Neonatal Outcomes Associated with Noncephalic Presentation at Delivery in Preterm Birth

2018 ◽  
Vol 35 (12) ◽  
pp. 1131-1137
Author(s):  
Annalisa Post ◽  
Geeta Swamy ◽  
Chad Grotegut ◽  
Amber Wood
Keyword(s):  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Neonatal Outcomes ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stratified Analysis

Objective The objective of this study is to evaluate the effect of noncephalic presentation on neonatal outcomes in preterm delivery. Study Design In this study a secondary analysis of the BEAM trial was performed. It included women with singleton, liveborn, and nonanomalous fetuses. Neonatal outcomes were compared in noncephalic versus cephalic presentation. Adjusted odds ratios and 95% confidence intervals were calculated for each outcome with logistic regression while controlling for possible confounders. A stratified analysis by mode of delivery was also performed in this study. Results A total of 458 noncephalic deliveries were compared with 1,485 cephalic deliveries. In multivariate analysis, noncephalic presentation was associated with increased risk of death in the neonatal intensive care unit (NICU) or death at <15 months corrected gestational age (cGA), and a decreased risk of IVH. The risk of death persisted in stratified analysis, with increased risk of death at <15 months cGA in noncephalic neonates born via cesarean delivery. In the vaginal delivery group, there was an increased risk of death at <15 months cGA and NICU death. Conclusion After controlling for possible confounders, neonates who are noncephalic at delivery have higher risk for death <15 months cGA and death in the NICU while their risk of IVH is reduced. The risk of death persisted in stratified analyses by mode of delivery.

scholarly journals The Association Between Maternal Hypoglycemia on the 75 g Glucose Tolerance Test and Maternal-Neonatal Outcomes: A Matched Case Control Study

2021 ◽  
Author(s):  
Emine Öztürk ◽  
Şükrü Yıldız
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Case Control ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Control Study

Objective: The aim of this study was to determine whether pregnant women who developed maternal hypoglycemia during the 75 g Oral Glucose Test (OGT) were at an increased risk for adverse obstetric and neonatal outcomes. Methods: This case-control study was conducted from computer-based medical records of women who delivered in a tertiary center between January 2015 and December 2018. OGT had been performed with 75 gr glucose for gestational diabetes screening at 24-28 weeks of gestation. The pregnants with 1st-hour blood glucose levels less than 90 mg/dl (low GT) were matched with normoglycemic patients according to age, body mass index (BMI), gravida and gestational weeks. Obstetric and neonatal outcomes were assessed. Results: Of the 1249 pregnant women included in the study, 62 (4.9%) were in the Low GT group. Admission to the neonatal intensive care unit (NICU) showed a rate of 3.48 increase in the Low GT group (95% confidence interval: 1.05-11.47, p=0.04). There was no difference between the two groups in the other obstetric and neonatal parameters such as: preeclampsia, preterm delivery, birth weight, and weight gained during pregnancy and the 5-minute Apgar scores adjusted for gestational age (SGA) of the fetus. Conclusion: Low 75 g OGT results are significantly associated with increased risk of neonatal intensive care unit (NICU) admissions.

The Risk of Adverse Neonatal Outcomes With Maternal Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Kristel K Leung ◽  
Parul Tandon ◽  
Vivek Govardhanam ◽  
Cynthia Maxwell ◽  
Vivian Huang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes ◽  
Inflammatory Bowel ◽  
Active Disease

Abstract Background Patients with inflammatory bowel disease (IBD) may be at increased risk of adverse neonatal outcomes. The aim of this study was to determine pooled incidences and risk factors for these outcomes. Methods Medline, Embase, and Cochrane Library were searched through May 2019 for studies reporting adverse neonatal outcomes in IBD. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results The pooled incidence of preterm birth, low birth weight, congenital anomalies, and infants transferred to the neonatal intensive care unit was 8.6% (95% CI, 7.0%–10.1%), 8.9% (95% CI, 7.3%–10.5%), 2.1% (95% CI, 1.6%–2.6%), and 4.9% (95% CI, 2.9%–6.9), respectively. Compared with healthy controls, patients with IBD were more likely to deliver infants with low birth weight (&lt;2500 grams; OR, 2.78; 95% CI, 1.16–6.66) and infants admitted to the intensive care unit (OR, 3.33; 95% CI, 1.83–6.05). Patients with Crohn’s disease had an increased incidence of congenital anomalies (OR, 3.03; 95% CI, 1.43–6.42). Among IBD patients, active disease was associated with increased incidence of preterm birth (OR, 2.06; 95% CI, 1.21–3.51), low birth weight (OR, 2.96; 95% CI, 1.54–5.70), and small for gestational age (OR, 2.62; 95% CI, 1.18–5.83). Antitumor necrosis factor (anti-TNF) use during pregnancy was associated with an increased incidence of neonatal intensive care unit admission (OR, 2.42; 95% CI, 1.31–4.45) and low birth weight (OR, 1.54; 95% CI, 1.01–2.35). Conclusions Patients with IBD, particularly with active disease or requiring anti-TNF therapy, may be at increased risk of developing adverse neonatal outcomes.

scholarly journals Evaluation of Nurses’ Workload in the Intensive Care Unit, Neonatal Intensive Care Unit and Coronary Care Unit: An Analytical Study

2020 ◽  
Author(s):  
Maryam Azadi ◽  
Jalil Azimian ◽  
Maryam Mafi ◽  
Farnoosh Rashvand
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Analytical Study ◽  
Pearson Correlation ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Mean ◽  
Coronary Care

Introduction: The workload on nurses can have adverse effects on the patient, nurse and healthcare system such as reduced quality of care, increased risk of nursing errors, reduced patient satisfaction, increased nurse anxiety, increased nursing job stress, increased risk of infection, increase in the length of hospital stay and increased risk of death. Aim: The present study was designed and conducted to compare nurses’ workload in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and Coronary Care Units (CCU). Materials and Methods: The present study is a cross sectional analytical study that was conducted in the ICU, NICU and CCU of educational hospitals affiliated to Qazvin University of Medical Sciences. The convenience sampling method was used. A nursing activity score was used to assess nurses’ workload. The total score in this instrument is between zero and 178. Data were analysed using SPSS 16. Pearson correlation coefficient, chi-square, independent t-test, one-way analysis of variance was used. Results: The mean score of the total workload in nurses was 104.19±25.18. Regarding the primary purpose of the study, the results of the present study showed that the mean score of nurses’ workload was significantly higher in nurses working in the NICU than nurses working in the ICU and CCU (p<0.05). Among the demographic variables, only the marital status was significantly associated with nurses’ workload, that married nurses experienced more workload in some shifts (p<0.05). Conclusion: Nurses working in NICUs experienced a higher level of workload compared to the nurses in ICU and CCU. Due to the high workload of nurses in the NICU and the complications that this can cause for neonatal patients and nurses, it is necessary to pay more attention to the distribution of nurses in these wards.

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. 

scholarly journals Increased Risk of Death, in the Hospital and Outside the Intensive Care Unit, for Patients With Cirrhosis After Cardiac Arrest

2017 ◽  
Vol 15 (11) ◽  
pp. 1808-1810 ◽  
Author(s):  
Megan E. Reinders ◽  
Gabriel Wardi ◽  
Ricki Bettencourt ◽  
Daniel Bouland ◽  
Jessica Bazick ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Risk Of Death ◽  
Increased Risk

Clinical characteristics and neonatal outcomes of liveborn newborns with hydrops fetalis treated in a tertiary level neonatal intensive care unit

2020 ◽  
Vol 112 (6) ◽  
pp. 515-522
Author(s):  
Nuriye Emiroğlu ◽  
Fatma Hilal Yılmaz ◽  
Ramazan Keçeci ◽  
Mehmet Yücel ◽  
Nazlı Dilay Gültekin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Clinical Characteristics ◽  
Hydrops Fetalis ◽  
Neonatal Outcomes ◽  
Tertiary Level

Labor and Delivery Outcomes with the Sequential Use of Misoprostol Followed by Cervical Foley Catheter

2020 ◽  
Author(s):  
Maeve K. Hopkins ◽  
Rebecca F. Hamm ◽  
Sindhu K. Srinivas ◽  
Lisa D. Levine
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Maternal Morbidity ◽  
Neonatal Intensive Care ◽  
Foley Catheter ◽  
Catheter Placement ◽  
Increased Risk ◽  
Nicu Admission ◽  
Time To Delivery

Objective Studies demonstrate shorter time to delivery with concurrent use of misoprostol and cervical Foley catheter. However, concurrent placement may not be feasible. If misoprostol is used to start an induction, little is known regarding the benefit of sequentially using Foley catheter. We examine obstetrical outcomes in women with Foley catheter placed after misoprostol compared with those only requiring misoprostol. Study design Retrospective cohort study of singleton pregnancies, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) undergoing term induction May 2013 to June 2015. We compared obstetrical outcomes between women receiving misoprostol alone versus those that had a Foley catheter placed after misoprostol. Outcomes are mode of delivery, time to delivery, chorioamnionitis, admission to neonatal intensive care unit, and maternal morbidity. Chi-square and Fisher's exact tests were used for categorical variables, Mann–Whitney U-tests compared continuous variables. Results Among 364 women, 281 began induction with misoprostol alone. A total of 135 (48%) subsequently had a Foley catheter placed. Characteristics were similar between the groups, although nulliparity and cervical dilation <1 cm at start of induction were more likely to have subsequent Foley catheter. Women with Foley catheter placement after misoprostol had a longer median time to delivery (15 vs. 11 hours, p < 0.001), twofold higher rate of cesarean (42 vs. 26%, odds ratio: 2.1, 95% confidence interval: 1.26–3.44, p = 0.004), and increased risk of neonatal intensive care unit (NICU) admission (21 vs. 11%, p = 0.024). There was a nonsignificant increased risk of chorioamnionitis (12 vs. 7%, p = 0.1) and maternal morbidity (15 vs. 8%, p = 0.08) in the misoprostol followed by Foley catheter group. Conclusion In women receiving misoprostol for induction, nulliparas and those with dilation <1 cm are more likely to have subsequent Foley catheter placement. Sequential use of cervical Foley catheter after misoprostol is associated with longer labor, higher cesarean rate, and increased NICU admission. Requirement of Foley catheter after misoprostol confers higher risk and may guide counseling. Key Points

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