The relationship between epidural analgesia and intrapartum maternal fever and the consequences for maternal and neonatal outcomes: a prospective observational study

OBJECTIVE: The Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated in this study for women attending the triage area of a tertiary hospital, to examine the effect on third delay and maternal and neonatal outcomes. DESIGN: Prospective observational study SETTING: The Labour and Delivery Unit of a tertiary care hospital SAMPLE: A convenience sample of 1000 women METHODS: Assessment included maternal history, baseline vital signs and obstetric examination and categorised the woman as per the MFTI scale. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance. MAIN OUTCOME MEASURES: Flow of patients to triage, presenting complaints, Duration of hospital stay, maternal and neonatal outcomes within 24h of admission. RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 ((p<0.0001). The average time spent in the triage room was 30±17minutes. A priority wise analysis of maternal and neonatal outcomes based on OBICU and NICU admissions, mortality and stillbirths was found to be significant. CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low resource setting. This also simplified handover, improved documentation and decreased time to secondary healthcare provider assessment. KEYWORDS:obstetrictriage,acuity,thirddelay,maternalmortality

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A prospective observational study to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20214345 ◽

2021 ◽

Vol 10 (11) ◽

pp. 4272

Author(s):

Vinitha Dharmalingam ◽

R. Kala

Keyword(s):

Observational Study ◽

Visual Impairment ◽

Prospective Observational Study ◽

Hypertensive Retinopathy ◽

Pregnancy Induced Hypertension ◽

Choroidal Ischemia ◽

Induced Hypertension ◽

Changes In Pregnancy ◽

The Relationship ◽

In Pregnancy

Background: Irreversible visual impairment and morbidity are associated with pregnancy induced hypertension. It causes pathological changes in vascularity of placenta, kidney and brain along with two major pathological types of changes in fundus namely arteriolar vasospasm and permeability changes in vascular endothelium. The aim of our study was to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility.Methods: A prospective observational study done on pregnant women with any grade of pregnancy induced hypertension with recent visual impairment from 24 completed weeks of pregnancy.Results: Out of 75 patients with PIH, all the patients had varying degree of fundus changes in one or both eyes. In 150 eyes of the 75 patients, 86 (57.30%) eyes had isolated arteriolar vasospasm, 14 (9.33%) had grade III hypertensive retinopathy, 4 (2.66%) had grade IV hypertensive retinopathy, 30 (20%) had macular oedema, 4 (2.66%) had central serous chorioretinopathy, 2 (1.33%) had vascular occlusion, 2 (2.66%) eyes had normal fundus with cortical blindness, 2 (2.66%) had exudative retinal detachment, 6 (4%) eyes had normal fundus with changes in the other eye.Conclusions: Out of 75 patients, 7 (9.3%) patients had irreversible loss of vision, 3 (42.85%) due to arteriolar vasospasm, and 4 (57.15%) due to choroidal ischemia. Among the 4 patients with choroidal ischemia, 3 (75%) were in the group of eclampsia and 1 (25%) in gestational hypertension.

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