scholarly journals Predictive Factors for Perinatal Outcomes of Infants Diagnosed With Micrognathia Antenatally

2019 ◽  
Vol 100 (1) ◽  
pp. NP16-NP20 ◽  
Author(s):  
Sok Yan Tay ◽  
Rekha Krishnasarma ◽  
Deepak Mehta ◽  
Amy Mehollin-Ray ◽  
Binoy Chandy
Keyword(s):  
Difficult Airway ◽  
Difficult Intubation ◽  
Multidisciplinary Approach ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Amniotic Fluid Index ◽  
Fetal Imaging ◽  
Emergency Tracheostomy

Introduction: Advances in fetal imaging have allowed us to identify abnormalities previously not appreciated. With this study, we hope to identify factors predicting a difficult airway at birth and review the perinatal outcomes of these patients. Methods: Sixteen patients with antenatally diagnosed micrognathia were reviewed from a tertiary care hospital database from 2011 to 2016. Jaw index (JI), amniotic fluid index (AFI), glossoptosis, gastric size, and oropharynx obliteration were assessed. The airway support required at birth, specialist team involvement, and outcomes were evaluated. Results: Nine (56.3%) of 16 patients had JI <5th percentile, 3 (33.3%) of 9 had difficult intubation, 2 (22.2%) of 9 needed an emergency tracheostomy, and 1 (11.1%) of 9 died. Seven patients had polyhydramnios, 2 (28.6%) of 7 had difficult intubation, 2 (28.6%) of 7 required tracheostomy, and 1 (14.3%) of 7 died. Twelve patients had either JI <5th percentile or abnormal AFI, 5 (41.7%) of 12 had difficult intubation, 2 (16.7%) of 12 required tracheostomy, and 1 (8.33%) of 12 died. For the group without otolaryngology consultation, 8 (50%) of 16, 1 (12.5%) of 8 had difficult intubation and 1 (12.5%) of 8 died because airway was not secured after 45 minutes of resuscitation. Conclusion: Jaw index <5th percentile or abnormal AFI predicts a difficult airway. A multidisciplinary approach with otolaryngology involvement for airway intervention may be required at birth.

scholarly journals A study on seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India with maternal and perinatal outcomes

2018 ◽  
Vol 7 (6) ◽  
pp. 2429
Author(s):  
Shruthi M. N. ◽  
Srinivas K. Jois
Keyword(s):  
Vertical Transmission ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Obstetric Outcomes ◽  
Care Hospital ◽  
Adequate Treatment ◽  
Co Morbidity

Background: HIV is prevalent in epidemic proportions in India. Identifying the target population and effective intervention reduces chances of vertical transmission and new infection. Authors studied the seroprevalence of HIV among women attending obstetric care in a tertiary care hospital of South India and associated maternal and perinatal outcomes among seropositive women.Methods: Retrospective descriptive study of all women who were screened for HIV at Integrated Counselling and Testing Centre, Vani Vilas hospital, from January 2014 to December 2017 in their antenatal, intranatal and postnatal period. Demographic data of seropositive women, obstetric outcomes and status of children at 18months were obtained.Results: Of the 35,455 women who were screened, 0.28% were found positive for HIV. Percentage prevalence of HIV was highest in 2014 (0.32%). Majority of the seroprevalence belonged to age group of 25-29 years (44%), 32% illiterates, 82% homemakers and 79% belonged to urban areas. Unknown partner status in 22% and majority were diagnosed in antenatal period (66%). Of them 82% had favourable CD4 count. 74 % of them delivered live baby. Three maternal deaths were observed and anaemia (65%) was the major associated co-morbidity. Vaginal route was common mode of delivery (84%). Thirteen babies required NICU admission and 6 neonates deaths were encountered. Exclusive breastfeeding was practised in 91% of live births. 62% of children were found seronegative at 18 months follow up.Conclusions: Authors observed with adequate treatment to mother and prophylaxis to the baby, the burden of vertical transmission can be significantly reduced.

scholarly journals Maternal and Perinatal outcomes of oligohydramnios in a tertiary care hospital in Salem, Tamil Nadu, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1939
Author(s):  
Jeyamani B. ◽  
Anurekha J. P. ◽  
Arun Daniel J.
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Tamil Nadu ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Care Hospital ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume

Background: Oligohydramnios is the term coined for a condition where the amount of liquor amnii is less than 200 ml at term. Using an ultrasonogram, oligohydramnios can be deliberated when the vertical pocket of liquor is less than 2 cm or when amniotic fluid index (AFI) is less than 5 cm. Oligohydramnios is reported to occur in 1 to 5% of total pregnancies. It has been associated with adverse maternal and foetal outcomes.Methods: This hospital-based follow-up study was conducted among 540 pregnant women at 37 weeks attending to the Department of Obstetrics and Gynaecology for a period of 1 year from January to December 2018. All included pregnant women were subjected to routine ultrasound examination and assessment of amniotic fluid volume using Amniotic fluid index.Results: The incidence of oligohydramnios was 17.04% (n=92) among the included women and 62% (n=57) among them were primigravida. Among those women diagnosed with Oligohydramnios, the caesarean section rate was 56.5% (n=52), the common indications for LSCS being fetal distress 44. 2% (n=23) and IUGR 34.6% (n=18). The oligohydramnios pregnancies had more associated post-dated deliveries (28.3%), pregnancy induced hypertension (10.9%) and gestational diabetes (8.7%). It was also associated with higher incidence of low birth weight (27.2%), NICU admissions (32.6%), congenital anomalies (3.3%) and fetal deaths (5.4%).Conclusions: The study showed that an amniotic fluid index of less than 5 at term was associated with adverse maternal and perinatal pregnancy outcomes emphasizing the importance of amniotic fluid volume surveillance during the antenatal period.

scholarly journals Outcome of Dengue infection in pregnancy at a tertiary care hospital in India

2020 ◽  
Vol 9 (3) ◽  
pp. 970
Author(s):  
Naimah Raza ◽  
Nitin P. Dhungat
Keyword(s):  
Clinical Laboratory ◽  
Tertiary Care Hospital ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Severe Dengue ◽  
Care Hospital ◽  
Laboratory Findings ◽  
Bleeding Manifestation ◽  
In Pregnancy

Background: Dengue is one of the most important mosquito-borne diseases in India. This study was done to study the course of dengue infection in pregnant women, its effects, foeto-maternal outcome, and associated complications.Methods: Clinical, laboratory findings, and maternal/foetal outcome were collected from patients with confirmed dengue infections in pregnancy treated at a tertiary care hospital in India, during a 6-month period.Results: A total 12 seropositive cases of dengue infection in pregnancy were diagnosed during the study period. Thrombocytopenia coupled with rising haematocrit were seen in all cases. Prophylactic platelet transfusion was not necessary in any of the cases without bleeding manifestation. Three patients developed severe dengue with some complication requiring extra measures, including a case of dengue encephalitis which responded to supportive treatment. One case of intra-uterine foetal demise and multi-organ failure leading to maternal death was seen. Perinatal outcomes of the other cases were satisfactory.Conclusions: Dengue in pregnancy requires early diagnosis and treatment. A high index of clinical suspicion is essential in any pregnant woman with fever, especially in endemic areas. Further studies are necessary as evidence-based data in the management of dengue in pregnancy is inadequate.

scholarly journals Prediction of Difficult Airway Among Patients Requiring Endotracheal Intubation in a Tertiary Care Hospital in Eastern Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 314-318 ◽  
Author(s):  
Sindhu Khatiwada ◽  
Balkrishna Bhattarai ◽  
Krishna Pokharel ◽  
Roshan Acharya
Keyword(s):  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Tertiary Care ◽  
Difficult Laryngoscopy ◽  
Screening Tests ◽  
Care Hospital ◽  
Laryngoscopic View ◽  
Predictive Values ◽  
Lehane Grade

Introduction: Unanticipated difficult intubation is an undesirable situation. Various bedside screening tests are routinely performed for predicting difficult airway. Although considered a surrogate indicator, difficult laryngoscopy is not the exact measure of intubation difficulty. We aimed to determine the best screening test for predicting difficult laryngoscopy and the association between difficult laryngoscopic view and difficult intubation. Methods: This prospective, observational study involved 314, ASA I/II adult patients requiring endotracheal intubation for various routine surgical procedures. Sternomental distance < 12 cm, thyromental distance < 6.5cm, inter-incisor distance < 3.5 cm, mandibular protrusion grade 3 and modified Mallampati class III/IV were the predictors of difficult laryngoscopy. Laryngoscopic view was defined as ‘difficult’ when the Cormack and Lehane grade was III/ IV. The sensitivity, specificity, positive and negative predictive values and accuracy of these predictors were compared to find out the best predictor. Requirement of >3 attempts for insertion of the tracheal tube was defined as ‘difficult intubation’. The association between difficult laryngoscopic view and difficult intubation was determined. Results: The sensitivity of the modified Mallampati class for predicting difficult laryngoscopy was highest (83%). Twelve (3.8%) patients had grade III laryngoscopic view and none had a grade of IV. Intubation was difficult in seven (2.2%) patients. Majority of patients (4 of 7) with difficult intubation had difficult laryngoscopic view (p<0.001). Conclusions: Modified Mallampati test was better for predicting difficult laryngoscopy compared to other bedside screeing tests. Difficult laryngoscopy could significantly predict difficult intubation in our patients.   Keywords: Airway evaluation; difficult intubation; difficult laryngoscopy; modified Mallampati class; Nepalese patients; sensitivity.

HIV infection in pregnancy: maternal and perinatal outcomes in a tertiary care hospital in Calabar, Nigeria

2015 ◽  
Vol 46 (2) ◽  
pp. 78-86 ◽  
Author(s):  
Ekott Mabel Ikpim ◽  
Udo Atim Edet ◽  
Akpan Ubong Bassey ◽  
Otu Akaninyene Asuquo ◽  
Ekanem Etim Inyang
Keyword(s):  
Hiv Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
In Pregnancy
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