scholarly journals Intrauterine fetal demise: a retrospective study in tertiary care center in India

2018 ◽  
Vol 7 (8) ◽  
pp. 3069
Author(s):  
Anand Karale ◽  
Kunaal K. Shinde ◽  
Hemant Damle
Keyword(s):  
Gestational Age ◽  
Maternal Age ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Maternal Complications ◽  
Fetal Demise ◽  
Maternal Risk ◽  
Intrauterine Fetal Demise

Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures.Methods: Retrospective observational study was done from Jan 2015 to Dec 2017 at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Statistical data were analyzed using SPSS version 25.Results: The incidence of IUFD at authors’ hospital was 27/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD.Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.

scholarly journals Obstetric outcome in twin pregnancies complicated with single intrauterine fetal demise

2020 ◽  
Vol 9 (7) ◽  
pp. 2998
Author(s):  
Priyanka Chaudhari ◽  
Vinita Gupta ◽  
Anshu Sharma ◽  
Archna Tandon ◽  
Namrata Saxena ◽  
...  
Keyword(s):  
Gestational Age ◽  
Mode Of Delivery ◽  
Intrauterine Fetal Death ◽  
Fetal Mortality ◽  
Delivery Mode ◽  
Fetal Demise ◽  
Maternal Risk ◽  
Monochorionic Twin ◽  
Intrauterine Fetal Demise ◽  
Twin Pregnancies

Background: It has been reported that single intrauterine fetal death in twin pregnancy occurs in 3.7-6.8% all twin pregnancies. The objective of this study was to evaluate the maternal and fetal demographic features and feto-maternal outcomes in twin pregnancies complicated with single intrauterine fetal demise and evaluation of available management guidelines.Methods: This retrospective study was conducted at obstetrics and gynecology department of SGRRIM and HS, Dehradun, Uttarakhand between January 2015 and December 2019. There was a total of 182 twin deliveries at study hospital during this period and 35 of these cases were complicated with single intrauterine fetal demise. Maternal age, parity, chorionicity of twin gestation, gestational age at single intrauterine fetal demise, gestational age at delivery, mode of delivery, birth weight, Apgar Score at birth, neonatal intensive care unit stay of newborn,  maternal fibrinogen levels during pregnancy and delivery time and associated obstetric complications were analyzed in these cases of single intrauterine fetal demise with twin gestation. All monochorionic twin pregnancies were included in the study Group A and dichorionic twin in Group B.Results: The mean age of 32 patients included in study was 29.7±4.6 years. Twenty (62.5%) of these patients were dichorionic and 12 (37.5%) of these were monochorionic twin gestation. Single intrauterine fetal demise occurred in first trimester in 8 (25%) patients, during the second trimester 20 (62.5%) and 4 (12.5%) patients had third trimester single intrauterine fetal demise. Preterm deliveries occurred in 18 (56.3%) of patients and 8 (44.4%) of patients were of monochorionic and 10 (55.6%) of dichorionic twin patients. Among thirty-two patients, 11 (34.4%) patients had caesarean delivery and 21 (65.6%) patient had vaginal birth. No maternal or fetal mortality noted and none of the patients had maternal coagulation disorder.Conclusions: This study indicates that in cases of twin pregnancies with single fetal intrauterine demise with individualized management plan at higher centre and close maternal and fetal surveillance live fetus can be saved without any maternal risk.

scholarly journals Prevalence and Outcome of Induction of Labor in a Tertiary Care Center of Kathmandu, Nepal

2019 ◽  
Vol 14 (2) ◽  
pp. 54-56
Author(s):  
Dhan Bahadur Shrestha ◽  
Rosy Malla ◽  
Reeta Manandhar ◽  
Ratna Khatri ◽  
Cimona Shrestha ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Induction Of Labor ◽  
Maternity Unit ◽  
Tertiary Care Center ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Vaginal Deliveries

Aim: To study the prevalence of induction of labor and obstetric and neonatal outcome among delivery cases in the maternity unit of a tertiary care center. Methods: This is a prospective cross-sectional study conducted on pregnant ladies presenting to maternity unit of Shree Birendra Hospital, Chhauni over a period of six months from March to August 2017. All pregnant ladies in labor during the study period were enrolled. Induction of labor, mode of delivery, perinatal outcome (gestational age at delivery, birth weight), and maternal complications if any were recorded. Results: Among 497 deliveries in the study period, induction of labor was performed in 117 (23.5%) cases with post-date pregnancy being the most common indication. Induction was successful with vaginal deliveries in 82(70.1%) cases, while in the rest, IOL failed. Among the induced cases, 17 (14.5%) neonates had poor APGAR at 5 minutes and there was significant association of IOL with low APGAR. There was normal post-natal recovery in 108 (92.3%) induced cases while 9 (7.7%) cases developed some maternal complications. IOL has no significant association with maternal and neonatal complications or perineal injury (p>0.05). Conclusions: The prevalence of induction in this center is slightly higher than other centers. The IOL has significant association with low APGAR at 5 minutes but no significant association with the neonatal and maternal complications.

scholarly journals Fetomaternal Outcome in Twin Pregnancies: A Retrospective Analysis from a Tertiary Care Centre

2020 ◽  
Author(s):  
Kamlesh Kumari ◽  
Minakshi Misra ◽  
Ambika Jhanwar ◽  
Asha Kumari
Keyword(s):  
Twin Pregnancy ◽  
Preterm Labour ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Maternal Risk ◽  
Antenatal Period ◽  
The Mean ◽  
Twin Pregnancies

Introduction: Twin pregnancies are among the major challenges faced by obstetricians globally. Increased maternal and foetal morbidity is observed with an increase in the incidence of twin pregnancies. Due to elevated rates of complications, a larger number of caesarean sections are performed in twin pregnancies in comparison to singleton gestation. Aim: The study aimed to find out the incidence of twin pregnancy with associated maternal risk factors and foetal outcome in the study population. Materials and Methods: This retrospective observational study was carried out at JNU Hospital and Medical College, Jaipur for a period of 4 years from December 2015 to December 2019. A total of 70 mothers, who presented with twin pregnancy, were included in this study. Data were collected from hospital records regarding maternal age, parity, whether spontaneous or assisted conception, gestational age, pregestational Body Mass Index (BMI) and family history. Details of maternal and foetal complications that occurred during the antenatal period and labour as well as the mode of delivery were collected and analysed. Statistical significance was considered if the p-value was ≤0.05. Qualitative data were represented as rate and proportions, while quantitative data were represented as mean and standard deviation. Results: A total of 70 mothers with twin births, resulting in 140 babies during the 4 years study period were included. A total of 4240 deliveries overall during the study period, gave a twin pregnancy incidence rate of 16.5 in 1000 deliveries. Preterm labour (25.4%), anaemia (26.8%) and hypertension (22.5%) were common problems. The most common indication for caesarean delivery was foetal malpresentation (37.8%) The mean weight of the first twin was 2.12±0.35 kg while the mean weight of the second twin was 1.97±0.30 kg. Among foetal complications, Intrauterine Growth Restriction (IUGR) was seen in 11.4% and birth weight discordance in 21.4% of children. A low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was noted in 21.4% of babies, while 12.9% of babies died in the early neonatal period. Conclusion: Maternal complications during twin pregnancy were mainly preterm labour, diabetes, hypertension and anaemia. Caesarean section was the main mode of delivery in this study with significant association with hypertension and preterm labour. Foetal complications were in the majority related to IUGR. More vigilance during the antenatal period and labour is needed for proper selection of mode of delivery. Active foetal surveillance and intervention with appropriate neonatal care can improve fetomaternal outcome.

scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Author(s):  
Mohammad Yakoob
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective: Previously, we have published univariate analyses on a cohort of all singleton, very preterm infants (N=101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report Odds Ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results: The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (Cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P≤0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete-case multivariate analyses, only gestational age (per week) was associated with survival (OR=2.5, 95% CI: 1.1–5.5, P=0.03); birth-weight (per 100 grams) and C-section were not associated-1.2, 0.88–1.6, P=0.26 and 2.4, 0.48–12.2, P=0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Author(s):  
Mohammad Yakoob
Keyword(s):  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective: Previously, we have published univariate analyses on a cohort of all singleton very preterm infants (N=101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report Odds Ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results: The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (Cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P≤0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete case multivariate analyses, only gestational age (per week) was associated with survival (OR=2.5, 95% CI: 1.1–5.5, P=0.03); birthweight and C-section were not associated-1.2, 0.88–1.6, P=0.26 and 2.4, 0.48–12.2, P=0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

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 Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammad Yawar Yakoob
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective Previously, we have published univariate analyses on a cohort of all singleton, very preterm infants (N = 101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report odds ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P ≤ 0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete-case multivariate analyses, only gestational age (per week) was associated with survival (OR = 2.5, 95% CI 1.1–5.5, P = 0.03); birth-weight (per 100 g) and C-section were not associated-1.2, 0.88–1.6, P = 0.26 and 2.4, 0.48–12.2, P = 0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEMATIAN PERINATAL DI RUMAH SAKIT MUHAMMADDIYAH PALEMBANG TAHUN 2013

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
LENY LENY
Keyword(s):  
Birth Weight ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Maternal Age ◽  
Case Control Study ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Case Control ◽  
P Value ◽  
Control Study

ABSTRACT [Perinatal mortality is a major problem, especially in developing countries. Approximately 98-99% of perinatal deaths occur in developing countries, while in developed countries only about 1-2%. Contributions perinatal mortality rate in Indonesia is still quite high, and perinatal mortality of 400 per 100,000 live births, or about 200,000 people per year so that the perinatal mortality occurs every 1.2-1.5 minutes. In the Muhammaddiyah hospital Palembang obtained perinatal mortality by the year 2013 as many as 52 cases. Many things that cause perinatal death include birth weight, maternal age, gestational age, mode of delivery and parity. The purpose of this study was to determine the relationship of birth weight, maternal age, gestational age, mode of delivery and parity simultaneously with perinatal death. This type of research is a case control study conducted retrospectively. The population in this study were all women giving birth in hospital Muhammadiyah Palembang in the year 2013 that berjumlah2565. The study sample totaled 156 respondents. In this study conducted univariate, bivariate and multivariate analyzes. From the analysis we found no association between birth weight to perinatal mortality (P Value 0.000 OR 4.250), no association of maternal age with perinatal mortality (OR 0.05 P Value 2.091), no correlation gestational age with perinatal mortality (OR 0.000 P Value 7.667), no association method of childbirth with perinatal mortality (P Value 1.000 OR 1.043), no parity relationship with perinatal mortality (P Value 0.511 OR 0.744). The most dominant variable is the age of the pregnancy. It is suggested to the leadership of Muhammadiyah hospital Palembang is hoped to be able to further improve health care programs for women giving birth so as to prevent the occurrence of complications during labor which can lead to perinatal mortality and increase the awareness programs on the importance of antenatal care during pregnancy that can detect early complications of pregnancy to facilitate the birth process.   ABSTRAK Kematian perinatal merupakan masalah besar khususnya di negara sedang berkembang. Sekitar 98-99 % kasus kematian perinatal terjadi di negara sedang berkembang sedangkan di negara maju hanya sekitar 1-2 %. Kontribusi angka kematian perinatal di Indonesia masih cukup tinggi, yaitu kematian perinatal 400 per 100.000 persalinan hidup atau sekitar 200.000 orang pertahun sehingga kematian perinatal terjadi setiap 1,2-1,5 menit. Di Rumah Sakit Muhammaddiyah Palembang didapatkan kematian perinatal pada tahun 2013 sebanyak 52 kasus. Banyak hal yang menyebabkan kematian perinatal diantaranya berat badan lahir, usia ibu, usia kehamilan, cara persalinan dan paritas. Tujuan penelitian ini untuk mengetahui hubungan berat badan lahir, usia ibu, usia kehamilan, cara persalinan dan paritas secara simultan dengan kematian perinatal. Jenis penelitian ini merupakan penelitian case control study yang dilakukan secara retrospektif. Populasi dalam penelitian ini adalah semua ibu bersalin di rumah sakit Muhammadiyah Palembang pada Tahun 2013 yang berjumlah2565. Sampel penelitian ini berjumlah 156 responden. Dalam penelitian ini dilakukan analisis univariat, bivariat dan multivariat. Dari hasil analisis didapatkan ada hubungan antara berat badan lahir dengan kematian perinatal (P Value 0,000 OR 4,250), ada hubungan usia ibu dengan kematian perinatal (P Value 0,05 OR 2,091), ada hubungan usia kehamilan dengan kematian perinatal (P Value 0,000 OR 7,667), tidak ada hubungan cara persalinan dengan kematian perinatal (P Value 1,000 OR 1,043), tidak ada hubungan paritas dengan kematian perinatal (P Value 0,511 OR 0,744). Variabel paling dominan adalah usia kehamilan. Disarankan kepada pimpinan rumah sakit Muhammadiyah Palembang Diharapkan untuk dapat lebih meningkatkan program pelayanan kesehatan kepada ibu bersalin sehingga  mencegah terjadinya komplikasi selama persalinan yang dapat menyebabkan kematian perinatal serta meningkatkan program penyuluhan tentang pentingnya pemeriksaan kehamilan selama masa kehamilan yang dapat mendeteksi dini komplikasi kehamilan untuk memperlancar proses persalinan.  

scholarly journals Intrauterine Foetal Death and Its Probable Causes: Two Years Experience in Dhulikhel Hospital – Kathmandu University Hospital

2014 ◽  
Vol 10 (4) ◽  
pp. 44-48 ◽  
Author(s):  
SR Tamrakar ◽  
CD Chawla
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Care Center ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
University Hospital ◽  
World Health ◽  
Control Group ◽  
P Value ◽  
Health Care Center

Background World health Organization definition of intrauterine foetal demise encompasses any abortion or fetal demise prior to expulsion from its mother, and recommends different protocols according to gestational age. However, conventionally and also in our institution, foetal demise prior to 28 weeks of gestation is managed as abortion in a manner different from foetal demise post 28 weeks of gestation. Objective To find the incidence and characteristics of pregnancies that resulted in stillbirths. Methods A retrospective study, done in Dhulikhel Hospital, Kathmandu University Hospital in the year 2010 and 2011, among 4219 deliveries and 97 fetal deaths. Cases of multiple pregnancy and fetal death diagnosed by ultrasound before the 28th week of gestation were excluded. The included intrauterine foetal demise cases (n=90) were compared with a control group of randomly selected pregnancies (n = 537) delivered during the same time period. Assumed predictors of stillbirth were examined through inferential ways (Chi square, t test) using SPSS Version 13.0 for Windows. Results Incidence of intrauterine foetal demise was 2.13% in the year 2010 and 2011. Mothers in the stillbirth group were slightly older than mothers of live-born infants (25.47±5.64 years vs 23.62±4.31 years, p value=0.000). A slightly higher proportion of women in the stillbirth group were of Tamang ethnic origin and primiparous (p = 0.011, 0.000) . Foetus expelled after IUFD had lower weight compared to live births, (2925.14±444.14gram vs 2182.78±821.04gram, p=0.000) for gestational age. The stillborn babies were generally born at an earlier gestational age, as would be expected (p=0.000). Incidence of intrauterine foetal demise gradually decreases as parity advances. The incidence was higher in patients receiving antenatal care outside Dhulikhel Hospital, Kathmandu University Hospital. Conclusions While comparing the subject with the theme of the national conference of Nepal Society of Obstetricians and Gynaecologist, most of the cases were mother not receiving antenatal care or those receiving antenatal care in the periphery, There is no denying that there would be a massive improvement in women’s health if the co-ordination between the peripheral health care center and tertiary care center was to be improved. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10994 Kathmandu Univ Med J 2012;10(4):44-48

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