scholarly journals Role of cardiotocography in high risk pregnancy and its correlation with increase cesarean section rate

2016 ◽  
Vol 6 (1) ◽  
pp. 168 ◽  
Author(s):  
Manisha Gupta ◽  
Punit Gupta
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
High Risk Pregnancy ◽  
Cesarean Section Rate ◽  
Reactive Group ◽  
Risk Pregnancy ◽  
Nicu Admission

Background: FHR monitoring plays the most important role in management of labouring patient when incidence of fetal hypoxia and progressive asphyxia increases. Now a day’s cardiotocography (CTG) become a popular method for monitoring of fetal wellbeing and it is assisting the obstetrician in making the decision on the mode of delivery to improve perinatal outcome. The aim of the study was to assess the effect of cardiotocography on perinatal outcome and its correlation with caesarean section rate.Methods: In this prospective observational study 201 gravid women with high risk pregnancy in first stage of labour were taken. Result was assessed in the form of Apgar score at five minute, NICU admission, perinatal mortality and mode of delivery. Statistical analysis is done by using Chi square test and p<0.05 is considered as statistically significant.Results: Perinatal morbidity in the form of NICU admission is higher in nonreactive group as compare to reactive group (75.7% v/s 22.8%). Cesarean section rate for fetal distress were higher in nonreactive group (87.8%) in comparison to reactive group (20.5%). So this study suggest that there is significant difference in mode of delivery with increasing chances of caesarean section in cases belong to non-reactive traces (p<0.001).Conclusions: Admission test is non-invasive and the best screening test to evaluate the fetal health and to predict the perinatal outcome but it also associated with increase caesarean section rate.

scholarly journals Admission cardiotocography: Forecasting perinatal outcome

2021 ◽  
Vol 8 (2) ◽  
pp. 158-161
Author(s):  
Nity ◽  
Asima Das
Keyword(s):  
High Risk ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Admission Test

The Admission test (AT) in high risk pregnancy for continuous monitoring of FHR (fetal heart rate) has become crucial in the modern day obstetric practice. As it senses the presence of fetal intrapartum hypoxia and assist the obstetrician in making decision on the mode of delivery to improve perinatal outcome in high risk pregnancy.A prospective observational study was carried out in 230 pregnant women with high risk pregnancy in KIMS BBSR, Odisha during period of 2018-2020 who were admitted to labor room with gestational age more than 33 weeks for continuous FHR monitoring with CTG (cardiotocography) for 20 minutes.Among 230 patients majority of them were primigravida in age group of 21-25 years. About 39.1% were postdated pregnancy followed by Pregnancy Induced Hypertension (PIH) (21.1%), Premature Rupture of the Membranes (PROM) (10.4%), Bad Obstetric History (BOH) (6.9%), PIH with IUGR (Intrauterine Growth Restriction) (6.5%), IUGR (5.6%), Oligohydramnios (4.3%), Diabetes (3.5%) and Rh negative pregnancy (2.6%). The admission test were normal in (68.7%), suspicious in (21.7%) and pathological in (9.6%). The incidence of fetal distress, meconium stained liqour, NICU (Neonatal Intensive Care Unit) admission and APGAR score less than 7 was significantly higher with pathological AT as compared with suspicious and normal AT.The admission CTG appears to be simple noninvasive tool for screening the high risk pregnancy and prioritizing fetuses and deciding the mode of delivery.

scholarly journals A study on maternal and perinatal outcome of oligohydramnios in term low risk pregnancy

2019 ◽  
Vol 8 (11) ◽  
pp. 4346
Author(s):  
Sripreethika Rajavelu ◽  
Vinitra Dayalan ◽  
Surya S.
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Low Risk ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
Nicu Admission

Background: Oligohydramnios is a frequent complication of pregnancy that is associated with increased perinatal morbidity and mortality. Once diagnosed; oligohydramnios should further lead to intensive fetal surveillance including ultrasound evaluation. The aim of the study was to determine obstetric outcome in term low risk pregnancy with AFI less than or equal to 5 and to assess whether antepartum oligohydramnios is associated with adverse perinatal outcome.Methods: 200 patients in third trimester in the hospital with evidence of oligohydramnios (AFI less than or equal to 5) were selected after satisfying inclusion and exclusion criteria and studied prospectively. Observations regarding the outcome of labour in form of maternal and perinatal parameters including AFI value, CTG features, mode of delivery, LSCS rate, meconium stained, APGAR score, birth weight and NICU admission were made.Results: Overall perinatal outcome with respect to CTG, 128 (64%) out of 200 patients had non-reactive CTG and only 72 (36%) had reactive CTG. 128 (64%) of non-reactive CTG delivered by LSCS, 72 (36%) delivered by labour natural. Nil labour natural in the subset of AFI 1 to 2, birth weight (<2.5 kg-8% and >2.5 kg-92%), Apgar score (<7 at 1-5 mins:18%), still birth (1%), meconium (58.5%), NICU admission (6%) and perinatal mortality (2%).Conclusions: AFI measurement of less than 5 cm detected after 37 completed weeks of gestation with a low risk pregnancy is found to be an indicator of adverse pregnancy outcome with higher fetal distress, meconium stained liquor and higher caesarean section rate. AFI assessment serves as an important tool and remains as an effective screening test in predicting fetal distress in labour that requires caesarean section.

scholarly journals Outcome of pregnancy among high risk pregnancies in rural area of Nagpur, Central India

2017 ◽  
Vol 4 (3) ◽  
pp. 628
Author(s):  
Ashok Rupraoji Jadhao ◽  
Mahendra D. Gawade ◽  
Suresh N. Ughade
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Rural Area ◽  
Mode Of Delivery ◽  
Central India ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
History Of

Background: All pregnant women, by virtue of their pregnancy status, face some level of maternal risk. Some pregnancies are complicated by problems associated with mother’s health. Most maternal morbidities could be prevented if mother had access to appropriate and timely healthcare during pregnancy. Study was intended to find out prevalence of high risk pregnancy and pregnancy outcome among them in rural area of Nagpur district, Central India.Methods: Community based observational descriptive study was conducted on consecutive sample of 214 pregnant women, who had 20 weeks and above gestational period.Results: Prevalence of high risk pregnancy observed was 33.64% (95% CI 27.31%-39.97%). Caesarean section (OR=7.63, 95% CI=4.04-14.40, P=0.0001) and birth weight less than 2500gm (OR= 3.47, 95% CI=1.47-8.20, P=0.003) were significantly associated with high risk pregnancy. Mode of delivery caesarean section had strong relationship with previous history of caesarean section (OR=37.53, 95% CI=8.64-163.05, P=0.0001) and mothers height less than or equal to 140cm (OR=8.87, 95% CI=1.02-77.32, P = 0.0183). Pregnancy outcome low birth weight was significantly associated with oligohyramnios (OR = 8.45, 95 % CI=1.61-44.48, P=0.003) and history of caesarean section (OR=2.67, 95 % CI=1.01-7.07, P = 0.041).Conclusions: Prevalence of high risk pregnancy was almost one-third in pregnant women in rural area of central India. Mode of delivery caesarean section and birth weight less than 2500gm was significantly associated with high risk pregnancy. History of caesarean section and height less than or equal to 140 cm influence the outcome of pregnancy i.e. caesarean section. Birth weight, LBW (Low Birth Weight) was associated with history of caesarean section and oligohyramnios.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

scholarly journals COLOUR DOPPLER EVALUATION IN HIGH-RISK PREGNANCY AND PERINATAL OUTCOME

2018 ◽  
Vol 7 (43) ◽  
pp. 4603-4608
Author(s):  
Harshika Singh ◽  
Manjusha Agrawal ◽  
Arvind Bhake ◽  
Nihar Gupta
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
Risk Pregnancy ◽  
Doppler Evaluation

scholarly journals COMPARISON OF INTRAPARTUM CARDIOTOCOGRAPHY & OBSTETRIC DOPPLER IN PREDICTING PERINATAL OUTCOME IN HIGH RISK PREGNANCY

2020 ◽  
pp. 1-3
Author(s):  
Karishma Gandhi ◽  
Ishit Shah ◽  
Ram Kumar Patidar
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Normal Delivery ◽  
Risk Pregnancy ◽  
Fetal Wellbeing ◽  
Adverse Fetal Outcome

Background: High risk pregnancy needs special antepartum as well as intrapartum care and investigations. CTG is aadmissionscreening test to monitor fetal wellbeing by use of cardiotocograph. It monitors fetal heart rate and uterine contractions. Color Doppler is ultrasound dependent test which uses vascular flow velocities and Doppler waveform to predict fetal outcome. Objective: Comparison of efficiency of CTG & Color Doppler ultrasound for intrapartum fetal surveillance in high risk pregnancy. Methods: Retrospective study of 100 high risk pregnancies of ≥ 34 weeks POG in labor with CTG and color Doppler findings were done on admission at Gujarat Adani Institute of Medical Sciences, Bhuj. Subjects were classified into 4 groups based on CTG and color Doppler findings. Maternal and fetal outcome were recorded and correlated with CTGand color Dopplerfindings. Results: Most common cause of high-risk pregnancy was preeclampsia(n=60/100,60%).In our study, rate of normal delivery was 40% and c-section was 60% (31% elective & 29% emergency). Out of 100 fetuses, 76 were healthy, 22 were admitted in NICU (6 NICU deaths) and 2 were still birth. Perinatal outcome was most favorable with normal CTG and Color doppler and was least favorable with both of them abnormal. Outcome was intermittent in other two groups. CTG found to have sensitivity 62.5% and specificity 82.5% in detection of adverse fetal outcome. Similarly,sensitivity and specificity of color doppler was 48.8% and 98.6% respectively. Conclusions: In our study it was found that CTG is more sensitive and color Doppler is more specific in detection of adverse fetal outcome.

scholarly journals High risk scoring in pregnancy using modified Coopland’s scoring system and its association with perinatal outcome

2021 ◽  
Vol 10 (4) ◽  
pp. 1608
Author(s):  
Shobha S. Pillai ◽  
Swapna Mohan
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Perinatal Outcome ◽  
Risk Group ◽  
Cost Effective ◽  
High Risk Group ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Significant Difference ◽  
Risk Scoring

Background: High-risk pregnancy is one in which the mother, foetus or the newborn has an elevated risk of experiencing an adverse outcome. These high-risk women form a special vulnerable cohort that can be identified in the antenatal period using a simple, easy to use, cost-effective tool- a maternal risk scoring system. Early identification of these high-risk mothers will facilitate effective intervention strategies to deal with the complications.Methods: This study was carried out on 300 pregnant women with gestational age more than 28 weeks. Detailed history, examination and necessary investigations were done and then using the Modified Coopland scoring system, each pregnant woman was assigned a risk score and stratified into 3 risk groups- low risk (0-3), moderate risk (4-6) and high risk (≥7) and followed up till delivery and 7 days postpartum. Subsequently, the maternal and perinatal outcomes were compared with their respective scores.Results: In this study, 14.66% patients belonged to the high-risk category. Statistically, a significant difference was noted in the number of low-birth-weight babies, in 5 minutes APGAR score <7 and in NICU admissions in the high-risk group compared to the low-risk group. Overall perinatal mortality was 13.33/1000 live births. In the high-risk group, a significant difference was seen in the occurrence of PPH and the need for operative delivery.Conclusions: Significant association between high-risk pregnancy and the poor maternal and perinatal outcome was noted. Therefore, a simple, cost-effective high-risk pregnancy scoring system such as the one proposed in this study can be used to identify potential high-risk pregnancies, provide them with tertiary care facilities and also corrective measures can be undertaken to prevent or minimize the complicating factors.

Role of Non-Stress Test and Doppler in Assessment of Perinatal Outcome in High-Risk Pregnancy

2012 ◽  
Vol 2 (8) ◽  
pp. 379-380
Author(s):  
Dr. Latika Mehta ◽  
◽  
Dr. Monark Vyas ◽  
Dr. Nilesh chauhan ◽  
Dr. Abhas Shah ◽  
...  
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Stress Test ◽  
High Risk Pregnancy ◽  
Risk Pregnancy
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