scholarly journals Obstetric outcome in twin gestation with reference to chorionicity

2017 ◽  
Vol 6 (11) ◽  
pp. 4908
Author(s):  
Lekshmi Murukesan ◽  
Mayadevi Brahmanandan ◽  
Sujamol Sujamol Jacob
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Newborn Care ◽  
First Trimester ◽  
Care Hospital ◽  
Adverse Perinatal Outcome ◽  
The Mean ◽  
Twin Pregnancies

Background: Monochorionic twin pregnancies are at greater risk for growth abnormalities and other complications. This study aims to outline the obstetric problems faced by twins in general and also to determine the influence of chorionicity on pregnancy and perinatal outcome in twins. Objective of present study was to compare the obstetric and perinatal outcome between monochorionic and dichorionic twins.Methods: A clinical non-interventional prospective observational study was conducted in a tertiary care hospital over a period of 1 year. 232cases of twin pregnancies were followed up from first trimester. The antepartum complications, mode of delivery, presentation, pregnancy outcome, condition of babies and perinatal mortality were compared between mono-chorionic and dichorionic twins.Results: Among 232 cases of twins studied, 2/3rd were dichorionic and 1/3rd were monochorionic. The mean gestational age for Monochorionic (MC) twins was 33.2 weeks whereas it was 35.6 weeks for Dichorionic (DC) twins. Preterm delivery was significantly associated with mono-chorionicity. Elective CS was done more for MC twins compared to DC twins. The mean birth weight of MC twins was 1.7 kg compared to 2.1 kg among DC twins. Low APGAR scores were seen in 31.3% of MC twins compared to 15.8% of DC twins. The number of asphyxiated babies (12.5%), stillborn (7.5%) and macerated babies (10%) were more in MC group in comparison to DC group where it was (9.9%, 2.1%, 0.7%) respectively. Risk of IBN admissions were more in MC than DC twins. (31.3% Vs 21.1%) Adverse perinatal outcome was associated more with MC pregnancies (37.5%) than DC. (11.8%).Conclusions: Mono-chorioncity was significantly associated with pregnancy complications and adverse perinatal outcome. Hence early diagnosis of chorionicity and referral to a tertiary centre with fetal medicine unit and newborn care is very important in reducing morbidity and perinatal mortality among MC twins.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Perinatal Outcome in Twin Pregnancy at Khaipur Medical College, Khairpur Mirs, Pakistan

2021 ◽  
pp. 46-52
Author(s):  
Nusrat Fozia Pathan ◽  
Shazia Jamali ◽  
Maqsood Ahmed Siddiqui ◽  
Khushi Muhammad Sohu ◽  
Ameer Ali Jamali ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Gestational Age ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Mode Of Delivery ◽  
Case Series ◽  
Risk Pregnancy ◽  
The Mean ◽  
Twin Pregnancies

Objective: To determine the perinatal outcome of twin pregnancy and to find out the frequency of twin deliveries in hospital based population. Study Design: Descriptive case series. Place and Duration of Study: The study was conducted over a period of 02 Year 1st January 2018 to 31st December 2019 in the Obstetrics and Gynaecology Department at KMC Khairpur Mirs, Sindh Pakistan. Methodology: All the patients of age 20-35 years with twin pregnancies of gestational age above 30 weeks presenting in labour ward of KMC Khairpur Mirs were studied. A detailed history was taken, general physical (G.P) examination and obstetrical examination performed, targeted investigations carried out to detect various fetal complications. Patients were assessed for a mode of delivery, records for data like age, gestational age, weight of baby, APGAR score expressed in term of mean±SD and data like perinatal mortality, prematurity, intra uterine growth restriction (IUGR), the weight of baby and APGAR score expressed in terms of frequencies and percentages on SPSS version 20. Results: In this study total numbers of deliveries were 7200, among them 83 were twin pregnancies the frequency of twin was 1.15%. Booked cases were 24.1%, unbooked was 75.9%. The highest incidence of 42.2% of twin gestation was seen in women between ages 31-35 years, the mean age of patients was seen 30.1±4.1 and regarding the parity incidence was high 54.2% in multiparous l-5. The total number of preterm deliveries was 45(55.2%), gestational age was (35-36+6dnys) weeks in 22.89% of cases, and the mean gestational age of patients was 35.7±2.5. Perinatal mortality was 38(22.9%), stillborn and early neonatal deaths (ENND) were 18.4% and 36.8% and common in twin-2. Conclusion: Twin pregnancy is-a-high-risk-pregnancy still is a major obstetrical and perinatal challenge. The frequency of twin pregnancy seen in this study is 1.15% unbooked and unsupervised pregnancies are more common i.e 75.9%.  Prematurity is common perinatal morbidity 51.20%.  perinatal mortality is 22.9% and highest in twin-2.

Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Labour Induction ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Perineal Tear ◽  
Meconium Stained Amniotic Fluid

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

scholarly journals Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Archana Kumari ◽  
Avinash Chakrawarty ◽  
Abha Singh ◽  
Ritu Singh
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neurological Involvement ◽  
First Episode ◽  
Care Hospital ◽  
Spot Urine ◽  
High Dependency ◽  
Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Clinical profile and outcome of neonates admitted in sick newborn care unit with hypernatremic dehydration and association with breastfeeding in a tertiary care hospital in Northern India

2021 ◽  
Vol 8 (6) ◽  
pp. 1074
Author(s):  
Mohit Bajaj ◽  
Chiranth R. ◽  
Swati Mahajan ◽  
Pancham Chauhan
Keyword(s):  
Sodium Level ◽  
Tertiary Care ◽  
Newborn Care ◽  
Main Step ◽  
Care Hospital ◽  
Sick Newborn ◽  
Hilly Region ◽  
The Mean ◽  
Time Of Admission ◽  
Hypernatremic Dehydration

Background: Neonatal hypernatremic dehydration is a very commonly seen potentially devastating condition. Inadequate breastfeeding, gastrointestinal losses, warm weather and improperly diluted mixed feeding are the main etiologies linked with neonatal hypernatremic dehydration. We conducted this study to evaluate the etiology, risk factors, clinical symptoms and outcomes of neonates admitted with hypernatremic dehydration and its association with breastfeeding from hilly region in northern India.Methods: The authors retrospectively studied records from extramural sick newborn care unit (SNCU) from April 2018 to June 2019. Inclusion criteria for the study included admitted neonates with documented hypernatremia (serum sodium level >145 mmol/L). Results: Nine hundred and twenty-two neonates were admitted in sick newborn care unit during this study period. One hundred and three (13.39%) newborns were admitted with hypernatremic dehydration at the time of admission. All newborns had deranged kidney function tests at time of admission. Most commonly found presenting complaints were poor feeding (85.71%), fever (45.71%), loose stools (42.8%) and decreased urine output (8%). The mean (SD) sodium on admission was 154.04 (7.41) meq/L. The mean (SD) time taken to correct hypernatremia was 35.6 (14.6) hours. Six of total admitted newborn developed neurological complications (2 had developed cerebral venous thrombosis and 4 had developed seizures). Mortality rate was 4.4%. Top fed neonates (50.41%) had higher percentage of mean sodium level and acute kidney injury at time of admission.Conclusions: Hypernatremic dehydration is preventable and treatable condition. Looking in to and addressing etiology in a timely manner is main step in management. All mothers should be taught correct breastfeeding technique. More breast examination during prenatal and postnatal periods and careful neonatal weight record postnatally could decrease the incidence of neonatal hypernatremic dehydration. Top feeding should be discouraged and only exclusive breastfeeding for 6 months. 

scholarly journals Cord Care Methods in Neonates

2021 ◽  
Vol 15 (10) ◽  
pp. 3509-3510
Author(s):  
Andleeb Kanwal ◽  
Zahid Anwar ◽  
Mateen Akram ◽  
Shahid Anwar ◽  
Saima Pirzada
Keyword(s):  
Urban Areas ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Newborn Care ◽  
Hospital Staff ◽  
Care Hospital ◽  
Cord Care ◽  
Level 3 ◽  
The Mean ◽  
Nurses And Midwives

Background: Proper cord care methods in neonates have been known to reduce infections, sepsis, and death. This study intends to document the frequency of cord care methods. Methods: A questionnaire-based study was done in 6 months in a tertiary care hospital with a level 3 nursery and NICU (Fatima Memorial Hospital, Lahore). We interviewed mothers and female companions of neonates in wards and outpatient clinics. Answers were added to SPSS in socio-demographic categories and cord care methods. Result: A total of 778 females were interviewed. The mean age is 28 + 8.1 years, mostly educated (90%) and resided in urban areas (83%). 39.4% of the participants had personal experience of newborn care. Most were housewives (74.4%). 36.8% would not apply anything to the cord, but the other majority would apply some agent to the newborn cord, methylated spirit being the favourite (48.5%), remaining being mostly antibiotics and antimicrobial agents. Chlorhexidine was used only by one participant. Doctors and nurses had counselled 70% of the participants, but 10% listened to the advice of relatives and grandmothers. 18.5% declined any knowledge of safe practices. Conclusions: Our study emphasizes the need to educate our hospital staff (doctors, nurses and midwives) as well as family members of neonates with standardised cord care methods. Keywords: Neonates, Cord care, Umbilical cord,Methylated spirit.

scholarly journals Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 2210
Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Medical College ◽  
Abruptio Placenta

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.

scholarly journals Maternal and Perinatal Outcome of Multiple Pregnancy in a Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 18 (2) ◽  
pp. 54-58
Author(s):  
Most Sabina Yeasmin ◽  
Md Jalal Uddin ◽  
Shireen Akter Khanam
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Multiple Pregnancies ◽  
Medical College ◽  
Tertiary Teaching ◽  
Gestational Age At Delivery ◽  
Tertiary Teaching Hospital

Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. This study aimed to determine the maternal and perinatal outcome in a tertiary teaching hospital. Materials and methods: This prospective observational study was conducted in Chattogram-Maa-O-Shishu-Hospital Medical College, from July 2014 to June 2016. A total of 173 multiple pregnant women having 28 weeks completed gestation admitted for delivery were consecutively included in the study. Maternal and perinatal outcome were investigated. Results: The results show that the number of multiple pregnancies delivered during study periods was 173 with the incidence of 1.7% among total deliveries. There were 5 triplets pregnancies among these cases. The women with multiple pregnany were relatively older. There were no maternal mortality. Pregnancy complications were remarkabely higher. The main maternal adverse outcome were preterm delivery (84.97%), anaemia (39.88%), pregnancy induced hypertension (28.97%), premature rupture rupture of membrane (28.32%), postpartum haemorrhage (16.76%), antepartum haemorrhage (11.9%). The mean gestational age at delivery was 35.39 weeks for twins and 33.3 weeks for triplets. The commonest mode of delivery was by ceasarean section. The most common neonatal complications was low birth weight and most common cause of neonatal death was prematurity and neonatal sepsis. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and postpartum care to improve the outcome and should have mandatory hospital delivery. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 54-58

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