scholarly journals A study on maternal and perinatal outcome in pregnancy with oligohydramnios: study from a tertiary care hospital, Karnataka, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1676
Author(s):  
Shilpa Nabapure ◽  
Rashmi P. S. ◽  
Prema Prabhudeva
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Clinical History ◽  
Care Hospital ◽  
Ultrasound Technique ◽  
Doppler Study ◽  
Detailed Clinical History ◽  
Four Quadrant

Background: Oligohydramnios is described as a condition with decreased amniotic fluid volume relative to gestational age. It is a severe and common complication of pregnancy which is associated with increased maternal morbidity and adverse perinatal outcomes. This study was conducted to find out the significance of oligohydramnios in determining the maternal and perinatal outcome in pregnant women with oligohydramnios.Methods: The present study is a hospital-based study conducted in the department of obstetrics and gynecology, of SSIMS and RC Davanagere, during the period between August 2018 to April 2019. Detailed clinical history was taken, AFI was measured using Phelan’s four quadrant ultrasound technique. All the information was entered in the proforma and analyzed.Results: The mean age group of the study participants was 26.36±4.46 years. Majority (51.9%) of them were primigravida. Gestational age, birth weight and abnormal Doppler study were found to have an association with the perinatal outcome. Perinatal mortality in the present study was 4%.Conclusions: Oligohydramnios is a frequent occurrence in obstetrics and this condition requires intensive surveillance and proper antenatal care.

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 A CLINICAL STUDY OF MATERNALAND PERINATAL OUTCOME IN OLIGOHYDRAMNIOS AT DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 26-28
Author(s):  
Supriya Kumari ◽  
Surya Narayan ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Risk Factors ◽  
Apgar Score ◽  
Congenital Anomalies ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Clinical History ◽  
Ultrasound Technique ◽  
Admission Rates ◽  
Detailed Clinical History ◽  
Four Quadrant

Background:Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. Our study was aimed to study the maternal and perinatal outcome in oligohydramnios and measures needed to reduce the incidence. Aims: To find out the incidence of oligohydramnios by ultrasonographic evaluation of AFI, obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery. The purpose of this study is also to assess congenital anomalies in fetus along with their apgar score at birth, NICU admission rates and still birth rates. Materials and Methods: After taking consent from the women, risk factors at the time of admission were recorded. Detailed clinical history including obstetric, menstrual, past and personal history were taken.AFI to be measured using Phelan’s four quadrant ultrasound technique. All the information was entered in the proforma and analyzed and observations were made and accordingly discussion and recommendations were made. Results: The incidence of oligohydramnios was 3%. In the present study 78.5% cases had associated obstetrical complications; acting singly or in combination for causing oligohydramnios. The incidence of congenital anomalies is 9%. The LSCS was done in 47% in present study.17.5% babies had low Apgar score (less than 7 at 5 min).In our study 36% of neonates were admitted in nursery. The perinatal mortality was 15% in present study. Conclusion: Hence it can be concluded that maternal evaluation of risk factors, AFI, regular antenatal and intranatal monitoring of fetus should be done to improve maternal and neonatal outcome in oligohydramnios.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Perinatal outcome of stage-based management of fetal growth restriction in a government tertiary care hospital in Kerala, India

2021 ◽  
Vol 10 (6) ◽  
pp. 2354
Author(s):  
Bhargavi Rangarajan ◽  
Lalithambica Karunakaran
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Perinatal Outcome ◽  
Late Onset ◽  
Medical Condition ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Care Hospital ◽  
Medical College

BACKGROUND: Fetal Growth Restriction (FGR) is the largest contributing factor to perinatal morbidity, mortality and impaired neurodevelopment. This research strives to elucidate the perinatal outcomes of stage based management of fetal growth restriction using Obstetric Doppler and its  association with maternal sociodemographic profile.METHODS: The research was  conducted among 320 antenatal women whose Estimated Fetal weight was  <10th centile. Periodic follow up with Doppler was done and managed as per the stage of FGR. Perinatal outcomes were compiled.RESULTS: The incidence of FGR in T.D Medical College, Alappuzha  was 15.23%. SGA  accounted for 47 %.  The proportion of early and late onset FGR was  10.3%    &   89.7%    respectively.  57.18% of the newborns were admitted to NICU.  The common complications were: Low birth weight – 47.8% ARDS – 21% , Sepsis – 9.6%, Necrotizing enterocolitis – 4%, Hyperbilirubinemia – 4.9%. The incidence of Neonatal death and stillbirth were 1.56% and 0.3% respectively. Mothers who were underweight, inadequate weight gain during pregnancy and short inter pregnancy interval had increased risks. Hypertensive disorders of pregnancy was the commonly associated medical condition. CONCLUSION: Prolongation of pregnancy  even by one day results in 2% increased chances of survival of the newborn. Hence, it becomes imperative to identify the benign forms of FGR  to prevent iatrogenic prematurity. Antenatal women should be screened for risk factors and undergo vigilant antepartum surveillance to bring about favourable perinatal outcome. 

scholarly journals Childhood cardiomyopathies: a study in tertiary care hospital of Kashmir

2021 ◽  
Vol 8 (2) ◽  
pp. 289
Author(s):  
Abid Ahmad Shairgojri ◽  
Khalid Mohiuddin ◽  
Amber Bashir ◽  
Muzafar Jan
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Dilated Cardiomyopathy ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Clinical History ◽  
Left Ventricular ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
Detailed Clinical History

Background: Cardiomyopathy constitutes a group of diseases that directly affect the structural or functional ability of myocardium. They are the most common form of heart diseases that are inherited in children and responsible for sudden deaths in healthy young adults. The Aim of our study was to provide a detailed description of clinical profile, epidemiology and etiology of cardiomyopathies in children.Methods: This was a hospital based prospective observational study, conducted over a period of two and half years from September 2017 to March 2020 in the Post Graduate Department of Pediatrics Government Medical College Srinagar. Study group included all patients aged between 1 month and 18 years diagnosed with cardiomyopathy. They were subjected to a detailed clinical history and physical examination. All the patients underwent echocardiography.Results: During the study period 37 patients were diagnosed with different types of cardiomyopathies. Dilated cardiomyopathy was commonest seen in 19 (51.35%), followed by hypertrophic cardiomyopathy 13 (35%) cases. Fast breathing was most common presenting complaint in dilated cardiomyopathy while most of cases with hypertrophic cardiomyopathy were asymptomatic. There was one case of distinct form of cardiomyopathy isolated left ventricular hypoplasia. Males were more involved 21 (56.76%) cases. Majority of patients 18 (48.64%) were less than one year at time of diagnosis. Parental consanguity was seen in 6 (16.22%) cases. Underlying cause was identified in 10 (27.02%) cases with myocarditis being the commonest cause.Conclusions: Pediatric cardiomyopathy represents a considerable percentage of children with cardiac disorders. Dilated cardiomyopathy is the most common type usually presented with congestive heart failure, majority of cases of hypertrophic CMP were asymptomatic. Male preponderance was seen in dilated and hypertrophic cardiomyopathy. Parental consanguinity was seen in significant number of patients. Myocarditis and inborn error of metabolism was seen in significant number of patients.

scholarly journals A CLINICAL STUDY OF PATIENTS WITH IDIOPATHIC THROMBOCYTOPENIC PURPURA

2017 ◽  
Vol 10 (7) ◽  
pp. 373 ◽  
Author(s):  
Karthik Rao ◽  
Gurukanth Rao ◽  
Navin Patil ◽  
Balaji Ommurugan ◽  
N R Rao ◽  
...  
Keyword(s):  
Idiopathic Thrombocytopenic Purpura ◽  
Tertiary Care ◽  
Clinical History ◽  
Sustained Remission ◽  
Care Hospital ◽  
College Hospital ◽  
Thrombocytopenic Purpura ◽  
Medical College ◽  
Immune Globulins ◽  
Detailed Clinical History

OBJECTIVE To study the incidence, age and sex distribution among adults, various modes of presentation, correlation between thrombocytopenia and bleeding manifestations and various modalities of treatment of Idiopathic Thrombocytopenic Purpura in a tertiary care hospital in India.MATERIALS AND METHODSProspective study consisting of 4o cases of ITP admitted to Kasturba Medical College Hospital, Manipal from November 2005 to March 2007. Patients above 14 years of age admitted with thrombocytopenia in this institution were screened based on detailed clinical history, physical examination and laboratory investigations.RESULTSThe maximum incidence was in the 3 rd decade of life accounting for 27.5% of the patients. Ratio of male to female was 1:1.9 with female preponderance. Females in 3 rd decade had maximum incidence while males in 4th decade have maximum incidence. Majority 12 (85.71%) of male patients and 15(57.69%) of female patients  developed purpura during the course of disease. The mean count was 17.8X109/L with range between 2.0 X109/L to 76 X109/L. Cutaneous bleeding spots were found to be assosiated with counts above 25000X109/L and hematuria with lowest counts around 4000 X109/L. 20 (50%) of the above 40 patients responded to corticposteroids alone and did not have any further relapse. Among the remaining patients 3 (7.5%) had a relapse of symptoms within next 6 months and responded to repeat prednisolone started at 1mg/kg. 2 (5%) patients were given steroids tapering dose with IV Immune globulins for initial 5 days as therapy to which they responded.CONCLUSIONIdiopathic thrombocytopenia is 1.9 times more common in females than males. Most common presentation is bleeding spots over body. Bleeding manifestations are more common with thrombocytopenia less than 30000/mm3. Corticosteroids are the mainstay in treatment. Complete remission is seen in up to 57.5% of the patients. Splenectomy is the second modality of treatment in ITP. Complete and sustained remission is seen 75% of patients.  

scholarly journals Perinatal Outcomes in Premature Placental Calcification and the Association of a Color Doppler Study: Report from a Tertiary Care Hospital in Eastern India

2021 ◽  
Vol 11 (4) ◽  
pp. 841-849
Author(s):  
Sudarshan Dash ◽  
Banya Das ◽  
Soumya Ranjan Panda ◽  
Monalisa Rajguru ◽  
Pramila Jena ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Color Doppler ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Primary Objective ◽  
Care Hospital ◽  
Doppler Study ◽  
Low Birth Weight Babies ◽  
Grade Iii

Introduction: Placental calcification, identified before the 36th week of gestational age, is known as premature placental calcification (PPC). PPC could be a clue for the poor fetal outcome. However, its association with adverse perinatal outcomes is yet to be confirmed. Objective: The primary objective was to determine and compare the perinatal outcomes in pregnancies with and without documented premature placental calcification. Methodology: The present study was a prospective cohort study performed from October 2017 to September 2019. We consecutively enrolled 494 antenatal women who presented to our antenatal OPD after taking consent to participate in our study. Transabdominal sonographies were conducted between 28–36 weeks of gestation to document placental maturity. We compared maternal and fetal outcomes between those who were identified with grade III placental calcification (n = 140) and those without grade III placental calcification (n = 354). Results: The incidence of preeclampsia, at least one abnormal Doppler index, obstetrics cholestasis, placental abruption, and FGR (fetal growth restriction) pregnancies were significantly higher in the group premature placental calcification. We also found a significantly increased incidence of Low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores, NICU (Neonatal Intensive Care Unit) Admission, Abnormal CTG (cardiotocography), meconium-stained liquor, and low birth weight babies in those with grade III placental calcification. Conclusion: Clinicians should be aware of documenting placental grading while performing ultrasonography during 28 to 36 weeks. Ultrasonographically, the absence of PPC can define a subcategory of low-risk pregnant populations which probably need no referral to specialized centers and can be managed in these settings.

EVALUATION OF PANCYTOPENIA IN ADULTS PATIENTS OF BIHAR

2021 ◽  
pp. 6-7
Author(s):  
Rachana Rachana ◽  
Nivedita Singh ◽  
Om Prakash Diwedi
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Clinical History ◽  
Bone Marrow Examination ◽  
Underlying Disease ◽  
Care Hospital ◽  
Detailed Clinical History

INTRODUCTION– Pancytopenia usually indicates presence of serious underlying disease. Determining the etiology of pancytopenia is important for appropriate management of the patients. AIMS AND OBJECTIVES- This study was undertaken to identify the etiological factors leading to pancytopenia in a tertiary care hospital of Bihar. MATERIAL AND METHODS– This was a prospective study conducted over 12 months in the department of pathology, Nalanda medical college, Patna. The study included adult patients (>18yrs) who had pancytopenia in complete blood count. Relevant blood tests and bone marrow aspiration (BMA) and bone marrow biopsy (BMB) were done to delineate the etiology of pancytopenia. RESULTS– The commonest cause of pancytopenia in our study was aplastic anemia (46.67%) followed by megaloblastic anemia (23.33%) and hematological malignancies (acute leukemia and lymphoma- 15%). Other causes include infective diseases (kala-azar, malaria and tuberculosis), hypersplenism and hemophagocytosis. CONCLUSION- Determination of etiology of pancytopenia needs detailed clinical history and physical examination, and appropriate hematological tests and bone marrow examination.

scholarly journals Maternal and fetal outcome in oligohydramnios: study from a tertiary care hospital, Ahmedabad, India

2018 ◽  
Vol 7 (3) ◽  
pp. 907
Author(s):  
Runoo Ghosh ◽  
Heena Oza ◽  
Bhakti Padhiyar
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Vaginal Route ◽  
Still Birth ◽  
Medical College ◽  
Gestation Age ◽  
Post Natal Care

Background: Most severe and frequent complication of pregnancy is Oligohydramnios and the incidence of this is observed to be about 1-5 % of total pregnancies. Objective of present study was to find the maternal and perinatal outcome, etiology associated with oligohydramnios at tertiary care hospital.Methods: This prospective study was done among 55 patients with gestational age from 30-40wks with Oligohydramnios AFI<5cms with intact membranes were analysed for perinatal outcomes admitted at department of obstetrics and Gynecology in B.J. Medical college, Ahmedabad during July 2008 to July 2010.Results: 65.5% participants were belonged to 20 to 25 age group and 35.5% participants were Primigravida. Mean age was 23.9±3.3 years and mean gestation age was 36.9 week. Almost 72.2% were in 34 to 37 weeks of gestational age. Study found FMC <10 in 56.4% of participants. Forty percent participants have AFI 4 and 27.3% have AFI 5.  47.3% delivery was done by vaginal route. 5.5% baby was still birth and prematurity were the most common cause of still birth. Around 71% babies were low birth weight and congenital anomalies were present in 7.3% babies. APGAR score measured <7 at 1 minute was in 65.4% and <7 at 5 minutes was in 43.6% babies.Conclusions: Oligohydramnios in obstetrics is a frequent occurrence and it points towards intensive surveillance and proper ante-natal and post-natal care. Due to high perinatal morbidity and mortality, the incidence of LSCS increases. However, vaginal delivery has similar outcome, but strict vigilance in labor is mandatory.

scholarly journals Clinical profile of falciparum, vivax and mixed infections of malaria, from a tertiary care hospital, Coastal Andhra, India

2020 ◽  
Vol 7 (4) ◽  
pp. 541
Author(s):  
Usham Gangaram ◽  
Giri Raju Sarikonda ◽  
Bhimasen Soren ◽  
Venkatakrishnan .
Keyword(s):  
Tertiary Care ◽  
Clinical History ◽  
Clinical Profile ◽  
Common Disease ◽  
Care Hospital ◽  
Major Health Problem ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Detailed Clinical History ◽  
Endemic Areas

Background: Malaria is a major health problem in many parts of India and some parts of Andhra Pradesh is one of the endemic areas for malaria. The objective was to study clinical profile and outcome of malaria in both species and mixed infection.Methods: Present study was carried out on 100 patients admitted during the period of  November 2016 - October 2018 in Narayana medical college and hospital, Nellore. Malaria confirmed by Peripheral thick and thin smear or Antigen Assay underwent detailed clinical history and physical examination. This was followed by monitoring the outcome of the patients with respect to morbidity and mortality.Results: Out Of the 100 patients 58 patients were from rural background, males were predominant, most common age group was 20-30 (34%) followed by 31-40 (31%). Out of 100 patients, 54 patients were  falciparum,44 patients had vivax  and two had mixed infection. All of the patients had fever followed by chills and rigors (75%), nausea and vomiting (59%), easy fatiguability (28%), pain abdomen (17), cough (14%) in both infections, altered sensorium was seen in only falciparum (20.3%). On clinical examination,70% of the patients had pallor, splenomegaly in 46%, icterus (23%), hepatomegaly (14%) and pedal edema in12 patients were observed. All 0f the patients were treated with appropriate antimalarial drugs for appropriate duration, and all were recovered without any mortality.Conclusions:Malaria is very common disease in our country especially in South India, which is one of the endemic areas. Severe malaria usually caused by the falciparum more than vivax, early diagnosis and treatment decreases the mortality and morbidity. 

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