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

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Maternal and Perinatal Outcomes in Women with Eclampsia by Mode of delivery at Riley Mother Baby Hospital: A longitudinal case-series study

10.21203/rs.3.rs-61697/v1 ◽

2020 ◽

Author(s):

Philippe Amubuomombe Poli ◽

Koech MMED Irene ◽

Richard Mogeni ◽

Ann Mwangi ◽

Andrew Cheruiyot ◽

...

Keyword(s):

Mode Of Delivery ◽

Case Series ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Sub Saharan Africa ◽

Categorical Variables ◽

Chi Square ◽

Case Series Study ◽

Chi Square Test ◽

Series Study

Abstract Background Eclampsia, considered a 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. Instead, it increases the risk of perinatal adverse outcomes, including the risk of admission to the newborn unit and perinatal death.

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Clinical profile and outcome of acute lower respiratory tract infection in children aged between 2 months to 5 years

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20164587 ◽

2016 ◽

Vol 4 (1) ◽

pp. 105

Author(s):

Alok Kumar M. K. ◽

Ashok V. Badakali ◽

Gangadhar Mirji ◽

Raghavendra N. Vanaki ◽

Ramesh Pol

Keyword(s):

Case Series ◽

Severe Pneumonia ◽

Clinical Profile ◽

Research Centre ◽

Test Results ◽

Chi Square ◽

Case Series Study ◽

Common Diagnosis ◽

Chi Square Test ◽

Series Study

Background: Acute respiratory infection is a leading cause of morbidity and mortality in under five children in developing countries. Hence, the present study was undertaken to study the clinical profile and factors predicting the outcome.Methods: Hospital based case series study conducted at HSK hospital & Research centre. The study conducted from 01 March 2014 to 31 August 2015. 200 ALRI cases in the age group of 2 months to 5 years as per WHO criteria for pneumonia fulfilling the study criteria were evaluated for clinical profile and outcome as per predesigned proforma. Data collected was analyzed using chi square test. Results: We found higher incidence of ALRTI cases among infants (53.5%) and male (58%) children. Majority had PEM (60.5%) and anemia (73.5%). Parental smoking, period of EBF and gestation at delivery were significantly associated with severity of pneumonia (p <0.05). 1.5%, 77.5% and 21% had pneumonia, severe and very severe pneumonia with mean duration of hospital stay of 5, 7.43 and 10.36 days. Need of change in antibiotics and duration of stay were significantly associated with pneumonia severity (p <0.05). 56.5% cases required oxygen and 4.5% required mechanical ventilation. Bronchopneumonia (33.5%) was the most common diagnosis and sepsis (6%) was the most frequent complication. Mortality was 3%.Conclusions: Present study has identified prevalence of various risk factors among ALRI cases and predictors of severity and outcome. ARI burden and severity can be reduced by promoting EBF and immunization, effective management of malnutrition, improving the living standards and educating parents about hazards of smoking.

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Perioperative Management of Pregnant Women With Idiopathic Pulmonary Arterial Hypertension: An Observational Case Series Study From China

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2018.01.043 ◽

2018 ◽

Vol 32 (6) ◽

pp. 2547-2559 ◽

Cited By ~ 7

Author(s):

Jinglan Zhang ◽

Jiakai Lu ◽

Xiaorui Zhou ◽

Xuefeng Xu ◽

Qing Ye ◽

...

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Pregnant Women ◽

Perioperative Management ◽

Case Series ◽

Idiopathic Pulmonary Arterial Hypertension ◽

Case Series Study ◽

Pulmonary Arterial ◽

Series Study

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Study of perinatal outcome of foetuses with nuchal cord

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183403 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3507

Author(s):

Misbah M. Inamdar ◽

Asmita N. Patil

Keyword(s):

Perinatal Outcome ◽

Demographic Data ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Common Finding ◽

Chi Square ◽

Cross Sectional ◽

Nuchal Cord ◽

Chi Square Test ◽

Meconium Staining

Background: Entanglement of the umbilical cord around the foetal neck (nuchal cord) is a common finding at delivery, but its clinical relevance is not entirely clear. Nuchal cords have generally been considered to be rather benign. However, the insufficiency in data regarding the role of nuchal cord in foetal morbidity and mortality is a source of anxiety and frustration to both parturient and healthcare professionals. Considering the above facts the present study was taken up to establish the incidence of nuchal cord at delivery in the existing setup.Methods: This was a cross sectional comparative study conducted over a period of one year from May 2013 to April 2014. A total of 362 women were selected for the study. These women were briefed about the nature of the study and a written informed consent was obtained. The demographic data and obstetrical history were documented on predesigned proforma. The data obtained was analysed using percentages and comparison done using chi-square test for discrete variables.Results: Incidence of Nuchal Cord was 17.7% among study cases. Based on this study gestational age may have an effect on the presence of nuchal cord (p<0.05). Out of 64 cases with nuchal cord’, 11.4% of cases had meconium stained liquor present. 9.8% of cases with nuchal cord had FHR irregularity, which was significantly less as compared to 20.0% of cases who did not show FHR irregularity. This was statistically significant. (p=0.032). 18.7% of mother who showed presence of nuchal cord had delivery by caesarean section. 22.7% of cases with nuchal cord had NICU admissions, which was insignificantly more as compared to 17.0% of cases who did not have NICU admissions.Conclusions: Intrapartum events such as meconium staining of liquor and foetal heart rate irregularities were more commonly associated with nuchal cord but it did not affect the perinatal outcome. However, the mode of delivery was independent of the presence of nuchal cord, thereby reducing the morbidity to the mother. Hence nuchal cord is not associated with adverse perinatal outcomes and the presence of a nuchal cord per se is not found to be an indication of operative delivery.

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OBESE PRIMIGRAVID WOMEN;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.08.955 ◽

2017 ◽

Vol 24 (08) ◽

pp. 1147-1151

Author(s):

Raheela Rani Junejo ◽

Rabail Rani Junejo ◽

Raheel Sikandar ◽

Shahla Baloch ◽

Mehrunnisa Khaskheli

Keyword(s):

Case Series ◽

Categorical Variables ◽

P Value ◽

Antenatal Visit ◽

Age Group ◽

Chi Square ◽

Case Series Study ◽

Pregnancy And Delivery ◽

Chi Square Test ◽

To Come

Objectives: To determine the frequency of macrosomia in obese primigravidwomen. Study Design: Case series study. Period: Six months. Setting: Department ofGynecology and Obstetrics Department Jamshoro. Patients and Methods: The inclusioncriteria of the study were primigravida women between age 18 to 35 years with singletonpregnancy and gestational duration of 37 to 42 weeks, and during labour with BMI 30 or >30kg/m2 and All booked women who were primigravid during antenatal visit try to come and BMIcalculated by weight in kg and height in meter square. The variables include post-delivery ifthe weight of baby is 4.5 kg is macrosomic and mode of the delivery. The data was analyzed inSPSS version 17, the frequency and percentage was calculated while the chi-square test wasapplied on categorical variables and the p-value ≤0.05 was considered as significant. Results:During six months study period total 203 pregnant obese ladies were observed for macrosomicbabies. Age group was analyzed which shows that in age group between 18-25 years were105(52.00%) women, in age group of 26-30 years were 62 (30.69%) women and age group of30 years and above were 35 (17.31%) women with mean age ± SD of ladies was 24.6 ±6.2years. Regarding modes of delivery shown 132 (65.02%) ladies had C-section and 71 (34.97%)ladies had vaginally delivery. Weight of the babies was assessed which shows 27 (13%) wereborn with less than 2.5 Kg, babies having weight between 2.6-3 Kg were 71 (35.3%) , babieswere having weight 3 kg to 4.5kg 38 (18.7%) and babies having more than 4.5kg which shows67 (33%). Neonatal complications observed were macrosomic babies 67 (33.1%). Frequencyof macrosomic babies was higher in women with BMI more than 3.5kg/m2 44(21.67%) andin women with BMI between 30 to 35kg/m2 25(12.31%). Conclusion: Obesity responsible forcomplications during pregnancy and delivery for both mother and babies. Fetal complicationsare macrosomia and these obese ladies should motivate for maintenance of weight.

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POSTPARTUM HAEMORRHAGE;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.07.1031 ◽

2017 ◽

Vol 24 (07) ◽

pp. 1016-1019

Author(s):

Raheela Rani Junejo ◽

Rabail Rani Junejo ◽

Shahla Baloch ◽

Raheel Sikandar ◽

Mehrunnisa Khaskheli

Keyword(s):

Blood Loss ◽

Postpartum Haemorrhage ◽

Case Series ◽

University Hospital ◽

Age Group ◽

Chi Square ◽

Case Series Study ◽

Increased Risk ◽

Maternal Risks ◽

Series Study

Objectives: To determine the frequency of postpartum haemorrhage in obeseprimigravid women. Study Design: Case series study. Period: Six months was conductedfrom 1st October 2014 to 30 March 2015. Setting: Department of gynecology and obstetricsat Liaquat University Hospital Jamshoro. Patients and Methods: All the primigravid obese(≥30kg/m2) ladies 18 to 35 years of age with 37-42 weeks of gestational age were evaluate forthe occurrence of PPH by estimating blood loss of greater than 500 ml of blood following vaginaldelivery or 1000 ml of blood loss following caesarean section. All data was entered and analyzedthrough statistical package SPSS version 17, the chi-square statistical test was applied and thep-value ≤0.05 was considered as statistical significant. Results: Total 203 primigravid obeseladies were studies, the age group was analyzed which shows that in age group between 18-25years were 105(52.00%) women, in age group of 26-30 years were 62(30.69%) women and agegroup of 30 years and above were 35 (17.31%) women. The modes of delivery were evaluatedwhich shows that 66.5% women underwent C-section and 33.4% women had normal vaginaldelivery. The PPH was observed in 34.97% patients (70.4% with C-Section and 29.6 with NVD).Conclusion: Obesity carries a significant increased risk of complications during pregnancyand maternal risks during labour are PPH and more frequent C-section and nulliparous obesewomen have twofold high risk for PPH

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TEENAGE PREGNANCY

The Professional Medical Journal ◽

10.29309/tpmj/18.4656 ◽

2018 ◽

Vol 25 (10) ◽

pp. 1525-1531

Author(s):

Afshan Sultana Zia Mahesar ◽

Muhammad Nadeem Chohan ◽

Mumtaz Mahesar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Teenage Pregnancy ◽

Case Series ◽

Perinatal Outcomes ◽

Fetal Outcome ◽

Term Pregnancy ◽

Case Series Study ◽

Induced Hypertension ◽

Series Study

Objectives: To assess the fetomaternal outcome in teenage pregnancy atCivil Hospital Hyderabad. Study Design: Case series study. Place and Duration of Study:Department of Obstetrics and Gynecology, Civil Hospital, Hyderabad, from 1st July 2014 to31st December 2014. Subject and Methods: A total of 117 primigravida teenage women withsingleton term pregnancy were included in this study. Maternal and Perinatal outcomes weremeasured and recorded. Results: The average age of the women was 17.35±1.06 years.Considering adverse maternal outcome anemia was observed in 35.89% women, Pregnancyinduced hypertension (PIH) 35.04%, preterm pregnancy 23.07% and pre-eclampsia wasobserved in 15.38% women. Regarding fetal outcome, there were 99 (84.61%) live births and18 (15.38%) stillbirths and low birth weight was observed in 19.6% (20/102). Conclusion: Thisstudy found Still Birth, Low Birth Weight and prematurity a major problem to babies of Teenagewomen, while Pregnancy induced hypertension, anemia and Pre eclampsia are the problemsfaced by Teenage pregnant women.

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