scholarly journals Doppler study (cerebroplacental ratio) as a predictor of adverse perinatal outcome

Author(s):  
Subha S. Sengodan ◽  
Sankari Mathiyalagan

Background: Objective of the current study was to determine the importance of Doppler screening (cerebroplacental ratio i.e. CPR) in antenatal mothers and its effect on perinatal outcome of the baby so that appropriate management can be planned effectively for a better reduction in perinatal mortality and morbidity.Methods: A prospective study conducted on hundred antenatal women in GMKMCH, Salem with gestational age >32 weeks, with singleton pregnancies. Doppler ultrasonogram of fetal middle cerebral artery and umbilical artery and thus CPR obtained.Results: 25 out of the 100 patients in the study had CPR<1. CPR was compared against factors such as maternal age, parity, associated risk factors, gestational age (GA) at diagnosis (LMP GA and scan GA), time duration to delivery from diagnosis, requiring neonatal intensive care unit (NICU) admission, duration of stay in NICU and perinatal mortality. The CPR≤1 has a good sensitivity of 68% but a very high specificity of around 98% in predicting neonatal complications which was found to be statistically significant with a p value <0.0001.Conclusions: Since CPR has a high negative predictive value, CPR>1 helps to rule out adverse perinatal outcomes. When CPR<1, it acts as an effective tool in helping the obstetrician to decide on the mode of delivery to ensure that the baby is delivered within 12 hours of diagnosis, to improve the perinatal outcome of the baby.

Author(s):  
Shilpa Nabapure ◽  
Rashmi P. S. ◽  
Prema Prabhudeva

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Temesgen Debero Mere ◽  
Tilahun Beyene Handiso ◽  
Abera Beyamo Mekiso ◽  
Markos Selamu Jifar ◽  
Shabeza Aliye Ibrahim ◽  
...  

Background.Breech deliveries have always been topical issues in obstetrics. Neonates undergoing term breech deliveries have long-term morbidity up to the school age irrespective of mode of delivery.Objective. To determine prevalence and perinatal outcomes of singleton term breech delivery.Methods. Hospital based cross-sectional study was conducted on 384 participants retrospectively. Descriptive and analytical statistics was used.Result. A total of 384 breech deliveries were included. Prevalence of singleton breech deliveries in the hospital was 3.4%. The perinatal outcome of breech deliveries was 322 (83.9%). Adverse perinatal outcome of singleton term breech delivery was significantly associated with women’s age of greater than or equal to 35 years (AOR = 2.62, 95% CI = 1.14–6.03), fully dilated cervix (AOR = 0.48, 95% CI = 0.25–0.91), ruptured membrane (AOR = 5.11, 95% CI = 2.25–11.6), and fetal weight of <2500 g (AOR = 6.77, 95% CI = 3.22–14.25).Conclusion. Entrapment of head, birth asphyxia, and cord prolapse were the most common causes of perinatal mortality. Factors like fetal weight <2500 gm, mothers of age 35 years and above, those mothers not having a fully dilated cervix, and mothers with ruptured membrane were associated with increased perinatal mortality.


Author(s):  
Shivali Bhalla ◽  
Seema Grover Bhatti ◽  
Shalini Devgan

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.


Author(s):  
Nusrat Fozia Pathan ◽  
Shazia Jamali ◽  
Maqsood Ahmed Siddiqui ◽  
Khushi Muhammad Sohu ◽  
Ameer Ali Jamali ◽  
...  

Objective: To determine the perinatal outcome of twin pregnancy and to find out the frequency of twin deliveries in hospital based population. Study Design: Descriptive case series. Place and Duration of Study: The study was conducted over a period of 02 Year 1st January 2018 to 31st December 2019 in the Obstetrics and Gynaecology Department at KMC Khairpur Mirs, Sindh Pakistan. Methodology: All the patients of age 20-35 years with twin pregnancies of gestational age above 30 weeks presenting in labour ward of KMC Khairpur Mirs were studied. A detailed history was taken, general physical (G.P) examination and obstetrical examination performed, targeted investigations carried out to detect various fetal complications. Patients were assessed for a mode of delivery, records for data like age, gestational age, weight of baby, APGAR score expressed in term of mean±SD and data like perinatal mortality, prematurity, intra uterine growth restriction (IUGR), the weight of baby and APGAR score expressed in terms of frequencies and percentages on SPSS version 20. Results: In this study total numbers of deliveries were 7200, among them 83 were twin pregnancies the frequency of twin was 1.15%. Booked cases were 24.1%, unbooked was 75.9%. The highest incidence of 42.2% of twin gestation was seen in women between ages 31-35 years, the mean age of patients was seen 30.1±4.1 and regarding the parity incidence was high 54.2% in multiparous l-5. The total number of preterm deliveries was 45(55.2%), gestational age was (35-36+6dnys) weeks in 22.89% of cases, and the mean gestational age of patients was 35.7±2.5. Perinatal mortality was 38(22.9%), stillborn and early neonatal deaths (ENND) were 18.4% and 36.8% and common in twin-2. Conclusion: Twin pregnancy is-a-high-risk-pregnancy still is a major obstetrical and perinatal challenge. The frequency of twin pregnancy seen in this study is 1.15% unbooked and unsupervised pregnancies are more common i.e 75.9%.  Prematurity is common perinatal morbidity 51.20%.  perinatal mortality is 22.9% and highest in twin-2.


2014 ◽  
Vol 6 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Anita Singh ◽  
Shaheen LNU ◽  
Imam Bano ◽  
Ibne Ahmad

ABSTRACT Objective This study was done to assess the Doppler cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome especially in growth restricted pregnancies. Materials and methods In this study, 62 antenatal women were subjected to Doppler studies at 34 to 42 weeks of gestations. CPR was calculated and less than 1 was taken as predictor of adverse perinatal outcome. Adverse perinatal outcomes was evaluated by mode of delivery, meconium staining, 1 and 5-minute Apgar scores, birth weight, admission to NICU and other neonatal complications. Results Of 62 antenatal women, with an abnormal CPR had higher incidence of meconium, clinical fetal distress, operative delivery, low Apgar score (5 mins), NICU admission and neonatal death, 42.88, 47.62, 26.57, 76.19, 66.17 and 66.67% respectively as compared to women with normal CPR who had 4.88, 2.88, 2.88. 2.88, 12.19, 17.07 and 0% respectively. With the use of an abnormal CPR, the sensitivity, specificity, and positive and negative predictive values for predicting an adverse outcome were 62, 80, 62 and 80%, respectively, with an odds ratio (95% confidence interval). Conclusion An abnormal CPR is associated with adverse perinatal outcomes, especially in growth-restricted fetuses. How to cite this article Shaheen S, Bano I, Ahmad I, Singh A. Doppler Cerebroplacental Ratio and Adverse Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(1):25-27.


Author(s):  
LENY LENY

ABSTRACT [Perinatal mortality is a major problem, especially in developing countries. Approximately 98-99% of perinatal deaths occur in developing countries, while in developed countries only about 1-2%. Contributions perinatal mortality rate in Indonesia is still quite high, and perinatal mortality of 400 per 100,000 live births, or about 200,000 people per year so that the perinatal mortality occurs every 1.2-1.5 minutes. In the Muhammaddiyah hospital Palembang obtained perinatal mortality by the year 2013 as many as 52 cases. Many things that cause perinatal death include birth weight, maternal age, gestational age, mode of delivery and parity. The purpose of this study was to determine the relationship of birth weight, maternal age, gestational age, mode of delivery and parity simultaneously with perinatal death. This type of research is a case control study conducted retrospectively. The population in this study were all women giving birth in hospital Muhammadiyah Palembang in the year 2013 that berjumlah2565. The study sample totaled 156 respondents. In this study conducted univariate, bivariate and multivariate analyzes. From the analysis we found no association between birth weight to perinatal mortality (P Value 0.000 OR 4.250), no association of maternal age with perinatal mortality (OR 0.05 P Value 2.091), no correlation gestational age with perinatal mortality (OR 0.000 P Value 7.667), no association method of childbirth with perinatal mortality (P Value 1.000 OR 1.043), no parity relationship with perinatal mortality (P Value 0.511 OR 0.744). The most dominant variable is the age of the pregnancy. It is suggested to the leadership of Muhammadiyah hospital Palembang is hoped to be able to further improve health care programs for women giving birth so as to prevent the occurrence of complications during labor which can lead to perinatal mortality and increase the awareness programs on the importance of antenatal care during pregnancy that can detect early complications of pregnancy to facilitate the birth process.   ABSTRAK Kematian perinatal merupakan masalah besar khususnya di negara sedang berkembang. Sekitar 98-99 % kasus kematian perinatal terjadi di negara sedang berkembang sedangkan di negara maju hanya sekitar 1-2 %. Kontribusi angka kematian perinatal di Indonesia masih cukup tinggi, yaitu kematian perinatal 400 per 100.000 persalinan hidup atau sekitar 200.000 orang pertahun sehingga kematian perinatal terjadi setiap 1,2-1,5 menit. Di Rumah Sakit Muhammaddiyah Palembang didapatkan kematian perinatal pada tahun 2013 sebanyak 52 kasus. Banyak hal yang menyebabkan kematian perinatal diantaranya berat badan lahir, usia ibu, usia kehamilan, cara persalinan dan paritas. Tujuan penelitian ini untuk mengetahui hubungan berat badan lahir, usia ibu, usia kehamilan, cara persalinan dan paritas secara simultan dengan kematian perinatal. Jenis penelitian ini merupakan penelitian case control study yang dilakukan secara retrospektif. Populasi dalam penelitian ini adalah semua ibu bersalin di rumah sakit Muhammadiyah Palembang pada Tahun 2013 yang berjumlah2565. Sampel penelitian ini berjumlah 156 responden. Dalam penelitian ini dilakukan analisis univariat, bivariat dan multivariat. Dari hasil analisis didapatkan ada hubungan antara berat badan lahir dengan kematian perinatal (P Value 0,000 OR 4,250), ada hubungan usia ibu dengan kematian perinatal (P Value 0,05 OR 2,091), ada hubungan usia kehamilan dengan kematian perinatal (P Value 0,000 OR 7,667), tidak ada hubungan cara persalinan dengan kematian perinatal (P Value 1,000 OR 1,043), tidak ada hubungan paritas dengan kematian perinatal (P Value 0,511 OR 0,744). Variabel paling dominan adalah usia kehamilan. Disarankan kepada pimpinan rumah sakit Muhammadiyah Palembang Diharapkan untuk dapat lebih meningkatkan program pelayanan kesehatan kepada ibu bersalin sehingga  mencegah terjadinya komplikasi selama persalinan yang dapat menyebabkan kematian perinatal serta meningkatkan program penyuluhan tentang pentingnya pemeriksaan kehamilan selama masa kehamilan yang dapat mendeteksi dini komplikasi kehamilan untuk memperlancar proses persalinan.  


2020 ◽  
Vol 7 ◽  
pp. 2333794X2098130
Author(s):  
Ebissa Bayana Kebede ◽  
Adugna Olani Akuma ◽  
Yonas Biratu Tarfa

Background: Perinatal asphyxia is a severe problem which causes serious problem in neonates in developing countries. This study is aimed to determine magnitude of perinatal asphyxia and its associated factors. Methods: A cross-sectional study design was conducted among neonates admitted over a period of 4 years on 740 samples. Systematic sampling method was employed to get required samples from log book. Epi-data 3.1 is used for data entry and the entered data was exported to SPSS Version 23 for analysis. Bivariable and multiple variable logistic regressions analysis were applied to see the association between dependent and independent variables. Finally, P-value <.05 at 95% CI was declared statistically significant. Results: The main significant factor associated to perinatal asphyxia were prolonged labor ( P = .04, AOR = 1.68 95%CI: [1.00, 2.80]), being primipara ( P = .003, AOR = 2.06, 95%CI: [1.28, 3.30]), Small for Gestational Age (SGA) ( P = .001, AOR = 4.35, 95%CI: [1.85, 10.19]), Large for Gestational Age ( P = .001, AOR = 16.75, 95%CI: [3.82, 73.33]) and mode of delivery. Conclusion: The magnitude of perinatal asphyxia was 18%. Prolonged labor, parity, birth size, mode of delivery, and APGAR score at 1st minute were significantly associated with perinatal asphyxia. So, Nurses, Midwives, Medical Doctors, and health extension workers have to engage and contribute to on how to decrease the magnitude of perinatal asphyxia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koech Irene ◽  
Poli Philippe Amubuomombe ◽  
Richard Mogeni ◽  
Cheruiyot Andrew ◽  
Ann Mwangi ◽  
...  

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.


2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.


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