scholarly journals Obstetric and neonatal outcomes of the pregnancies complicated with thrombocytopenia

2019 ◽  
Vol 8 (11) ◽  
pp. 4276
Author(s):  
Pratima Kumari ◽  
Saurabh V. Bhangale ◽  
Asmita N. Patil
Keyword(s):  
Statistical Significance ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
P Value ◽  
Blood Product Transfusion ◽  
Maternal Complications ◽  
Common Cause ◽  
Gestational Thrombocytopenia ◽  
In Pregnancy

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.

scholarly journals Management of preterm severe preeclampsia: interventional versus expectant management

2018 ◽  
Vol 7 (10) ◽  
pp. 3931 ◽  
Author(s):  
Anitha Durairaj
Keyword(s):  
Gestational Age ◽  
Perinatal Death ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Severe Preeclampsia ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
A Prospective Study

Background: Management of preterm severe preeclampsia is challenging. This study aims to determine the maternal and perinatal outcomes in interventional and expectant management.Methods: This was a prospective study conducted at Institute of obstetrics and gynecology, Chennai over a period of three years. Patients with preterm severe preeclampsia of gestational age 28 weeks to 31 weeks and 6 days who had interventional and expectant management were recruited. Clinical details relevant to maternal, fetal and neonatal outcome were collected and the data were analyzed using IBM.SPSS statistics software 23.0 Version.Results: Termination of pregnancy in the expectant management was done mostly for maternal indications (66%). The mean prolongation of pregnancy in the expectant management was 7.67 days and it was statistically significant. Though maternal complications were slightly higher with the expectant management, but it was not statistically significant. Early neonatal death, perinatal death and mean NICU stay were lower in the expectant management with statistical significance. Mean gestational age at delivery, mean birth weight and neonatal survival rate were statistically significantly higher in the expectant management than the interventional management.Conclusions: Optimizing maternal and perinatal outcome is the key in the management of preterm severe preeclampsia. Expectant management of preterm severe preeclampsia results in a better obstetric outcome and should be done only in well selected patients in a tertiary care centre. 

scholarly journals Thrombocytopenia in pregnancy

2021 ◽  
Vol 10 (3) ◽  
pp. 1050
Author(s):  
Jui Manish Shah ◽  
Rakesh Anand
Keyword(s):  
Complete Blood Count ◽  
Incidental Finding ◽  
Tertiary Care ◽  
Severe Thrombocytopenia ◽  
Tertiary Care Centre ◽  
Common Cause ◽  
Gestational Thrombocytopenia ◽  
Fetal Complications ◽  
Severe Degree ◽  
In Pregnancy

Background: Thrombocytopenia in pregnancy is defined as platelet count of less than 150,000/µl. It may be inherited or idiopathic, acute or chronic in onset, either primary or associated with other disorders. Gestational thrombocytopenia is the most common type which is diagnosed usually in the last trimester. When there is severe thrombocytopenia, it is usually pathological in origin. The goal of this study was to identify thrombocytopenia in early stages of pregnancy and evaluate the risk factors involved. Aim was the evaluation of thrombocytopenia in pregnancy.Methods: This was a prospective observational study conducted in the Obstetrics and Gynecology Department of a tertiary care centre from 1st January 2020 to 31st December 2020. Data was collected and analyzed by SPSS version 17.Results: In the current study, 71.1% of cases were mild thrombocytopenia and 64.4% were picked up in the third trimester. Out of the 90 cases taken, 64% of the cases were due to the most common cause i.e., gestational thrombocytopenia. The second most common cause of thrombocytopenia was pregnancy induced hypertension which accounted for 18% of the total number of cases. Symptomatic thrombocytopenia of moderate and severe degree was seen in cases of PIH and ITP. 37.5% of the cases had underlying hypertension.Conclusions: Timely identification and management of the cause of thrombocytopenia is crucial in the antenatal group of women. Although it is an incidental finding in most cases, when there is an underlying cause, severity of thrombocytopenia increases tremendously and has dire consequences. Every pregnant woman should undergo complete blood count examination once in each trimester to avoid maternal and fetal complications.

scholarly journals Maternal and neonatal outcome in pregnancy at 40 years and beyond in a tertiary care center: a retrospective case control study

2019 ◽  
Vol 8 (8) ◽  
pp. 3129
Author(s):  
Vrunda Appannagiri ◽  
Divya K. ◽  
Beena Kingsbury ◽  
Swati Rathore ◽  
Jiji E. Mathews ◽  
...  
Keyword(s):  
Case Control Study ◽  
Care Center ◽  
Tertiary Care ◽  
Case Control ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Maternal Complications ◽  
Retrospective Case ◽  
Control Study ◽  
In Pregnancy

Background: Obstetric outcome in women with advanced maternal age (AMA) is not usually studied especially in India.Methods: This study was a case control study. The cases were pregnancy in 100 women at 40 years of age and beyond and there were two control arms of 100 each of ages 20-29 years and 30-39 years. The demography, maternal complications, delivery outcomes and neonatal outcomes were compared.Results: Women with AMA were mostly multipavrous and had higher Body Mass Index (BMI). Hypertensive disease in pregnancy was more common in AMA but the difference was statistically significant. Women with AMA were more likely to have gestational diabetes (p ≤ 0.011), more likely to have anemia (p = 0.038), more likely to have preterm birth (p = 0.001), other medical complications compare to the control group (p = 0.005). They were also more likely to have Lower Segment Caesarean Section (LSCS) (p ≤ 0.001) and have postpartum complications. The birth weight of the neonate was significantly decreased in the AMA group (p < 0.001). The neonates were also more likely to be admitted to Neonatal Intensive Care Unit (NICU) (p ≤ 0.006).Conclusions: Adverse maternal and neonatal outcomes were seen despite individualized and optimal obstetric care. Thus, these women need preconceptional counselling.

scholarly journals MATERNAL SEPSIS;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Fehmida Parveen Memon ◽  
Majida Khan ◽  
Samya Aijaz
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
P Value ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Maternal Morbidity And Mortality ◽  
Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

REFERRAL PATTERN AND OUTCOMES OF NEONATES FROM SECONDARY CARE SETTING OF AGA KHAN UNIVERSITY HOSPITAL TO TERTIARY CARE CENTERS IN PAKISTAN

2021 ◽  
pp. 1-13
Author(s):  
Suneeta khemani ◽  
Nazia Shamim ◽  
Adnan Mirza ◽  
Nadia Muhammad ◽  
Safdar Kagazwala ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Neonatal Mortality ◽  
Secondary Care ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
P Value ◽  
Tertiary Care Centers ◽  
Tertiary Care Hospitals

ABSTRACT:Objective: To determine the reasons of neonatal referrals from secondary care settings of Aga Khan University Hospital (AKUH) to tertiary care centers of Karachi, Pakistan and to assess the neonatal outcomes for referred cases. Methodology: This retrospective observational study was conducted at AKUH from July 2015 tjune 2019. All neonates born after 32 weeks of gestation at AKUH secondary care(Kharadar, Garden & Karimabad)and referred to tertiary care hospitals were consecutively enrolled. The reason for referral, i.e. surgical intervention, respiratory support, care of prematurity; need of mechanical ventilation, referral place and neonatal outcomes like discharge in stable condition, left against medical advice (LAMA) and mortality, were noted. Results: Of 348 referred cases, 306 (87.9%)were reported alive. neonatal mortality was reported in 42 (12.1%) of the cases. Of these 306 alive participants, 284 (92.81%) were discharged from the hospital whereas 22 (7.18%) LAMA. Of 348 patients, the referral place of most of the patients was outside AKU,i.e.189(56.3%).The need of mechanical ventilation was reported in, 63 (18.1%) patients. A significant association of mechanical ventilation in tertiary centers was observed in neonates born with low APGAR score at 1 and 5 min (p-value <0.001), shorter duration of stay at secondary care(p-value 0.007),and aggressive resuscitation requirement at birth (p-value <0.001). Conclusion: Most common reasons for referral of newborns to tertiary care hospital was respiratory diseases requiring respiratory support and surgical intervention. Neonatal mortality noted for referrals made to AKUH were much less as compared to cases referred to other tertiary care hospitals. Continuous...  

scholarly journals Study of thrombocytopenia in pregnancy: clinical presentation and outcome at tertiary care rural institute

2020 ◽  
Vol 9 (4) ◽  
pp. 1622
Author(s):  
Jigyasa Singh ◽  
Kalpana Kumari ◽  
Vandana Verma
Keyword(s):  
Platelet Count ◽  
Prospective Observational Study ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Late Pregnancy ◽  
Normal Platelet ◽  
Gestational Thrombocytopenia ◽  
Underlying Causes ◽  
In Pregnancy ◽  
Rule Out

Background: Platelet count below 1.5 lakh/cumm is called as thrombocytopenia. After anaemia it is the second most common haematological disorder in pregnancy. It affects nearly 6 to 15%; on an average 10% of all pregnancies. Gestational thrombocytopenia is a clinically benign thrombocytopenic disorder usually occurring in late pregnancy. It resolves spontaneously after delivery.Methods: It is a hospital based prospective observational study over a period of 1 year. All pregnant women who attended OPD at the department of obstetrics and gynecology, UPUMS, Saifai for antenatal checkup were included for the study and blood sample was withdrawn.Results: Out of 263 cases enrolled for study, 90 women were found to have thrombocytopenia, and 173 had normal platelet count. Thus, incidence of thrombocytopenia was 34%. Gestational thrombocytopenia accounted for majority of cases of thrombocytopenia in pregnancy (50%) followed by hypertensive disorders (22.4%). It was further followed by ITP (11.11%) and dengue (5.5%).Conclusions: Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy (50%), but other underlying causes must be considered as well. A thorough history and physical examination will rule out most causes.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

2017 ◽  
Vol 6 (3) ◽  
pp. 781
Author(s):  
Radha K. R. ◽  
Nishu Sugunan ◽  
Resmy C. R.
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

scholarly journals Endovascular Versus Open Versus Hybrid Revascularisation In Infra Inguinal Disease – 2 Years Prospective Study in A Tertiary Care Center in South India

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 97-101
Author(s):  
Senthilnathan T. T. ◽  
Manoj Prabakar R. ◽  
Subramaniyan S. R. ◽  
Marunraj G. ◽  
Saravanan B. ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Statistical Significance ◽  
Care Center ◽  
Tertiary Care ◽  
Individual Risk ◽  
P Value ◽  
Acute Limb Ischemia ◽  
Number Of Patients ◽  
Treatment Procedures

Our aim is to share the clinical experience of , open and combined hybrid in infra inguinal disease and compare the results. A prospective study of 150 patients undergoing infra inguinal procedures was done, a period ranging from October 2017 to June 2019 with 3 months follow up. A number of patients undergoing CT , Digital Subtraction (DSA) were recorded. A number of cases undergoing Angioplasty, Catheter Directed (CDT), Open Surgical Bypass were noted. Cases of acute limb ischemia were excluded and chronic cases included in our study, age 35-85 years, sex distribution male 134(89.3%) and female 16(10.7%) cases. Similarly, individual risk factors were stratified. Ct was done in 60 (40%) and DSA in 90 (60%) cases. Diagnostic variables : left occlusion 42 (28%), right occlusion 55(36.7%), left tibial occlusion 18 (12%) and right tibial occlusion 35(23.3%). Treatment procedure variables : CDT and Angioplasty 1(0.7%), angioplasty 87(58%), angioplasty and bypass 8(5.3%), bypass 35(23.3%), CDT 15 (10%), CDT and bypass 4(2.7%). The results of the analysis were compared and statistical significance P-value were calculated by chi-square tests, SPSS software. Statistic significance was seen for risk factors CAD (0.001), Smoking (0.008), Hypertension (0.000) on comparison to treatment procedures and for corresponding clinical diagnosis (0.002), investigation modality (0.000) and treatment procedures.

scholarly journals Foetomaternal outcome in multifoetal pregnancy in a tertiary rural teaching hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 614
Author(s):  
Sneha Gond ◽  
Partha Pratim Sharma ◽  
Narra Madhuri ◽  
Kasturi Barman
Keyword(s):  
Prospective Observational Study ◽  
Statistical Significance ◽  
P Value ◽  
Statistical Association ◽  
Maternal Complications ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Rural Teaching

Background: Aim of the study was to find out foeto-maternal outcome of multifoetal pregnancy in relation to chorionicity and to analyse the associated risk factors.Methods: This study was a prospective observational study on multifoetal pregnancy conducted at Midnapore medical college and hospital. Statistical analysis was done by chi-square test and statistical significance was set at p-value<0.05.Results: Incidence of multifoetal pregnancy was 1.7%. Modal age group was 20-24 years age and 82% conceived spontaneously. Among chorionicity, Dichorionic diamniotic (DCDA) were 60% followed by 34% Monochorionic diamniotic (MCDA), 4% Monochorionic monoamniotic (MCMA) and 2% Trichorionic triamniotic (TCTA). Among maternal complications preterm labour were present in both twins and triplets followed by anemia. LSCS was required in 60.8 % of twins and common indication was malpresentation. Majority of MC and TC were delivered at gestational age of 31-33 weeks (47.1% MCDA, 50% MCMA and 60% TCTA) and dichorionic delivered at 34-36 week (48.7%). Statistical association between neonatal outcomes and chorionicity were significant in IUGR (p=<0.0001), stillbirth (p=0.0356), congenital anomalies (p=0.0017), discordant growth (p<0.0001), Apgar score <7 (p<0.0001), low birth weight (p=0.014), live birth (p≤0.0001) and NICU admission (p<0.0001).Conclusions: Maternal and perinatal outcome was significant in monochorionic and trichorionic pregnancies compared to dichorionic pregnancies with increased NICU admissions required in monochorionic and trichorionic gestations.

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