scholarly journals Biophysical profile and modified biophysical profile in predicting the fetal outcome

2018 ◽  
Vol 7 (9) ◽  
pp. 3516
Author(s):  
V. G. Vanamala ◽  
Aruna Rachel ◽  
Sushil Pakyanadhan ◽  
Sudheep Abraham P.
Keyword(s):  
Amniotic Fluid ◽  
Stress Test ◽  
Well Being ◽  
Fetal Outcome ◽  
Heart Beat ◽  
Amniotic Fluid Index ◽  
Uterine Contractions ◽  
Beat Pattern ◽  
Biophysical Profile ◽  
Fetal Movements

Background: Baby’s well-being in utero is often done by using a cardiotocograph (CTG) machine, which assesses the baby’s heart beat pattern as well as the mother’s uterine contractions. However, lowered fetal movements sometimes may be fatal for the baby. Thus, the biophysical and the modified biophysical profile have been introduced.Methods: 242 patients with over 34 weeks of gestation and with one or more risk factors were included in the study. After taking the demographic details, the patients were subjected to detailed physical and clinical evaluation. Modified BPP was done on all the patients. Index of acute fetal hypoxia the NST was done along with the cardiotocograph (CTG). Amniotic fluid volume was calculated.Results: According to the fetal non-stress test, majority of the patients (70.7%) were reactive while 29.3% were non-reactive. Most of the patients had an amniotic fluid index in the normal range i.e. between 8 -<25, 18.6%) had an AFI value of <6 cm while 13.6% had between 6 - <8. Among the babies with reactive NST, non-reactive NST and AFI ≤5, the most common outcome was low birth weight.  APGAR score <7 was observed in 11.1%, 13.1%, 20% among Reactive NST, Non-reactive NST and AFI ≤5 respectively.Conclusions: Present study shows that BPP and MBPP are both comparable to each other, therefore, MBPP, being an easier test can be substituted for BPP.

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.

Perinatal outcome associated with oligohydramnios in term pregnancies

2018 ◽  
Vol 1 (01) ◽  
pp. 25-30
Author(s):  
Deepa Chudal ◽  
Keshang Diki Bista ◽  
Neelam Pradhan
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Fetal Outcome ◽  
University Teaching ◽  
Amniotic Fluid Index ◽  
Prelabor Rupture Of Membranes

Introduction: Amniotic fluid is a complex substance essential to fetal well-beingand dynamic milieu that changes as pregnancy progresses andsurrounds developing fetus providing an ideal environment for normal fetal growth and development. Amniotic fluid volume is fetal well being which varies with gestational age and depends on a dynamic interaction between placenta, fetus and maternal components. Methods: This was a hospital based descriptive study conducted at Tribhuvan University Teaching Hospital, from 14th April 2013 to 13th April 2014(2070) which consisted of singleton, term (37-42weeks) pregnancies admitted with ultrasonographicfinding of Amniotic Fluid Index≤ 5 with delivery within one week of ultrasonographicfinding. A prefixed questionnaire was used to fill maternal and fetal outcome parameters like age, parity, period of gestation, Amniotic Fluid Index, associated maternal conditions, mode of delivery, indication of Cesarean section, color of liquor and perinatal outcomes. Results: Total 115 cases of oligohydramnioswere noted accounting for an incidence of 2.4%. 92 women were term, giving incidence of term oligohydramnios to be 2%. Out of 92 cases, 77(83.6%) underwent emergency caesarean section and 15 (16.3%) were delivered vaginally. Low birth weight of < 2.5 kg was noted in 14 (15.2%) babies and meconium stained liquor was present in 12 (13%) of oligohydramnios cases. APGAR score of < 7 at 1 minute and 5 minute was seen in 13 (14.13%) and 3 (3.26%) cases respectively. . Among 92 cases, 44 (47.8%) were associated with Prelabor Rupture of Membranes followed by post dated pregnancies and Intrauterine Growth Retardation accounting for 12 (13.1%) cases in each group Conclusion: Prelabor Rupture of Membranes was  most common cause of term oligohydramnios resulting in high risk of caesarean delivery in oligohydramnios cases. Cesarean Section for oligohydramnios has been associated with good perinatal outcome.

scholarly journals Comparative study of maternal and fetal outcome between low and normal amniotic fluid index at term

2017 ◽  
Vol 6 (2) ◽  
pp. 640
Author(s):  
Gayatri Mathuriya ◽  
Megha Verma ◽  
Sudha Rajpoot
Keyword(s):  
Comparative Study ◽  
Amniotic Fluid ◽  
Well Being ◽  
Fetal Outcome ◽  
Low Risk ◽  
Amniotic Fluid Index ◽  
Risk Pregnancy ◽  
Ready Availability ◽  
Prospective Comparative Study ◽  
Low Risk Pregnancy

Background: Amniotic fluid index (AFI) is kind of an estimate of the amount of amniotic fluid. It is an index for the fetal well-being. The aim was to study fetal and maternal out come in cases of low AFI and normal AFI.Methods: This was a case control prospective comparative study performed on 200 randomly selected low risk pregnant patients at term (37-40 weeks of gestation) admitted in Obstetrics and Gynaecology Department. 100 patients with AFI <5 cm (cases) and 100 patients with AFI 8-20 cm (control).Results: Increased number of LSCS in cases that is 35 while only 10 in control and almost equal incidences of MSL and FD in both the groups, while in cases 17 women were planned for elective LSCS for various indications in expectation of better fetal outcome.  There was significant low APGAR score in babies of cases, but clinically we refute this. In present study almost double the no. of babies in cases was IUGR or FGR. Significant association between low AFI and congenital anomalies in babies. Most of the anomalies were of urinary tract system.Conclusions: An AFI ≤5 cm detected at term that was at or after 37 completed weeks of gestation in a low risk pregnancy was an indicator of poor perinatal outcome. Oligohydramnios was being detected more frequently now-a-days due to ready availability of ultrasonography these days.

scholarly journals THE CORRELATION BETWEEN FOETAL MOVEMENTS COUNT AND FOETAL OUTCOME

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Mamta Gangwal
Keyword(s):  
High Risk ◽  
Apgar Score ◽  
Stress Test ◽  
Mode Of Delivery ◽  
Well Being ◽  
Fetal Outcome ◽  
Fetal Movement ◽  
Risk Pregnancy ◽  
Fetal Movements ◽  
Reduced Fetal Movement

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.

scholarly journals Role of Modified Biophysical Profile in High Risk Pregnancy in Predicting Fetal Outcome

2020 ◽  
Vol 18 (3) ◽  
pp. 401-405
Author(s):  
Santosh Jha ◽  
Ganesh Dangal
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
Biophysical Profile

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

scholarly journals Low amniotic uid index and the materno-fetal out come in 3rd trimester of pregnancy

2016 ◽  
Vol 44 (1) ◽  
pp. 16-20
Author(s):  
Fahmida Monir ◽  
Rumana Nazneen ◽  
Rumana Akhter ◽  
Tahmina Begum ◽  
AKM Abdul Kayum ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Well Being ◽  
Fetal Outcome ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Medical Disorders ◽  
Indirect Indicator

Amniotic fluid volume is an indirect indicator of fetal well being. About 8% of pregnant women can have low amniotic fluid, with about 4% being diagnosed with oligohydramnios. Oligohydramnios can cause complications in about 12% of pregnancies that go past 41 wks of gestation. This cross-sectional observational study was carried out in the Department of Obstetrics and Gynaecology, BSMMU, Dhaka from July 2010 to December 2010 on 55 admitted pregnant mother of 28-40 weeks gestational age with low amniotic fluid index (<8cm) with or without medical disorders specially during and after delivery along with its impact on mode of termination of pregnancy & complications of the fetus. Most of the mother (64%) had mild oligohydramnios. Most of them were < 37weeks of gestation and 69.1% of them had to undergo caesarean section as there mode of delivery. The indications were mostly (66%) due to less fetal movement, IUGR, previous C/S, malpresentation etc. The current study showed significantly higher rate (65.5%) of low birth weight resulting from the low AFI. The APGAR score less than 7 in 5 minute was significantly higher in severe oligohydramnios group and majority of the neonate experienced complications like RDS (13%), meconeum aspiration (21%) with admission in neonatal ward (54%). Low AFI has poorer prognosis to some extent with maternal as well as fetal outcome. It is responsible for a significantly higher rate of caesarean section & also associated with low birth rate along with low APGAR score and increase in neonatal complications.Bangladesh Med J. 2015 Jan; 44 (1): 16-20

scholarly journals Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios

2021 ◽  
Vol 10 (12) ◽  
pp. 4418
Author(s):  
Lavanya B. ◽  
A. Prajwala
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Research Centre ◽  
Amniotic Fluid Index ◽  
Normal Delivery ◽  
Maternal Risk ◽  
Doppler Study ◽  
Biophysical Profile

Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome.

scholarly journals The role of modified biophysical profile in predicting perinatal outcome in high risk pregnancies

2018 ◽  
Vol 7 (6) ◽  
pp. 2287
Author(s):  
Jankidevi S. Borade ◽  
Sushma P. Sharma
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Stress Test ◽  
Neonatal Resuscitation ◽  
Amniotic Fluid Index ◽  
Biophysical Profile ◽  
Fetal Surveillance ◽  
The Impact

Background: The goal of antepartum fetal surveillance is early identification of the compromised fetus and timely intervention when the fetus is at risk, but still in an uncompromised state. Modified Biophysical Profile (MBPP) includes Amniotic Fluid Index (AFI) and non stress test (NST). AFI is a marker of long term placental function and NST is a marker of short term fetal condition. The aim of this study is to assess the role of Modified Biophysical Profile in high risk pregnancies and assess perinatal outcome and to study the impact of NST and AFI individually in high risk pregnancies.Methods: 100 ANC patients with high risk factors were evaluated with modified biophysical profile 37 week onwards with non stress test (NST) for 20 mins and amniotic fluid index (AFI) with 4 quadrant technique. High risk pregnancies include preeclampsia, IUGR, oligohydramnios, postdated pregnancy, etc. and various parameters were assessed to determine perinatal and maternal morbidity. All parameters were statistically analyzed.Results: The above study states that need for LSCS, intrapartum fetal distress, meconium stained liquor, APGAR score, need for neonatal resuscitation and perinatal morbidity were definitely higher in cases with abnormal MBPP.Conclusions: Thus MBPP is an easy, cost effective and time saving measure and hence can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.

scholarly journals Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

2018 ◽  
Vol 7 (11) ◽  
pp. 4604
Author(s):  
Mahantappa A. Chiniwar ◽  
Joe Kaushik M. ◽  
Sharada B. Menasinkai
Keyword(s):  
Amniotic Fluid ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Research Centre ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Chi Square

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

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