scholarly journals Efficacy of Mefipristone for induction of labour in late term pregnancy

2019 ◽  
Vol 8 (6) ◽  
pp. 2384
Author(s):  
Roopa N. K. ◽  
Rekha N.
Keyword(s):  
Induction Of Labour ◽  
Fetal Mortality ◽  
Bishop Score ◽  
Medical Sciences ◽  
Term Pregnancy ◽  
Mortality And Morbidity ◽  
Vaginal Deliveries ◽  
Increased Risk ◽  
Study Population ◽  
Progesterone Antagonist

Background: Late-term pregnancy defined as one that has reached between 41 0/7 weeks and 41 6/7 weeks of gestation is associated with an increased maternal morbidity as well as an increased risk of fetal and neonatal mortality and morbidity. Mifepristone, an anti-glucocorticoid and antiprogesterone, though not an oxytocic increases uterine activity and causes cervical effacement and dilatation and improves the Bishop score without over/hyper stimulation of uterus. Increased maternal and fetal mortality from late term pregnancy could be prevented by induction of labour. The objective of this study was to know the efficacy of single dose of oral mifepristone in induction of labour in late term pregnancy and to assess the induction delivery interval in the study population.Methods: This was a prospective interventional study conducted in Department of Obstetrics and Gynaecology at BGS Global Institute of Medical Sciences, Bengaluru. 100 Women with late term pregnancy who fulfilled the inclusion and exclusion criteria were considered for the study after an informed written consent.Results: 73.5% (n=36) of multigravida and 80.4% (n=41) of prim gravida showed improvement in the Bishop score post induction with mifepristone and majority (89.79 % primigravida and 84.31% multigravida) of the study population had vaginal delivery. Multigravida (73.5%) had less induction delivery interval (less than 48hours) compared to primigravida (19.6%).Conclusions: Mifepristone, a progesterone antagonist causes a significant improvement in the Bishop’s score and is associated with an increased rate of vaginal deliveries.

Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Marlit Karen Strobel ◽  
Maria Eveslage ◽  
Helen Ann Köster ◽  
Mareike Möllers ◽  
Janina Braun ◽  
...  
Keyword(s):  
Strain Ratio ◽  
Cervical Length ◽  
Transformation Process ◽  
Induction Of Labour ◽  
Bishop Score ◽  
Cervical Tissue ◽  
Strain Pattern ◽  
Successful Induction ◽  
Study Population ◽  
First Time

AbstractObjectivesThe aim of this study was to introduce cervical strain elastography to objectively assess the cervical tissue transformation process during induction of labour (IOL) and to evaluate the potential of cervical elastography as a predictor of successful IOL.MethodsA total of 41 patients with full-term pregnancies elected for an IOL were included. Vaginal ultrasound with measurement of cervical length and elastography and assessment of the Bishop Score were performed before and 3 h after IOL. The measured parameters were correlated to the outcome of IOL and the time until delivery.ResultsWe observed an association between the strain pattern and the value of the strain ratio 3 h after IOL and a successful IOL (p=0.0343 and p=0.0342, respectively) which can be well demonstrated by the results after 48 h. In our study population the cervical length and the Bishop Score did not prove to be relevant parameters for the prediction of a successful IOL.ConclusionsWe demonstrated for the first time that the cervical elastography pattern after the first prostaglandine application can help predict the outcome of IOL.

scholarly journals Case Report on Pregnancy with Lupus Nephritis Type IV with Hypothyroidism – A Clinical Vignette

2021 ◽  
Vol 8 (05) ◽  
pp. 272-274
Author(s):  
Abirbhab Pal
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
First Trimester ◽  
The Body ◽  
Fetal Mortality ◽  
Thyroid Disorder ◽  
Multisystem Disease ◽  
Mortality And Morbidity ◽  
Multiple Systems ◽  
Increased Risk

Lupus is a multisystem disease affecting almost all systems including the immune system of our body. Its aetiology is not known. Lupus involving kidneys causes lupus nephritis and adds more complications in the multisystem disease. Lupus or systemic lupus erythematosus (SLE) is a multifactorial chronic disease involving multiple systems of the body. It is autoimmune1 in nature. There is increase in maternal and fetal risk of mortality and morbidity in lupus with pregnancy. The rate of pregnancy loss is 1.7 %2 in active SLE during initial first trimester and the most common adverse morbidity causing factor of fetomaternal side.3 There can be an increase in fetal mortality and morbidity associated with lupus nephritis.4,5 There is increased risk of intrauterine growth restriction (IUGR) / neonatal lupus / gestational diabetes mellitus / osteoporosis / HELLP syndrome / preeclampsia. Associated thyroid disorder is increased with preterm pregnancy.

Validation of risk assessment models predicting venous thromboembolism in inpatients with AECOPD: a multicenter cohort study

2021 ◽  
Author(s):  
Chen Zhou ◽  
Qun Yi ◽  
Huiqing Ge ◽  
Hailong Wei ◽  
Huiguo Liu ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Assessment Model ◽  
Risk Level ◽  
Chronic Obstructive ◽  
Multicenter Cohort Study ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Study Population

Background: As inpatients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at increased risk for venous thromboembolism (VTE), identifying high-risk patients requiring thromboprophylaxis is critical to reduce the mortality and morbidity associated with VTE. This study aimed to evaluate and compare the validities of the Padua Prediction Score and Caprini risk assessment model (RAM) in predicting the risk of VTE in inpatients with AECOPD. Methods: The inpatients with AECOPD were prospectively enrolled from seven medical centers of China between September 2017 and January 2020. Caprini and Padua scores were calculated on admission, and the incidence of 3-month VTE was investigated. Results: Among the 3277 eligible patients with AECOPD, 128 patients (3.9%) developed VTE within 3 months after admission. The distribution of the study population by the Caprini risk level was as follows: high, 53.6%; moderate, 43.0%; and low, 3.5%. The incidence of VTE increased by risk level as high, 6.1%; moderate, 1.5%; and low, 0%. According to the Padua RAM, only 10.9% of the study population was classified as high risk and 89.1% as low risk, with the corresponding incidence of VTE 7.9% and 3.4%, respectively. The Caprini RAM had higher area under curve (AUC) compared with the Padua RAM (0.713  0.021 vs 0.644 ± 0.023, P = 0.029). Conclusion: The Caprini RAM was superior to the Padua RAM in predicting the risk of VTE in inpatients with AECOPD and might better guide thromboprophylaxis in these patients.

scholarly journals Use of Misoprostol in Term pregnant women for Good Delivery Outcome: Experience at a tertiary care Hospital in Dhaka

2016 ◽  
Vol 12 (2) ◽  
pp. 22-26
Author(s):  
Aftabun Nahar ◽  
Rifat Sultana ◽  
Fatema Mahbooba Akter ◽  
Munira Ferdausi ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Induction Of Labour ◽  
Care Hospital ◽  
Term Pregnancy ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
Unfavourable Cervix ◽  
Study Population

Background: Use of misoprostol in term pregnancy is very useful for the better outcome during delivery. Objective: The purpose of the present study was to see the delivery outcome among the term pregnant women. Methodology: This cohort study was carried out in the Department of Obstetrics and Gynaecology at Sir Salimullah Medical College and Mitford Hospital during the period from 1 st September 2005 to 28th February 2006. Primi or second gravida patients with the gestational age between 37 weeks to 42 weeks in singleton pregnancy with cephalic presentation and not in labour who came for delivery purposes during the study period at any age were selected as study population. After proper selection of the cases, induction of labour (IOL) was done by applying Tab Misoprostol 50mcg in the posterior vaginal fornix. Purpose of induction of labour was successful when vaginal delivery occurred without any untoward side effects and without any surgical interference. Result: Out of 60 pregnant women 21 (35%) patients had unfavourable Bishops' score with 3-5 and 39 (65%) patients had favorable Bishops' score with 6-10. 39 patients had favourable pre- induction cervical score, among them 79% had delivered vaginally and 21% had undergone LUCS. 21 patients had unfavourable cervix, among them 57% experienced vaginal delivery and 43% experienced LUCS. Out of all study population 60% of study population who were primigravide had vaginal delivery in 67% cases and caesarean section in 33% cases and among 40% 2nd gravida cases vaginal delivery was 79% and caesarean delivery was 21%. Conclusion: In conclusion the use of misoprostol during term pregnancy is significantly related with the normal delivery.Journal of Science Foundation 2014;12(2):22-26DOI:  http://dx.doi.org/10.3329/jsf.v12i2.27733

scholarly journals Perinatal mortality of placenta previa: a 1-year retrospective study

2018 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Shibram Chattopadhyay ◽  
Siddhartha Majumder ◽  
Kajal Kumar Patra ◽  
A. H. Mostafa Kamal
Keyword(s):  
Retrospective Study ◽  
Perinatal Mortality ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Severe Anaemia ◽  
Placenta Praevia ◽  
Perinatal Morbidity ◽  
Mortality And Morbidity ◽  
Vaginal Deliveries ◽  
Increased Risk

Background: Antepartum haemorrhage is one of the important causes of perinatal mortality and morbidity in India. The increased risk of perinatal morbidity and mortality in placenta praevia is due to preterm birth, low birth weight, birth asphyxia and neonatal sepsis. This is a retrospective study done over a period of 5years to determine the incidence, demographic features, risk factors, obstetric management, maternal mortality and morbidity, and perinatal outcome in women presenting with placenta praevia.Methods: This was a retrospective study done at Nil Ratan Sircar Medical College and Hospital over a period of five years starting from January 2016 to December 2017. Antenatal women with more than 28 weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta praevia on routine ultrasound examination were included in this study and hospitalised.  Among them cases of placenta praevia were 21.Results: There were21 cases of placenta praevia registered amounting to 0.23% incidence. The various antenatal complications seen associated with placenta praevia were severe anaemia (14.28%), coexisting PIH (4.76%), IUD (4.76%), IUGR/Oligohydraminos (4.76%). All the patients in the study had undergone caesarean deliveries. Perinatal morbidity studied as percentage of new-borns requiring resuscitation followed by NICU admission was 33.3%. Among the delivered patients of placenta praevia incidence of perinatal mortality was 23.8%. Prematurity (42.85%) contributed to most cases of perinatal mortality, followed by RDS (14.28%) and asphyxia (14.28%).Conclusions: In this study placenta praevia is seen more commonly in 28-34 weeks of gestation and patients mainly presented with a bout of bleeding eventually had preterm deliveries. Although vaginal deliveries are appropriate in selected cases of placenta paevia liberal use of caesarean section in well-equipped hospitals with availability of blood transfusion services have helped to lower complications.

scholarly journals Clinical Presentation and Outcome of Ruptured Uterus in A Tertiary Hospital

2018 ◽  
Vol 17 (1) ◽  
pp. 29-33
Author(s):  
Kazi Farhana Noor ◽  
Farida Yasmin ◽  
Rupasree Biswas ◽  
Moumita Tripura Mumu ◽  
Uma Dev
Keyword(s):  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Fetal Mortality ◽  
College Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Economic Class ◽  
Total Hysterectomy ◽  
Increased Risk ◽  
Ruptured Uterus

Background: Ruptured uterus is an obstetric emergency, carrying increased risk of maternal and perinatal mortality and morbidity especially in the developing countries. To determine the various aspects such as antecedent factors, clinical profile, management, outcome of ruptured uterus in a tertiary hospital. Methods: This prospective cross-sectional study conducted in the Department of Obstetrics and Gynecology in Chittagong Medical College Hospital, Chittagong, from January 2010 to December 2010. 70 consecutive admitted patients during this period was taken in this study. Results: During study period total 13635 obstetric patients were admitted and among them 70 cases were of ruptured uterus which gives an incidence of 0.5%. 92.85% of the women were multiparous. 77% patient did not have any antenatal care. 81% were illiterate and 82% belong to low socio-economic class. Common risk factors were mal-handling of labor by untrained dai (44%) cephalopelvic disproportion (35%) previous caesarean scar (34.28%) shoulder presentation 15%, abused of oxytocic drug (14%). Shock and sepsis were the prominent presenting features. In most cases, the tear was in the lower segment and in 54 patients (80%) the tear was complete. 25 (37%) patients had sub-total hysterectomy, 22 had repair and 13 (19.4%) had total hysterectomy. Maternal and fetal mortality rate was 11.42% and 88.5% respectively. Conclusion: A high incidence (1 in 195) of ruptured uterus mainly because of inadequate natal and intranatal care, high parity, mismanagement of labor, Low socio-economic condition and illiteracy. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 29-33

scholarly journals Pregnancy in women with liver cirrhosis is associated with increased risk for complications: a systematic review and meta-analysis of the literature

2021 ◽  
Author(s):  
Laurine van der Slink ◽  
Irma Scholten ◽  
Faridi van Etten-Jamaludin ◽  
Bart Takkenberg ◽  
Rebecca Painter
Keyword(s):  
Liver Cirrhosis ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Fetal Mortality ◽  
Variceal Hemorrhage ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Fetal Complications ◽  
Obstetric Population

Background Pregnancy and liver cirrhosis is a rare but increasing combination. Liver cirrhosis can raise the chance of maternal and fetal mortality and morbidity, although the exact risks remain unclear. Objective To provide a systematic literature review and meta-analysis on maternal, fetal and obstetric complications among pregnant women with liver cirrhosis. Search strategy We performed a systematic literature search in the databases PubMed/MEDLINE and EMBASE (Ovid) from inception through 25 January 2021. Selection criteria Studies including pregnancies with liver cirrhosis and controls were eligible. Data collection and analysis Two reviewers independently evaluated study eligibility. We used the random-effects model for meta-analysis. Main results Our search yielded 3118 unique papers. We included 11 studies, including 2912 pregnancies in women with cirrhosis from 1982-2020. Seven studies were eligible for inclusion in the meta-analysis. The overall maternal mortality rate was 0.89%. Maternal mortality and variceal hemorrhage decreased comparing recent and older studies. Most cases of maternal mortality due to variceal hemorrhage (70%) occurred during vaginal delivery. Pregnant women with liver cirrhosis had a higher chance of preterm delivery (OR 6.7 95% CI 5.1- 9.1), cesarean section (OR 2.6, 95% CI 1.7-3.9), preeclampsia (OR 3.8, 95% CI 2.2-6.5) and small for gestational age neonates (OR 2.6, 95% CI 1.6-4.2) compared to the general obstetric population. Subgroup-analyses could not be conducted. Conclusions Liver cirrhosis in pregnant women is associated with serious increases in maternal mortality and obstetric and fetal complications. Large international prospective studies are needed to identify risk factors for unfavorable outcome.

scholarly journals Use of intracervical Foley catheter for pre-induction cervical ripening in women planned for vaginal birth after previous caesarean section

2020 ◽  
Vol 9 (12) ◽  
pp. 4927
Author(s):  
Sheenam Jakhar ◽  
Veena Ganju Malla
Keyword(s):  
Caesarean Section ◽  
Foley Catheter ◽  
Mode Of Delivery ◽  
Vaginal Birth ◽  
Induction Of Labour ◽  
Cervical Ripening ◽  
Labour Induction ◽  
Previous Caesarean Section ◽  
Bishop Score ◽  
Increased Risk

Background: Vaginal birth after previous caesarean section is challenging for obstetricians due to increased risk of uterine rupture. Common methods for labour induction in post caesarean pregnancies are membrane sweeping, balloon catheters, prostaglandins (PGE2), and oxytocin. As currently available data is limited, the evidence of safest method of induction is lacking. The present study aimed to assess the effectiveness of intra-cervical Foley catheter for pre-induction cervical ripening in women planned for vaginal birth after caesarean section.Methods: This prospective cross-sectional study included 24 pregnant women with a history of previous caesarean section, admitted for induction of labour. Induction was performed in patients with unfavourable modified Bishop Score by intra-cervical Foley catheter. The change in modified Bishop Score, oxytocin requirement, induction-delivery interval, mode of delivery, maternal complications and neonatal outcome were observed.Results: There was significant improvement in modified BS noted at the end of trans-cervical Foley catheter induction and this improvement in mean of modified BS was observed to be statistically significant (p<0.0001). The vaginal delivery rate was 29.2% while 70.8% of patients underwent caesarean section. No significant maternal or foetal complications were observed with Foley catheter induction except for one case of vaginal bleeding. There was no case of intrapartum or postpartum maternal infection.Conclusions: Foley catheter may be a cheap and effective method for pre-induction cervical ripening and induction of labour in patients with previous caesarean section.

scholarly journals Neonatal and maternal outcome in term primigravida with isolated oligohydramnios

2018 ◽  
Vol 8 (1) ◽  
pp. 258
Author(s):  
Shelly Agarwal ◽  
Samta Gupta
Keyword(s):  
Perinatal Outcome ◽  
Induction Of Labour ◽  
Exclusion Criterion ◽  
Control Group ◽  
Medical Sciences ◽  
Retrospective Case ◽  
Study Population ◽  
Vertex Presentation ◽  
And Control ◽  
Control Study

Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes.  After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome. 

Determine the Outcome of Newborn in Post-Term Pregnancy

2021 ◽  
Vol 15 (5) ◽  
pp. 1180-1182
Author(s):  
A. S. Rizwan ◽  
A. Fatima ◽  
M. Gul ◽  
S. Anwar ◽  
A. Jadaan ◽  
...  
Keyword(s):  
Gestational Age ◽  
Mode Of Delivery ◽  
High Rate ◽  
Fetal Mortality ◽  
Term Pregnancy ◽  
Meconium Aspiration ◽  
Mortality And Morbidity ◽  
Medical Disorders ◽  
Prolonged Pregnancy ◽  
Post Term Pregnancy

Objective: The objective of this study was to assess the outcome of newborn among pregnant females who deliver after prolonged pregnancy. Study Design: Descriptive study Place and Duration: Obstetrics & Gynaecology department of Shahida Islam Teaching Hospital, Lodhran for duration of six months from September 2020 to February 2021. Materials and Methods: 100 patients with pregnancy of >40 weeks were included in study. The patients were not included in this study with medical disorders, intrauterine demise or pregnancy complications. Identification of parameters regarding poor neonatal outcome was done. Variable e.g. gestational age, parity, fetal movement, age, mode of delivery, ultrasound, admission cardiotocogram (CTG) and past prolonged pregnancy were studied. Results: Most of the patients i.e. 39 (39%) were between twenty to twenty five years of age. In this study group multigravida were found in 60 (60%). Emergency caesarean section 65 (65%). Most of babies 64% were admitted to neonatal intensive care unit (ICU). Meconium aspiration syndrome was most general among complications which were found in 67 (67%). No fetal mortality was observed. Conclusion: Pregnancy should be managed before 42 weeks of gestation and should not allow to go post-term due to high rate of neonatal mortality and morbidity. Key words: Neonate, Post-term Pregnancy, Gestational Age, Meconium Aspiration, NICU, Mortality

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