scholarly journals Maternal outcome in preterm labor in a tertiary care hospital

Author(s):  
Preeti Frank Lewis ◽  
Ayushi Kumari ◽  
Nitin Bavdekar

Background: To study the fetal and maternal outcome in preterm labor cases.Methods: It was Prospective, single centered, observational study. All women with preterm labor in the study period i.e. from September 2018 to March 2020 were included in the study i.e. 100 patients.Results: Out of 100 subjects, majority of mothers 65(65%) were in age group of 21-30 years followed by 23 (23%) in age group of ≤20 years. Majority 52 (52%) of study subjects were primigravida followed by 28 (28%) having parity 1. Only one case had parity 4. Majority 36 (36%) of study subjects were in lower class followed by 28 (28%) cases in lower middle class. 23 (23%) cases in middle class and 6 (6%) were in upper class. Maximum 61 (61%) cases were unbooked cases and rest 39 (39%) cases were booked. Out of 90 babies who were <2500 grams, maximum 57 (63.33%) were low birth weight (less than 2.5 kg) followed by 22 (24.44%) being VLBW babies. 10 cases were ≥2.5 kg, which are not LBW babies according to WHO Classification of low birth weight. Majority 34 (47.22%) stayed for 1-10 days followed by 17 (23.61%) babies for 11-20 days. Also 15 (20.83%) babies stayed for 21-30 days.Conclusions: Compared with term infants, preterm infants are at high risk of overall morbidity and mortality. Clinical suspicion, early detection and correction of risk factors, institutional delivery and good neonatal care back up facilities can improve the outcome of preterm labour and decrease the maternal complications as well.

Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


2018 ◽  
Vol 5 (2) ◽  
pp. 427 ◽  
Author(s):  
Anuradha D. ◽  
Rajesh Kumar S. ◽  
Aravind M. A. ◽  
Jayakumar M. ◽  
J. Ganesh J.

Background: Every year, nearly four million newborn babies die in the first month of life. India carries the single largest share (around 25-30%) of neonatal deaths in the world. Neonatal deaths constitute two thirds of infant deaths in India. 45% of the deaths occur within the first two days of life. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively at the appropriate time. It was further estimated that health facility-based interventions can reduce neonatal mortality by 23-50% in different settings. Facility-based newborn care, thus, has a significant potential for improving the survival of newborns in India. This research has been planned with an aim to study the profile of pattern of admissions in a SNCU and their outcomes following admission and management in the unit.Methods: All babies referred for neonatal problems (less than 28 days) and admitted in NICU will be included. Both term and preterm babies will be considered. The criteria for admission includes various causes like low birth weight, preterm, birth asphyxia, respiratory distress, hyperbilirubinemia, congenital anomalies, risk factors (maternal, neonatal, prenatal), infections and outcome will be analysed.Results: Among the 2927 admissions term babies and boys outnumbered. The common causes for admission were birth asphyxia, respiratory distress, low birthweight and preterm. Most babies had an uncomplicated stay. The mortality in the extramural neonates was due to neonatal sepsis, extreme preterm and congenital malformations.Conclusions: Intensive and interventional management, along with good neonatal monitoring and care can reduce the mortality and improve the survival of low birth weight babies and other treatable problems. Thus, a combined effort of management by pediatricians, nursing care, neonatal intensive care unit can improve the survival rates of neonates.


2017 ◽  
Vol 15 (1) ◽  
pp. 2-4
Author(s):  
Husneyara Haque ◽  
Upendra Pandit

Introduction: Placenta previa is an obstetric complication which causes considerable maternal and fetal morbidity and mortality during pregnancy. This study is done with the objective to find out the clinico-demographic factors associated with placenta previa and to analyze maternal and perinatal outcome in these cases. Methods: This was a retrospective study done in the department of Obstetrics and Gynecology of Nepalgunj Medical College Teaching Hospital, Nepalgunj, a tertiary care hospital from Midwestern Nepal. Relevant data were retrieved from maternity register from June 2015 to May 2017. All women who had undergone caesarean section for placenta previa were included in this study. Result: Out of total 5812 deliveries during the study period there were 50 caesarian sections done for placenta previa which is 0.86% of total deliveries. Maximum number of mothers belonged to 26- 30 years of age group. Commonest type of placenta previa was minor type. About 72% were multiparous. 20% had previous LSCS and 24% had previous abortion. Postpartum hemorrhage was present in 36% mothers and 32% received blood transfusion. About 64% new born were preterm and low birth weight. 34% babies had less than 7 apgar score at 5 min. Still births were 6%. Conclusion: Placenta previa poses greater risk and need of blood transfusion to mother as well as birth of preterm and low birth weight babies which leads to perinatal morbidity and mortality. Timely diagnosis, regular antenatal check up and effective management may improve pregnancy outcome.


Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.


Author(s):  
Premlata Yadav

Background: Anaemia is commonest medical disorder in pregnancy with 88% prevalence in India mainly due to ignorance, poverty and gender bias. 40-60% of maternal deaths in developing countries. According to the recent standard laid down by WHO anemia is present when the hemoglobin (Hb) concentration in the peripheral blood is less than 11 gm/dl. The most common cause of anemia in pregnancy is iron deficiency. Anemia is diagnosed by estimating the hemoglobin concentration and examining a peripheral blood smear for the characteristic red blood cell changes. The aim of the study was to determine the association between severe anemia, maternal and perinatal complications.Methods: Case control study was done in department of Obstetrics and Gynecology, Rajendra Institute of Medical Sciences Ranchi, India from February 2016 to July 2016. 100 pregnant women, admitted for delivery and having severe anemia were studied and compared with 100 non-anaemic women of similar demographic features. Maternal and perinatal complications were observed. Pearson, chi-square and Fischer exact tests were used to calculate significance of results.Results: Of the severely anaemic mothers, 36% babies were low birth weight (p=0.042) and 20% were small for gestational age (p = 0.026), as compared to 18% and 10% of controls, respectively.Conclusions: Severe maternal anemia carries significant risk of hemorrhage and infection in the mother. It is also associated with preterm birth, low birth weight.


2017 ◽  
Vol 4 (5) ◽  
pp. 1827
Author(s):  
Vikram R. ◽  
C. S. Balachandran

Background: To study non-obstructive causes and laboratory profile of neonatal hyperbilirubinemia. Design: prospective study.Methods: Selection of cases were done from routine cases reporting to newborn unit in the department of paediatrics, with clinical evidence of jaundice in neonates. Blood group of the mother and baby, Serum bilirubin estimation, Complete blood count with peripheral smear examination, Reticulocyte count, Direct coomb’s test and C-reactive protein of the baby were done.Results: Study includes 89 cases of newborn admitted in our tertiary care institute. Out of 89 neonates, 52 (58.42%) were male while 37 (41.57%) were females. Total number of Pre-term babies was 35 (39.32%). Neonates having low birth weight were 30 (33.7%) and very low birth were 10 (11.23%). Physiological jaundice constituted majority cases. Septicemia was the commonest cause of pathological jaundice and ABO incompatibility is second commonest cause of pathological jaundice. Pre-term and low birth weight babies were having higher levels of serum total bilirubin but the difference was not significant (P >0.05). The rise in serum bilirubin level was found to be more in pathological jaundice as compare to physiological jaundice. Difference was significant statistically with p value of <0.05.Conclusions: Most of the cases were having physiological jaundice although septicemia and ABO-Rh incompatibility were not exceptional. Peak serum bilirubin levels were found to be more among the pathological jaundice. Also, prematurity and low birth weight were having higher levels of serum bilirubin. Special care must be given to them in order to avoid future complications of hyperbilirubinemia.


Author(s):  
Badri Kumar Gupta ◽  
Amit Kumar Shrivastava ◽  
Laxmi Shrestha

Background: Hypertensive disorders in pregnancy remain a major cause of maternal and neonatal morbidity and mortality worldwide. This study prospectively examined the immediate neonatal outcome of women with maternal hypertensive disorder of pregnancy (HPD).Methods: This is a prospective study conducted at NICU in Universal College of Medical Sciences Hospital over a period from 2nd February 2018 to 1st February 2019. Fifty-two mothers and their newborn were selected. Mothers with gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension and chronic hypertension were included.Results: Mean maternal age was 26.4 years. Mean gestational age was 34±4 weeks. 38 were male and 24 were female with male: female ratio 1.72:1. Thirty seven (71.2%) mothers needed lower uterine caesarian section, fourteen (26.9%) mothers delivered NVD and one (1.9%) forceps delivery. Low birth weight (<2.5kg) babies were 25 (48.1%%), very low birth weight (<1.5kg) were 9 (17.3%) and normal weight were 18 (34.3%). Intrauterine growth retardation (IUGR) were 18(30%). Perinatal asphyxia 10 (19.2%) were most common cause of admission, other cause of admission were sepsis and prematurity.Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high risk patient, administered of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.


2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.


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