Pankaj Desai's Blogs

  Not being high-risk does not necessarily mean one is low-risk. It is well known that amongst many parameters to identify potential subjects for developing preeclampsia, nearly all are for identifying high-risk subjects. However there is hardly any research work published that can guide us to low-risk subjects. These are the days of not stopping at identifying high-risk but actually identifying low-risk subjects of preeclampsia. Why do we need to identify the low-risk subjects also? It has been found in clinical practice long since that not being high-risk does not necessarily mean one is low-risk. There are majority of subjects who are not high-risk but are also not necessarily low-risk. As a result we all are over using prophylactic measures. Also we are scared to stop prophylaxis once a subject is labelled high-risk and is never tested again. While pregnancy is a dynamic state, it surely happens that some subjects who may be high risk initially may cease to be so as pregnan...

  Becoming More Scientific, More Rational and More Accurate In Preeclampsia   Abstract Currently the etiopathological changes in preeclampsia are believed to begin at the fetomaternal interface and so the placenta is labeled as the main cause of these conditions. A group from George's University of London and some from other parts of the world have proposed that in mothers with an already compromised cardiovascular function, before the commencement of pregnancy, pregnancy adds to a heavy load resulting in a series of adverse manifestations. In one study, it was found that on an average in a pregnant mother the left ventricular mass increased by 52% in about 9 months. When this was compared with the increase in the left ventricular mass of athletes, it was found that they register an increase of only 25% over a long period of 24 months. This means that the mother gets a much lesser time to bring about the necessary cardiac changes than even the robustly training athletes....

Micronutrient Supplementation in Pregnancy: How much rational? Introduction:                 It is strange but true that in many aspects of clinical practice, the decision-making on prescribing a drug is based on the information provided by pharmaceutical companies and their representatives who are ubiquitously surrounding us. Micro-nutrient supplementation in pregnancy is one such aspect where many a times, the pharmaceutical companies have a tendency to overhype an agent. Their overhype tends to get potentiated by our laziness in keeping our information updated. Ultimately this brings us dangerously close to being irrational in prescribing these agents. The purpose of this write-up is to make one sensitive to the current evidence based thinking in prescribing different micronutrient in clinical practice of obstetrics. Vitamin A supplementation during pregnancy:     ...