Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

2021 ◽  
Vol 91 (4) ◽  
pp. 627-632
Author(s):  
Ho Nam Choi ◽  
Bertrand Ren Joon Ng ◽  
Yasser Arafat ◽  
Balapuwaduge A. S. Mendis ◽  
Anoj Dharmawardhane ◽  
...  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.


2014 ◽  
Vol 2 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Nirmala C ◽  
Jayakumari C ◽  
Rajasekharan C ◽  
Nandini VR

2021 ◽  
pp. 837-898
Author(s):  
James Eldridge ◽  
Nicola Cox ◽  
Alisha Allana ◽  
Heidi Lightfoot

This chapter discusses the anaesthetic management of the pregnant patient, for labour analgesia as well as surgical intervention. It begins with a description of the physiological and pharmacological changes of pregnancy. It describes methods of labour analgesia, including remifentanil, and epidural analgesia and its complications, such as post dural puncture headache (PDPH). It describes anaesthesia for Caesarean section (both regional and general); failed intubation; antacid prophylaxis; postoperative analgesia; retained placenta; in utero fetal death; hypertensive disease of pregnancy (pre-eclampsia, eclampsia and the hypertension, elevated liver enzymes and low platelets (HELLP) syndrome); massive obstetric haemorrhage; placenta praevia and morbidly adherent placenta (placenta accreta, increta and percreta); amniotic fluid embolism (AFE); maternal sepsis, and maternal resuscitation. It discusses comorbidity in pregnancy such as obesity and cardiac disease, and the patient who requires non-obstetric surgery while pregnant. It provides information on safe prescribing in pregnancy and breast-feeding.


Author(s):  
Megha Gupta ◽  
Yashodhara Pradeep ◽  
Renu Singh ◽  
P. K. Shrivastava

Background: Neurological diseases contribute to 20% of maternal deaths. The objective of this study was to find the prevalence of primary and secondary neurological disorders in pregnant and postpartum patients, to study their clinical features, feto-maternal outcome and diagnosis using radiological imaging.Methods: This is a prospective cross-sectional study done over a period of 1 year. Pregnant and postpartum women with neurological disorders except eclampsia were enrolled. A total of 100 cases were analysed out of which 92 underwent radiological imaging to confirm diagnosis. Primary outcome in the form of prevalence of neurological disorders and secondary outcome in the form of maternal and foetal outcome was assessed.Results: The prevalence of neurological disorders in pregnancy is 1150/100000 deliveries. 75 cases were classified as primary neurological disorders (prevalence of 862/100000) which included epilepsy, cerebrovascular accidents, CNS infections, neoplasm, neuropathies and miscellaneous. 25 cases were secondary neurological disorders (prevalence of 287/100000) which included hepatic and septic encephalopathy. Among primary disorders the prevalence of cerebrovascular accidents was found to be highest (33.3%) followed by epilepsy (32%) while that among secondary neurological disorder was of Hepatic encephalopathy (92%). Majority (68%) had recovery while 15%of women had residual deficit. There were 17 (17%) cases of maternal mortality.Conclusions: Neurological disorders were significantly associated with poor feto- maternal outcome. Radiological imaging in the form of MRI is an excellent diagnostic tool for confirming diagnosis of neurological disorders.


2014 ◽  
Vol 13 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Dr.Thanuja. P.M ◽  
◽  
Dr. Rajgopal K ◽  
Dr. Sadiqunnisa

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