasing awareness can be created among obstetricians. This is important because early diagnosis and timely intervention can significantly improve maternal and fetal outcome in these cases. SETTINGS AND DESIGN There is a retrospective case study of potentially grave GIT problems encountered at Vanivilas hospital, Bangalore, a tertiary referral institute wherein the clinical presentation was confounded by pregnancy. MATERIALS AND METHODS All the included cases were analysed for age of the patient, pre-existing gastrointestinal tract disorders, gestational age at diagnosis, maternal and fetal outcome. RESULTS A total of 8 cases of GIT problems in pregnancy were studied. Though acute appendicitis is the most common cause of GIT emergency in pregnancy as quoted in literature 5, we did not encounter any case of acute appendicitis in pregnancy in the study period. Other conditions which were encountered were small bowel obstruction, stomach and bowel perforation and bleeding oesophageal varices. Whilst few of the conditions could be managed conservatively without harm to the pregnancy, others required a laparotomy and reparative procedures. Delay in diagnosis and intervention proved to be fatal in some of these women. CONCLUSIONS Knowledge about potentially grave gastrointestinal tract problems during pregnancy, high index of clinical suspicion, prompt diagnosis (including radiological investigations) and timely intervention including laparotomy, when indicated will help to reduce maternal and foetal morbidity and mortality.

Pregnancy Hypertension, Jul 1, 2017

Introduction: Preeclampsia (PE) is a serious pregnancy-related disease with hypertension and prot... more Introduction: Preeclampsia (PE) is a serious pregnancy-related disease with hypertension and proteinuria manifesting after 20 weeks of gestation. The worldwide prevalence is 3-8%, making it the most common cause of maternal and fetal mortality. PE lacks an effective therapy, and the only cure is delivery. We have previously shown that exogenously administered alpha-1-microglobulin (A1M) alleviates PE-like symptoms and the effects of oxidative stress in a dualplacenta perfusion model as well as in pregnant animal PE-models. Objectives: A1M was evaluated as a therapeutic agent in the STOX1 PE-model. Materials and methods: The STOX1 transgene mouse PE-model is one of the most complete PE-models available, since it reflects both stages of the disease and exhibit symptoms that mimic human PE. STOX1 is a transcription factor associated with PE that modulates proliferation and migration of trophoblasts. Wild type females are mated to STOX1-transgenic males, resulting in transgeneexpressing fetuses and thereby restricting the expression to the utero-placental unit and typical PE symptoms in the female. Results: One group of pregnant females received A1M injections i. p. every second day from day 6 of pregnancy until day 17, while another group received buffer. A1M significantly reduced the hypertension during gestation, especially at mid-gestation. It significantly reduced the level of hypoxia as well as the level of nitrative stress in the placenta. Also, A1M treatment reduced cellular damage in placenta and kidney tissue, such as disruption of plasma membranes, ER structures and mitochondria. However, A1M treatment had no significant effect on increased plasma levels of anti-angiogenic factors or the increased heart weight observed in the STOX1 PEmodel. A1M was well tolerated with no side effects at the given dose. Conclusion: A1M was able to alleviate PE symptoms observed in the STOX1 PE-model.

Asian Journal of Medical Sciences, 2022

Background: Induction of labor is a crucial and customary clinical procedure in obstetrics. It is... more Background: Induction of labor is a crucial and customary clinical procedure in obstetrics. It is arguably one of the most abused procedures. Cervical ripening determines the success of delivery. The availability of newer oxytocics and induction techniques which are simpler and also more predictable has significantly modified our traditionally conservative attitude toward induction of labor. Aims and Objectives: The objective of this study was to determine the effectiveness of Foleys catheter against prostaglandin E2 (PGE2) gel for pre-induction cervical ripening. Materials and Methods: Women attending hospital for induction of labor, with a Bishop’s score <6, were allocated randomly to Foley’s group (Group F) and PGE2 gel group (Group P). Fifty women were allocated to Foley’s group (Group F) and 50 were allocated to gel group (Group P). The Foley’s group had a number 18 Foley catheter inserted into cervix, bulb inflated and placed on traction. Further augmentation was done, afte...

Pregnancy Hypertension, 2018

Journal of Evidence Based Medicine and Healthcare, 2016

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2017

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

Pregnancy Hypertension, 2021

OBJECTIVES The utility of angiogenic biomarkers in a low resource outpatient setting is not well ... more OBJECTIVES The utility of angiogenic biomarkers in a low resource outpatient setting is not well known. This study evaluates the clinical utility of angiogenic biomarkers, soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PlGF) among patients at risk for preeclampsia in a low resource outpatient setting. STUDY DESIGN This was a prospective pilot study among high risk third trimester outpatients conducted in Bengaluru, India. Serum sFlt1/PlGF was measured between 28 and 37 weeks. Patients with high risk ratio were managed with close observation, intermediate risk had serum redrawn in one week, and those with low risk ratio received routine care. Delivery decisions were made based on local protocols. MAIN OUTCOME MEASURES Maternal complication rate, development of preeclampsia with severe features, and latency to delivery was examined by sFlt1/PlGF ratio. RESULTS The study included 50 patients. Compared to women with a low risk ratio, women with a high-risk ratio were more likely to have preeclampsia with severe features (90.91% vs 8.00%, p < 0.0001), a higher composite maternal complication rate (18.18% vs 0%, p = 0.04) and deliver at earlier gestational ages (32.57 [30.43, 34.71] vs 37.43 [36.86, 38.14] weeks, p = 0.0001). CONCLUSION Angiogenic factors may have utility in the low resource outpatient setting for women with a hypertensive disease. Low sFlt1/PlGF levels were associated with a longer latency to delivery and no maternal complications. This study confirms the broad clinical utility of biomarkers in the real world.