scholarly journals Role of umbilicocerebral and cerebroplacental ratios in prediction of perinatal outcome in FGR pregnancies

2021 ◽  
Author(s):  
H. Coenen ◽  
J. Braun ◽  
H. Köster ◽  
M. Möllers ◽  
R. Schmitz ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Gestational Age ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Linear Regression Analysis ◽  
Mode Of Delivery ◽  
Roc Curves ◽  
Odds Ratios ◽  
Outcome Parameters ◽  
Prognostic Accuracy

Abstract Purpose Aim of our study was to compare the prognostic value of the Umbilical-to-Cerebral ratio (UCR) directly to the Cerebroplacental ratio (CPR) in the prediction of poor perinatal outcomes in pregnancies complicated by Fetal Growth Restriction (FGR). Methods A retrospective study was carried out on pregnant women with either a small-for-gestational age (SGA) fetus or that were diagnosed with FGR. Doppler measurements of the two subgroups were assessed and the correlation between CPR, UCR and relevant outcome parameters was evaluated by performing linear regression analysis, binary logistic analysis and receiver operator characteristic (ROC) curves. Outcomes of interest were mode of delivery, acidosis, preterm delivery, gestational age at birth as well as birthweight and centiles. Results Boxplots and Scatterplots illustrated the different distribution of CPR and UCR leading to deviant correlational relationships with adverse outcome parameters. In almost all parameters examined, UCR showed a higher independent association with preterm delivery (OR: 5.85, CI 2.23–15.34), APGAR score < 7 (OR: 3.52; CI 1.58–7.85) as well as weight under 10th centile (OR: 2.04; CI 0.97–4.28) in binary logistic regression compared to CPR which was only associated with preterm delivery (OR: 0.38; CI 0.22–0.66) and APGAR score < 7 (OR: 0.27; CI 0.06–1.13). When combined with different ultrasound parameters in order to differentiate between SGA and FGR during pregnancy, odds ratios for UCR were highly significant compared to odds ratios for CPR (OR: 0.065, 0.168–0.901; p = 0.027; OR: 0.810, 0.369–1.781; p = 0.601). ROC curves plotted for CPR and UCR showed almost identical moderate prediction performance. Conclusion Since UCR is a better discriminator of Doppler values in abnormal range it presents a viable option to Doppler parameters and ratios that are used in clinical practice. UCR and CPR showed equal prognostic accuracy conserning sensitivity and specificity for adverse perinatal outcome, while adding UA PI and GA_scan increased prognostic accuracy regarding negative outcomes.

scholarly journals Perinatal Outcome in Twin Pregnancy at Khaipur Medical College, Khairpur Mirs, Pakistan

2021 ◽  
pp. 46-52
Author(s):  
Nusrat Fozia Pathan ◽  
Shazia Jamali ◽  
Maqsood Ahmed Siddiqui ◽  
Khushi Muhammad Sohu ◽  
Ameer Ali Jamali ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Gestational Age ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Mode Of Delivery ◽  
Case Series ◽  
Risk Pregnancy ◽  
The Mean ◽  
Twin Pregnancies

Objective: To determine the perinatal outcome of twin pregnancy and to find out the frequency of twin deliveries in hospital based population. Study Design: Descriptive case series. Place and Duration of Study: The study was conducted over a period of 02 Year 1st January 2018 to 31st December 2019 in the Obstetrics and Gynaecology Department at KMC Khairpur Mirs, Sindh Pakistan. Methodology: All the patients of age 20-35 years with twin pregnancies of gestational age above 30 weeks presenting in labour ward of KMC Khairpur Mirs were studied. A detailed history was taken, general physical (G.P) examination and obstetrical examination performed, targeted investigations carried out to detect various fetal complications. Patients were assessed for a mode of delivery, records for data like age, gestational age, weight of baby, APGAR score expressed in term of mean±SD and data like perinatal mortality, prematurity, intra uterine growth restriction (IUGR), the weight of baby and APGAR score expressed in terms of frequencies and percentages on SPSS version 20. Results: In this study total numbers of deliveries were 7200, among them 83 were twin pregnancies the frequency of twin was 1.15%. Booked cases were 24.1%, unbooked was 75.9%. The highest incidence of 42.2% of twin gestation was seen in women between ages 31-35 years, the mean age of patients was seen 30.1±4.1 and regarding the parity incidence was high 54.2% in multiparous l-5. The total number of preterm deliveries was 45(55.2%), gestational age was (35-36+6dnys) weeks in 22.89% of cases, and the mean gestational age of patients was 35.7±2.5. Perinatal mortality was 38(22.9%), stillborn and early neonatal deaths (ENND) were 18.4% and 36.8% and common in twin-2. Conclusion: Twin pregnancy is-a-high-risk-pregnancy still is a major obstetrical and perinatal challenge. The frequency of twin pregnancy seen in this study is 1.15% unbooked and unsupervised pregnancies are more common i.e 75.9%.  Prematurity is common perinatal morbidity 51.20%.  perinatal mortality is 22.9% and highest in twin-2.

scholarly journals Perinatal Outcome of the Second Twin

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
Second Twin

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 

OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
West Bengal ◽  
Mode Of Delivery ◽  
Reproductive Technologies ◽  
Time Interval ◽  
Age Group ◽  
Multiple Pregnancies ◽  
Second Twin

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

scholarly journals Gambaran Kejadian Ketuban Pecah Dini (KPD) di RSUP Prof. Dr. R.D. Kandou Manado Tahun 2018

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Teuku I. Syarwani ◽  
Hermie M. M. Tendean ◽  
John J. E. Wantania
Keyword(s):  
High School ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Perinatal Outcomes ◽  
Senior High School ◽  
Premature Rupture ◽  
Type Of Delivery

Abstract: Premature rupture of membrane (PROM) is the rupture of the membrane before delivery. This study was aimed to determine the profile of PROM based on maternal age, parity, occupation, duration of PROM, type of delivery, gestational age, and perinatal outcomes. This was a descriptive and retrospective study. Samples were delivery women who had PROM at gestational age≥ 37 weeks and <37 weeks at Prof. Dr. R. D. Kandou Manado form January 1 to December 31, 2018. The results showed a total of 78 patients of PROM. Most patients were 20-34 years (65.39%), senior high school educated (71.80%), housewifery (69.23%), multiparity (58.87%), PROM ≥24 hours (65.38%), gestational age ≥37 weeks (85.90%), cesarean delivery (85.90%), and Apgar score of 7-10 (79.48%). In conclusion, PROM patients in 2018 were more common in age 20-34 years, senior high school educated, housewifery, multiparity, PROM ≥24 hours, gestational age ≥37 weeks, cesarean delivery, and a perinatal outcome of Apgar score of 7-10 (79.48%)Keywords: premature rupture of membrane Abstrak: Ketuban pecah dini (KPD) adalah keadaan pecahnya selaput ketuban sebelum persalinan. Penelitian ini bertujuan untuk mengetahui gambaran kejadian KPD berdasarkan usia ibu, paritas, pekerjaan, lamanya ketuban pecah, jenis persalinan, usia kehamilan, dan luaran perinatal. Jenis penelitian ialah deskriptif retrospektif. Sampelpenelitian ini ialah ibu bersalin yang mengalami KPD pada usia kehamilan ≥37 minggu dan <7 minggu di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari -31 Desember 2018. Hasil penelitian mendapatkan total 78 kasus KPD yang terdiri dari ibu berusia 20-34 tahun (65,39%), pendidikan SMA (71,80%), IRT (69,23%), multipara (58,87%), ketuban pecah ≥24 jam (65,38%), usia kehamilan ≥37 minggu (85,90%), persalinan seksio sesarea (85,90%), dan Apgar score 7-10 (79,48%). Simpulan penelitian ini ialah kasus KPD pada tahun 2018 yang paling sering pada usia ibu 20-34 tahun, pendidikan SMA, IRT, multipara, ketuban pecah ≥24 jam, usia kehamilan ≥37 minggu, persalinan seksio sesarea, dan luaran perinatal Apgar score 7-10.Kata kunci: ketuban pecah dini

scholarly journals Nuchal Cord and Perinatal Outcome

2015 ◽  
Vol 7 (1) ◽  
pp. 15-17
Author(s):  
K Shereen ◽  
K Patil
Keyword(s):  
South Asian ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Research Centre ◽  
Chi Square ◽  
Cross Sectional ◽  
Nuchal Cord ◽  
Chi Square Test

ABSTRACT Aims To establish the incidence of nuchal cord at the time of delivery and to assess its impact on the intrapartum and perinatal outcome. Materials and methods This was a cross-sectional study conducted at KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belgaum, India, from January 2011 to March 2011. A sample size of 429 was calculated. Informed consent was obtained and eligible women were enrolled. The babies born with a cord around the neck were compared to those without. The particulars noted were age, BMI, parity, loops of cord around the neck (single or multiple), type of loop, mode of delivery, weight of the baby and Apgar score at birth and 5 minutes. The parameters were then compared and statistically analyzed using Chi-square test. Results Incidence of nuchal cord at the time of delivery was 13.75%, of which single nuchal cord was highest (76.66%). The study revealed that age, BMI (in kg/m2), parity, gestational age and birth weight were not statistically significant to the presence of nuchal cord. Though instrumental deliveries were more in babies with nuchal cord, it was not statistically significant (p = 0.932). Apgar score < 7 at 1 minute was significantly low in nuchal cord group and Apgar score at 5 minutes and admission to neonatal unit was equivalent to those babies born without nuchal cord (p = 0.947). Conclusion Nuchal cord is not associated with adverse perinatal outcome. How to cite this article Shereen K, Patil K, Swamy MK. Nuchal Cord and Perinatal Outcome. J South Asian Feder Obst Gynae 2015;7(1):15-17.

scholarly journals Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

2018 ◽  
Vol 7 (6) ◽  
pp. 2455
Author(s):  
Shivali Bhalla ◽  
Seema Grover Bhatti ◽  
Shalini Devgan
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
North India ◽  
Care Hospital ◽  
Perinatal Morbidity

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

scholarly journals Umbilical Cord Abnormalities and Maternal and Perinatal Outcome: A Prospective Observational Study

2021 ◽  
Author(s):  
Kalpna Kulshrestha ◽  
Debbarma Sukla ◽  
Kalpana Verma
Keyword(s):  
Observational Study ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Insertion Site ◽  
Circulatory System ◽  
P Value ◽  
Maternal Complications

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.

scholarly journals Effect of Magnesium Sulfate on Prevention of Preterm Labour and Perinatal Outcome

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 145-149
Author(s):  
Kazi Shaila Naznin ◽  
Sayeed Bin Sharif ◽  
Nadia Mirza ◽  
Farzana Hamid ◽  
Tanzia Akter
Keyword(s):  
Magnesium Sulfate ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Preterm Labour ◽  
Muscle Relaxation ◽  
Mode Of Delivery ◽  
Smooth Muscle Relaxation ◽  
Medical College ◽  
Tocolytic Agent ◽  
Harmful Effects

Background: Preterm labour is a major cause of maternal mortality in our country. Hypomagnesaemia during pregnancy could be an indirect cause of preterm labour. Magnesium has a role on uterine smooth muscle relaxation, which is the basis for the use of magnesium sulphate as a tocolytic agent. Objective: This study was done to see the effect of magnesium sulfate to prevent preterm labour and perinatal outcome. Materials and Methods: This study was carried out in Comilla Medical College & Hospital, from December 2011 to May 2012. Fifty pregnant women, both primi and multi with preterm labour were selected for the study. Results: Study showed labour delayed >24 hours in 86% cases. And the majority of newborn (96%) had Apgar score in 5 minute was 8-10, 4% had Apgar score 7-8. The mode of delivery was vaginal in 70% cases and by c/s in 16% cases; among subject whose labour delayed more than 24 hours. Conclusion: Intravenously administration of magnesium sulfate is safe, well tolerated and effective tocolytic agent for prolongation of pregnancy in preterm labour. It produces minimal harmful effects on mother and fetus. KYAMC Journal Vol. 11, No.-3, October 2020, Page 145-149

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