scholarly journals Are preeclampsia and small for gestational age baby could be predicted by placental location?

2017 ◽  
Vol 6 (12) ◽  
pp. 5568
Author(s):  
Alpana Singh ◽  
Garima Vats ◽  
Taruna Sharma ◽  
Rashmi Shriya
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
High Risk Factors ◽  
Multiple Organs ◽  
Gestation Age ◽  
Lost To Follow Up

Objective: Preeclampsia is one of the major cause of maternal and perinatal mortality and morbidity. The pathophysiology is complex and involves multiple organs. The purpose of this study was to find out whether the placental laterality as a predictor of preeclampsia and small for gestational age baby.Methods: This was prospective observational study conducted from February 2015 to December 2015, in a tertiary care hospital of Delhi. 347 antenatal patients attending obstetrics OPD without high risk factors were enrolled. After enrolment 50 patients were lost to follow up and 27 not delivered in our hospital. Ultrasonography for placental localization was done at 18-24 weeks of pregnancy. Patients were followed till delivery for pregnancy outcomes such as preeclampsia, small for gestation age (SGA) baby and mode of delivery. Placenta locations were divided into lateral (either right or left) and central (anterior, posterior or fundal).Results: Out of 347, a total of 270 patients were analysed, 39 (14.4%) had lateral placenta and among them 17 (43.5%) developed preeclampsia and 24 (61.5%) had small for gestational age baby (p<0.001). 231 (85.5%) had central placenta and among them 49 (21.2%) developed preeclampsia and 63 (27.2%) had small for gestational age baby (p <0.001).Conclusions: Laterally located placenta had significant association with preeclampsia and small for gestational age babies.

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 Short-term outcome in preterm infants depending on whether they were born from singleton, twin or triplet pregnancy: Data from a tertiary care hospital in Serbia

2020 ◽  
Vol 148 (1-2) ◽  
pp. 58-63
Author(s):  
Gordana Velisavljev-Filipovic ◽  
Aleksandra Matic ◽  
Marina Dragicevic ◽  
Divna Damjanovski
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fertility Treatment ◽  
Care Hospital ◽  
Multiple Pregnancies ◽  
Short Term ◽  
Gestation Age ◽  
Increased Risk ◽  
Significant Difference

Introduction/Objective. After the introduction of the national program of fertility treatment, increased frequency of multiple pregnancies was noted. The literature has shown controversies regarding the higher risk of morbidity and mortality of the preterm newborns from multiple pregnancies. Methods. Preterm singletons, twins and triplets born within a two-year study period were included in the analysis. Data about preterm twins were extracted first. For each pair of twins, two singletons of the same gestation age were chosen. The set of the examinees was completed by including the triplets born during the same period. The short-term outcomes were compared between these three groups. Results. A total of 210 preterm infants were included in the study, out of which 84 singletons, 84 twins and 42 triplets. Statistical analysis showed significant difference between the three groups regarding type of conception (p < 0.0001), mode of delivery (p < 0.001) and birth weight (p = 0.005). Short-term mortality and morbidity (neonatal death, the need for intubation at birth, respiratory support, surfactant therapy, and intracranial hemorrhage) were significantly increased in triplets comparing to singletons and twins. Conclusion. Preterm triplets have an increased risk for adverse short-term outcomes comparing to singletons and twins of the similar gestation age in our study sample.

scholarly journals Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1108
Author(s):  
Aruna Rani R. ◽  
Dheeba Jayanthi R. ◽  
Eswari S.
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Obstetric Emergencies ◽  
One Year ◽  
A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

scholarly journals Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

2018 ◽  
Vol 7 (6) ◽  
pp. 2455
Author(s):  
Shivali Bhalla ◽  
Seema Grover Bhatti ◽  
Shalini Devgan
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
North India ◽  
Care Hospital ◽  
Perinatal Morbidity

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

scholarly journals Perinatal variables influencing cord blood thyroid stimulating hormone

2018 ◽  
Vol 5 (4) ◽  
pp. 1537 ◽  
Author(s):  
Manasi D. Garg ◽  
Poornima Kumar ◽  
Sakthi Abirami ◽  
Manikandan M. ◽  
Lalitha Krishnan
Keyword(s):  
Newborn Screening ◽  
Cord Blood ◽  
Congenital Hypothyroidism ◽  
Gestational Age ◽  
Maternal Age ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Thyroid Stimulating Hormone ◽  
Care Hospital ◽  
Stimulating Hormone

Background: Newborn screening using cord blood Thyroid Stimulating Hormone (TSH) is an effective and an easy way to screen babies for congenital hypothyroidism. Congenital hypothyroidism is a common preventable and treatable cause of mental retardation. Early diagnosis with the help of newborn screening aids in timely management and decreased morbidity. Various maternal and neonatal variables can affect cord blood TSH level thereby affecting the accurate diagnosis of congenital hypothyroidism. This study aims at studying the perinatal variables affecting cord blood TSH.Methods: In a retrospective cross-sectional study conducted in a tertiary care hospital, the hospital case records of 1465 newborn and their mother were studied for variables including cord blood TSH, maternal age, mode of delivery, parity, gender of baby, gestational age and growth of baby. The effect of these perinatal variables on cord blood TSH was analysed statistically. P value below 0.05 was considered as statistically significant. The statistical analysis was done used the SPSS software version 18.0.Results: The median cord blood TSH was 8 microIU/ml (IQR= 6-12) with 8.1% newborns having values more than 20 microIU/ml. Cord blood TSH was significantly raised in male babies (p <0.01) and in neonates born by assisted vaginal delivery (p <0.01).  Significant increase in cord blood TSH (p <0.02) was observed in neonates born to primiparous mothers. Maternal age, gestational age of the newborn and growth of the newborn did not have significant effect on cord blood TSH values.Conclusions: The mode of delivery, parity and gender of the baby were found to be significant variables affecting cord blood TSH values. Hence, cord blood TSH values should be interpreted in the light of these perinatal variables.

scholarly journals Maternal and fetal outcome in oligohydramnios: study from a tertiary care hospital, Ahmedabad, India

2018 ◽  
Vol 7 (3) ◽  
pp. 907
Author(s):  
Runoo Ghosh ◽  
Heena Oza ◽  
Bhakti Padhiyar
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Vaginal Route ◽  
Still Birth ◽  
Medical College ◽  
Gestation Age ◽  
Post Natal Care

Background: Most severe and frequent complication of pregnancy is Oligohydramnios and the incidence of this is observed to be about 1-5 % of total pregnancies. Objective of present study was to find the maternal and perinatal outcome, etiology associated with oligohydramnios at tertiary care hospital.Methods: This prospective study was done among 55 patients with gestational age from 30-40wks with Oligohydramnios AFI<5cms with intact membranes were analysed for perinatal outcomes admitted at department of obstetrics and Gynecology in B.J. Medical college, Ahmedabad during July 2008 to July 2010.Results: 65.5% participants were belonged to 20 to 25 age group and 35.5% participants were Primigravida. Mean age was 23.9±3.3 years and mean gestation age was 36.9 week. Almost 72.2% were in 34 to 37 weeks of gestational age. Study found FMC <10 in 56.4% of participants. Forty percent participants have AFI 4 and 27.3% have AFI 5.  47.3% delivery was done by vaginal route. 5.5% baby was still birth and prematurity were the most common cause of still birth. Around 71% babies were low birth weight and congenital anomalies were present in 7.3% babies. APGAR score measured <7 at 1 minute was in 65.4% and <7 at 5 minutes was in 43.6% babies.Conclusions: Oligohydramnios in obstetrics is a frequent occurrence and it points towards intensive surveillance and proper ante-natal and post-natal care. Due to high perinatal morbidity and mortality, the incidence of LSCS increases. However, vaginal delivery has similar outcome, but strict vigilance in labor is mandatory.

scholarly journals Outcome of moderate preterm and term babies at tertiary care centre

2018 ◽  
Vol 5 (6) ◽  
pp. 2222
Author(s):  
Shaitan Singh Balai ◽  
Durgavati Katara ◽  
Vivek Arora
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Preterm Births ◽  
Preterm Neonates ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Major Morbidity ◽  
Mortality And Morbidity ◽  
Maternal Risk ◽  
Maternal Hypertension

Background: To study the maternal risk factors, morbidity, mortality of moderate preterm in comparison to term neonates.Methods: This Cohort study involved two hundred fifty consecutively born moderate preterm and equal number of term newborns delivered in a tertiary care hospital. They were followed till discharge for morbidities and mortality. Detailed maternal and neonatal factors were studied and compared between the two groups.Results: Moderate preterm babies constituted 55% of all live preterm births during the study period. The odds of babies developing major morbidity was significantly more in those whose mothers had hypertension and infections (OR 2.69 95% CI: 1.55, 4.68 and 2.08, 95% CI: 1.6, 2.71 respectively). In the study group, 42.4% and 20.8% babies suffered major and minor morbidity compared to 8.4% and 6.8% of term controls respectively. moderate preterm neonates had significantly higher odds of developing morbidity like respiratory distress (12.4% vs. 5.6%, OR 2.21, 95%CI 1.21,4.11), need for non-invasive(17.3% vs. 5.7%, OR 3.05 95% CI 1.69, 5.47) and invasive ventilation (14.6% vs. 1.7%, OR 8.62, 95% CI 3.09, 24.04), sepsis (20.8% vs. 5.2%, OR 5.20, 95% CI 2.71, 9.99), seizures (22.8% vs. 4.8%, OR 4.75 95%CI 2.61, 8.63), shock (17.6% vs. 4.4%, OR 4.00 95% CI 2.12,7.56), and jaundice (26% vs. 6%, OR 4.33 95%CI 2.54, 7.39). By logistic regression, the odds of developing major morbidity decreased with increasing gestational age (aOR 0.28 95% CI 0.18, 0.45; p<0.001) and increased with hypertensive disease of pregnancy (aOR 2.16 95% CI 1.09, 4.260; p00.026).Conclusions: Moderate preterm neonates have significantly more mortality and morbidity compared to term controls. Maternal hypertension and lower gestational age are the strongest predictors of morbidity.

scholarly journals Prevalence of maternal periodontitis and its association with preterm and low birth weight infants: a hospital-based study

2019 ◽  
Vol 8 (5) ◽  
pp. 1767
Author(s):  
Priyanka S. ◽  
Sowmya Koteshwara ◽  
Anitha Subappa
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Tertiary Care ◽  
Care Hospital ◽  
Low Birth Weight Infants ◽  
Mortality And Morbidity ◽  
Severe Periodontitis ◽  
Gestational Age At Delivery

Background: Preterm deliveries and low birth are important causes of infant mortality and morbidity. The aim of this study was to evaluate the association between maternal periodontitis and preterm and low birth weight at delivery and to correlate the severity of periodontitis with obstetric outcome.Methods: This was a prospective observational study conducted in Outpatient Department of Tertiary Care Hospital. Pregnant women who had regular antenatal checkup at were screened clinically for periodontitis. Those who were diagnosed with periodontitis and satisfied the inclusion and exclusion criteria were considered as cases (n=45) and equal number of pregnant women without periodontal disease (n=45) were included in the study as controls. These patients were followed up and gestational age at delivery and baby’s birth weight was noted and correlated to the maternal periodontal status.Results: The prevalence of maternal periodontitis was found to be 11.4%. Mean age, socioeconomic status and educational status was comparable. 33.3%, 40% of the cases v/s 17.8%, 24.4% of controls had preterm deliveries and LBW infants respectively. 26.8% of cases with mild periodontitis and all cases of moderate and severe periodontitis had preterm birth. Additionally, 34.1% of cases with mild periodontitis and all cases with moderate and severe periodontitis had low birth weight infants (p=0.02).Conclusions: Maternal periodontitis is found to be associated with preterm and low birth weight deliveries. The severity of periodontitis is inversely related to gestational age at delivery and birth weight of infant. Thus, periodontitis is suggested to be a modifiable risk factor for preterm and low birth deliveries.

scholarly journals Small for Gestational Age Babies: Morbidity and Immediate Outcome in a Tertiary Care Hospital - A Prospective Study

1970 ◽  
pp. 1-7
Author(s):  
Arjun Chandra Dey ◽  
Farid Uddin Ahmed ◽  
Md Abdul Mannan ◽  
Laxmi Saha ◽  
Chowdhury Chiranjib Barua ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Very Low Birth Weight ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital

Background: Birth weight is the single most important determinant of survival and subsequent growth and development of the newborn. In Bangladesh there is high prevalence of low birth weight (LBW) babies and most of them are small for gestational age. The study was conducted to identify the proportion and category of the small for gestational age babies and determination of the short-term outcome with the aim to the reduction of neonatal mortality and morbidity by problem-wise intervention. Methods: This cross sectional study was conducted in the Neonatal Unit of Chittagong Medical College Hospital, Chittagong between December 2000 and July 2001. Neonates admitted into this unit weighing less than 10th percentile of weight for gestational age were included. On admission the weight was taken and gestational age was calculated using last menstrual period and Ballard score. The infants were monitored daily till discharge or death. Result: A total of 200 SGA babies were included in the study. Among 200 cases 114 were male and 86 were female. All cases were included within 24 hours of age. The anthropometric analysis of the SGA babies showed more than 80% of the SGA babies were normal in length whereas 19.5% fell below 10th percentile of normal. Seventy three percent of SGA babies were asymmetrically (disproportionate) and 27% of babies were symmetrically (proportionate) growth retarded. The main problems associated with the SGA babies were perinatal asphyxia (65.5%), sepsis (54%), jaundice (42.0%), hypothermia (31%), apnea (29%), hypoglycemia (25%), and bleeding manifestations (9%). Asymmetrical SGA babies were at higher risk of infection and jaundice. Present study revealed the mortality of SGA babies were 17% and mortality was significantly higher among the neonates from low socio-economic status and having very low birth weight, hypothermia, apnea, sepsis, bleeding manifestations, and polycythemia. Conclusion: Findings in this study could be important in identifying the areas requiring attention to improve perinatal care in order to prevent SGA babies and also to manage the problems associated with them. DOI: 10.3329/bjch.v31i1.6066 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 1-7

scholarly journals Prospective study on ectopic pregnancy in a tertiary care hospital

2021 ◽  
Vol 10 (5) ◽  
pp. 1889
Author(s):  
M. Ilanjselvi ◽  
K. Shobana Priya
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
High Risk Factors ◽  
Ectopic Pregnancies ◽  
Laparoscopic Salpingectomy

Background: Pregnancy of unknown location was frequently missed and increasing incidence of ectopic pregnancy needs awareness about common risk factors, mortality and morbidity. Aim of this study is identify the incidence, clinical presentation, risk factors, treatment, mortality and morbidity associated with ectopic pregnancies.Methods: Prospective analysis of ectopic was done in Chengalpattu Government Medical College and Hospital from December 2018 to December 2019. Parameters included in this study was age, parity, gestational age, risk factors, clinical presentation, site of ectopic, need of blood transfusion, mode of management, mortality and morbidity were identified.Results: Out of 10900 deliveries, 53 were ectopic pregnancies (0.48%). Women with age 20-25 years had highest incidence (54.71%) and with least below 20yrs and above 40 years (1.88%). Ectopic pregnancies were common in multiparous women (70.68%) than primigravida (28.30%). Common symptoms: amennorhea (98.11%), pain abdomen (96.22%), bleeding per vaginum (47.16%) patients. Urine pregnancy test positive in 98.11%. Etiology was pelvic infection (18.88%), surgeries including LSCS and tubal surgeries (15.09%), previous dilatation and curettage was done in (15.09%) cases, previous ectopic (5.66%), intrauterine contraception usage seen in (1.88%). Right sided ectopic was more common. Site of ectopic: common in fallopian tube- ampullary region (54.71%)), fimbria (22.64%), isthumus (11.32%), followed by ovarian ectopic (5.66%) cornual (3.77%), caesarean scar (1.88%) tubal abortion (1.88%). About 94.33% of ectopic was ruptured, 3/4th of these patients presented with shock at the time of presentation. Most of cases being ruptured ectopic pregnancies, unilateral salpingectomy in 75.47% and unilateral salpingoopherectomy in 3.77%. Salpingectomy with contralateral tubal ligation done in 15.09%, laparoscopic salpingectomy done in 3.77%, hysterectomy done for 1.88%. Blood transfusion was done in (96.22%), without single mortality.Conclusions: Immediate prompt diagnosis, identifying the high-risk factors and early intervention by conservative or surgical management will help in reducing the mortality and morbidity associated with ectopic pregnancted.

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