scholarly journals Cerebroplacental ratio for prediction of adverse intrapartum and neonatal outcomes in a term uncomplicated pregnancy

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Mariam Lotfy Mohamed ◽  
Salwa Adel Mohamed ◽  
Amal Mohamed Elshahat
Keyword(s):  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Uncomplicated Pregnancy ◽  
Cerebroplacental Ratio ◽  
Flow Disturbances ◽  
Increased Risk ◽  
Nicu Admission ◽  
Fetal Compromise

Abstract Background Fetal hypoxia is one of the major causes of high perinatal morbidity and mortality rates. Doppler ultrasound tests such as cerebroplacental ratio (CPR) evaluation are commonly used to assess blood flow disturbances in placento-umbilical and feto-cerebral circulations. A low cerebroplacental ratio has been shown to be associated with an increased risk of stillbirth regardless of the gestation or fetal weight. We conducted this study to assess the fetal cerebroplacental ratio in prediction of adverse intrapartum and neonatal outcomes in a term, uncomplicated pregnancy to reduce fetal and neonatal morbidity and mortality. Results It was found that neonates with CPR ≤1.1 had significantly higher frequencies of cesarean delivery (CS) for intrapartum fetal compromise compared to those with CPR >1.1 (p=0.043). Neonates with CPR ≤1.1 had significantly lower Apgar score at 1 min and 5 min than those with CPR >1.1 (p=0.004) and (p=0.003), respectively. Neonates with CPR ≤1.1 had significantly higher rates of NICU admission than those with CPR <1.1 (p=0.004). Conclusion The cerebroplacental ratio shows the highest sensitivity in the prediction of fetal heart rate abnormalities and adverse neonatal outcome in uncomplicated pregnancies at term. The cerebroplacental ratio index is useful in clinical practice in antenatal monitoring of these women in order to select those at high risk of intra- and postpartum complications.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

scholarly journals ASSESSMENT OF NEONATAL OUTCOMES IN ECLAMPTIC MOTHERS ADMITTED TO NMCH, PATNA, BIHAR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Samiksha Sharma ◽  
Girijanand Jha ◽  
Binod Kr Singh ◽  
Saroj Kumar
Keyword(s):  
Neonatal Morbidity ◽  
Perinatal Loss ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Pregnancy Induced Hypertension ◽  
Perinatal Morbidity ◽  
Medical College ◽  
Risk Pregnancy ◽  
Induced Hypertension ◽  
Prevention Of Prematurity

Hypertension during pregnancy is a highly variable disorder unique to pregnancy and a leading cause of maternal and fetal/neonatal morbidity and mortality. Pregnancy-induced hypertension is the general classification for hypertension diseases during pregnancy, which include pregnancy-induced hypertension usually after 20th week of gestation (without proteinuria), pre-eclampsia (with proteinuria), and eclampsia (pre-eclampsia with convulsions). This disease is responsible for high maternal and perinatal morbidity and mortality rates, and is one of the main public health problems. Hence based on above findings the present study was planned for Assessment of Neonatal Outcomes in Eclamptic Mothers Admitted to NMCH, Patna, Bihar. The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from March 2019 to October 2019. In the present study 50 females admitted with eclampsia or with pre-eclampsia but subsequently developing eclampsia were enrolled. Also the control females were also evaluated for comparative evaluation. The data generated from the present study concludes that Prevention of prematurity, treatment of morbidities & prevention of infection among infants should be done to reduce the PMR and improve perinatal outcome. Thus High risk pregnancy should be identified prospectively and then given special care, perhaps a major impact on overall perinatal loss could be reduced.     Keywords: Eclamptic Mothers, Patna, Bihar, etc.

scholarly journals Perinatal and Neonatal Outcomes of Triplet Gestations Based on Chorionicity

2017 ◽  
Vol 07 (01) ◽  
pp. e59-e63 ◽  
Author(s):  
Maureen Downing ◽  
Suela Sulo ◽  
Barbara Parilla
Keyword(s):  
Intrauterine Growth Restriction ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Prenatal Management ◽  
Baseline Characteristics

Objective To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations. Methods A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC, n = 26; DC + MC, n = 16). Maternal demographics and pregnancy data were compared. Neonatal outcomes were assessed using composite morbidity and mortality. Results Maternal baseline characteristics including age, mode of conception, race, parity, body mass index, and previous preterm delivery were statistically comparable. Comparison of prenatal management and complications yielded no significant differences in terms of presence of shortened cervix, cerclage placement, use of tocolytics, intrauterine growth restriction, premature rupture of membranes, pregnancy-induced hypertension, or gestational diabetes. However, evaluation of composite morbidity and mortality (RDS, IVH, NEC, IUGR, and death) illustrated that all infants born from DC + MC triplet gestations suffered some morbidity or mortality compared with TC pregnancies (p < 0.01). Conclusion DC + MC triplet gestations are at an increased risk of neonatal morbidity and mortality compared with TC triplet gestations.

Prolonged pregnancy

2020 ◽  
pp. 389-394
Author(s):  
Kate F. Walker ◽  
Jim G. Thornton
Keyword(s):  
Caesarean Section ◽  
Pregnancy Loss ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Increased Risk ◽  
Oxytocin Infusion ◽  
Prolonged Pregnancy ◽  
Overall Risk

Prolongation of gestation beyond 42+0 weeks (or 294 days) affects about 6% of pregnancies. It is associated with an increased risk of perinatal morbidity and mortality; the overall risk of pregnancy loss (stillbirth plus death occurring up to the age of 1 year) increases eightfold between 37 weeks and 43 weeks. Since trials comparing induction of labour with expectant management suggest that induction does not increase the rate of caesarean section, many clinicians offer it for pregnancies beyond 41 weeks. Induction of labour is usually performed using prostaglandin ripening followed, if necessary, by amniotomy and oxytocin infusion.

scholarly journals Study of sociodemographic profile, maternal, fetal outcome in preeclamptic and eclamptic women: a prospective study

2019 ◽  
Vol 9 (1) ◽  
pp. 230
Author(s):  
Vedavathi . ◽  
Rajeev Sood
Keyword(s):  
Blood Pressure ◽  
Prospective Study ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Intrauterine Death ◽  
Perinatal Morbidity

Background: Preeclampsia is pregnancy specific disease, lead to maternal, perinatal morbidity and mortality. This study is conducted to identify the socio demographic profile of subjects suffering from preeclampsia and its effect on maternal and fetal health.Methods: This prospective study was conducted at department of obstetrics and gynecology, Kamla Nehru State Hospital, Shimla, in this, 100 preeclamptic women were included. Preeclampsia was diagnosed with blood pressure of ≥140/90 mmHg noted for the first-time during pregnancy, after 20 wks of gestation and proteinuria. Demographic details were collected. Investigations i.e. hemogram, liver and renal function tests, coagulation profile and fundoscopy were done. Maternal and perinatal outcomes were recorded.Results: In this study, majority of the subjects were primigravida 65. In this, 11 subjects had systolic blood pressure of 140-159 mmHg and 89 subjects had systolic blood pressure of > 160 mmHg. 25 subjects had diastolic blood pressure of 90-109 mmHg and 75 subjects had diastolic blood pressure of > 110 mmHg. In this, 82 subjects had warning symptoms, mainly headache 49. 14 subjects showed hypertensive changes in fundus. Unfavorable Bishop Score, observed in 86 subjects and 78 subjects were induced after controlling blood pressure. Majority of subjects had vaginal delivery 73. Majority of the subjects had deranged liver function 61. Maternal morbidity was reported in 54 subjects. Intrauterine death reported in 14 subjects. Birth weight was < 2.5 kg was observed in 70 babies. Out of 74 live births, 53 neonates required admission in NICU and 16 neonates died in NICU.Conclusions: It may be concluded that, maternal and neonatal morbidity and mortality can be reduced by early identification of risk factors and timely intervention is the hall mark in preventing the maternal and perinatal morbidity and mortality.

scholarly journals 17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdulaali R. Almutairi ◽  
Hadir I. Aljohani ◽  
Nouf S. Al-fadel
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Relative Risk Ratio ◽  
Analysis Model ◽  
Clinical Trial Registries

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.Work Design: Systematic review and meta-analysis.Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (&lt;32, &lt;35, and &lt;37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at &lt;32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), &lt;35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and &lt;37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.

scholarly journals Elevated IL-6 in Pre-Eclampsia Increases Neurite Growth and Mitochondrial Respiration in an in vitro Model of Neuronal Development

2021 ◽  
Author(s):  
Aaron Barron ◽  
Samprikta Manna ◽  
Colm McElwain ◽  
Andrea Musumeci ◽  
Fergus McCarthy ◽  
...  
Keyword(s):  
Mitochondrial Respiration ◽  
Neuronal Development ◽  
Neonatal Morbidity ◽  
Neurite Growth ◽  
Maternal Serum ◽  
Hypertensive Disorder ◽  
Uncomplicated Pregnancy ◽  
Increased Risk ◽  
Control Serum

Abstract Pre-eclampsia (PE) is a common and serious hypertensive disorder of pregnancy, which affects 3-5% of first-time pregnancies and is a leading cause of maternal and neonatal morbidity and mortality. Prenatal exposure to PE is associated with an increased risk of neurodevelopmental disorders in affected offspring, although the cellular and molecular basis of this are largely unknown. In this study we examined the effects of exposure to maternal serum from women with PE or a healthy uncomplicated pregnancy on the survival, neurite growth and mitochondrial function of SH-SY5Y cells. We report that cells exposed to PE serum exhibited increased neurite growth and mitochondrial respiration, two important neurodevelopmental parameters, compared to those treated with control serum. Levels of the pleiotropic cytokine IL-6 were significantly elevated in the PE sera, and cells exposed to PE serum displayed increased phospho-STAT3 levels which is a key intracellular mediator of IL-6 signalling. Finally, we show that treating these cells with IL-6 alone is sufficient to induce a similar neurite growth and respiratory phenotype to PE serum-exposed cells. This suggests that elevated IL-6 seen in maternal serum in PE may be responsible at least in part for its inducing increased neurite growth and mitochondrial respiration in SH-SY5Y cells. Overall, this study demonstrates that there are circulating factors in the serum of women with pre-eclampsia that affect neuronal development and oxygen consumption differently to that of a healthy uncomplicated pregnancy, and that immune dysregulation via elevated IL-6 may be important in mediating these effects.

scholarly journals Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 193-203
Author(s):  
Phoibe Uwizeyimana ◽  
Emerthe Musabyemariya ◽  
Olive Tengera ◽  
Anita Collins
Keyword(s):  
Retrospective Study ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
University Teaching ◽  
Delivery Mode ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Maternal Hypertension ◽  
In Pregnancy

Background Globally, maternal hypertensive disorders in pregnancy significantly increase both maternal and perinatal morbidity and mortality. Maternal hypertension affects 14 percent of pregnancies. Eearly detection and management are critical for improving the health outcomes of both mother and neonate. Objective To assess the association between maternal hypertension disorders in pregnancy and immediate neonatal outcomes at a University Teaching Hospital in Rwanda. Methods A retrospective study of maternal files with hypertension disorders was conducted from January 1, 2016, to March 31, 2019. A census sample of 114 records and pretested checklist was used to collect data. Descriptive statistics were used to analyze associations between maternal factors and immediate neonatal outcomes. Results Neonatal outcomes included low birth weight (75.4%), prematurity (59.6%), admission to neonatal intensive care unit (50.4%), intrauterine growth restriction (32.4%), and neonatal death (22.8%). Nearly two-thirds (62%) of mothers had preeclampsia. Significant associations with immediate neonatal outcomes included gestational age, medical history, delivery mode, maternal referral status, preterm birth, prematurity, and abortion. Conclusion Maternal hypertensive disorders were significantly associated with adverse neonatal outcomes in our study population in Rwanda. Improving early detection, health education, and management of hypertensive disorders in pregnancy is critical to reduce maternal and neonatal morbidity and mortality. Rwanda J Med Health Sci 2020;3(2):193-203

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