Relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome

Objectives: To determine relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome Methods: This descriptive cross-sectional study was conducted in the department of Gynaecology, Lady Reading Hospital Peshawar, Pakistan, from January 2019 to July 2019. This study included 27 full-term pregnant women who had abnormal CTG during the active or latent phase of labour. Data were analyzed by IBM SPSS Statistics for Windows, Version 23.0. Results: Out of 27, most patients 13 (48.14%) were in the age group 20-25 years,11 (40.74%) to 26-30 years and 3 (11.11%) belonged to 31-35 years of age group. CTG abnormalities were severe bradycardia, late deccelerations and persistent variable deccelerations with loss of baseline variability. Of all delivered babies, 21 (77%) babies had birth weight<3.5 kg and 6 (22%) had >3.5 kg birth weight. 20 (74.07%) had acidosis (pH <7.2) at the time of birth, of which one had severe hypoxemia and acidosis with pH 6.85. APGAR score at 0 minutes showed a strong positive correlation (r=0.818, p= <0.001) with cord pH, while APGAR at five minutes was also strongly correlated (r= 773, p=<0.001). Of all babies 18(66.66%) with PH less than 7.2 were admitted in NICU while only 2 babies with PH more than 7.2 were admitted. (p value= 0.005). Conclusion: Low umbilical cord pH values of babies born by cesarean section (for fetal distress) are strongly correlated with low APGAR score at birth and higher rates of NICU admission. doi: https://doi.org/10.12669/pjms.36.7.2536 How to cite this:Syed W, Liaqat N, Qazi Q, Yasmeen S. Relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2536 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Maternal and Fetal Outcomes of Adolescent Pregnancies at Patan Hospital

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v11i1.16235 ◽

2016 ◽

Vol 11 (1) ◽

pp. 11-13

Author(s):

Laxmi RC ◽

Reetu Baral ◽

R Shrestha ◽

P Gurung ◽

S Lama

Keyword(s):

Birth Weight ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Fetal Distress ◽

P Value ◽

Delivery Mode ◽

Age Group ◽

Premature Rupture ◽

Maternal Complications ◽

Adult Age

Aims: This study aims to review obstetric and neonatal outcome and risk factors in adolescent pregnant women and to compare perinatal outcomes with the adult group.Methods: This is a retrospective comparative study in between primiparous pregnant teenager women aged 15-19 years and 20-24 years from April 2012 to April 2013 in Patan Hospital Lalitpur, Nepal. The data was retrieved from the hospital records. Frequency of prenatal care, perinatal outcome (newborn’s weight and gestational age at delivery), mode of delivery and maternal complications if any were recorded. Results: Neonates with normal birth weight (>2.5-4 kg) was seen in 70% (n=248) of the adolescent age group and 85% (n=1797) of adult age group. Neonates with low birth weight (<2.5 kg) was significantly higher in the adolescent age group with 29% (n=102) than the adult age group with only 13% (n=287). The occurrence of premature rupture of membrane and preterm premature rupture of membrane also show statistically significant association (Chi-square test p-value 0.000) on mother’s age having 18% and 2% respectively in adolescent pregnancy.Conclusions: There was significant association of neonatal complications like still birth, fetal distress, and meconium aspiration with the adolescent pregnancy. There was no significant association between neonatal death and age of mother.

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Apgar Score and Umbilical Cord pH as Prognostic Predictors in Very Low Birth Weight Premature Neonates

10.21203/rs.2.22119/v1 ◽

2020 ◽

Author(s):

Bernard Barzilay ◽

Miri Ratner ◽

Haim Bibi ◽

Ibrahim Abu-Kishk

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Umbilical Cord ◽

Gestational Age ◽

Apgar Score ◽

Very Low Birth Weight ◽

Medical Center ◽

Correlation Coefficients ◽

Complication Score ◽

Umbilical Cord Ph

Abstract Objective To estimate the reliability of the Apgar score (AS) and umbilical cord pH (UCP) as prognostic tools among very low birth weight (VLBW) infants. Study Design Retrospective study based on data of 1237 VLBW neonates born between 1997 and 2013 at one tertiary medical center. For each newborn, a complication score (CS) was calculated based on common complications of prematurity. Results The AS at 1 and 5 minutes correlated well with CS (correlation coefficients -0.47 and -0.52, respectively). No significant correlation was found between UCP and CS (correlation coefficient -0.08). Multi regression analysis revealed that the variables with the greatest prognostic contribution were birth weight, gestational age and prenatal steroid administration (beta values 0.277, 0.251 and 0.087, respectively). Conclusion The AS at 1 and 5 minutes, but not UCP, combined with gestational age, birth weight, and prenatal steroids, can be significant parameters for predicting prognosis among VLBW neonates.

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Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health

Journal of Clinical Medicine ◽

10.3390/jcm10040695 ◽

2021 ◽

Vol 10 (4) ◽

pp. 695 ◽

Cited By ~ 1

Author(s):

David Ramiro-Cortijo ◽

María de la Calle ◽

Andrea Gila-Díaz ◽

Bernardo Moreno-Jiménez ◽

Maria A. Martin-Cabrejas ◽

...

Keyword(s):

Life Satisfaction ◽

Birth Weight ◽

Pregnant Women ◽

Maternal Depression ◽

Psychological Health ◽

Neonatal Outcome ◽

P Value ◽

Linear Regression Models ◽

Psychological Outcome ◽

Biological Variables

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family–work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (β = 0.08 ± 0.03, p-value = 0.003), cholesterol (β = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (β = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (β = −0.14 ± 0.09, p-value = 0.010) and life satisfaction (β = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (β = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (β = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (β = 370.2 ± 97.0, p-value = 0.001), red blood cells (β = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (β = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.

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A Case of BeckwithWiedemann Syndrome with Polyhydramnios

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v5i3.549 ◽

2017 ◽

pp. 185

Author(s):

Yusrawati Yusrawati ◽

Reno Muhatiah

Keyword(s):

Birth Weight ◽

Prenatal Diagnosis ◽

Caesarean Section ◽

Apgar Score ◽

Rare Case ◽

Obstet Gynecol ◽

Fetal Distress ◽

Polycystic Kidney ◽

Prenatal Diagnostic ◽

Female Baby

Objective: To report a rare case of Beckwith-Wiedemann Syndrome with polyhydramnios. Methods: Reporting a case of Beckwith-Wiedemann syndrome with polyhydramnios. Results: Case of Mrs. Y, 27 years old woman, G2P1A0L1 preterm pregnancy (30-31 weeks) with polyhidramnios. From ultrasound found renomegaly, bilateral hyperechogenic polycystic kidney, and the karyotype result was 46,XX. Caesarean section was performed due to fetal distress. A female baby was born by caesarean section with birth weight of 1300 grams, 37 centimeters of body length, and APGAR score of 6/8. The congenital anomalies found were hepatomegaly, renomegaly, bilateral hyperechogenic renal polycystic, low set ears. The baby was died in NICU on day care 5th, with suspected of sepsis. Conclusion: Prenatal diagnosis of Beckwith-Wiedemann syndrome on fetus with polyhydramnios. [Indones J Obstet Gynecol 2017; 5-3: 185-188] Keywords: amniocentesis, beckwith-wiedemann syndrome, polyhydramnios, prenatal diagnostic, USG

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Neonatal Outcome Among Adolescent and Adult Pregnancy in a Tertiary Care Center of Nepal

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v14i2.21541 ◽

2018 ◽

Vol 14 (2) ◽

pp. 56-59

Author(s):

Jyoti Adhikari ◽

Shristi Kharel ◽

Lalita Bahl ◽

Deepal Poudel ◽

Rajesh K.C.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Adolescent Mothers ◽

Neonatal Outcome ◽

Birth Asphyxia ◽

Adolescent Mother ◽

P Value ◽

The Common ◽

Mother Group

Background: Teenage pregnancy is a common public health problem worldwide which is detrimental to the health of mother and child and has long been considered a high-risk situation. The risk of low birth weight (LBW) and preterm delivery is particularly high among teenagers.Methods: A comparative study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur during the period of July 2015 to June 2016. The study was carried out to compare the immediate neonatal outcome and morbidity pattern in neonates of 50 adolescent and 50 adult mothers.Results: In the present study, 84% belonged to adolescent mother group (17-19 years) whereas 50% belonged to adult mother group (20-23 years). Illiteracy was seen more in adolescent mothers (62%) and most were from rural areas (68%). The common immediate neonatal outcome found in adolescent and adult mothers were preterm delivery (96% vs. 52%; p value 0.001), low birth weight (LBW) (70% vs. 38%; p value 0.001). The common neonatal morbidities seen significantly high in neonates of adolescent mothers, viz: Neonatal sepsis (NNS)(54% vs. 20% p value <0.02), apnea (30% vs. 14% P value <0.02), neonatal jaundice(NNJ)(44% vs. 30% p value <0.01) while the other morbidities found were birth asphyxia (20% vs. 14%; p value <0.1), Respiratory distress syndrome (RDS) (36% vs. 24% p value<0.1), anemia (16% vs. 8%; p value <0.1), seizure (10% vs. 8%; p value <0.1), meconium aspiration syndrome (MAS) (6% vs. 18%; p value<0.1) and intrauterine growth retardation(IUGR)(22% vs. 20%; p value <0.5). Similarly mortality was found to be more in neonates of adolescent mothers (14% vs. 8%; p value <0.1).Conclusion: Adolescent pregnant mothers are at risk of having poor neonatal outcome and morbidities like NNS, NNJ, RDS, apnea, IUGR, birth asphyxia, anemia and seizure. JNGMC, Vol. 14 No. 2 December 2016, Page: 56-59

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Perinatal outcome associated with oligohydramnios in third trimester

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164635 ◽

2016 ◽

Vol 6 (1) ◽

pp. 72 ◽

Cited By ~ 1

Author(s):

Kamlesh R. Chaudhari ◽

Kushagra R. Chaudhari ◽

Omkar M. Desai

Keyword(s):

Birth Weight ◽

Amniotic Fluid ◽

Apgar Score ◽

Neonatal Morbidity ◽

Fetal Distress ◽

Fetal Outcome ◽

High Rate ◽

Research Centre ◽

Meconium Staining ◽

Nicu Admission

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.

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Decision to Incision and Risk for Fetal Acidemia, Low Apgar Scores, and Hypoxic Ischemic Encephalopathy

American Journal of Perinatology ◽

10.1055/s-0040-1717068 ◽

2020 ◽

Author(s):

Sabine Bousleiman ◽

Dwight J. Rouse ◽

Cynthia Gyamfi-Bannerman ◽

Yongmei Huang ◽

Mary E. D'Alton ◽

...

Keyword(s):

Umbilical Cord ◽

Apgar Score ◽

Hypoxic Ischemic Encephalopathy ◽

Apgar Scores ◽

Fetal Heart Rate Monitoring ◽

Emergency Cesarean ◽

Increased Risk ◽

Secondary Outcomes ◽

Ischemic Encephalopathy ◽

Umbilical Cord Ph

Objective This study aimed to assess risk for fetal acidemia, low Apgar scores, and hypoxic ischemic encephalopathy based on decision-to-incision time interval in the setting of emergency cesarean delivery. Study Design This unplanned secondary analysis of the Maternal–Fetal Medicine Units prospective observational cesarean registry dataset evaluated risk for hypoxic ischemic encephalopathy, umbilical cord pH ≤7.0, and Apgar score ≤4 at 5 minutes based on decision-to-incision time for emergency cesarean deliveries. Cesarean occurring for nonreassuring fetal heart rate monitoring, bleeding previa, nonreassuring antepartum testing, placental abruption, or cord prolapse was classified as emergent. Decision-to-incision time was categorized as <10 minutes, 10 to <20 minutes, 20 to <30 minutes, 30 to <50 minutes, or ≥50 minutes. As secondary outcomes umbilical cord pH ≤7.1, umbilical artery pH ≤7.0, and Apgar score ≤5 at 5 minutes were analyzed. Results Of 5,784 women included in the primary analysis, 12.4% had a decision-to-incision interval ≤10 minutes, 20.2% 11 to 20 minutes, 14.9% 21 to 30 minutes, 18.2% 31 to 50 minutes, and 16.5% >50 minutes. Risk for umbilical cord pH ≤7.0 was highest at ≤10 and 11 to 20 minutes (10.2 and 7.9%, respectively), and lowest at 21 to 30 minutes (3.9%), 31 to 50 minutes (3.9%), and >50 minutes (3.5%) (p < 0.01). Risk for Apgar scores ≤4 at 5 minutes was also higher with decision-to-incision intervals ≤10 and 11 to 20 minutes (4.3 and 4.4%, respectively) compared with intervals of 21 to 30 minutes (1.7%), 31 to 50 minutes (2.1%), and >50 minutes (2.0%) (p < 0.01). Hypoxic ischemic encephalopathy occurred in 1.5 and 1.0% of women with decision-to-incision intervals of ≤10 and 11 to 20 minutes compared with 0.3 and 0.5% for women with decision-to-incision intervals of 21 to 30 minutes and 31 to 50 minutes (p = 0.04). Risk for secondary outcomes was also higher with shorter decision-to-incision intervals. Conclusion Shorter decision-to-incision times were associated with increased risk for adverse outcomes in the setting of emergency cesarean. Key Points

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Justification of Cesarean section in fetal distress: Experience in a tertiary care military hospital in Bangladesh

BIRDEM Medical Journal ◽

10.3329/birdem.v10i1.44762 ◽

2019 ◽

Vol 10 (1) ◽

pp. 60-63

Author(s):

Shakila Khanum ◽

Liza Chowdhury

Keyword(s):

Intensive Care ◽

Apgar Score ◽

Neonatal Intensive Care ◽

Neonatal Outcome ◽

Tertiary Care ◽

Fetal Distress ◽

High Rate ◽

Military Hospital ◽

Cross Sectional ◽

Heart Rate Pattern

Background: The trend of Caesarean section (CS) carried out is rising worldwide. One of the most common indications of CS is fetal distress which is based on the cardiotocograph (CTG) recording, abnormal fetal heart rate pattern and meconium stained liquor. The aim of this study was to carry out an audit of CS performed due to fetal distress in a tertiary care military hospital with a view to justify the methods for diagnosis of fetal distress to fetal outcome. Methods: This cross-sectional observational study was carried out over a period of 1 year and 6 months (July 2013 to January 2015) in the Combined Military Hospital (CMH), Dhaka. All pregnant women at or beyond 37 weeks of gestation who underwent CS for fetal distress were included. Neonatal outcome were assessed based on APGAR score and neonatal intensive care admission. Results: Among the 260 (100%) women who underwent CS due to fetal distress, mean age was 27.8 ± 5.3 years. More than half (54.6%) of the women were primigravida. Majority (48%) of the patients presented with spontaneous onset of labor and in 43% cases labor was induced by medical methods. In the majority (40%) of the patients, fetal distress was diagnosed by seeing abnormal patterns in CTG. During CS, signs of fetal distress was found in the majority (64.6%) of the patients (meconium stained liquor 42.3%, cord abnormality 13.5% and placental abnormality 8.8%). APGAR score of the newborn babies was abnormal (<7) in the majority (60%) cases. More than half of the newborn babies required admission in neonatal intensive care unit for different diagnosis. There was only 4 (1.5%) cases of neonatal death. Conclusion: The rate of CS for fetal distress in this study was comparable to other study findings and within recommendation of WHO. The high rate of identifiable causes of fetal distress as well as neonatal outcome justifies doing CS in these cases. Birdem Med J 2020; 10(1): 60-63

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Food habits and Pregnancy outcomes

10.21203/rs.3.rs-132630/v1 ◽

2021 ◽

Author(s):

Devdatt Pitale

Keyword(s):

Socioeconomic Status ◽

Birth Weight ◽

Nutritional Status ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Food Habits ◽

P Value ◽

Age Group ◽

Maternal Nutritional Status ◽

Nicu Admission

Abstract Introduction: Nutrition during pregnancy plays an important role for an optimum outcome of pregnancy. Women may be malnourished even before they become pregnant and this may further adversely affect the pregnancy. Maternal undernutrition can lead to poor intrauterine growth and low weight of the baby at birth. Moreover, the leading causes for maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. Aim of the Study: To study the impact of existing food habits on pregnancy outcome in a south Indian population. Materials and Methods: This prospective study was conducted at a tertiary health care and research institute in India. From the antenatal clinic, 350 women who satisfied the following inclusion and exclusion criteria were admitted to the study. Results: The majority of pregnant women belonged to the age group of 21-25 yrs (47%) followed by the 26-30 yrs age group (40%).The number of teenage pregnancies was 30 (8%) whereas 5% of pregnant women belong the age group of 31-35 yrs.83% of the study population belonged to the low socioeconomic class. Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kgs. 29 % of babies had birth weight in the range of 3-3.5 kgs. There was a significant association (p value < 0.05) between the socioeconomic status of the mother, parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status, the birth weight of the baby and the need for NICU admission (p value < 0.05). Conclusion: Maternal food habits have an impact on the pregnancy outcome. Maternal food habits are influenced by many factors like socioeconomic status, parity, social food taboos and pregnancy itself. The pregnancy outcomes like birth weight, need for NICU admission and postnatal complications are influenced by maternal nutritional status.

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Effects of Hypertensive Disorders of Pregnancy On The Mortality and Complications in Very Low Birth Weight Neonates

10.21203/rs.3.rs-742435/v1 ◽

2021 ◽

Author(s):

Baoquan Zhang ◽

Xiujuan Chen ◽

Changyi Yang ◽

Huiying Shi ◽

Wenlong Xiu ◽

...

Keyword(s):

Mechanical Ventilation ◽

Risk Factor ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Apgar Score ◽

Very Low Birth Weight ◽

Fetal Distress ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

Abstract Purpose This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the mortality and complications in very low birth weight neonates. Methods Premature infants at a gestational age of < 37 weeks with a birth weight of < 1,500g were included in this retrospective analysis. Gestational age-matched pregnant women with normal blood pressure giving birth to a very low birth weight neonate served as normal control. HDP neonates were divided into three subgroups based on the disease severity, including gestational hypertension, pre-eclampsia and eclampsia. Then we compared the incidence of complications among three subgroups. We also analyzed the relationship between the subgroups and the neonatal prognosis. Results The incidence of fetal distress, small for gestational age (SGA), mechanical ventilation, neonatal respiratory distress syndrome (RDS), neonatal necrotizing enterocolitis (NEC, ≥ 2 stage), and mortality in HDP group were significantly higher than those of the control. The 1 min Apgar score in HDP group was significantly lower than that of the normal control (P < 0.05). There were significant differences in fetal distress, 1 min Apgar score, mechanical ventilation, RDS and NEC (≥ 2 stage) among HDP, pre-eclampsia and eclampsia subgroups (P < 0.05). Multivariate regression analysis indicated that pre-eclampsia was an independent risk factor for SGA (OR = 4.123, 95%CI: 2.783–6.109) and NEC (OR = 2.493, 95%CI: 1.161–5.351). Eclampsia was a risk factor for SGA (OR = 3.804, 95%CI: 1.239–11.681) and NEC (OR = 7.264, 95%CI: 1.771–29.797). Conclusions HDP may affect the prognosis of very low birth weight neonates. Pre-eclampsia and eclampsia were risk factors for SGA and NEC.

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