scholarly journals A clinical study on maternal and fetal outcome in twin pregnancy at KIMS hospital, Hubli, Karnataka, India

Author(s):  
Seeta Sunil Garag ◽  
Vinay Raju D.

Background: Development of two fetus inside the uterus is called twin gestation. Twin gestation is considered as high-risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies. The past two decades have witnessed a sharp rise in the incidence of twin and higher order gestations.Methods: Prospective analytical study of all women admitted in Obstetrics and Gynaecology department with twin pregnancy at KIMS Hubli, over a period of one year between November 2016 and October 2017.Results: There were 11,127 deliveries occurred in study period of one year, out of which there were 174 twin deliveries accounting for 1.56% of prevalence rate. Anemia was the commonest complication occurring in 160 cases contributing around 90%. Preterm delivery was the second complication occurring in 124 cases accounting for 71%. Among 348 babies, there were 40 perinatal death accounting 11%. There was no maternal death.Conclusions: Twin pregnancy is a high-risk condition, should have mandatory hospital delivery. Early detection, proper treatment improves both maternal and neonatal outcome.

Author(s):  
Lata Singh ◽  
Kiran Trivedi

Background: Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries. The present study aims to understand the maternal and perinatal outcomes of multiple and singleton pregnancies delivering at Rajendra Institute of Medical Sciences, Ranchi, India. Aim of study was to investigate the maternal and fetal outcome in twin pregnancies in Rajendra Institute of Medical Sciences (RIMS), RanchiMethods: This comparative prospective study was conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi from the period of 1st April 2015 to 30th September 2016. Consecutive sampling was done till the sample size of 75 was reached for both twin and singleton pregnancies. It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation.Results: The incidence of twins in this study was 1.85%. Mean maternal age was 25.25±4.5 years for twin pregnancies and 23.53 ± 3.3 for singleton pregnancies. Twins were seen more in multigravida (70.7%) as compared to primigravida (29.3%). Preterm labor (74.7%), anemia (44%) and hypertensive disorders (32%) and PPH (13.33%) were the most common complication in twin pregnancies. Significantly higher rate of LSCS were seen in twin pregnancies (32.67%) as compared to singletons 18.67%. Mean weight of first twin was 2.03±0.52kg and for second twin it was 1.98±0.51kg. There was higher incidence of moderate to severe asphyxia, IUGR and higher rate of NICU admissions in twins as compared to singletons. Perinatal mortality rate of monchrionic pregnancy was 30% and it was 10.2% for dichorionic pregnancy which shows a significant association of perinatal mortality rate and chorionicity.Conclusions: Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.


2020 ◽  
pp. 1-3
Author(s):  
Karishma Gandhi ◽  
Ishit Shah ◽  
Ram Kumar Patidar

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.


2015 ◽  
Vol 95 (2) ◽  
pp. 142-145 ◽  
Author(s):  
Vytautas Bilius ◽  
Gilvydas Verkauskas ◽  
Darius Dasevicius ◽  
Vytis Kazlauskas ◽  
Dalius Malcius ◽  
...  

Background: Increasing evidence of progressive damage to germ cell development in boys with cryptorchidism suggests recommending surgery until one year of age. However, despite early and successful orchidopexy, cryptorchid boys with impaired mini-puberty will suffer from infertility. We reviewed changes in the timing of surgery during the past decade and the incidence of unilateral cryptorchid boys with defective mini-puberty. Methods: Medical registries were reviewed for all patients who were operated on for cryptorchidism at the main pediatric urological center of the country. The ages of surgery in cases of unilateral cryptorchidism were compared between the years 2000-2001 and 2012-2013. A high risk of infertility was considered when no Ad spermatogonia were found. Two groups were compared: group I - operated on until the age of 1.5 years and group II - older than 1.5 years. Results: The average age at operation decreased from 5.3 to 4.1 years. Forty-six biopsies in boys with unilateral cryptorchidism were made during orchidopexy on undescended testicles. Overall, 44% in group I and 50 % in group II (p > 0.05) had no Ad spermatogonia. Conclusions: The average age of operation for cryptorchidism has decreased, but remains far above the recommended age. The high prevalence of histologically proven risk of infertility underscores the necessity of more education regarding the importance of earlier surgery and the research on hormonal prevention of infertility.


Author(s):  
Mamta Gangwal

Background: A reduced fetal movement is a common indication for assessment of fetal well being. A reduced fetal movement is considered as high risk pregnancy because the fetus is at high risk of hypoxia and sudden demise. Methods: Hospital based prospective study conducted at Department of Obstetrics and Gynecology, RVRS Medical College, Bhilwara. Total 130 pregnant women were included in this study. Results: 10.77% patients didn’t perceive fetal movements after admission. Out of 14 patients with absent DFMC, 6 babies (42.86%) died and 8 babies (57.14%) survived. The association betweenNon Stress Test and mode of delivery was found statistically significant. 83.33%) were admitted in NICU. Out of 24 patients presenting with non reactive NST, 20.83% (5) babies born with APGAR score more than 7 and 79.17% (19) babies had APGAR score 4-7. Conclusion: The association between NST & DFMC and fetal outcome was found statistically significant. Keywords: DFMC, NST, Fetal outcome, survived.


Author(s):  
Dr. Ankita Metkari

Background: Objectives of the current study were to detect high-risk-risk-risk factors in pregnancy their presentations and to develop a simple scoring system to identify and categorize high-risk pregnancies and to predict the maternal and neonatal outcomes by comparing our results to previous studies. Methods: In this retrospective study, antepartum, intrapartum and neonatal parameters were integrated into the clinical records and the relationship of a risk score to the outcome was evaluated for 346 randomly selected pregnant patients over 7 months. Conclusions: The present study shows that we achieve comparative and better results in high-risk pregnancy, improving both maternal and fetal outcome at our institute.


2020 ◽  
Vol 18 (3) ◽  
pp. 401-405
Author(s):  
Santosh Jha ◽  
Ganesh Dangal

Background: High risk pregnant women have increased risk of maternal and neonatal morbidity and mortality. Antepartum surveillance is important and should be effective in such conditions. Modified biophysical profile is the method of antepartum surveillance which comprises of cardiotocography and amniotic fluid index. Methods: A cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital from February 2019 to January 2020 to determine the effectiveness of modified biophysical profile. Cardiotocography was interpreted as reactive, equivocal and non-reactive. AFI was considered normal if it was 5 to 24 cm. In the study 172 high risk cases at term and not in labor were included. Each case was subjected to cardiotocography then amniotic fluid index was obtained using real time sonography where it was measured from all four quadrants. Modified biophysical results were obtained and then were divided into 2 arms as normal modified biophysical profile and abnormal modified biophysical profile then analysis was done. Results: Of 172 cases, there were 97 (56.4%) cases in normal modified biophysical profile and remaining 75 (43.6%) in abnormal modified biophysical profile group. The rate of cesarean section increased when there was abnormal modified biophysical profile.  Neonatal resuscitation and admission was increased in abnormal modified biophysical profile. Conclusions: Normal modified biophysical profile in high risk pregnancy had more cases of vaginal delivery and less adverse fetal outcome like low APGAR score, neonatal resuscitation and neonatal intensive care admission. Keywords: Amniotic fluid index; cardiotocography; fetal surveillance; modified biophysical profile


Author(s):  
Sparsh Madaan ◽  
Dhruv Talwar ◽  
Sunil Kumar ◽  
Arpita Jaiswal ◽  
Neema Acharya ◽  
...  

Incidence of Dengue has been on the up rise ever since the second wave of the pandemic of COVID19 has ended introducing an old enemy on the frontline to the health care professionals.A 28 year old Gravida 2 Parity 0 Living 0 Abortion 1 with twin pregnancy presented with fever along with chills and retro orbital pain along with body ache since two days in the emergency department  with the gestational age of 36 weeks.She tested positive for Dengue NS1 antigen.Patient was having thrombocytopenia and was managed with intravenous fluids,platelet and blood transfusion and was taken for caesarian section and she delivered twins with normal birth weight.During the post operative period the patient went into dengue shock syndrome and which was managed with fluids and inotropic support and patient ultimately recovered and was discharged on day seventeen of admission .This case report emphasises on the importance of prompt detection and management of dengue in a case of high risk pregnancy such as twin pregnancy.After extensive review of literature we found that this is the first case report to report the association of twin pregnancy with dengue shock syndrome making it an important topic of discussion.


2020 ◽  
Vol 33 (2) ◽  
pp. 94-99
Author(s):  
Farzana Begum ◽  
Shahela Jesmin ◽  
Rokeya Khatun ◽  
Somerose Parvin ◽  
Anisur Rahman

Background: Antenatal ultrasound assessment of placental morphology plays an important role in evaluating fetal health, revealing abnormalities, such as infract & calcification.  Abnormal placental maturity is associated with poor pregnancy outcome. In some high risk pregnancy placental maturity is accelerated as in pregancy –induced hypertension (PIH), intrauterine growth retardation (IUGR), whether in other high risk cases like diabetes and Rh-isoimmunization there is delayed placental maturation. Objectives: This was a cross sectional type of descriptive study. The study was carried out to assess placental grading by USG in high risk and normal pregnancy for predicting neonatal outcome. Material and method: The study was carried out in the Department of Obstetrics & Gynaecology in collaboration with the Department of Radiology & Imaging of Rajshahi Medical College Hospital from January 2012 to December 2013. : A total 200 pregnant mother, attending the inpatient department constituted study population who delivered their babies at Rajshahi Medical College Hospital were selected in antenatal period for USG examination to detect placental grade. Result: Ultrasonography showed, 35% had Grade-II placental maturity, 33.5%- Grade-III, 25% Grade - I and 6.5% had Grade-0 maturity. Majority of the mother (75%) were normal and had healthy baby. The relationship of placental maturity with gestational age of mother in normal pregnancy and in high risk pregnancy was found to be statistically significant. Placental maturity and fetal outcome in normal pregnancy was found significantly associated (p<0.001) but in high risk pregnancy it was not associated significantly (p>0.5). Early maturation of placenta in hypertensive women and delayed maturation in diabetic women were observed. Conclusion: Sonographic diagnosis of grade-III placenta has been reported to be as excellent predictor of fetal lung maturity than difficult and hazardous invasive procedure like amniocentesis. TAJ 2020; 33(2): 94-99


2017 ◽  
Vol 5 (2) ◽  
pp. 113-118
Author(s):  
Shivakumar H.C. ◽  
◽  
Chandrasheker . ◽  
Ramaraju H.E. ◽  
◽  
...  

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