scholarly journals Antepartum hemorrhage and its fetomaternal outcome: a retrospective study

2020 ◽  
Vol 9 (11) ◽  
pp. 4562
Author(s):  
Saloni K. Gandhi ◽  
Ayushi P. Vamja ◽  
Kishor P. Chauhan
Keyword(s):  
Genital Tract ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Placenta Previa ◽  
Age Group ◽  
Cesarean Sections ◽  
Obstetrics And Gynaecology ◽  
Still Births ◽  
Abruptio Placenta ◽  
Nicu Admission

Background: Antepartum hemorrhage (APH) is defined as any bleeding from or into the genital tract after the period of viability and before the delivery of the baby. Aim of the research was to study the fetomaternal outcome in patients with APH.Methods: The present study was a retrospective observational study undertaken in Obstetrics and Gynaecology department of Dhiraj General Hospital, during a period of 1.5 years from November 2018 to May 2020 in 84 cases of antepartum hemorrhage. Only patients with APH >28 weeks gestational age and willing to participate in study were included. Open STAT statistical software has been used to analyse the data in this study.Results: The incidence of antepartum hemorrhage was 2.86%. Maximum patients of APH lie between the age group of 26-34 years. In abruptio placenta (AP) 65% and in placenta previa (PP) 77.2% of the patients were multiparous. APH presents mostly between 34-36 weeks. Around 90% patients of APH required blood transfusion. APH overall shows increased rate of cesarean sections upto 62%. Around 9.5% patients went into shock, 4.7% had disseminated intravascular coagulation (DIC), 3.5% postpartum hemorrhage (PPH) and 8.3% had wound gap and peurperial pyrexia. 23.8% babies had asphyxia of which 60% were contributed to PP and 40% were in AP group. Respiratory distress syndrome was in 7.1% babies of which both groups equally contributed. Septicemia was seen in 13% and jaundice in 29.8%.Conclusions: Higher rates of neonatal intensive care unit (NICU) admission and stay were seen with these complications. This study showed 20.2% perinatal deaths as outcome of APH and 14.2% still births. 

scholarly journals A 3 year retrospective study of pregnancies complicated with placenta previa in a tertiary care centre

2021 ◽  
Author(s):  
Vatsala Kamath ◽  
Aparna C. Aravind ◽  
Nishita Shettian
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Placenta Previa ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Age Group ◽  
Tertiary Care Centre

Background: Placenta previa describes when a placenta is implanted partially or completely over the internal OS. About one third of the ante partum haemorrhage belongs to placenta previa. The incidence is increased beyond the age of 35 years, with high birth order pregnancies, prior caesarean deliveries and in multiple pregnancy. The aim of the study was to determine maternal and fetal outcome in pregnancies complicated with placenta previa.Methods: A 3 year retrospective study done in OBG department of A. J. Institute of Medical Sciences, Mangalore from January 2017- January 2020. All pregnant women who are diagnosed with placenta previa during regular antenatal care (ANC) follow up, at or after admission and during caesarean delivery are included in the study. Data were collected from the hospital records.Results: During the study period, there were 34 pregnant women with placenta previa. Maximum were in the age group of 31-35 years of age and 8.82 percentage were in the age group more than 35 years. Out of the study subjects,76.5 percentage were multigravidas and 50 percentage were giving history of prior one caesarean section. 29.4 percentage of study subjects had true placenta previa and 85.2 percentage underwent elective caesarean section. There were significantly higher number of babies required neonatal intensive care unit (NICU) admissions.Conclusions: An increase in the incidence of women with advanced maternal age, multiparity, prior caesarean deliveries contributes to a rise in the number of pregnancies complicated with placenta previa.

scholarly journals Perinatal Outcome of Twins Delivered Vaginally in a Tertiary Care Hospital

2021 ◽  
Vol 25 (1) ◽  
pp. 66-71
Author(s):  
Ayesha Zulfiqar ◽  
Maliha Sadaf ◽  
Amina Abbasi ◽  
Sabeen Ashraf ◽  
Omair Ashraf
Keyword(s):  
Intensive Care ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Obstetrics And Gynaecology ◽  
Nicu Admission ◽  
Twin Pregnancies ◽  
Second Twin

Objective: To determine the perinatal outcome of first and second twin delivered vaginally in terms of frequency of poor APGAR score and NICU admission in the patient at term in a tertiary care health facility.Introduction: This study aims to improve the perinatal outcome of twin pregnancies through awareness of the need for antenatal care, the recommendation of regular antenatal visits, early recognition of complications, and the presence of neonatal intensive care facilities to improve neonatal outcome by knowing the burden of adverse outcomes in our population.Materials and Methods: This is a descriptive study, conducted at the Department of Obstetrics and Gynaecology at DHQ Hospital, Rawalpindi from January 2019 to June 2019.A total of 91 individuals (female pregnant ladies) who delivered twins (Dichorionic Diamniotic) babies through normal vaginally were selected for descriptive study in the Department of Obstetrics and Gynaecology, DHQ hospital Rawalpindi. All consecutive patients admitted in the labour ward with twin pregnancies were included. Before delivery, the fetal wellbeing of both the twins was evaluated also by ultrasonography. Data collection was done by interview schedule from the patients. Data were analyzed using descriptive statistics using SPSS version 17. For all the quantitative variables like age, gestational age and intertwine interval in seconds.Results: Out of 6278 deliveries during the study period, 91 twin births gave a frequency of 15.16/1000 births. Patients' mean age was 30.14+2.64 years, and mean gestational age was 37.47+0.72 weeks. The mean inter twin delivery interval (mins) in the study was 23.74+4.75. Perinatal outcome of first and second twin in terms of frequency of poor APGAR score and NICU admission in a patient at term was 09 (9.9%) and 27 (29.7%), (p<0.001) respectively.Conclusion: The study concludes that there was a high risk of perinatal outcomes in the second twin as compared to the first twin delivered vaginally. Poor Apgar score and neonatal intensive care admission were more so for the second twin.  

Morbidity Associated with Fetal Macrosomia among Women with Diabetes Mellitus

2017 ◽  
Vol 35 (05) ◽  
pp. 515-520 ◽  
Author(s):  
Amy O'Neil Dudley ◽  
Hector Mendez-Figueroa ◽  
Viviana Ellis ◽  
Han-Yang Chen ◽  
Suneet Chauhan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Regression Models ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Error Variance ◽  
Outcome Data ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
Study Population ◽  
Nicu Admission

Objective This article aims to compare the composite maternal and neonatal morbidities (CMM and CNM, respectively) between macrosomic (≥4,000 g) and nonmacrosomic (<4,000 g) newborns among women with diabetes mellitus (DM). Methods Maternal demographic and peripartum outcome data (N = 1,260) were collected from a retrospective cohort. CMM included chorioamnionitis/endometritis, wound infection, shoulder dystocia, eclampsia, pulmonary edema, admission for hypoglycemia, 3rd/4th degree perineal laceration, and death. CNM included 5-minute Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score of <4, neonatal intensive care unit (NICU) admission, respiratory distress syndrome, mechanical ventilation, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis stage II/III, hypoglycemia, hypocalcemia, bronchopulmonary dysplasia, sepsis, seizures, hyperbilirubinemia, and death. Multivariable Poisson regression models with robust error variance were used to calculate adjusted relative risk (aRR) and 95% confidence interval (CI). Results The study population consisted of 967 subjects, including 854 (88.3%) nonmacrosomic and 113 (11.7%) macrosomic infants. After adjustment, the risk of CMM was higher among macrosomic deliveries (aRR = 4.08, 95% CI = 2.45–6.80). The risk of CNM was also higher among macrosomic deliveries (aRR = 1.77, 95% CI = 1.39–2.24). Macrosomia was associated with an increased risk in NICU admission, hypoglycemia, and hyperbilirubinemia. Conclusion Among DM deliveries, macrosomia was associated with a fourfold higher risk of CMM and almost twofold higher risk of CNM.

scholarly journals Lung ultrasound features predict admission to the neonatal intensive care unit in infants with transient neonatal tachypnoea or respiratory distress syndrome born by caesarean section

2020 ◽  
Author(s):  
Antonio Poerio ◽  
Silvia Galletti ◽  
Michelangelo Baldazzi ◽  
Silvia Martini ◽  
Alessandra Rollo ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Neonatal Intensive Care Unit ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Lung Ultrasound ◽  
Late Preterm ◽  
Late Preterm Infants ◽  
Nicu Admission

Abstract We aimed to evaluate the reliability of lung ultrasound (LU) to predict admission to the neonatal intensive care unit (NICU) for transient neonatal tachypnoea or respiratory distress syndrome in infants born by caesarean section (CS). A prospective, observational, single-centre study was performed in the delivery room and NICU of Sant’Orsola-Malpighi Hospital in Bologna, Italy. Term and late-preterm infants born by CS were included. LU was performed at 30’ and 4 h after birth. LU appearance was graded according to a previously validated three-point scoring system (3P-LUS: type-1, white lung; type-2, black/white lung; type-3, normal lung). Full LUS was also calculated. One hundred infants were enrolled, and seven were admitted to the NICU. The 5 infants with bilateral type-1 lung at birth were all admitted to the NICU. Infants with type-2 and/or type-3 lung were unlikely to be admitted to the NICU. Mean full-LUS was 17 in infants admitted to the NICU, and 8 in infants not admitted. In two separate binary logistic regression models, both the 3P- and the full LUS proved to be independently associated with NICU admission (OR [95% CI] 0.001 [0.000–0.058], P = .001, and 2.890 [1.472–5.672], P = .002, respectively). The ROC analysis for the 3P-LUS yielded an AUC of 0.942 (95%CI, 0.876–0.979; P<.001), while ROC analysis for the full LUS yielded an AUC of 0.978 (95%CI, 0.926–0.997; P<.001). The AUCs for the two LU scores were not significantly different (p = .261). Conclusion: the 3P-LUS performed 30 min after birth proved to be a reliable tool to identify, among term and late preterm infants born to CS, those who will require NICU admission for transient neonatal tachypnoea or respiratory distress syndrome. What is known• Lung ultrasound (LU) has become an attractive diagnostic tool in neonatal settings, and guidelines on point-of-care LU in the neonatal intensive care unit (NICU) have been recently issued.• LU is currently used for diagnosing several neonatal respiratory morbidities and has been also proposed for predicting further intervention, such as NICU admission, need for surfactant treatment or mechanical ventilation in preterm infants. What is new• LU performed 30′ after birth and evaluated through a simple three-point scoring system represents a reliable tool to identify, among term and late preterm infants born to caesarean section, those with transient neonatal tachypnoea or respiratory distress syndrome who will require NICU admission.• LU performed in the neonatal period confirms its potential role in ameliorating routine neonatal clinical management.

scholarly journals A STUDY OF INCIDENCE OF ANTE-PARTUM HEMORRHAGE AND ITS TYPES AT TERTIARY HEALTH CARE CENTRE

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr Pratibha. Patil ◽  
Dr. Sanjay Patil
Keyword(s):  
Health Care ◽  
Placenta Previa ◽  
Hypochromic Anemia ◽  
Third Party ◽  
Age Group ◽  
Care Centre ◽  
Anemia Of Chronic Disease ◽  
Health Care Centre ◽  
Second Stage Of Labor ◽  
Abruptio Placenta

Introduction: Worldwide approximately 830 women die every day from preventable causes related to pregnancy and childbirth; 99% of those 830 daily deaths are women from developing countries. Aims and Objectives: To Study incidence of ante-partum hemorrhage and its types at tertiary health care centre Methodology: This study was conducted in Medical college & General hospital, in the Department of Obsterics & Gynecology. A Total no. of 104 cases of antepartum hemorrhage admitted in hospital were studied & analyzed .In the present study all patients who had bleeding from genital tract after 20 weeks of gestation & before second stage of labor were included . The data was entered in excel sheets and analyzed and presented in tabular form expressed in percentages. Result: In our study we have seen that the majority of the patients were of Placenta previa were 1.39%, followed by Abruption placenta Were -0.93%, Local lesions were 0.05%, Unclassified group were 0.05%, Total APH were - 2.42%, Of the Total No. of deliveries 4307.  The majority of the patients were in the age group of 21-25 were -37.50%, 26-30 - 28.84%, 16-20- 20.20%, 31-35- 9.62%, 35 & above were 2.84%. The majority of the patients of APH were of Third party were -25.00%, Second –21.15%, Primi-18.27%, Fourth –16.34%, Fifth and Sixth & above were -9.62%. Placenta previa was more common in Third- 26.67%, followed by Second – 23.33%, and Primi -16.27%. Abruptio placenta placenta was more common in Primi and Third-22.5%, second and fifth was 17.5%, Sixth & above were 12.5%. This observed difference was not statistically significant (p>0.05) . Conclusion: In our study we have seen that the majority of the patients were of Placenta previa, the majority of the patients were in the age group of 21-25, The majority of the patients of APH were of Third party. Placenta previa was more common in Third parity, Abruptio placenta placenta was more common in Primi and followed by Second Third parity. Key words: Ante-Partum hemorrhage (APH), Abruptio placenta, Placenta previa, Anemia of chronic disease, Microcytic hypochromic anemia.

scholarly journals Antenatal injection betamethasone- A fetal lung warrior

2021 ◽  
Vol 8 (2) ◽  
pp. 255-258
Author(s):  
Manish R Pandya ◽  
Kalpana Khandheriya ◽  
Vinay Trivedi ◽  
Khushbu Patel
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Admission Rate ◽  
Antenatal Corticosteroids ◽  
Antenatal Steroids ◽  
Term Delivery ◽  
Nicu Admission

One of the most frequent causes of neonatal mortality or NICU admission of neonates especially in premature infants is Neonatal Respiratory Distress Syndrome (NRDS). Antenatal steroids are the most important and widely utilized interventions for improvement of neonatal outcomes like reducing incidence of respiratory distress syndrome (RDS), reducing neonatal NICU (neonatal intensive care unit) admission rates and also improve outcomes of pre-term infants. Antenatal steroids (ANS) like betamethasone 12 mg are given at 24 hourly IM at 28-34 weeks of gestation to mother. For administration of corticosteroids at less than 24 weeks of gestational age decision should be made at a senior level by taking all clinical aspects into consideration.To observe the effect of Betamethasone administration IM in pregnant women at risk of pre-term delivery and fetal outcomes in terms of development of Respiratory Distress Syndrome (RDS) and Neonatal Intensive Care Unit (NICU) admission rate by giving it between 28 to 34 weeks of gestation. Antenatal corticosteroids (betamethasone) play an important role for prevention of respiratory distress syndrome and reducing NICU admission rate of new borns and also reduce neonatal mortality and morbidity but benefits related to the time between administration of corticosteroid and delivery needed to be explored. Benefits of the injection betamethasone administration IM 12 mg between 24 hours and seven days on pre-term delivery has been established., This was prospective study conducted in private setup from November 2020 to March 2021 in Scientific Research Institute, Surendranagar, Gujarat, India. Study comprised of 100 women with single tone pregnancies (28 – 36 weeks gestational age) in age group of 19 – 33 years not in labour, but at risk for pre-term delivery based on fetal or maternal indications. These pregnant women were treated with two doses of 12 mg Betamethasone Intramuscularly apart of 24 hourly for maturation of fetal lungs. Antenatal corticosteroids like betamethasone have a significant benefit on neonatal outcome even if used after 34 weeks of pregnancy. This was given prophylactically to those who are known to have increased risk of pre-term labour. Antenatal steroid like betamethasone 12 mg IM is also of benefit to reduce neonatal respiratory distress syndrome (NRDS) and NICU admission rates by giving it at 28-34 weeks of gestational age.

Stillbirths in women with pre-gravid obesity

2019 ◽  
Vol 47 (3) ◽  
pp. 319-322 ◽  
Author(s):  
Maja Dolanc Merc ◽  
Miha Lučovnik ◽  
Andreja Trojner Bregar ◽  
Ivan Verdenik ◽  
Nataša Tul ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Population Based ◽  
Obese Women ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Gestational Week ◽  
Near Term ◽  
Nicu Admission

Abstract Objective To determine the association between pre-gravid obesity and stillbirth. Methods A retrospective study of a population-based dataset of births at ≥34 weeks’ gestation. We excluded fetal deaths due to lethal anomalies and intrapartum fetal deaths. We calculated the incidence of stillbirths, neonatal respiratory distress syndrome (RDS) and neonatal intensive care unit (NICU) admissions per ongoing pregnancies for each gestational week in the two body mass index (BMI) categories (≥30 vs.<30). Results Pre-pregnancy obesity (BMI≥30), pre-pregnancy diabetes, oligo- and polyhydramnios, being small for gestational age (SGA) and preeclampsia were significantly associated with stillbirth. However, the only pre-gravid factor that is amenable to intervention was obesity [adjusted odds ratio (OR) 2.0; 95% confidence interval (CI) 1.20, 3.3]. The rates of stillbirth seem to increase with gestational age in both BMI categories. RDS and NICU admission would be presented. Conclusion Birth near term might reduce stillbirths and decrease NICU admissions occurring in term and in post-term obese women. This presumable advantage might be offset by the potential risk of labor induction and cesarean section among obese women. Women of childbearing age with a BMI≥30 should be counseled about these risks of obesity during pregnancy and childbirth.

scholarly journals An empirical study on maternal and perinatal outcome of placenta previa-risk factors, morbidity and mortality in JNIMS, Imphal, India

2019 ◽  
Vol 9 (1) ◽  
pp. 364
Author(s):  
Haripriya Devi Sanglakpam ◽  
Indrakumar Singh Ng.
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Observational Study ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Age Group ◽  
Transabdominal Ultrasonography ◽  
Obstetrics And Gynaecology ◽  
Estimated Risk ◽  
Prospective Longitudinal

Background: The observational study to analyse the maternal and perinatal outcome in pregnancies complicated with placental previa evaluating the potential risk factor, associated with morbidity and mortality.Methods: The study was a prospective longitudinal comprising of all the pregnant women after 28 week of gestation irrespective of gravid and parity that attended or admitted in the department of obstetrics and gynaecology, JNIMS, diagnosed as having placental previa by transabdominal ultrasonography and conducted for the period of 20 months i.e. from October 2017 to June 2019 analyzing 54 cases of placenta previa.Results: During this period there were total of 9967 deliveries with incidence of placenta previa being 0.54% in JNIMS, Porompat. The estimated risk factors out of total 54 cases were 20-30 (52%) years by age group, 25 (46%) gravida, 18 (32%) parity, 36 low lying placenta and 11 cases (20%) preterm.Conclusions: Highest levels of placenta previa are associated with poor maternal and perinatal outcome.

Association between Number of Prior Cesareans and Early Preterm Delivery in Women with Abnormal Placentation

2020 ◽  
Author(s):  
Ayamo Oben ◽  
Elizabeth B. Ausbeck ◽  
Melissa N. Gazi ◽  
Akila Subramaniam ◽  
Lorie M. Harper ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Secondary Analysis ◽  
Blood Products ◽  
Primary Analysis ◽  
Logistic Regression Models ◽  
Placenta Accreta Spectrum ◽  
Nicu Admission ◽  
Early Preterm Birth

Objective Delivery timing at 34 to 36 weeks is nationally recommended for pregnancies complicated by placenta accreta spectrum (PAS). However, it has recently been suggested that those with ≥2 prior cesarean deliveries (CD) and PAS should be delivered earlier than 34 weeks because of a higher risk of unscheduled delivery and complications. We sought to evaluate whether the number of prior CD in women with PAS is associated with early preterm delivery (PTD) (<34 weeks). We also evaluated the same relationship in women with placenta previa alone (without PAS). Study Design This is a secondary analysis of a multicenter and observational study that included women with prior CD (maternal–fetal medicine unit cesarean registry). Women with a diagnosis of PAS (regardless of placenta previa) were included for our primary analysis, and women with known placenta previa (without a component of PAS) were independently analyzed in a second analysis. Two groups of patients from the registry were studied: patients with PAS (regardless of placenta previa) and patients with placenta previa without PAS. The exposure of interest was the number of prior CD: ≥2 CD compared with <2 CD. The primary outcome was PTD <34 weeks. Secondary outcomes included preterm labor requiring hospitalization or tocolysis, transfusion of blood products, composites of maternal and neonatal morbidities, and NICU admission. Outcomes by prior CD number groups were compared in both cohorts. Backward selection was used to identify parsimonious logistic regression models. Results There were 194 women with PAS, 97 (50%) of whom had <2 prior CD and 97 (50%) of whom had ≥2 prior CD. The rate of PTD <34 weeks in women with ≥2 prior CD compared with <2 in the setting of PAS was 23.7 versus 29.9%, p = 0.27; preterm labor requiring hospitalization was 24.7 versus 13.5%; p = 0.05. The rates of plasma transfusion were increased with ≥2 prior CD (29.9 vs. 17.5%, p = 0.04), but there were no differences in transfusion of other products or in composite maternal or neonatal morbidities. After multivariable adjustments, having ≥2 CDs was not associated with PTD <34 weeks in women with PAS (adjusted odds ratio (aOR): 0.73, 95% confidence interval [CI]: 0.39–13.8) despite an association with preterm labor requiring hospitalization (aOR: 2.69; 95% CI: 1.15–6.32). In our second analysis, there were 687 women with placenta previa, 633 (92%) with <2 prior CD, and 54 (8%) with ≥2 prior CD. The rate of PTD <34 weeks with ≥2 CD in the setting of placenta previa was not significantly increased (27.8 vs. 22.1%, aOR: 1.49; 95% CI: 0.77–2.90, p = 0.08); the maternal composite outcome (aOR: 4.85; 95% CI: 2.43–9.67) and transfusion of blood products (aOR: 6.41; 95% CI: 2.30–17.82) were noted to be higher in the group with ≥2 prior CD. Conclusion Women with PAS who have had ≥2 prior CD as compared with women with <2 prior CD did not appear to have a higher risk of complications leading to delivery prior to 34 weeks. As such, considering the associated morbidity with early preterm birth, we would not recommend scheduled delivery prior to 34 weeks in this population. Key Points

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