scholarly journals Labour admission test: a screening test for foetal distress in labour

2017 ◽  
Vol 6 (2) ◽  
pp. 452
Author(s):  
Mohd Rasheed ◽  
Ajay K. Srivastava
Keyword(s):  
Statistical Analysis ◽  
Predictive Value ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Well Being ◽  
P Value ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Short Period ◽  
Admission Test

Background: Labour is a very short period in the life of a foetus but poses the maximum threat. Improvements in medical technology have made it possible to monitor fetal well-being during labour. The introduction of labour admission test has proven to be of benefit in identifying patients at risk for developing distress and implementing timely intervention.Methods: The present study was undertaken to evaluate the same. This was a prospective study done on 500 patients above 37 weeks of gestation in cephalic presentation. EFM was done using oxford sonicaid 8002 CTG machine and Gem premier 3000 (model no 5700) arterial blood gas analyzer machine was used for determining the pH of fetal blood.Results: Statistical analysis was done using SPSS version 15.0 statistical analysis software. p value <0.001 was considered highly significant. Results revealed that a total of 105 (80.77%) babies had fetal distress in category II and III out of 135, whereas only 30 (8.11%) were distressed in category I out of 370. Test had a sensitivity of 77.7% and specificity of 93.15% with a positive predictive value of 80.7% and a negative predictive value of 91.89%.Conclusions: It has become evident that combined use of CTG with cord blood pH is more accurate way of predicting and diagnosing birth asphyxia.

scholarly journals Admission test as a screening test for fetal distress in labour

2018 ◽  
Vol 7 (3) ◽  
pp. 870
Author(s):  
Smitha B. Rao ◽  
Reena D’Souza ◽  
Bhavana Sherigar ◽  
Soumya R ◽  
Vismaya Kaveri ◽  
...  
Keyword(s):  
Screening Test ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Well Being ◽  
P Value ◽  
Care Hospital ◽  
Foetal Heart ◽  
Singleton Pregnancy ◽  
Admission Test

Background: This study was undertaken with the purpose of evaluating the efficacy of labour admission test as a screening test to identify the compromised fetus or fetus at risk and to correlate with perinatal outcome.Methods: This was a retrospective cohort study of 300 patients in 1st stage of labour admitted to labour room at tertiary care hospital over a period of one and a half years. Patients with Singleton pregnancy, Cephalic presentation & Gestational age beyond 34 weeks were included in this study. A BPL electronic foetal heart monitor was used to perform the admission test. With the patient in left lateral position a 20 minute continuous electronic recording (paper speed of 3 cm per minute) of foetal heart rate and uterine activity was obtained, on a cardiotocograph.Results: Statistical significance was calculated between different categories for different parameters too. A p value of of<0.05 was considered to be statistically significant. Fetal distress was seen 64.71% in Category III group 33.33% with Category II group and 4.74 % in Category I trace. admission test has 97.75% specificity and 95.5% negative predictive value.Conclusions: Admission test makes screening convenient. Since it is non-invasive, patients also cooperate. Admission test helps to plan subsequent management of labour. It is a good predictor of foetal well-being at the time of admission and for the next few hours.

Neutrophil gelatinase-associated lipocalin as a potential biomarker for pulmonary thromboembolism

2019 ◽  
Vol 45 (1) ◽  
pp. 51-56
Author(s):  
Songul Ozyurt ◽  
Mevlut Karatas ◽  
Medeni Arpa ◽  
Bilge Yilmaz Kara ◽  
Hakan Duman ◽  
...  
Keyword(s):  
Predictive Value ◽  
Pulmonary Thromboembolism ◽  
High Sensitivity ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Arterial Blood ◽  
Potential Biomarker ◽  
Healthy Control ◽  
Neutrophil Gelatinase

Abstract Objective Pulmonary thromboembolism (PTE) is a clinical condition that can be lethal unless promptly diagnosed and treated. The objective was to evaluate the significance of serum neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of PTE. Materials and methods In this study, 60 patients hospitalized for acute PTE between May 2015 and December 2016 were enrolled. PTE was diagnosed using spiral computed tomography angiography of the thorax. Cardiac enzyme levels, arterial blood gas, and echocardiography measurements were performed. Whole blood samples were drawn to measure serum NGAL before treatment. Results The PTE group comprised 34 women and 26 men, and the healthy control group included 22 women and 18 men. The mean ages of the patient and control groups were 70.3 ± 14.4 years and 69.0 ± 10.2 years, respectively. Serum NGAL was significantly higher in the patients than in the controls (88.6 ± 33.6 vs. 31.7 ± 10.0 ng/mL, p < 0.001, respectively). The optimal NGAL cut-off value was >50 ng/mL, the sensitivity was 100%, specificity was 98.3%, the negative predictive value was 100%, and the positive predictive value was 68%. Conclusion Serum NGAL is a new biomarker with high sensitivity and specificity to detect, diagnose, and exclude PTE.

scholarly journals Assessment of Accuracy of Continuous Noninvasive versus Invasive Method of Hemoglobin Estimation in Patients Undergoing Pituitary Surgery

2018 ◽  
Vol 05 (03) ◽  
pp. 168-172
Author(s):  
Indu Kapoor ◽  
Charu Mahajan ◽  
Ruhi Mamuliya ◽  
Hemanshu Prabhakar
Keyword(s):  
Pituitary Surgery ◽  
Poor Correlation ◽  
P Value ◽  
Arterial Line ◽  
Female Ratio ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Invasive Method ◽  
American Society ◽  
Hb Concentration

Abstract Aim Determination of hemoglobin (Hb) concentration by standard methods is time consuming, invasive, and intermittent. Noninvasive (NI) methods of Hb estimation are less time consuming, and reduce the risk of infection, number of required working personnel, and long-term costs. In this study, we aimed to find the accuracy of Hb values at various time points using noninvasive (NI) Hb monitoring and standard invasive techniques such as laboratory (LabHb) and arterial blood gas (ABG). Methods All American Society of Anesthesiologists (ASA) physical grade I and II adult patients between 18 and 65 years of either gender undergoing pituitary surgery under general anesthesia were included over a period of 1 year. Samples were collected for Hb estimation from the arterial line (aHb) using ABG analyzer machine and LabHb using automated Hb analyzer. Simultaneously, Hb reading from the NI Hb monitor was recorded using Masimo Spot Hemoglobin Check Device. Bland–Altman plot was used to find out agreement between Hb values drawn from three different techniques. A p-value < 0.05 was considered significant. Results A total of 30 patients participated in the study. The male to female ratio was 13:17. Statistical analysis showed poor correlation between the invasive and NI methods of Hb estimation. Conclusion NI method of Hb estimation may be successfully used in clinical practice, replacing estimation from ABG analysis or laboratory tests. However, NI method cannot replace the invasive methods of Hb estimation.

scholarly journals Birth asphyxia following delayed recognition and response to abnormal labour progress and fetal distress in a 31-year-old multiparous Malawian woman

2019 ◽  
Vol 12 (9) ◽  
pp. e227973 ◽  
Author(s):  
Yvette N Löwensteyn ◽  
Natasha Housseine ◽  
Thokozani Masina ◽  
Joyce L Browne ◽  
Marcus J Rijken
Keyword(s):  
Low Income ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Well Being ◽  
Good Health ◽  
Sub Saharan Africa ◽  
Care Staff ◽  
Health Care Staff ◽  
Fetal Heart Rate Monitoring ◽  
Delayed Recognition

Reducing neonatal mortality is one of the targets of Sustainable Development Goal 3 on good health and well-being. The highest rates of neonatal death occur in sub-Saharan Africa. Birth asphyxia is one of the major preventable causes. Early detection and timely management of abnormal labour progress and fetal compromise are critical to reduce the global burden of birth asphyxia. Labour progress, maternal and fetal well-being are assessed using the WHO partograph and intermittent fetal heart rate monitoring. However, in low-resource settings adherence to labour guidelines and timely response to arising labour complications is generally poor. Reasons for this are multifactorial and include lack of resources and skilled health care staff. This case study in a Malawian hospital illustrates how delayed recognition of abnormal labour and prolonged decision-to-delivery interval contributed to birth asphyxia, as an example of many delivery rooms in low-income country settings.

scholarly journals Investigation of Frequency of the Lethal Triad and Its 24 Hours Prognostic Value among Patients with Multiple Traumas

2019 ◽  
Vol 7 (6) ◽  
pp. 962-966 ◽  
Author(s):  
Iraj Goli Khatir ◽  
Farzad Bozorgi ◽  
Hesam Ghanbari ◽  
Fatemeh Jahanian ◽  
Mohsen Arabi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Predictive Value ◽  
Coagulation Factors ◽  
Cross Sectional Study ◽  
Care Plan ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Lethal Triad ◽  
Multiple Traumas

BACKGROUND: Death in multiple trauma (MT) patients is one of the serious concerns of the medical service provider. Any prediction of the likelihood of death on the assessment of the patient's condition is performed using different variables, one of the tools in the triage of patients to determine their condition. AIM: We aimed to investigate the frequency and the predictive value of death in 24 hours triad of death in patients qualified with multiple traumas admitted to Imam Khomeini hospital. METHODS: This was a prospective cross-sectional study to determine the prevalence and predictive value of 24-hour triad of death among patients with MT referred to an emergency department. Three factors including acidosis, hypothermia and coagulopathy and predictive value of 24-hour death were evaluated. Arterial blood gas, oral temperature and blood samples for coagulation factors were analysed. Data were analysed using SPSS version 19. Multivariate analysis (logistic regression) was used to determine the predictive value of the triad of death. RESULTS: A group of 199 MT patients referring to Imam Khomeini hospital during the first 6 months of 2015 were evaluated for the first 24 hours of admission. Logistic regression analysis showed that using the following formula based on the triad of death can predict death in 96% of cases can be based on the triad of a death foretold death upon admission to the emergency room. It should be noted that this prediction tool as 173 people left alive after 24 hours as live predicts (100% correct). CONCLUSION: The triad of death is one of the tools in the triage of patients to determine their condition and care plan to be used, provided valuable information to predict the prognosis of patients with a medical team.

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

scholarly journals True Umbilical Cord Knot Leading to Fetal Distress – an Obstetric Emergency

2021 ◽  
pp. 60-63
Author(s):  
Twisha Patel ◽  
Sandhya Pajai
Keyword(s):  
Umbilical Cord ◽  
Stress Test ◽  
Birth Asphyxia ◽  
Rare Condition ◽  
Fetal Distress ◽  
Well Being ◽  
Fetal Outcome ◽  
Fetal Movement ◽  
Normal Limits ◽  
Fetal Movements

Background: Umbilical cord true knot is a rare condition which affects about 1% of all pregnancies. Though the incidence is lower, it often goes undetected in antenatal period despite the availability of prenatal sonography and may lead to a compromised fetal outcome as presented in this case. In this case the presence of true knot of umbilical cord was missed despite routine sonography done just 1 week prior to delivery, when patient presented to casualty with complains of decreased fetal movements since 24 hours. This modality is said to be associated with adverse fetal outcome such as birth asphyxia or in adverse cases intra uterine fetal demise. Risk factors include long cord, polyhydramnios, small sized fetus, etc. Case Summary: 27 years old gravida two, para two, with 1 live issue with k/c/o hypothyroidism with previous lesions came with complaints of decreased fetal movement since 24 hours at 36 weeks 3 days of gestational period. The patient recorded regular ANC checkups and routine investigations within normal limits. Her USG scan done at 34.2 wks showing single loop of cord around neck and normal doppler findings. On examination her vitals were normal .Her abdominal examination showed uterus of 34 wks size, longitudinal lie, cephalic presentation and irritable with mild contractions present with scar tenderness . Her FHS were present/irregular/112 bpm with less variability. On p/v examination os was admitting tip of finger, cervix soft, 25% effaced, station high up, presenting part vertex, membrane present. She was advised admission and a cardio-tocography (CTG) was done which showed recurrent deep atypical variable decelerations with decreased beat to beat variability. An emergent cesarean section was taken. Newborn was a female diagnosed with true umbilical cord knot, 2 cm away from fetal insertion with cord length of 84 cm. The baby was shifted to NICU in view of respiratory distress. Conclusion: Despite of modern day ultrasonography and Doppler studies, true umbilical cord knot still remains a lesser diagnosed entity and so every pregnant patients should be monitored carefully with a watch for daily fetal movement count (DFMC)and weekly non stress test (NST) for fetal well being.

scholarly journals Acrocyanosis - An uncommon event at post anaesthesia recovery room- A case report

2014 ◽  
Vol 26 (1) ◽  
pp. 58-60
Author(s):  
Md Azmal Hossain ◽  
Mosammat Maksuhuda Begum
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Cold Environment ◽  
Blood Gas ◽  
Operation Theatre ◽  
Left Ureter ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Short Period

A healthy patient of aged 26 years underwent left ureter-lithotomy and cystostomy under general anesthesia. In post-operative ward, both extremities were cold & nailed were cyanosed. This cyanosis persisted for as long as 8-10 hours. No abnormality was detected in arterial blood gas analysis. This is not a simple peripheral cyanosis induced by cold environment of operation theatre, as warming usually reverses the phenomenon within a short period. But in this case, peripheral cyanosis persisted for as long as 8-10 hours. Therefore, this is a case of acrocyanosis. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19819 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 58-60

Comparison outcomes of percutaneous nephrolithotomy in prone and flank position in obese patients: A randomized clinical trial

2021 ◽  
pp. 039156032110355
Author(s):  
Seyed Reza Hosseini ◽  
Behrouz Fatahi ◽  
Ali Mohammad Fakhr Yasseri
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Percutaneous Nephrolithotomy ◽  
Blood Gases ◽  
P Value ◽  
Obese Patients ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Surgical Methods

Background: The aim of this study was to compare the complications of percutaneous nephrolithotomy (PCNL) surgery in Flank and Prone positions in patients with a BMI above 30. Methods: In this randomized clinical trial patients were randomly assigned to PCNL treatment in one of two groups undergoing PCNL under fluoroscopic guidance in Flank or Prone positions. Patient demographic information, stone number, size and location, stent duration, hospital stay, blood loss, Creatinine, hemoglobin, hematocrit changes, and arterial blood gas changes and acid-base hemostasis were collected. Results: In this study, 60 patients were examined, which were divided into two groups of 29 people, prone and 31 people. Mean stone size was 3.16 ± 0.82 cm. arterial blood gases did not differ significantly between two groups. The SFR (stone free rate) in the prone and flank groups was 91.02% and 86.89%, respectively. However, SFR and Complications in the prone and flank groups were not significantly different ( p value of 0.081 and 0.13, respectively). Conclusions: According to the results of this study, PCNL complications and acid-base changes is not significantly different in flank and prone positions in obese patients. However, SFR is slightly lower in flank group. Thus, PCNL in flank position is not superior to prone position in obese Patients. It is recommended to choose each of these surgical methods according to the surgeon’s facilities and skills.

scholarly journals The correlation between the cerebroplacental ratio and fetal arterial blood gas in appropriate-for-gestational-age fetuses: A cross-sectional study

2021 ◽  
pp. 821-826
Author(s):  
Ashraf Jamal ◽  
Vajiheh Marsoosi ◽  
Fatemeh Sarvestani ◽  
Neda Hashemi
Keyword(s):  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Emergency Cesarean ◽  
Appropriate For Gestational Age ◽  
Adverse Pregnancy

Background: The cerebroplacental ratio (CPR) is an important index for predicting adverse pregnancy outcomes in small-for-gestational-age and appropriate-forgestational-age fetuses. Objective: To find out whether there is an association between the CPR level and the blood cord gases analysis in appropriate for gestational age fetuses. Materials and Methods: This cross-sectional study included 347 pregnant women at the gestational age of 37-40 wk. Patients had an appropriate-for-gestational-age fetus confirmed from their first ultrasonography results. Participants were divided into two groups based on their CPR, measured before delivery. Finally, after delivery, arterial blood gas level and the incidence of emergency cesarean section, intrapartum fetal distress and neonatal intensive care unit admissions were compared between the two groups. Results: Fifty-four (15.6%) cases had a CPR below the detection limit of the assay. The incidence of fetal distress, emergency cesarean section, neonatal hospitalization in the neonatal intensive care unit, and pH < 7.2 were significantly lower in women with CPR ≥ 0.67 multiples than in women with a CPR < 0.67 multiples of the median. Conclusion: The third-trimester CPR is an independent predictor of stillbirth and perinatal mortality and morbidity. The role of UA/MCA Doppler and the CPR in assessing the risk of adverse pregnancy outcomes should be evaluated prospectively. Key words: Umbilical cord blood, Color Doppler ultrasonography, Gestational age.

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