scholarly journals Perinatal outcomes of high dose versus low dose oxytocin regimen used for labor induction and factors associated with adverse perinatal outcome in four hospitals of Ethiopia: a multicenter comparative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melese Gezahegn Tesemma ◽  
Demisew Amenu Sori ◽  
Desta Hiko Gemeda
Keyword(s):  
Risk Factors ◽  
Perinatal Outcome ◽  
Low Dose ◽  
Perinatal Outcomes ◽  
Labor Induction ◽  
High Dose ◽  
Factors Associated ◽  
Caesarean Birth ◽  
Adverse Perinatal Outcomes ◽  
Pregnant Mothers

Abstract Background There is limited evidence on effect of high and low dose oxytocin used for labor induction on perinatal outcomes. We compared perinatal outcomes among pregnant mothers who received the two different oxytocin regimens and identified risk factors associated with adverse perinatal outcomes. Methods Facility based comparative cross-sectional study was conducted in four hospitals of Ethiopia over eight month’s period during 2017/2018 year with 216 pregnant women who received high and low dose oxytocin for labor induction. Socio-demographics, reproductive characteristics of mothers and perinatal outcomes data were collected and entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to see the effect of different oxytocin regimens on perinatal outcome. The result was presented using 95 % confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance. Result Higher adverse perinatal outcomes (29 % vs. 13.9 %, p = 0.005) and higher non-reassuring fetal heart rate pattern (23.1 % vs. 7.4 %, p = 0.001) was observed among mothers who received high dose oxytocin compared to mothers who received low dose oxytocin. Using high oxytocin dose [AOR = 2.4, 95 % CI: 1.1, 5.5], caesarean birth [AOR = 9.3, 95 %CI: 3.8, 22.5], instrumental birth [AOR = 7.7, 95 % CI: 2.1, 27.8], and antepartum hemorrhage [AOR = 17.8, 95 %CI: 1.9, 168.7] were risk factors of adverse perinatal outcomes. Conclusions There was significance difference in the occurrence of adverse perinatal outcomes among pregnant mothers who received high and low dose of oxytocin. Using high dose oxytocin, antepartum hemorrhage, caesarean birth and instrumental birth were associated with increased risk of adverse perinatal outcomes. We recommend using low dose oxytocin for better perinatal outcomes.

scholarly journals Exploring  the influence of advanced maternal age on adverse perinatal outcome in Southern Anhui province, China

2019 ◽  
Author(s):  
Dandan Ge ◽  
Mingshu Si ◽  
Yong Xia
Keyword(s):  
Risk Factors ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Advanced Maternal Age ◽  
Multiple Logistic Regression ◽  
Adverse Perinatal Outcome ◽  
Adverse Perinatal Outcomes

Abstract Background : Elderly parturient women may face many pregnancy risks, which have serious consequences for perinatal and maternal. The objective of this study is to explore the association between advanced maternal age and adverse perinatal outcomes. Methods : In this study, we used retrospective study to randomly selected 977 puerpera ( aged 35 years and older) as the research group and 977 puerpera (aged 20 to 34 years older) as the control group from Yijishan Hospital for the years 2017-2018. Univariate analysis was used to test the association between gestational age and adverse perinatal outcomes. Multiple logistic regression analysis was performed to examine the factors associated with adverse perinatal outcome. A nomogram was conducted to explore the risk probability between risk factors and adverse perinatal outcome. Results : the AMA group (23.2%)exhibited a higher incidence of adverse perinatal outcome than the Non-AMA group(17.8%). Multiple logistic regression analysis showed among those who experienced multiple pregnancy, premature, hypertension, diabetes were more likely to induce adverse perinatal outcome. In this study, the risk of adverse perinatal outcome occurred in women aged 35 to 45 years with multiple pregnancy and preterm birth all was 42%-48%. The risk of adverse perinatal outcome in women aged 35 to 45 years with other variables respectively were 18%-19% (diabetes), 16%-18% (hypertension).The risk of adverse perinatal outcomes among women with AMA combined with these variables were higher than the counterpart. Conclusions : AMA is the risk factor for adverse perinatal outcome among pregnancy women and the probability that these risk factors combined with age produced poor perinatal outcome were also found. Active intervention measures focusing on the complications and treatment in AMA should be taken to ensure the health of mother and baby.

scholarly journals Perinatal Outcomes of Twin Pregnancies With Preterm Premature Rupture of the Membranes at 24–34 Weeks’ Gestation

2021 ◽  
Author(s):  
Shuwei Zhou ◽  
Yajun Yang ◽  
XiaoYan Zhang ◽  
Xiaoling Mu ◽  
Quan Quan ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Factors Associated ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.

Herpesviridae Viral Infections Following Chemotherapy in Patients with Lymphoma : Incidence, Risk Factors, and Prevention.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3704-3704
Author(s):  
Ho Sup Lee ◽  
Ji Young Park ◽  
Seong Hoon Shin ◽  
Sung Bin Kim ◽  
Aeran Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
B Cell ◽  
Cumulative Dose ◽  
Low Dose ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
Neutropenic Fever ◽  
High Dose ◽  
Acyclovir Prophylaxis

Abstract Abstract 3704 Poster Board III-640 Abstract Backgroud Herpesviridae family includes herpes simplex virus, varicella zoster virus, Epstein-Barr virus, and cytomegalovirus, etc. Herpesviridae viral infection(HVI) can lead to serious complications including dissemination, secondary infection, bacterial superinfection in patients with lymphoma undergoing chemotherapy. But there was no consensus on the dose and duration of antiviral agents prophylaxis in lymphoma undergoing chemotherapy. We retrospectively analyzed the incidence, the risk factors and the prevention with low-dose acyclovir for HVI. Method A total of 266 patients who newly diagnosed and received an chemotherapy without prophylaxis of acyclovir at the Kosin University Gospel Hospital, Busan, South Korea between June 1996 and August 2009 were enrolled retrospectively in the current study. HVI was confirmed based on clinical diagnosis, serologic test or pathologic diagnosis. The characteristics of the patients were as follows: the median age was 54years (range 15-83 years) with a female-to-male ratio of 150:116. The enrolled diseases included diffuse large B cell lymphoma (DLBL, n=151, 56.8%), Hodgkin's disease (HD, n=16, 6.0%), T cell lymphoma (TCL, n=43, 16.2%) and other lymphoma (n=56, 21.1%) including mantle cell lymphoma, marzinal zone B cell lymphoma, follicular lymphoma, small lymphocytic lymphoma and burkitt's lymphoma. The results were analyzed using a chi-square test and independent samples T test. For the multivariate analysises, we used logistic regression test. Results Fourty three patients (16.2%) developed HVI at a median of 5.43 months (range 0.43-51.33 months) after initial chemotherapy. In univariate analyses, risk factors for HVI were gender (p=0.002, 10% in male vs 24.1% in female), cumulative dose of prednisone (p < 0.001, 4.0% in less than 4000mg vs 31.6% in more than 4000mg), duration of chemotherapy (p=0.009, 11.8% in less than 6 months vs 24.0% in more than 6 months), presence of relapse (p=0.007, 24.7% in relapse vs 11.9% in non-relapse), receiving salvage chemotherapy (p=0.009, 11.8% in no receiving salvage chemotherapy vs 24.0% in receiving salvage chemotherapy), and presence of neutropenic fever (p=0.019, 26.9% in neutropenic fever vs 13.6% in no neutropenic fever). In multivariate analysis, the results confirmed 2 variables as independent predictive factors for the female (P < 0.001, hazard ratio (HR): 4.915, 95% confidence interval (CI) 2.200-10981) and cumulative dose of prednisone (P < 0.001, HR: 14.269, 95% CI 5.241-38.848). There was no different mortality rate and survival rate between HVI and non-HVI group. Conclusion Female and high dose prednisone was seemed to be high risk for HVI in patients with lymphoma undergoing chemotherapy without acyclovir prophylaxis. Low-dose acyclovir prophylaxis for HVI may be needed in higher risk lymphoma patients undergoing chemotherapy. Disclosures: No relevant conflicts of interest to declare.

scholarly journals High Dose and Low Dose Oxytocin Regimens as Determinants of Successful Labor Induction: A multicenter comparative study

2019 ◽  
Author(s):  
MELESE GEZAHEGN TESEMMA ◽  
Demisew Amenu Sori ◽  
Desta Hiko Gemeda
Keyword(s):  
Low Dose ◽  
Statistical Significance ◽  
Labor Induction ◽  
Induction Of Labor ◽  
P Value ◽  
High Dose ◽  
Bishop Score ◽  
Delivery Time ◽  
Number Of Patients ◽  
Successful Induction

Abstract Background: Induction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study was aimed at comparing the effects of high dose versus low dose oxytocin regimens on success of induction. Methods: Hospital-based comparative cross-sectional study was conducted in four selected hospitals in Ethiopia from October 1, 2017 to May 30, 2018. A total of 216 pregnant women who undergo induction of labor at gestational age of 37 weeks and above were included. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to look for determinants of successful induction. The result was presented using 95% confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance. Result: The mean “Induction to delivery time” was 5.9 hours and 6.3 hours for participants who received high dose Oxytocin and low dose Oxytocin respectively. Higher successful induction (72.2% versus 61.1%) and lower Cesarean Section rate (27.8% vs. 38.9) were observed among participants who received low dose Oxytocin compared to high dose. Favourable bishop score [AOR 4.0 95% CI 1.9, 8.5], elective induction [AOR 0.2 95% CI 0.1, 0.4], performing artificial rupture of membrane [AOR 10.1 95% CI 3.2, 32.2], neonatal birth weight of < 4Kg [AOR 4.3, 95% CI 1.6, 11.6] and being parous [AOR 2.1 95% CI 1.1, 4.0] were significantly associated with success of induction. Conclusions: In this study, Different oxytocin regimens didn’t show significant association with success of induction. But, high dose oxytocin regimen was significantly associated with slightly shorter induction to delivery time. Favourable bishop score, emergency induction, performing artificial rupture of membrane and delivery to non-macrosomic fetuses were positive determinants of successful induction.We recommend researchers to conduct multicenter research on a large number of patients that controls confounders to see the real effects of different oxytocin regimens on success of labor induction.

scholarly journals Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

2019 ◽  
Vol 8 (8) ◽  
pp. 3350
Author(s):  
Lalitha Natarajan ◽  
G. UmaMaheswari
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Diabetic Control ◽  
Placental Pathology ◽  
Foetal Death ◽  
Mild Gestational Hyperglycemia ◽  
Gestational Hyperglycemia ◽  
Adverse Perinatal Outcomes ◽  
Oral Hypoglycemic Drugs

Background: To evaluate the placental morphology and perinatal outcome in patients with gestational hyperglycemia on diet and medication.Methods: Placental examinations performed at the Department of Pathology between August 2016 to August 2018 were retrospectively reviewed. Of the received 140 placentas, 35 of gestational diabetes (GDM) and pre gestational diabetes were identified and segregated into hyperglycemia on diet and on medication. The clinical details, placental findings and perinatal outcome of patients in both the groups (gestational hyperglycemia on diet and medication) were collected and analyzed.Results: Among the 35 cases, there were 24 cases of mild gestational hyperglycemia controlled with diet and 11 cases of hyperglycemia on medication (oral hypoglycemic drugs ± insulin).Most of the placentae in both the groups weighed less than tenth centile. The cord abnormalities such as hyper coiling, velamentous /marginal insertion and furcate cord were observed more in women with GDM on diet. There was no significant gross placental lesion in those on medication. Placental histological features most consistently associated with both the groups include, disturbances of villous maturation (DVM), Derangements in uteroplacental / foetoplacental circulation and villous capillary lesions. Small for gestational age and intrauterine foetal death were found in both the groups, but more commonly in patients with hyperglycemia on medication.Conclusions: Villous maturation defects, uteroplacental / foetoplacental malperfusion are the essential placental changes which can result in adverse perinatal outcomes in women with hyperglycemia irrespective of the diabetic control.

Domestic Violence in Pregnant Women: A Study Conducted in the Postpartum Period of Adolescents and Adults

2016 ◽  
Vol 34 (6) ◽  
pp. 1183-1197 ◽  
Author(s):  
Lucia Helena Mello de Lima ◽  
Rosiane Mattar ◽  
Anelise Riedel Abrahão
Keyword(s):  
Risk Factors ◽  
Domestic Violence ◽  
Medical Records ◽  
Perinatal Outcomes ◽  
Sexual Partners ◽  
Factors Associated ◽  
Adolescents And Adults ◽  
Number Of Sexual Partners ◽  
History Of ◽  
Violence During Pregnancy

The aim of this study was to estimate the prevalence of domestic violence in adolescent and adult mothers who were admitted to obstetrics services centers in Brazil and to identify risk factors of domestic violence and any adverse obstetric and perinatal outcomes. Researchers used standardized interviews, the questionnaire Abuse Assessment Screen, and a review of patients’ medical records. Descriptive statistical analyses were also used. The prevalence of domestic violence among all participants totaled 40.1% (38.5% of adolescents, 41.7% of adults). Factors associated with domestic violence during pregnancy were as follows: a history of family violence, a greater number of sexual partners, and being a smoker. No statistically significant association was found for adverse obstetric and perinatal outcomes. Results showed that, in Vitória, Espírito Santo, Brazil, pregnancy did not protect a woman from suffering domestic violence.

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