Comparison between AFI and DVP in predicting adverse neonatal respiratory outcomes in women with prolonged pregnancy undergoing induction of labour

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Elkady ◽  
Dina Yahia Mansour ◽  
Hamada Farag Abu zaid
Keyword(s):  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Neonatal Outcomes ◽  
Induction Of Labour ◽  
University Hospitals ◽  
Amniotic Fluid Index ◽  
Assessment Tests ◽  
Prolonged Pregnancy ◽  
Heart Rate Pattern ◽  
Respiratory Outcomes

Abstract Background The intrapartum management of prolonged pregnancies is aunique challenge to the obstetricians, as the perinatal outcomes areadverse after completed 40 weeks. In such cases, intrapartumasphyxia and meconium aspiration are associated with almost. Objective To comparison between MVP and AFI in predicting neonatal respiratory outcomes in induction of labour in prolonged pregnancies. Patients and Methods The study was a prospective comparative study that was conducted on 266 women with prolonged pregnancy undergoing induction of labour. The patients were recruited from Ain Shams university hospitals during the period from February 2019 to August 2019. Results Amniotic fluid index and MVP were evaluated in 269 women with pregnancies of 40 or more weeks and intact membranes using a 3.5-MHz linear transducer. Both measurements were obtained for each participant by the same obstetrician in one sitting. Oligohydramnios was defined as an AFI of 5 cm or less or an DVP of 1 cm or less. External cardiotocography was performed during intrapartum period in all cases. Fetal distress was diagnosed when any one of the nonreassuring fetal heart rate pattern occurred or when the Apgar score at birth was 6 or less. The results were analyzed by the chi(2) and the t tests. Conclusion The use of the AFI and SDVP is useful in predicting neonatal outcomes in the induction of labor in prolonged pregnancies. The SDVP measurement appears to be the more appropriate method for predicting neonatal outcomes. The same observation was found when AFI and SDVP were combined. It is also logical to recommend that only one method should be used for fetal assessment tests.

scholarly journals A study of fetomaternal outcome in induction of labour in third trimester oligohydramnios

2019 ◽  
Vol 8 (11) ◽  
pp. 4196
Author(s):  
Nalini Sharma ◽  
Hanslata Gehlot
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Labor Induction ◽  
Operative Delivery ◽  
Amniotic Fluid Index ◽  
Gestational Age At Delivery ◽  
A Prospective Study

Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.

scholarly journals Comparison of Perinatal Outcomes between Borderline and Normal Amniotic Fluid Index in Term Singleton Pregnancies

2021 ◽  
Vol 18 (4) ◽  
pp. 709-713
Author(s):  
Nishma Bajracharya ◽  
Ganesh Dangal ◽  
Rekha Poudel ◽  
Kenusha Devi Tiwari ◽  
Sonu Bharati ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Normal Group ◽  
Amniotic Fluid Index ◽  
Safe Delivery ◽  
Meconium Stained Amniotic Fluid ◽  
Singleton Pregnancies

Background: Amniotic fluid provides necessary fluid and growth factors for normal development of fetal lungs, cushions the umbilical cord from compression and protects the fetus. This study aims to compare the perinatal outcome between pregnancy with borderline and normal Amniotic Fluid Index that provide greatest chance for appropriate safe delivery with least maternal fetal and neonatal risk.Methods: A total of 94 singleton full term pregnant women were included in the study-at Kathmandu Model Hospital from February to August 2020. Forty Seven women each with Amniotic Fluid Index 5-8 cm was taken as borderline oligohydramnios group and Amniotic Fluid Index 8.1-24 cm was taken as normal group. Ultrasonography was taken as the medium for measuring Amniotic Fluid Index.Results: The rate of intra-partum fetal distress, meconium-stained amniotic fluid, low birth weight and neonatal intensive care unit admission were not statistically significant between the two groups while rate of cesarean section was noted to be 76.6% in exposed groups as compared to 44.7% among women with non-exposed normal group [RR=1.71; 95%CI: 1.2-2.44 p=0.006]. Conclusions: We concluded that in cases of borderline oligohydramnios there was higher risk of operative delivery.Keywords: Adverse perinatal outcome; amniotic fluid; borderline oligohydramnios; meconium-stained amniotic fluid

scholarly journals Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study

2014 ◽  
Vol 5 (1) ◽  
pp. 22-26
Author(s):  
Sailaja Devi Kallur ◽  
Nuzhat Aziz
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Negative Likelihood Ratio ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Likelihood Ratios ◽  
Amniotic Fluid Index ◽  
Diastolic Flow ◽  
Adverse Perinatal Outcomes

Abstract Aim To determine the ability of fetal monitoring tests to predict adverse perinatal outcomes in absent end diastolic flow (AEDF) babies. Materials and methods A retrospective cohort study of pregnant women with AEDF during the period 2001 to 2009. Fetal monitoring tests of interest included amniotic fluid index (AFI), nonstress tests (NST), and Doppler flow studies. Adverse perinatal outcomes included perinatal/neonatal mortality, necrotizing enterocolitis, respiratory distress syndrome, and grades III/IV intraventricular hemorrhage. Sensitivity, specificity, likelihood ratios, adjusted odds ratios, area under the receiver operator characteristic curves (AUROC) and the 95% confidence intervals were determined. Study included 142 women with AEDF who delivered before 34 weeks. Indications for delivery included abnormal AFI in 6 (4.23%), worsening Doppler in 31 (21.83%), and abnormal NST in 48 (33.80%). An adverse fetal event was noted in 107 [75.35%, 95% confidence interial (CI) 68.18%, 82.53%]. Birth weight adjusted odds for an adverse perinatal outcome decreased (Odds ratio: 0.79, 95% CI: 0.56, 1.10, p = 0.16) with an increase in each week of gestation. Fetal monitoring tests did not have clinically meaningful positive/negative likelihood ratio or significant AUROC. Conclusion Current fetal monitoring tests are more useful to identify noncompromised fetuses than to identify fetal distress. Delaying delivery till 34 weeks might improve outcomes. How to cite this article Kallur SD, Aziz N. Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study. Int J Infertil Fetal Med 2014;5(1):22-26.

Comparative analysis of perinatal complications in intrahepatic cholestasis of pregnant women

2021 ◽  
Vol 9-10 (219-220) ◽  
pp. 28-33
Author(s):  
Makpal Beketova ◽  
◽  
Serik Iskakov ◽  
Keyword(s):  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Perinatal Complications ◽  
Perinatal Risk ◽  
Ultrasound Doppler ◽  
Hepatic Transaminases

Intrahepatic cholestasis of pregnancy is associated with a higher incidence of adverse neonatal outcomes, including preterm birth, neonatal respiratory distress syndrome, meconium aspiration syndrome (MAS), and stillborn foetuses. Despite the successes achieved in the problem of Intrahepatic cholestasis of pregnant women (ICPW), a significant number of unfavorable outcomes for the mother and the fetus are associated with insufficiently developed possibilities for predicting them. Unsatisfactory results of pregnancy, childbirth and perinatal indicators, which cause a number of medical and social problems, can be reduced with the availability of effective methods for predicting and, if it, successful prevention and treatment of ICPW. Purpose of the study. To study the relationship between clinical and laboratory parameters in pregnant women with ICP W with obstetric and perinatal outcomes. Material and methods. A retrospective analysis of 600 birth histories and exchange cards of pregnant women in the period from 2015 to 2019 with ICPW was carried out, of which 301 pregnant women with intrahepatic cholestasis in the main group, and 299 pregnant women without intrahepatic cholestasis in the control group. Results and discussion. The most frequent complications of pregnancy and childbirth in ICPW were preterm labor, threatening fetal healthcare, preeclampsia, and postpartum hemorrhage. In patients with ICPW, an increase in the level of hepatic transaminases was significantly associated with a high perinatal risk. Respiratory disorders prevailed in the structure of diseases in newborns. An increase in the incidence of unfavorable neonatal outcomes (fetal distress, low Apgar score, low gestational age) is associated with severe hyperenzymemia in severe forms of ICPW. Conclusions. An increase in the level of hepatic transaminases is significantly associated with a high perinatal risk. The isolated use of ultrasound doppler in ICPW does not allow to reliably assess the risk of unfavorable perinatal outcomes. Analysis of the results of ultrasound doppler, with an increase in the level of transaminases, is insufficient to assess the degree of risk of antenatal death or a threatening condition of the fetus. Keywords: Intrahepatic cholestasis, pregnancy, perinatal outcomes.

scholarly journals Perinatal Outcome in Pregnancies Complicated by Isolated Oligohydramnios at

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Aneela Umber
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Caesarean Delivery ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Amniotic Fluid Index ◽  
Singleton Pregnancy ◽  
Increased Risk ◽  
Comparative Cohort Study

Objective:  To determine the perinatal outcome in pregnancies complicated by isolated oligohydramnios at term. Study Design:  Comparative / Cohort study. Place and Duration of Study:  This study was carried out in Unit-III at Sir Ganga Ram Hospital, Lahore from 14-05-2002 to15-06-2003. Patients and Methods:  During this study 500 patients with singleton pregnancy were selected and Amniotic Fluid Index (AFI) was evaluated within 4 days of delivery in these patients with technique of Phelan et al. All selected outcome variables of these pregnancies were recorded on printed proformas. On the bases of AFI measurements patients were divided in two groups. Those who have AFI > 50 mm and < 50 mm. The significance of difference or comparison of means was measured by Chai square test (by Yats corrections). Perinatal outcomes in pregnancies with oligohydramnios were compared with those with normal amniotic fluid volume. Results:  The selected outcomes showed significant variations in both groups. The statistical significance was present between advanced gestational age, presence of meconium, deceleration of fetal heart rate and chances of caesarean delivery. There were increased chances of induction of labor (41% Vs 22%) and caesarean delivery (32% Vs 23%) in oligohydramnios group. Conclusion:  Oligohydramnios is associated with an increased risk of caesarean delivery for fetal distress and perinatal morbidity. Key Words:  Isolated Oligohydramnios, perinatal outcome.

On the possibility of targeted prophylaxis of calcitriol-associated pregnancy complications at the preclinical stage

2020 ◽  
pp. 43-50
Author(s):  
N.V. Didenkul ◽  
Keyword(s):  
Vitamin D ◽  
Pregnancy Complications ◽  
Comparison Group ◽  
Reproductive Potential ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Optimal Level ◽  
Initial Study ◽  
Management Plan ◽  
Placental Dysfunction

According to recent studies, in the vitamin D deficiency state (VDD), pregnancy can be complicated and the optimal level of VD in the blood is one of the conditions for the realization of reproductive potential. The objective: the possibility to preventing calcitriol-associated pregnancy complications by the correcting VD deficiency at the preconception period. Materials and methods. 57 women with VDD were examined. A history of all women had a pregnancy complicated by placental dysfunction (PD); 27 of them were observed from the preconception period (main group – IA) and 30 – from the 1st trimester of pregnancy (comparison group – IB). The VD status by the blood level of the 25-hydroxyvitamin D by ELISA was determined. Women of both groups, in addition to the vitamin-mineral complex (VMC) were prescribed supplementation colecalciferol at a dose of 4.000 IU per day. Pregnant women of both groups received VMCs up to 16 weeks. After optimizing the level (3–4 months), women continued to take VD at a dose of 2.000 IU per day throughout pregnancy. Results. At the initial study, the VD level was 15.72±2.59 ng/ml in ІА and 16.1±1.99 ng/ml in ІВ group (U=883; p>0.05); after treatment increased to 38.31±3.29 ng/ml and 36.13±2.99 ng/ml (U=900; p>0.05). In group IA, the course of pregnancy was characterized by a lower frequency of complications: PD was diagnosed in 22.2% in group IA and 50% in group IB (F=0.0001; p<0.01); fetal distress in 3.7% and 10% (F=0.16; p<0.05): signs of amnionitis – in 18.5% and 33.3% (F=0.035; p<0.05); placental hypertrophy or hypotrophy – in 7.4% and 36.7% (F=0.00001; p<0.01), preeclampsia in 3.7% and 6.7% of women (F=0,54; p<0.05). The frequency of cesarean section in the comparison group was significantly higher (40% VS 25.9%, F=0.034; p<0.05). Conclusions. During pregnancy, which occurred in conditions of VDD, the frequency of some pregnancy complications, including preeclampsia, the threat of miscarriage, placental dysfunction was in 2–4 times higher than in women with optimized VD status. One of the directions of the individual management plan for women with a negative obstetric history can be the determination of the level of VD in the blood and correction of the VDD at the preconception period. This approach is a pathogenetically substantiated and promising direction for the prevention of some pregnancy complications and improvement of perinatal outcomes. Keywords: pregnancy, deficiency vitamin D, placental dysfunction, preconception period.

scholarly journals Maternal and perinatal outcomes in women with eclampsia by mode of delivery at Riley mother baby hospital: a longitudinal case-series study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koech Irene ◽  
Poli Philippe Amubuomombe ◽  
Richard Mogeni ◽  
Cheruiyot Andrew ◽  
Ann Mwangi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Mortality ◽  
Mode Of Delivery ◽  
Case Series ◽  
Perinatal Outcomes ◽  
Induction Of Labour ◽  
Chi Square ◽  
Case Series Study ◽  
Chi Square Test ◽  
Series Study

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.

COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries

2020 ◽  
Vol 48 (9) ◽  
pp. 900-911 ◽  
Author(s):  
Ernesto Antonio Figueiro-Filho ◽  
Mark Yudin ◽  
Dan Farine
Keyword(s):  
General Population ◽  
Pregnant Women ◽  
Clinical Symptoms ◽  
Case Series ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Eligibility Criteria ◽  
Maternal Characteristics ◽  
Th2 Immune Response ◽  
Maternal And Neonatal Outcomes

AbstractThe objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1–7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.

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