Amniotic fluid and cord plasma erythropoietin levels in pregnancies complicated by preeclampsia, pregnancy-induced hypertension and chronic hypertension

2004 ◽  
Vol 32 (3) ◽  
Author(s):  
K.A. Teramo ◽  
V.K. Hiilesmaa ◽  
R. Schwartz ◽  
G.K. Clemons ◽  
J.A. Widness
Author(s):  
Hemalatha S. ◽  
S. M. Shaheedha ◽  
Ramakrishna Borra

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.


Author(s):  
Richa Rathoria ◽  
Ekansh Rathoria ◽  
Utkarsh Bansal ◽  
Madhulika Mishra ◽  
Ila Jalote ◽  
...  

Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Addisu Ginbu Dubie ◽  
Mehretie Kokeb ◽  
Abraham Tarkegn Mersha ◽  
Chilot Desta Agegnehu

Abstract Background Perinatal asphyxia is one of the leading causes of neonatal mortality and morbidity in Ethiopia. Understanding associated factors of perinatal asphyxia are important to identify vulnerable groups and to improve care during the perinatal period. Thus, this study aimed to assess the prevalence and associated factors of perinatal asphyxia among newborns admitted to NICU at the Gondar University Comprehensive Specialized Hospital Northwest Ethiopia, Ethiopia. Method Institutional based cross-sectional study was conducted on 364 newborns from November 2018 - August 2019. Data was collected using a structured and pre-tested questionnaire. It was then cleaned, coded, and entered using EPI INFO version 7, then analyzed with SPSS statistics version 20.0. Binary logistic regression analysis was used to identify variables with p < 0.2. An adjusted odds ratio (AOR) with a 95% CI and P-value of <0.05 was used to identify significantly associated variables with perinatal asphyxia. Result The prevalence of perinatal asphyxia in this study was 19.8, 95%CI (15.9, 24.2). Absence of maternal formal education (AOR = 4.09, 95%CI: 1.25, 13.38), pregnancy-induced hypertension (AOR = 4.07, 95%CI: 1.76, 9.40), antepartum hemorrhage (AOR = 6.35, 95%CI: 1.68, 23.97), prolonged duration of labor (AOR = 3.69, 95%CI: 1.68, 8.10), instrumental delivery (AOR = 3.17, 95%CI: 1.22, 8.21), and meconium-stained amniotic fluid (AOR = 4.50, 95%CI: 2.19, 9.26) were significantly associated with perinatal asphyxia. Conclusion The prevalence rate of perinatal asphyxia in this study was comparable to other resource poor countries. The absence of maternal formal education, pregnancy-induced hypertension, and Antepartum hemorrhage, prolonged duration of labor, Instrumental assisted delivery, and meconium-stained amniotic fluid was having significant association with perinatal asphyxia in this study.


2021 ◽  
Vol 8 (06) ◽  
pp. 5490-5497
Author(s):  
Ifeoma Anne Njelita ◽  
Chinyerem Cynthia Nwachukwu ◽  
Gabriel Ifeanyi Eyisi ◽  
Josephat Chukwudi Akabuike Akabuike ◽  
Chijioke Amara Ezenyeaku ◽  
...  

Background: Preeclampsia is a pregnancy-related disorder. Symptoms commonly associated with it include elevated blood pressure, protein in the urine and leg swelling. It is one of the leading causes of maternal and fetal morbidity and mortality especially in limited resource settings. This study was aimed at determining the risk factors for preeclampsia in a tertiary hospital in south east Nigeria.                                                                                                                         Methods:  This was a retrospective case-control study carried out at Chukwuemeka Odumegwu Ojukwu University teaching hospital Awka, south east of Nigeria. There were 50 cases with 100 controls. Data was retrieved from hospital case notes of both cases and controls. Tables were used to illustrate the descriptive statistics comparing the cases and controls. Categorical variables were compared using the Chi-square test. To ascertain the determinants of preeclampsia, Univariate and multivariate logistic regression analyses were conducted.                                                                                              Results: Maternal age less than 30 years, lower educational status, primigravida, previous history of pregnancy induced hypertension, polyhydramnios, maternal obesity, chronic hypertension, diabetes, and family history of preeclampsia were predictive of preeclampsia (Adjusted odds ratio (AOR) = 2.50, 9.08, 20.25, 76.47, 5.11, 7.53, 2.73, 10.78, and 3.57 respectively).                                        Conclusions: The identified determinants of preeclampsia from this study especially previous history of pregnancy induced hypertension, primigravida, family history of preeclampsia among others should serve as a basis for the screening of antenatal clinic attendees for preeclampsia. This will serve to identify at risk pregnant women, and enhance early diagnosis and intervention to improve feto-maternal outcomes.


2021 ◽  
Author(s):  
Yeonseong Jeong ◽  
Yun Ji Jung ◽  
Eunjin Noh ◽  
Geum Joon Cho ◽  
Min-Jeong Oh ◽  
...  

Abstract Background: Physiologic changes during pregnancy affect the development of postpartum cerebrovascular disease (CVD) in women with Moyamoya disease (MMD). Due to the rare prevalence of MMD and large regional variations, large-scale studies on the risk of CVD after delivery have not been conducted. The aim of this study was to evaluate whether women with MMD have an increased risk of CVD after delivery.Methods: Research data was collected from the National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients delivered in Korea from 2007 to 2014 were enrolled. We classified women as CVD if they were diagnosed with stroke and/or cerebral infarction and/or intracranial hemorrhage and/or subarachnoid hemorrhage between delivery and December 31, 2016. To evaluate adjusted hazard ratio for CVD in women with MMD, we used multivariate Cox proportional hazard regression.Results: Among 3,611,216 Korean women who had delivery, 382 had Moyamoya disease. When compared to women without MMD, women with MMD had a higher prevalence of pregestational diabetes and chronic hypertension. Also, women with MMD had a significantly higher incidence of cesarean section, pregnancy-induced hypertension, and gestational diabetes mellitus (p<0.0001, <0.0001, 0.02, respectively). Among women with MMD, a total of 246(64.4%) women developed CVD within the follow-up postpartum period, and 87.8% occurred within 2 years of postpartum. Women with MMD were associated with an increased risk of CVD in later (adjusted HR 108.24; 95% CI, 95.37-122.86) after adjusting for maternal age, parity, pregnancy-induced hypertension, gestational diabetes mellitus, pregestational diabetes, chronic hypertension.Conclusion: Our study showed that the incidence of CVD after delivery was higher in women with MMD. Therefore, we have to have more cautions of women with MMD and provide long-term postpartum surveillance


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dafang Yu ◽  
Lihua Zhang ◽  
Shimin Yang ◽  
Qing Chen ◽  
Zhongliang Li

Abstract Background China was one of the few countries to achieve the Millennium Development Goals 5. China had taken many effective measures to reduce maternal mortality ratio (MMR) and has achieved encouraging progress. These measures were worth sharing for other countries to reduce the MMR, but the introduction of these measures from the national perspective was too grand, and the measures implemented in a city and the results achieved were more valuable. However, there were few studies on the prevalence and trends of prolonged maternal mortality in a city. In this study, we mainly introduced the prevalence of the MMR in Jinan,China from 1991 to 2020, analyzed the causes of trends and put forward some solutions to the difficulty existing in the process of reducing the MMR,hoping to serve as a model for some developing cities to reduce MMR. Methods We collected maternal mortality data from paper records, electronic files and network platforms. The time trend of MMR was tested by Cochran-Armitage Test (CAT). We divided the study period into three stages with 10 years as a stage and the Chi-square test or Fisher’s exact test was used to test the difference in MMR of different periods. Results From 1991 to 2020, We counted 1,804,162 live births and 323 maternal deaths, and the MMR was 17.93 per 100,000 live births. The MMR declined from 44.06 per 100,000 live births in 1991 to 5.94 per 100,000 live births in 2020, with a total decline of 86.52% and an annual decline of 2.89%. The MMR declined by 88.54% in rural areas, with an average annual decline 2.95%, faster than that in urban areas (82.06, 2.73%). From 1991 to 2020, the top five causes of maternal deaths were obstetric haemorrhage (4.55 per 100,000 live births), amniotic fluid embolism (3.27 per 100,000 live births), pregnancy-induced hypertension (2.61 per 100,000 live births), heart disease (2.33 per 100,000 live births) and other medical complications (2.05 per 100,000 live births). Postpartum hemorrhage, amniotic fluid embolism, pregnancy-induced hypertension showed a downward trend (P < 0.05) and other medical complications showed an upward trend (P < 0.05). Conclusions Subsidy for hospitalized delivery of rural women, free prenatal check-ups for pregnant women and rapid referral system between hospitals have contributed to reducing MMR in Jinan. However, it was still necessary to strengthen the treatment of obstetric hemorrhage by ensuring blood supply, reduce the MMR due to medical complications by improving the skills of obstetricians to deal with medical diseases, and reduce the MMR by strengthening the allocation of emergency equipment in county hospitals and the skills training of doctors.


Author(s):  
Khalil Jamil Elqatrawi ◽  
Ashraf Yaqoub Eljedi

Aims: To identify the possible effects of hypertensive disorders of pregnancy (HDP) on maternal health outcomes of women attended primary health care centers (PHCCs) in Gaza Strip – Palestine. Study Design:  A cross-sectional comparative design. Place and Duration of Study: The study was conducted at 6 PHCCs from August 2016 to May 2017. Methodology: Two groups of 215 hypertensive mothers and 215 normotensive mothers in the last pregnancy were recruited by 3-stage stratified random sampling technique. A detailed questionnaire filled through face to face interviews in addition to medical records revision in 2017. Pearson's Chi-square and t-tests were used to compare the outcomes between the two groups. Results: HDP in 215 women were classified as pregnancy-induced hypertension (n = 153, 71.2%) and chronic hypertension (n = 62, 27.8%). The mean age of HDP women was 28.8 ± 6.8 years. About 40.9% live in refugee camps; 23.7% had gravida ≥ 7; 54.6% had BMI > 30 and 21.9% had a history of twice or more abortions. Only 20% of HDP women received preconception care. Cesarean section and assisted delivery were significantly higher among hypertensive mothers (37.2% and 26.9%) compared with non-hypertensive (16.3% and 8.4%) respectively (P = 0.001). Incidence of preeclampsia/eclampsia, antepartum hemorrhage and postpartum hemorrhage, were significantly higher among HDP women (29.3%, P = 0.001; 14%, p=0.001; 7%, P = 0.003 respectively) while no significant differences in abrupio placenta (0.9%; P = 0.25), placenta previa (0.5%, P = 0.75) HELLP syndrome (0.9%, P = 0.24) were found between the two groups. 20.9% mothers with pregnancy-induced hypertension were not recovered and developed chronic hypertension. Conclusion: Women with HDP are at higher risk to have adverse maternal outcomes compared to normotensive women in GS. Preconception care, early diagnosis and prenatal follow-up would improve maternal and fetal prognosis.


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