scholarly journals Pregnancy outcome in elderly primigravida

Author(s):  
Kumudini Pradhan ◽  
Lina Baru ◽  
Ashish Dharua

Background: Incidence of elderly primigravida has increased now days, due to rising education level, effective means of birth control and high carrier goals. The women who conceived in advanced age more than 35 years for first time is defined as elderly primigravida. Indian standard is fixed at more than 30 years by Dutta 2013. These women are high risk for maternal and foetal complication and outcome. The study was done to assess pregnancy outcome in elderly primigravida.Methods: This is a prospective hospital-based study done from October 2016 to November 2018. Women of reproductive age group with first pregnancy admitted to department of obstetrics and gynaecology, Veer Surendra Sai Institute of Medical Science and Research, Burla were taken after exclusion criteria.Results: The incidence of elderly primigravida was 2.51%. But majority (84.76%) though married early, conceived late. Most of them are belongs to high socioeconomic group (62.86%). Anaemia was commonest complication (28.57%), fibroid in 5.71% cases. Pre-eclampsia (18.09%), eclampsia (3.81%), IUGR (12.38%) and twin pregnancies (5.72%) were seen more frequently than young primigravida. 55.24% were developed complications during labour like foetal distress (33.33%), PPH (3.81%) and retained placenta (2.86%). Gestational diabetes mellitus in (0.95%), caesarean section rate 29.52%, normal delivery 51.42%, and congenital anomaly 8.15%.Conclusions: Elderly primigravida are high-risk for several complications like spontaneous abortion, preterm labour, prolonged labour, foetal distress, high caesarean rate, PPH, congenital anomaly and increased incidence of perinatal mortality. Majority of this patients properly supervised are capable of safe and successful pregnancies ending in healthy mother and healthy baby.

2021 ◽  
Vol 9 (6) ◽  
pp. 1208-1217
Author(s):  
Anubha Srivastava ◽  
Anjana Saxena ◽  
Vijay Kumar Srivastava ◽  
Ashutosh Kumar Yadav

Ayurveda is the most ancient medical science and its fundamentals cover every aspect of human life. Acharya Sushruta has classified the diseases into seven types on the basis of its origin; among them first two are explained for birth defects. Genetic disorders (Adibala pravritta) and Congenital anomaly (Janmabala pravritta) are the two main categories of birth defects (Garbhajanya vikriti) encountered during the early infancy. The genetic disorders are either maternal or paternal and largely responsible for carrying genetic defects in progeny, whereas congenital birth defects are mainly due to faulty diet and lifestyle of mother and due to suppression of mental and physical desire of the pregnant lady. Ayurveda enlisted various desires of pregnant woman and their impact on the health and physical status of the progeny. Similarly, there are so many rituals and regimens are described for pregnant lady to prevent birth defects and to make woman ready for normal delivery. In brief, it can be said that if a preg-nant lady wishes for a healthy baby (Supraja), She should follow the Nine-month regimen (GarbhiniParicharya) mentioned for them in Ayurveda, so the chances of congenital anomaly will be minimal. Keywords: Congenital anomaly, Birth defect, Garbhajanya vikriti, Supraja, Garbhini paricharya


2018 ◽  
Vol 11 (2) ◽  
pp. 95-104
Author(s):  
Ivan D. Ivanov ◽  
Stefan A. Buzalov ◽  
Nadezhda H. Hinkova

Summary Preterm birth (PTB) is a worldwide problem with great social significance because it is a leading cause of perinatal complications and perinatal mortality. PTB is responsible for more than a half of neonatal deaths. The rate of preterm delivery varies between 5-18% worldwide and has not decreased in recent years, regardless of the development of medical science. One of the leading causes for that is the failure to identify the high-risk group in prenatal care. PTB is a heterogeneous syndrome in which many different factors interfere at different levels of the pathogenesis of the initiation of delivery, finally resulting in delivery before 37 weeks of gestation (wg). The various specificities of risk factors and the unclear mechanism of initiation of labour make it difficult to elaborate standard, unified and effective screening to diagnose pregnant women at high-risk for PTB correctly. Furthermore, they make primary and secondary prophylaxis less effective and render diagnostic and therapeutic measures ineffective and inappropriate. Reliable and accessible screening methods are necessary for antenatal care, and risk factors for PTB should be studied and clarified in search of useful tools to solve issues of risk pregnancies to decrease PTB rates and associated complications.


2021 ◽  
Vol 20 (4) ◽  
pp. 768-773
Author(s):  
Meidona Nurul Milla ◽  
Yani Istadi ◽  
Vania Shaula ◽  
Deastri Anjeas Wari ◽  
Chntyia Dwi Cahyani Puspitasari ◽  
...  

Background: Infertility has been more common problems among couple of reproductive age. One of the factors causing this disorder is unhealthy environmental factors including exposure to cigarette smoke. Polynuclear aromatic hydrocarbons (PAHs) in cigarette smoke can cause testicular atrophy, while the free radicals can inhibit the stages of spermatogenesis, and nicotine in cigarettes affects the brain dopamine levels affecting the levels of GnRH, and subsequently affect the levels of FSH and LH needed in spermatogenesis. The use of Mucuna pruriens seed extract containing antioxidants and L-dopa is expected to improve the quality of sperm after exposure to cigarette smoke. Objective: This study aimed to determine the effect of Mucuna pruriens seed extract on the sperm quality in mice exposed to cigarette smoke. Methods: This study was an experimental study with a post test only control group design. A total of 20 mice were divided into 4 groups of five mice each. All groups were exposed to cigarette smoke. Group 1 was the negative control exposed to cigarette smoke. Groups 2, 3, 4 were exposed to cigarettes smoke and given Mucuna pruriens seed extracts at the dose of 250; 300; and 350 mg/Kg BW/day. Parameters of sperm quality included concentration, morphology, motility and viability. Results: Post hoc tests showed there were significant differences among treatment groups. Conclusion: the administration of Mucuna pruriens seed extract affects the sperm quality of BALB/c mice exposed to cigarettes smoke. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.768-773


2021 ◽  
Vol 9 ◽  
Author(s):  
Jacqueline Cortinhas Monteiro ◽  
Ricardo Roberto de Souza Fonseca ◽  
Tuane Carolina de Sousa Ferreira ◽  
Luana Lorena Silva Rodrigues ◽  
Andreza Reis Brasil da Silva ◽  
...  

Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Several studies have shown a higher prevalence of HPV infection in HIV-infected women. The aim of this study was to determine the prevalence and the genotype diversity of HPV infection in HIV-infected women. From April 2010 to December 2012 cervical specimens were collected from 169 HIV-infected women who screening for cervical cancer at Reference Unit in Belém. The detection of HPV infection was performed by nested PCR and HPV type was performed using a commercial system. The prevalence of HPV infection was 63.3%. Of the 47 genotyped samples, 40.4% was found positive for high risk-HPV 16 and 12.8% for high risk-HPV 52. HPV infection was predominant in the group of women with no incidence of cytological abnormalities and more prevalent in women of reproductive age, unmarried, low education level, and who reported use condoms during sexual intercourse. It was observed an association between HPV infection and independent variables, such as condom use, multiple sexual partners, and history of sexually transmitted diseases. High-risk types of HPV infection were prevalent in our study. Infection with multiple high-risk HPV genotypes may potentiate the development of cervical cancer in HIV-infected women.


Author(s):  
Dipali Prasad ◽  
Huma Nishat ◽  
Bhawana Tiwary ◽  
Swet Nisha ◽  
Archana Sinha ◽  
...  

Background: Obstetric emergencies can occur suddenly and unexpectedly. Obstetrics is unique in that there are two patients to consider and care for, a mother and a baby or fetus. Identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness can reduce the incidence of obstetric emergencies. Present study was carried out to know the incidence, nature and outcome of obstetric emergencies.Methods: Retrospective study of obstetric emergencies admitted to Obstetrics and Gynaecology department of Indira Gandhi Institute of Medical science, Patna from March 2015 to September 2017.Results: The common clinical presentation was Ectopic Pregnancy (19.64%), Heart Disease (16.64%), Abortion (13.69%), Severe Anaemia (16.66%), Purpureal Sepsis (9.52%), Sever pregnancy induced hypertension (3.57%), Eclampsia/ HELLP Syndrome (2.38%), Multiple Pregnancy (1.19%) Malignancy Disorder with Pregnancy (2.97%) and HIV in pregnancy (0.59%). Intervention done include Dilation and evacuation (13.69%), Caesarean section (28.57%), Vaginal delivery (22.62%), Caesarean Hysterectomy (2.38%), Exploratory Laparotomy (20.83%) and conservative management in (11.90%) of patients. Maternal outcome include shock due to rupture ectopic and post-partum (16.68%), Blood Transfusion done in (27.99%), Septicaemia (15.48%), ICU admission (8.92%), HDU (12.5%), Pulmonary oedema (6.54%), DIC (4.16%), CCF (3.57%), Ventilatory Support (1.78%) and Maternal Mortality (2.38%). Fatal outcome includes live birth (58.8%), NICU Admission (27.45%), Ventilatory Support (7.84%) and Neonatal mortality (5.88%).Conclusions: High risk pregnancy identification and proper antenatal, intranatal and postnatal care will reduce the incidence of obstetrical emergencies. Peripheral health care system need to be strengthen and early referral need to be implemented for better maternal and fetal outcome.


2020 ◽  
Vol 40 (12) ◽  
pp. 1039-1047
Author(s):  
Natália Cristina de Souza ◽  
Fernanda Bovino ◽  
Larissa Gabriella Avilla ◽  
Maurício Deschk ◽  
Jefferson F. Alcindo ◽  
...  

Abstract: The aim of this study was to evaluate the lung maturity of premature and full-term lambs by analyzing amniotic fluid using the following methods: Clements test, Nile blue cytology test, hematoxylin-Shorr stain, lamellar body count, and radiographic tests. The use of these methods is intended to identify high-risk newborns and provide immediate clinical intervention after birth. Altogether, 56 animals (24 ewes and 32 lambs) were included in the study and divided into 3 groups. Group I consisted of 8 ewes that were at approximately 145 days of gestation; this group delivered 10 lambs naturally. Group II consisted of 8 ewes that were at 138 days’ gestation; this group delivered 11 lambs by cesarean section. Group III consisted of 8 ewes at 138 days’ gestation; this group was administered intramuscular dexamethasone (16mg/animal) 36 hours prior to a cesarean section. Group III delivered11 lambs. Cytological tests were performed using a microscope with a maximum magnification of 1000x, while the Clements test was visually observed by one of the researchers. Amnioticfluid lamellar body counts were measured using transmission electron microscopy. Among the staining methods, hematoxylin-Shorr was reliable, and Group III had a greater number of orangeophilic cells when compared to Group II, probably due to corticoid administration. The Clements test showed pulmonary maturity in approximately 20% of Group I lambs and Group II showed 9.1% of bubbles; however, Group III had the highest pulmonary maturity percentage (36.4%). The lamellar bodies were measured, and all groups had sizes between 0.019 and 0.590μm. Radiographic evaluation revealed that the majority of lambs presented some level of pulmonary radiodensity, indicating an acinar pattern at birth. These results are in line with the expectations of each group. We found that the normal group showed greater pulmonary maturity, whereas Group II presented pulmonary immaturity, which is expected because this group comprised lambs born prematurely and Group III showed pulmonary maturity almost comparable to the normal delivery group (Group I). This is due to the fact that although these animals are premature, the use of dexamethasone helped in pulmonary maturation. Therefore, these pulmonary maturity tests are considered effective when more than one technique is used and can be used routinely in the care of a pregnant ewe in labor, where a simple collection of amniotic fluid can predict a high-risk pregnancy and alert the veterinarian if the newborn needs intensive supportive treatment.


2017 ◽  
Vol 6 (3) ◽  
pp. 167
Author(s):  
Erna Setiawati ◽  
Oktia Woro Kasmini Handayani ◽  
Asih Kuswardinah

ABSTRACT Kelompok usia reproduksi terbagi dalam tiga fase yaitufase menunda kehamilan (<20 tahun), fase menjarangkan kehamilan (20-30 tahun) dan fase mengakhiri kehamilan (>30 tahun). Cara yang ditempuh yaitu dengan pemakaian kontrasepsi.baik  MKJPmaupunnon MKJP. Tujuan penelitian ini adalah untuk mengetahui ada atau tidak perbedaan pemilihan kontrasepsi MKJP dan non MKJP berdasarkan efek samping pada dua kelompok usia reproduksi. Penelitin ini menggunakan desain cross sectional, pengambilan data dengan kuesioner. Sampel dalam penelitian ini adalah akseptor KB baik MKJP maupun non MKJP pada bulan april sampai juni sebanyak 200 responden, dimana tekhnik pengambilan datanya dengan random sampling dan kuota sampling. Hasil penelitian kemudian diuji dengan mann-whitney test.Hasil penelitian dengan uji mann whitney test diperoleh p = 0.662 dengan kata lain p > α (0.05) yang berarti tidak ada perbedaan pemilihan MKJP dan non MKJP berdasarkan efek samping di Wilayah Kabupaten Semarang.      ABSTRACT Reproductive-age category can be divided into three groups which are the group of delayed interval pregnancy (less than 20 years old), the group of intervalcontrol pregnancy (20 to 30 years old), and the group of high risk pregnancy (more than 30 years old). An alternative to avoid high risk pregnancy is by using contraception tool namely long-term contraception (MKJP) and non long-term contraception (non MKJP).The purpose of this research is to analysedwhether there are differences in choosing MKJP and non –MKJP based on side effects in the two reproductive-age groups.This research was an explanatory research with cross-sectional design. The population were all women of contraception acceptors in Semarang Regency.The samples were 200 respondents, used simple random sampling and quota sampling. This research used quisionaire instrument and analyze used mann whitney test (α=0,05). Theresult showed thatP = 0,662 meaning P > α = 0.05 which means there is no difference in choosing MKJP and non-MKJP based on side effects in the two reproduction-age groups in Semarang regency.


2021 ◽  
Author(s):  
Aurore Nishimwe ◽  
Philomene Uwimana ◽  
Liberee Rumagihwa ◽  
Alfred Rutagengwa ◽  
Laetitia Nyirazinyoye ◽  
...  

Abstract Background: Maternal high-risk fertility behaviors have been linked to negative maternal and child health outcomes that include anaemia, undernutrition, and child mortality. In this context, we examined the association between maternal high-risk fertility behavior and pregnancy intention among women of reproductive age in Rwanda.Methods: This cross-sectional study is based on secondary data from the 2014–15 Rwanda Demographic and Health Survey (n=5661). The outcome of interest was pregnancy intention of the last child defined as intended or unintended. Maternal high-risk fertility behaviors were measured using maternal age at delivery, birth order, and birth interval. Chi-square test and multivariable regression models were performed. Results: The prevalence of unintended pregnancy was 46.8% (n=2652). Overall, 35.8% (n=2017) of women experienced single high-risk fertility behavior, while 23.1% (n=1282) of women experienced multiple high-risk fertility behaviors. Compared to women who have not experienced high-risk fertility behavior, the multivariable odds ratio (95% CI) of unintended pregnancy among women in single-risk and multiple-risk fertility behaviors were 2.00 (1.75, 2.28; p <0.001) and 2.49 (2.09, 2.95; p <0. 001.), respectively.Conclusion: Exposure to high-risk fertility behaviors is positively associated with unintended pregnancy among women in Rwanda. Therefore, reproductive and sexual health services should pay special attention to women who are <18 years or >34 years old; who have more than three children already; or have children with less than 24 months’ interval between giving birth.


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