Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Shakuntala Chhabra
Mahatma Gandhi Institute of Medical Sciences, India
Keynote: Pediatr Ther
Hypertensive disorders during pregnancy, labour (HDsP), dangerous disorders with persisting dilemmas, affect perinatal survival because of many reasons including gestation, and interventions done. In a recent study of 1046 cases of HDPs (11.73% of 8920 births), mean gestation at birth in early onset (EO) HDsP category A cases (>20 + <28 weeks pregnancy) was 30+1 weeks, B EO(>28 - <34 weeks) 32+6 weeks, C LO(>34-<37 weeks) 35+4 weeks and D LO(>37 weeks) 38+4 weeks. In category A preterm births were 97.5%, caesarean section rate 42.5%, category B, preterm births 84.29%, CSR 53.93%, category C, preterm births 31.37%, CSR 40.63%, category D, CSR 46%. Mean birth weight in category A was 1741.54 gms, B 1936.31 gms, C 2633.38 gms and D 2677.30 gms. Perinatal deaths in category A were 45%, (100% perinatal deaths in births before 28 weeks, 100% survival if reached term but only 2), B 25.13%, C 14.32%, D 14.00%. Critical gestation was 32 weeks plus. Around 34 weeks survival was similar to term. In our other study of HDsP, in cases with complete HELLP (Haemolysis, elevated liver enzymes Low platelets) or partial HELLP perinatal mortality rate was 275, overall in HDPs 150, in HDPs without HELLP it was 110. Overall PMR during same period was 50. In Eclampsia cases when conservatism was tried in cases of <32 weeks pregnancy, of 33(8%) cases, 14 intra uterus deaths, 1 fresh still birth + 3 neonatal deaths occurred. Mothers remained healthy. Babies birth weight got affected by premurity and dysmaturity affecting survival. In other study of HDsP lipid glucose metabolism affected birth weight. Calcium, vitamin C, E for prevention of HDsP in high risk cases continues to be controversial. Aspirin helps, controversy is when to start. Low-molecular-weight heparin has been studied with no effect on onset, severity. More research is needed.
Shakuntala Chhabra is Director-Professor of Obstetrics and Gynaecology, She has served as head of the Department, Obstetrics and Gynaecology at MGIMS (1984-2007), Medical Superintendent of the hospital (2005- 2007) and Dean (2007-10). She is right now helping MGIMS develop a child and mother care hospital at Village Utavali in Melghat, a region with a dubious distinction of high prevalence of severe malnutrition. She received MBBS (1970), DGO (1973) and MD (1975) from the Government Medical College Nagpur. She moved to MGIMS as a lecturer in 1975. In 1984, she was named head of the institute’s Obstetrics and Gynaecology department. She received several awards during her illustrious career. The list includes, but is not limited to: distinguished community services in Emergency Obstetric Care (Federation of International Gynaecologists and Obstetrician), best teacher (Maharashtra University of Health Sciences, Nashik) Dhanwantari Award (Coal India) and best academician-physician (Mahakali Education Society). She has received fellowship of Indian Academy of Juvenile & Adolescent Gynaecology and Obstetrics, Certificate for excellent work in National Family Welfare Programme in Wardha district and also Scroll of Honour of Breast feeding of Promotion Network of India. She also received International fellowships from the British Council; The Network of Community Oriented Educational Institutes for Health Sciences; The Netherlands WHO Aga Khan Foundation; Mother care International, Swedish International Development Agency; Dutch Education Ministry and Maastricht University; Global Health through Education, Training and Service. Over the last 33 years, she has mentored and guided several MD, DGO and PhD students. She is a prolific researcher: she has authored 405 scholarly papers and five chapters in books and some booklets and has held many editorial positions (International Journal of Gynecological Oncology, Women's reproductive health and Gynecological Oncology). She is a reviewer for several journals: British journal of Obstetrics and Gynaecology, Studies in Family Planning, Archives of Gynaecology and Obstetrics, Indian Journal of Medical Sciences, Indian Journal of Clinical Medicine, and Who’s Who in Science and Engineering. An Adviser for AGCO, she is a life member of Association of British Council of Scholars and also a member, faculty of Medicine, Rashtra Sant Tukdoji Maharaj Nagpur University. She is a member of the Women and Health Taskforce of the Global Health through Education Training and Services as well as Master trainer for the programme of Prevention of Parent- to- Child-Transmission of HIV, programme for breast feeding and young child feeding, Violence against Women. Dr Chhabra is assessor for National Baby Friendly Hospital Initiative, a WHO consultant and a supervisor and lecturer for the Swedish International Development Agency (SIDA). She was President of Association of Gynaecologic Oncologists of India in 2002. She is the officer- in- charge of the Sevagram Project for welfare of unwed mothers and Community based Reproductive Health Care project. For over two decades she has also served as Chief Executive Officer of Aakanksha. Her special areas of interest include women’s reproductive health, Gynecological Oncology, and education of health professionals.
E-mail: schhabra@mgims.ac.in