P08.06: Normal and abnormal ductus venosus in expectant management of early IUGR fetuses and risk of adverse neonatal outcome

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

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Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

Global Pediatric Health ◽

10.1177/2333794x211018350 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110183

Author(s):

Maleda Tefera ◽

Nega Assefa ◽

Kedir Teji Roba ◽

Letta Gedefa

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Neonatal Outcome ◽

Birth Asphyxia ◽

Public Hospitals ◽

Obstructed Labor ◽

Eastern Ethiopia ◽

Adverse Neonatal Outcome ◽

Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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Haemosiderosis in the placenta does not appear to be related to chronic placental separation or adverse neonatal outcome

Pathology ◽

10.3109/00313020903494094 ◽

2010 ◽

Vol 42 (2) ◽

pp. 119-124 ◽

Cited By ~ 7

Author(s):

T.Y. Khong ◽

T.J. Toering ◽

J.J.H.M. Erwich

Keyword(s):

Neonatal Outcome ◽

Adverse Neonatal Outcome

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STUDY OF RISK FACTORS CONTRIBUTING TO ADVERSE NEONATAL OUTCOME IN HYPERTENSIVE MOTHERS COMPARED TO NON HYPERTENSIVE MOTHERS

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1206 ◽

2015 ◽

Vol 4 (48) ◽

pp. 8304-8312

Author(s):

Swapna K Pillai ◽

Razin Nazarullah

Keyword(s):

Risk Factors ◽

Neonatal Outcome ◽

Adverse Neonatal Outcome

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Active versus expectant management of preterm premature rupture of membrane before 34 weeks and neonatal outcome

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20210654 ◽

2021 ◽

Vol 8 (3) ◽

pp. 501

Author(s):

Gouda A. P. Kartikeswar ◽

Dhyey I. Pandya ◽

Siddharth Madabhushi ◽

Vivek M. Joshi ◽

Sandeep Kadam

Keyword(s):

Gestational Age ◽

Neonatal Outcome ◽

Tertiary Care ◽

Expectant Management ◽

Active Management ◽

Respiratory Support ◽

Care Hospital ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Significant Difference

Background: Preterm premature rupture of membranes (PPROM) predisposes the mother for chorioamnionitis, endometritis, bacteremia and neonate to preterm delivery related complication. There is often dilemma regarding the management of PPROM in mothers with gestational age (GA) <34 weeks.Methods: A retrospective cohort study conducted in a tertiary care hospital over two year period. Neonates delivered before 34 weeks were enrolled and categorized into active management (AM) and expectant management (EM) group. Associated risk factors, duration of PPROM and latency period, Neonatal outcomes like sepsis, morbidity, duration of respiratory support, duration of NICU stay compared between groups.Results: Out of total 197 cases, AM group had 91 babies. Active management resulted in earlier delivery [mean GA (SD): 30.88(1.8) VS 31(2.1) weeks], higher number of caesarian section (76.9% versus 53.8%), lesser birth weight {1233.6 (±282.9) versus 1453.39 (±380.6) gm} and more ELBW babies (23.1% versus 7.5%). EM resulted in significantly higher antenatal steroid cover (73.6% in AM versus 89.6% in EM) and lesser need of surfactant for RDS [42.9% versus 28.3%]. Significant difference was found for NICU stay days {mean (SD): 25.46 (16.8) versus 20.94 (17.5)}. No difference found between respiratory support days [median (IQR) 2 (0, 6) versus 2 (0, 7)]. No significant differences found in incidence of maternal chorioamnionitis, NEC, sepsis, BPD and ROP. Early delivery resulted in higher mortality though that was statistically not significant.Conclusions: Gestational age at delivery is more important predictor of neonatal outcome then PPROM in early preterm.

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