scholarly journals A study on eclampsia and its maternal and perinatal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4990
Author(s):  
Devika J. Kamat ◽  
Guruprasad Pednecar
Keyword(s):  
Antenatal Care ◽  
Perinatal Outcome ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Tertiary Care Centre ◽  
Neonatal Deaths ◽  
Nicu Admission ◽  
A Prospective Study

Background: Eclampsia is one of the major causes of maternal and perinatal mortality in India. Here authors present a prospective study which was conducted in a tertiary health centre to study the cases of eclampsia, the mode of presentation and the maternal and perinatal outcomes.Methods: A total 95 women were diagnosed as eclampsia during the period of 2 years. Various parameters and their effects on maternal and perinatal morbidity and mortality were studied. Maternal outcomes were assessed based on parameters like antenatal care received, mode of delivery, complications associated with eclampsia. Perinatal outcomes were noted depending upon the period of gestation, NICU admission, stillbirths and neonatal deaths.Results: Authors found the incidence of eclampsia to be 0.9%. 52.7% women had irregular antenatal follow up at any nearby health centre. A total 76.8% women had antepartum eclampsia. 56.8% delivered by caesarean section while 7.4% required operative vaginal delivery. 61.1% women delivered within 10 hours of onset of convulsion. Authors had 02 deaths in the study group, one due to ARDS with DIC and the other attributed to pulmonary oedema. There were 51.6% preterm deliveries. 21 neonates required NICU admission with 5 neonatal deaths and 11 stillbirths.Conclusions: Due to inadequate antenatal care, most of the cases of pre-eclampsia go unnoticed increasing the referrals to tertiary care centre for intensive care. Thus, it is necessary to emphasise on timely interventions and availability of blood bank, ICU and NICU facilities at the closest referral centre for better maternal and perinatal outcome.

scholarly journals A prospective study of the incidence and outcomes of eclampsia in a tertiary care hospital and teaching institute in India

2019 ◽  
Vol 8 (7) ◽  
pp. 2766
Author(s):  
Garima Gandhi ◽  
Kavita Chandnani
Keyword(s):  
Magnesium Sulphate ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Outcome Data ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
A Prospective Study

Background: Eclampsia is a common cause of maternal and foetal morbidity and mortality in India and the rest of the world accounting for nearly 10% of all maternal deaths. However, there is a relative scarcity of outcome data for patients with eclampsia in India. Our goal was to estimate the incidence of eclampsia, the maternal and foetal outcomes of patients presenting with eclampsia, and predictors of clinical outcomes in these patients. Objective of this study was to estimate the incidence of eclampsia in patients who delivered at a single tertiary care institution over a 2-year period and to study the maternal and perinatal outcomes in those patients.Methods: Prospective cohort study conducted from September 2008 to August 2010 on all patients with eclampsia admitted during the study period at Lok Nayak Hospital, New Delhi, India.Results: The incidence of eclampsia among total deliveries was 0.45%.  About 97% of these patients received parenteral magnesium sulphate as the primary anticonvulsant therapy. Caesarean section was performed in 22.7% and majorities were done for foetal distress. Maternal complications were encountered among 17% of patients. There were 2 maternal deaths (2.3%), 13 stillbirths (14.1%) and 7 early neonatal deaths (7.9%).Conclusions: The incidence of eclampsia among all deliveries over a 2-year period at a tertiary care centre in India was 0.45%. Parenteral magnesium sulphate was effective in the vast majority of these patients in controlling the seizures. Further studies to evaluate whether early registration for antepartum care improves maternal and foetal outcomes in patients with eclampsia are warranted.

EPIDEMIOLOGICAL AND ETIOLOGICAL PROFILE OF IUFD: A PROSPECTIVE STUDY AT TERTIARY CARE CENTRE

2021 ◽  
pp. 31-34
Author(s):  
Deepali Jain ◽  
Uma Jain ◽  
Japhia David
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
National Level ◽  
Health Indicators ◽  
Fetal Mortality ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre

Introduction:- IUFD occurrence without warning in a previously normal pregnancy is really a challenge to obstetrician and distressing situation for parents. It becomes crucial to identify specic probable cause of fetal death, to prevent the re-occurance and get the corrective measures. Prenatal mortality is still of one of the top most health indicators in measuring the quality and impact of health services in developing countries Still birth is a useful index to measure the values of antenatal and intranatal care. To decrease the fetal mortality rate, evaluation, documentation and audit of the etiology and the associated risk factors for stillbirth is required. Material and method :- The present study aims at studying the various causes related to IUFD. Prospective observational study conducted on 112 patients at Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.) for 18 months. All those cases who were diagnosed as intrauterine dead fetus at the time of admission with gestational age >24 weeks pregnancy were included in the study. All those investigation available at the centre of mother and father were noted and details were taken. Epidemiological evaluation of causes of fetal death was done. Record of the method of induction and mode of delivery taken. RESULTS :-Total 112 cases found during the study period were included . We found maximum cases unbooked - 71.43%, which were mainly emergency admissions. Majority of the IUFD cases- 77.67% were found to lie in the age group of 20-30 yrs, most of them were primigravida 62.5%., maximum cases of IUFD were of the gestational age 31-35 weeks- 47.32%. Hypertensive disorder of pregnancy- 23.3 % cases were found to be the major associated cause followed by Antepartum Haemorrhage 11.5%, Severe anaemia 15.1%, diabetes- 14.2% jaundice - 9.8%. congenital anomaly- 9.8%. Oligohydromnios- 8.9% and IUGR were also found to be associated with IUFD, forming an indirect reason. 39.29% cases were unexplained. 86.6% cases delivered vaginally. 10.7% cases had to undergo LSCS and only 2.68% cases underwent laparotomy for rupture uterus. 11.61% cases were of macerated IUFD baby indicating long term neglected IUFD. 39.78% and 38.39% IUFD were of 2.0-2.5 kg and 1.5-2.0 kg. This show strong corelation with LBW and IUGR. CONCLUSION:- Unexplained cases, hypertensive disorder, anemia and diabetes were the major causes for IUFD. In spite of advances in diagnostic and therapeutic modalities a major cause of fetal death remain unexplained because of poverty, illiteracy, unawareness and inaccessibility of a health centre. Undoubtedly, continued surveillance of stillbirth rates is wanted for both high- and low-risk pregnancies at a state and national level.

MATERNALAND PERINATAL OUTCOMES WITH COVID-19: A TERTIARY CARE CENTRE STUDY

2021 ◽  
pp. 31-32
Author(s):  
Sweety Sinha ◽  
Anjana Sinha ◽  
Ankita Ankita
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Neonatal Infection ◽  
Fetal Distress ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Polymerase Chain ◽  
Poor Outcomes

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy. Methods:Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR). Results: Atotal of 40 pregnant women positive for COVID-19 as conrmed by RT-PCR, were included in the study. 5% cases had preterm deliveries and LSCS was the preferred mode of delivery in 28 of 40 i.e., 70% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD only in this study. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy. Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.

scholarly journals Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India

2021 ◽  
Vol 10 (7) ◽  
pp. 2830
Author(s):  
Deepika Jamwal ◽  
Gurpreet Kour ◽  
Anil Mehta
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Liver Disorder ◽  
North India ◽  
Tertiary Care Centre ◽  
Impaired Liver Function ◽  
Nicu Admission ◽  
Cholestasis Of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy related liver disorder. It typically presents with troublesome itching and can lead to complications for both mother and foetus. Present study was carried out to study the incidence of Obstetric Cholestasis and its fetomaternal outcome in a tertiary care hospital.Methods: It was a prospective epidemiological study during a period of one year (May 2020 to April 2021) over 120 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as perinatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.3%. Majority of cases delivered at term (78.3%). 41.6% patients delivered vaginally, 43.3% had emergency caesarean section, and 2.5% patients had instrumental delivery. Maternal morbidities are due to sleep disturbance (60%), coagulation abnormality (13.3%), increase chance of operative delivery (55.8%) and postpartum haemorrhage (12.5%). Neonatal complications include meconium aspiration (46.6%), NICU admission (36.6%), prematurity (5%) and perinatal mortality (3.3%).Conclusions: Cholestasis of pregnancy causes maternal pruritus with impaired liver function tests. Maternal morbidity is increased in terms of increased caesarean section rates and discomfort due to pruritus. A timely intervention at 37-38 weeks will reduce the adverse perinatal outcome. 

scholarly journals Obstetric Cholestasis: Comparison of Maternal and Perinatal Outcome of Ursodeoxycholic Acid versus Placebo

2020 ◽  
pp. 28-33
Author(s):  
Faiza Safdar ◽  
Shabana Kalsoom ◽  
Noreen Majeed ◽  
Khair-un Nisa ◽  
Shazia Rafique ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Parallel Group ◽  
Acid 500Mg ◽  
Serum Transaminases ◽  
Meconium Staining ◽  
Nicu Admission

Objectives: Objective: To compare the maternal and perinatal outcomes of ursodeoxycholic acid with placebo in obstetric cholestasis. Method: It was an open randomized parallel-group study with convenient sampling, conducted at Pakistan ordinance factories hospital (POF Hospital) Wah Cantt, from 1st June 2016-30th May 2019. Patients with obstetric cholestasis of pregnancy, diagnosed between 24-34 weeks of gestation, were randomized to receive either ursodeoxycholic acid 500mg twice daily or placebo one capsule twice daily for 4 weeks. The data was collected on a pre-designed proforma. The data of 84 patients, who full fill the inclusion criteria were analyzed using SPSS vs 19. Maternal outcomes measured were a relief in pruritus and a decrease in hepatic alanine aminotransferase levels (ALT) at the end of 2 weeks and 4 weeks of treatment. The mode of delivery was noted. Fetal outcomes measured were meconium staining of amniotic fluid and the need for neonatal intensive care unit (NICU) admission. Results: The results showed significant improvement in maternal itch score (P=0.001) and serum transaminases level (p=0.001) in patients using UDCA as compared to placebo. Although there were less number of caesarean sections (p=0.36), meconium-stained liquor (p=0.29) and NICU admissions (P=0.33) in the UDCA group the differences were not statistically significant. Conclusion: Treatment with UDCA in obstetric cholestasis improved maternal complaint of itching and decreased raised transaminases levels but did not affect significantly the mode of delivery, incidence of meconium-stained liquor and NICU admissions. Keywords: Obstetric cholestasis, Ursodeoxycholic acid, perinatal outcome, Pruritus.

scholarly journals Maternal and perinatal outcome of oligohydramnios in term pregnancy in rural tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 389
Author(s):  
Swati Kagne ◽  
Sambhaji Chate
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Term Pregnancy ◽  
Tertiary Care Centre ◽  
Study Population ◽  
Nicu Admission

Background: Disorders of amniotic volume is one of the commonest obstetric problem. Amniotic fluid acts as cushion to the foetus allowing musculoskeletal development and also helps in the differentiation of lungs and gastrointestinal tract. Decreased amniotic fluid, known as oligohydramnios, is known to be associated with adverse perinatal outcome. The objective is to study the maternal and perinatal complications of oligohydramnios in term pregnancy.Methods: The present study was carried out in the Department of Obstetrics at rural tertiary care hospital in Maharashtra from February 2018 through October 2018. women with Oligohyamnios were studied for obstetrical and neonatal complications.Results: The incidence of oligohyamnios was 7.6% in present study. The mean age of the study population was 22.6±3.6 years. Induction of labour was required in 44 (61.11%) patients out of which 23 patients underwent emergency LSCS. Low birth weight (birth weight<2.5kg) was found in 14 (19.44%) babies with 11 babies having intrauterine growth restriction. 5-minute APGAR (appearance, pulse, grimace, activity, respiration) score was <7 in 13.88% babies. 16 babied needed NICU admission out of which 1 neonate died.Conclusions: Detection of oligohydramnios increases obstetrical interventions in term pregnancy.

scholarly journals Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

2018 ◽  
Vol 7 (6) ◽  
pp. 2455
Author(s):  
Shivali Bhalla ◽  
Seema Grover Bhatti ◽  
Shalini Devgan
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
North India ◽  
Care Hospital ◽  
Perinatal Morbidity

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

scholarly journals Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

2017 ◽  
Vol 6 (2) ◽  
pp. 554
Author(s):  
Anju Padmasekar ◽  
Shyamala Jothy
Keyword(s):  
Retrospective Study ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Tertiary Care Centre ◽  
Fetal Outcomes ◽  
Medical College ◽  
Obstetric Haemorrhage

Background: Massive obstetric haemorrhage is defined as blood loss of >1500 ml, or a decrease in haemoglobin>4 gm/dl or acute transfusion requirement of >4 units of blood when need for further transfusion is foreseeable. The purpose of this study is to analyse the demographic, medical and obstetric risk factors for massive obstetric haemorrhage and it’s materno fetal outcomes.Methods: Criteria for patient selection was all patients who had an acute obstetric haemorrhage necessitating a transfusion of >4 units of blood at a stretch when there was a need for more. This is a retrospective study conducted for a period of one year January to December 2015. Data regarding all cases under study during this period was obtained from Medical Records Department with prior permission. This study was conducted in the Department of Obstetrics and Gynecology, Government Raja Mirasudhar Teaching Hospital, Thanjavur Medical College, Tamil Nadu. Maternal outcomes like mode of delivery, rate of hysterectomy, postpartum complications, maternal mortality and fetal outcomes like intra uterine death, still birth and preterm birth were analysed.Results: The rate of massive obstetric haemorrhage in our hospital during the study period was 5.7/1000 births. Massive obstetric haemorrhage contributed to 25% of all maternal deaths in 2015. Atonic PPH was the commonest cause. Multiparity and previous caesarean section were identified to be significant risk factors.Conclusions: We found an increased association of massive obstetric haemorrhage with multiparity, caesarean sections and pre-eclampsia. Atonic PPH was the commonest cause. Massive obstetric haemorrhage had contributed significantly to adverse maternal and perinatal outcomes.

scholarly journals Incidence and perinatal outcome of multiple pregnancy in a tertiary care centre in Central India

2018 ◽  
Vol 7 (5) ◽  
pp. 1912
Author(s):  
Nutan Yadav ◽  
Madhuri Alwani ◽  
Ankita Singh
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Post Partum ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
Central India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Indication

Background: The incidence of multiple pregnancy is increasing all over the world because of assisted reproductive technology or spontaneously as a result of numerous risk factors. The objective of this study was to study the perinatal outcome of multiple pregnancy in a tertiary care centre in central IndiaMethods: It is a prospective study total 2289 pregnant woman were enrolled. Out of which 72 pregnant women were either a twin or triplet. 2217 pregnant women were singleton and had acted as controls. Perinatal outcomes including perinatal morbidity and mortality in relation to history regarding any complication in the present pregnancy were noted and analyzed.Results: In case of multiple pregnancy 90.2% were conceived between 20-30 years of age and 9.8% more than 30 years.13.9% cases of multiple pregnancy were less than 34 weeks at the time of delivery. The IUGR in multifetal pregnant patient was significantly higher. Oligohydromnios was seen in 3 out of 72 multifetal gestation which accounted for 4.1%. The proportion of singleton and multiple pregnant females who had anemia during pregnancy was 92.33% and 91.67%. Most common indication of LSCS in multifetal gestation is abnormal presentation during labour accounting for 41.7% of LSCS. The most common indication for NICU admission in case of multifetal pregnancy was 80.8%.Conclusions: Majority of the twin pregnancy is high risk one, and as such all twin preganancies should have mandatory hospital delivery. Early diagnosis, antenatal, intra-natal and post-partum cares are necessary to improve the outcome.

scholarly journals Retrospective study on the effect of Body Mass Index (BMI) on maternal and neonatal outcome

2018 ◽  
Vol 7 (3) ◽  
pp. 1070
Author(s):  
Pooja M. Shah ◽  
Anagha K. Chhatrapati ◽  
Pooja K. Bandekar
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternity Hospital ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Increased Risk ◽  
Nicu Admission ◽  
Prolonged Hospital ◽  
High Bmi

Background: Obesity has become health problem worldwide. Prevalence of obesity has increased globally with more incidence observed in female than male. Objective of present study was assessment of maternal outcome in term of associated medical disorder and mode of delivery and assessment of neonatal outcome.Methods: The retrospective study performed at Nowrosjee Wadia Maternity Hospital, a tertiary care centre between 1st January 2017 to 30th November 2017. Total 64 patients were enrolled. Maternal and neonatal outcomes were studied in all nulligravida women with high BMI using logistic regression adjusted for confounding variable.Results: Women with high BMI were at increased risk of hypertensive disorder of pregnancy (40.65%), diabetes (7.81%), induction of labour (62.5%), instrumental delivery (14.06%), operative intervention (42.18%), prolonged hospital stay and NICU admission (26.56%).Conclusions: This study observes increase risk of adverse outcome in pregnant women with high BMI.

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