scholarly journals Prenatal 3RD Trimester Expectation of Fetal or Neonatal Demise and Perinatal Team Approach

2018 ◽  
Vol 8 (1) ◽  
pp. 14-19
Author(s):  
Michał Krekora ◽  
Mariusz Grzesiak ◽  
Maciej Słodki ◽  
Ewa Gulczyńska ◽  
Iwona Maroszyńska ◽  
...  
Keyword(s):  
Medical History ◽  
Congenital Malformations ◽  
Fetal Echocardiography ◽  
Difficult Problem ◽  
Team Approach ◽  
Final Decision ◽  
Neonatal Deaths ◽  
Tertiary Center ◽  
Practical Guidelines ◽  
Perinatal Management

Abstract INTRODUCTION: The aim of this study was to present our current practice of counseling patients and families with the most severe congenital malformations in the 3rd trimester of pregnancy and to develop practical guidelines for our team and involved healthcare/ socialcare professionals. MATERIAL & METHODS: It was a retrospective evaluation of a series of fetal cases in 2017 from single tertiary center. Maternal obstetrical medical history, time of prenatal detection of the anomaly (1st, 2nd or 3rd trimester), time between last fetal echocardiography and delivery, type of delivery, neonatal birth weight and time of neonatal demise. The total study group was subdived into early demise (during the 1st day after delivery) or late demise > 1st day after delivery. RESULTS: Mean maternal age was 30,4 +/- 5,6 years, and varied between 26 and 38 years. No chronic maternal diseases were found in medical history and no congenital malformations were present in previous children. All women had 1st trimester ultrasound, in 9 cases, it was reported as normal (with NT measurement < 2 mm), in 2 cases extracardiac abnormalities were detected: diaphragmatic hernia and omphalocele ( in both fetal karyotype 46,XY). In nine cases, the abnormalities were detected in midgestation and with maternal wish to continue the pregnancies. There were 8 neonatal deaths within 60 minutes after delivery, including one intrapartum death and 3 “late” neonatal deaths in the intensive care unit (on 12th, 21st and 22nd day). We stress upon the prenatal team approach and counseling of future parents, in order to prepare them for poor neonatal outcome. CONCLUSIONS: 1. In the most severe cases when fetal or neonatal demise was suspected, the two different opinions of specialists might not be enough and a third opinion should be recommended before final decision. 2. A Fetal Team of specialists is necessary in cases of expected fetal/neonatal demise in order to prepare a written report of recommended perinatal management for all sides involved in this difficult problem.

scholarly journals Congenital Malformations and Perinatal Deaths among the Children of Atomic Bomb Survivors: A Reappraisal

2021 ◽  
Author(s):  
Michiko Yamada ◽  
Kyoji Furukawa ◽  
Yoshimi Tatsukawa ◽  
Keiko Marumo ◽  
Sachiyo Funamoto ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Radiation Effects ◽  
Atomic Bomb ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Atomic Bomb Survivors ◽  
Parental Exposure ◽  
Increased Risk ◽  
Major Congenital Malformations

Abstract From 1948 to 1954, the Atomic Bomb Casualty Commission conducted a study of pregnancy outcomes of children of atomic bomb survivors who had received radiation doses from zero to near-lethal levels. Past reports (1956, 1981, and 1990) on the cohort did not identify significant associations of radiation exposure with untoward pregnancy outcomes such as major congenital malformations, stillbirths, or neonatal deaths, individually or in aggregate. We have re-examined the risk of major congenital malformations and perinatal deaths in the children of the atomic bomb survivors (N=71,603) using fully reconstructed data to minimize the potential for bias, with refined estimates of the gonadal dose from the Dosimetry System 2002 and refined analytical methods for characterizing dose-response relationships. The analyses show that parental exposure is associated with increased risk for major congenital malformations and perinatal deaths, but the estimates are imprecise for direct radiation effects and most are not statistically significant. Nonetheless, the uniformly positive estimates for untoward pregnancy outcomes among children of both maternal and paternal survivors are useful for risk assessment purposes, although extending them to circumstances other than atomic bomb survivors comes with uncertainty as to the generalizability of the Hiroshima and Nagasaki populations.

Mechanisms of Congenital Malformations. Proceedings of the Second Scientific Conference of the Association for the Aid of Crippled Children (1954)

PEDIATRICS ◽  
1957 ◽  
Vol 19 (3) ◽  
pp. 536-536
Author(s):  
JOSEF WARKANY
Keyword(s):  
Environmental Factors ◽  
Congenital Malformations ◽  
Scientific Conference ◽  
Neonatal Deaths ◽  
Present Volume ◽  
Physical Chemical

For many years the Association for the Aid of Crippled Children has supported teratologic research in many ways. Among the activities of the Association scientific conferences and publication of their proceedings play an important role. In the present volume one will find brief summaries of papers presented at a conference in 1954 and abstracts of the discussions contributed by the participants. Part I dealing with physical, chemical and sociological aspects of the fetal environment contains an interesting report by J. Walker of Aberdeen, Scotland, on the effects of obstetrical, physical and environmental factors on the incidence of stillbirths, neonatal deaths and prematurity.

scholarly journals Spectrum of Neonatal Surgical Problems in the Newborn: Incidence, Clinical Course, Immediate Outcome, Follow up Study in a Tertiary Care NICU

2019 ◽  
pp. 1-9
Author(s):  
K. G. Sachin ◽  
K. R. Sachin ◽  
H. Ramesh ◽  
Guru Prasad ◽  
Harsha Bullapur
Keyword(s):  
Congenital Anomalies ◽  
Congenital Malformations ◽  
Population Control ◽  
Tertiary Care ◽  
Relevant Information ◽  
The United States ◽  
Physical Structure ◽  
Neonatal Deaths ◽  
Medical College

Background: A congenital anomaly may be defined in terms of physical structure as a malformation, an abnormality of physical structure or form usually found at birth or during the first few weeks of life. Congenital anomalies affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. Congenital anomalies or birth defects are relatively common, affecting 3% to 5% of live births in the United States (US) and 2.1% in Europe. Congenital anomalies account for 8% to 15% of perinatal deaths and 13% to 16% of neonatal deaths in India. Objectives: To provide an insight on the burden and types of surgical problems encountered in our NICU of Bapuji Child Health Institute & Research Center, JJM Medical College, Davangere, Karnataka, India and to study the incidence, clinical profile and outcome of surgical condition. Methodology: A total of 3820 babies were examined over a period of 2 years. The relevant information was documented on a semi-structured proforma and analysed. Results: Overall incidence of congenital malformations at birth was 24.8 per 1000 births. The GIT system (51.58%) was most commonly involved followed by respiratory system (26.32%). The incidence of congenital malformation was more in male babies than female babies. Increased frequency was seen in babies born to mothers between 26–30 years & primigravida. The factors which significantly increased the rate of congenital malformations were consanguinity in parents & bad obstetric history. Out of 95 cases, 72% got discharged normally, 18% died in NICU and 10% got discharged against medical advise. Conclusion: With emphasis on “small family” norms and population control it is necessary to identify malformations so that interventional programmes can be planned. Systematic clinical examination of newborns for early detection of anomalies that may warrant medical or surgical intervention. Accurate antenatal anomaly scan need to be done to identify major malformations and terminate the pregnancy.

scholarly journals Analysis of neonatal mortality in Tomsk

2003 ◽  
Vol 2 (3) ◽  
pp. 99-102
Author(s):  
T. Ye. Tropova ◽  
T. S. Krivonogova ◽  
L. A. Matveyeva ◽  
R. A. Zlobina
Keyword(s):  
Medical Care ◽  
Neonatal Mortality ◽  
Congenital Malformations ◽  
Neonatal Deaths ◽  
New Born ◽  
Article Analysis

Dynamics of neonatal mortality in Tomsk within the period of 1999—2001 has been analyzed in the article. Analysis has been made according to the T. Kern’s method by G.S. Muchiyev’s and O.G. Frolova’s modification. This method permits to evaluate the dynamics of neonatal mortality from the viewpoint of its averting and gives opportunities to reveal the errors at all stages of medical care of women and new-born children. 170 cases of neonatal deaths have been analyzed. There has been marked the decrease of both early and common neonatal mortality due to avertable reasons. Unavertable death reasons tend to increase due to congenital malformations. Ways of the further decrease of neonatal mortality have been defined.

scholarly journals A review of garbhavikruti

2019 ◽  
Vol 7 (06) ◽  
Author(s):  
Tanmay Laxman Rupanawar
Keyword(s):  
Congenital Malformation ◽  
Congenital Malformations ◽  
Genetic Disorders ◽  
Medical System ◽  
Health Issues ◽  
Neonatal Deaths ◽  
Infant Deaths ◽  
Social Risks ◽  
Indian Medical ◽  
In Pregnancy

The health of the nation depends on the health of its citizens. Data reveals that 3-5 % of all births result in congenital malformations, 20-30% of all infant deaths are due to genetic disorders and 30-50% of post neonatal deaths are due to congenital malformation.1 Ayurveda the ancient Indian medical system has given due emphasis on this and  postulated various measures to minimize the risks. The measures start well before conception. Proper pre conception preparations of the parents are essential pre-requisites for a healthy progeny. Biomedical behavioral of social risks to the health of the mother and the baby is identified by pre-conception care. It includes both prevention and management emphasizing health issues that require action before conception very early in pregnancy for maximum impact.

scholarly journals Placenta Accreta Overlying a Caesarean Section Scar: A 10-Year Experience in a Tertiary-Care Centre in Portugal

2021 ◽  
Vol 34 (4) ◽  
pp. 266
Author(s):  
Margarida Cal ◽  
Carla Nunes ◽  
Nuno Clode ◽  
Diogo Ayres-de-Campos
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Team Approach ◽  
Tertiary Center ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders

Introduction: Placenta accreta spectrum disorders are among the leading causes of maternal morbidity and mortality and their prevalence is likely to increase in the future. The risk of placenta accreta spectrum disorders is highest in cases of placenta previa overlying a previous cesarean section scar. Few studies have evaluated placenta accreta spectrum disorders in Portugal. The aim of this study was to review the cases of placenta accreta spectrum overlying a cesarean section scar managed in a Portuguese tertiary center over the last decade.Material and Methods: Retrospective, cross-sectional study, with data collected from hospital databases. Only cases with histopathological confirmation of placenta accreta spectrum were included.Results: During the study period, 15 cases of placenta accreta spectrum overlying a cesarean section scar were diagnosed (prevalence 0.6/1000). All cases were diagnosed antenatally. A transverse cesarean section was present in all cases; 13 were managed by a scheduled multidisciplinary approach, while two required emergent management. Total or subtotal hysterectomy was performed in 12 cases. There were no cases of maternal or neonatal death. Histopathological evaluation confirmed nine cases of placenta accreta, three cases of placenta increta and three cases of placenta percreta.Discussion: Early antenatal diagnosis is important for a programmed multidisciplinary management of these cases, which may reduce potential morbidity and mortality and ensure better obstetric outcomes.Conclusion: This case series of placenta accreta spectrum overlying a cesarean section scar reports the reality of a tertiary-care perinatal center in Portugal, in which no maternal or neonatal mortality due to placenta accreta spectrum was registered over the last decade; this may be attributed to prenatal diagnosis and a coordinated multidisciplinary team approach.

scholarly journals Nutrition in burns: A practical solution to a difficult problem

2006 ◽  
Vol 39 (01) ◽  
pp. 62-64
Author(s):  
M P Suri ◽  
C K Patel ◽  
VJ S Dhingra ◽  
S C Raibagkar ◽  
D R Mehta
Keyword(s):  
Enteral Nutrition ◽  
Difficult Problem ◽  
Early Enteral Nutrition ◽  
Team Approach ◽  
Practical Solution ◽  
Frequent Assessment

AbstractThe nutritional aspects of burns is an important but yet not properly looked after problem in the management of burns. We present our experience with dealing with such a problem giving a practical and easy to deliver solution to nutrition. Early enteral nutrition should be started with frequent assessment to the need of the patient and it requires a team approach.

scholarly journals A five year retrospective study on maternal and perinatal outcome in pregnancy after cardiac surgery

2018 ◽  
Vol 7 (5) ◽  
pp. 1949
Author(s):  
Swati Rathore ◽  
Ravi Shankar ◽  
Annie P. Vijjeswarapu ◽  
Anuja Abraham ◽  
Bijesh Yadav
Keyword(s):  
Cardiac Surgery ◽  
Retrospective Study ◽  
Nyha Class ◽  
Progressive Increase ◽  
Prior History ◽  
Team Approach ◽  
Atrial Septal Defect Closure ◽  
Tertiary Center ◽  
Neonatal Icu ◽  
Cardiac Status

Background: Pregnancy is a hypercoaguable state with physiological haemodynamic changes occurring during pregnancy. There is a progressive increase in intravascular volume in second trimester of pregnancy and increase in cardiac output. Pregnancy makes a significant impact on cardiovascular system. It is important to evaluate and study the effect of pregnancy on women with surgically corrected heart conditions so as to preempt potential complications.Methods: This is a retrospective study of patients with prior history of cardiac surgery and their pregnancy outcomes in a tertiary center of Southern India over a period of five years from January 2011 to December 2016.Results: In this study, descriptive statistical analysis was done in 87 women with pregnancy following cardiac surgery. 58.6% were nulliparous. Around 52% had associated obstetric risk factors. The most common cardiac surgery in this population was Mitral valve replacement (40.2%) and Atrial septal defect closure (37.9%). Women belonged to NYHA class I in 90.8% of cases. 58.6% had vaginal delivery and 36.8% had caesarean section. 6 women had postpartum haemorrhage which was medically managed, and 6 women needed ICU care.74.7% women had term deliveries. 18.4 % of the babies were less than 2.5 kg weight at birth. 13 babies required Neonatal ICU care.Conclusions: Maternal and neonatal outcome mainly depends on the functional cardiac status of women before conception. In this study we emphasize on the importance of multidisciplinary team approach involving cardiologist, obstetrician and neonatologist in the management of women with prior cardiac surgery.

scholarly journals Study of spectrum of cardiac disease complicating pregnancy and the maternal and foetal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4803
Author(s):  
Sudha R. ◽  
Anjali R.
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Cardiac Complications ◽  
Team Approach ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Foetal Outcome ◽  
Grade Iii

Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.

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