scholarly journals Fetomaternal outcomes in conservative management of preterm premature rupture of membrane

2021 ◽  
Vol 10 (2) ◽  
pp. 691
Author(s):  
Rama Chundawat ◽  
Meenakshi Singh ◽  
Arun Gupta ◽  
Bhamini Jakhetiya ◽  
Ruhina Khan
Keyword(s):  
Gestational Age ◽  
Conservative Management ◽  
Latency Period ◽  
Fetal Distress ◽  
P Value ◽  
Complete Evaluation ◽  
E Coli ◽  
Medical College ◽  
Membrane Rupture ◽  
Prophylactic Use

Background: The management of PPROM remains controversial. Aim of this study was to determine the fetomaternal outcome in conservative management of PPROM.Methods: A prospective observational study was done on a total of 110 pregnant women between 24 and 36 weeks 6 days gestation with PPROM visiting Geetanjali medical college and hospital from February 2019 to July 2020. All the patients were subjected to detailed history and examination and followed till their delivery.Results: The incidence of PPROM in our study was 4.94%. The mean latency period from membrane rupture to delivery decreased from 12.1±14 days at >28 weeks, 5.3±7.7 days at 28-31 weeks 6 days to 1.1±1.2 days at 32 to 36 weeks 6 days. The most common indication of LSCS was fetal distress (26.31%). E. coli was the most common organism (36.36%) isolated and it was significantly associated with gestational age at PPROM (p value <0.040405). The maternal morbidity was 24.53% and was closely associated with the gestational age at PPROM (p value <0.001). The perinatal morbidity was 44.20% and perinatal mortality was 13.04% which was mainly due to RDS (33.34%).Conclusions: Management of PPROM involves complete evaluation of risks and benefits of conservative management. The treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and corticosteroids thereby reducing fetomaternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis, septicaemia.

scholarly journals Fetomaternal Outcome in Preterm Premature Rupture of Membrane

2014 ◽  
Vol 5 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Manju Puri ◽  
Minakeshi Rana ◽  
Sharda Patra ◽  
Shubha Sagar Trivedi
Keyword(s):  
Gestational Age ◽  
Latency Period ◽  
Intrauterine Fetal Death ◽  
Premature Rupture ◽  
Complete Evaluation ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Maternal Morbidity And Mortality ◽  
The Difference ◽  
Prophylactic Use

Abstract This prospective observational study was carried out to study the fetomaternal outcome in women with preterm premature rupture of membrane (PPROM) between 24 and 36 weeks of gestation. Materials and methods A total of 150 pregnant women between 24 and 36 weeks gestation with PROM were subjected to detailed history and examination. Each patient was followed till her delivery and fetomaternal outcome was recorded gestation-wise between 24 and 28 weeks (n = 15), 28 and 32 weeks (n = 30), 32 and 34 weeks (n = 90), and 34 and 36 weeks (n = 15). Result The mean latency period from membrane rupture to delivery decreased from 15 days at 24 to 28 weeks, 11 days at 28 to 32 weeks to 4.4 days at 32 to 34 weeks to 2.1 days at 34 to 36 weeks. Majority of women delivered vaginally. The rate of spontaneous labor increased as the gestational age at admission increased, the difference between rate of spontaneous labor of 67% at 28 to 32 weeks and 86% at 34 to 36 weeks was statistically significant (p = 0.001). The indications for induction of labor were intrauterine fetal death, gross oligohydramnios, and clinical chorioamnionitis. The most common complication was clinical chorioamnionitis (6%) and postpartum sepsis (6%). The perinatal outcome was favorable in majority of cases and improved with the increase in gestational age at PROM. The overall perinatal mortality was 9.3%. Conclusion Management of PPROM involves complete evaluation of risks and benefits of conservative management. Wherever possible, the treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and steroids thereby reducing fetal-maternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis. How to cite this article Rana M, patra s, Puri M, Trivedi SS. Fetomaternal Outcome in Preterm Premature Rupture of Membrane. Int J Infertil Fetal Med 2014;5(1):18-21.

scholarly journals ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Uterine Scar ◽  
Age Range ◽  
The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

scholarly journals Effect of oral 25% dextrose on pain relief in newborn infants undergoing venepuncture

2020 ◽  
Vol 7 (4) ◽  
pp. 891
Author(s):  
H. N. Yashwanth Raju ◽  
Rudrappa Sudha ◽  
Shwetha B. N.
Keyword(s):  
Heart Rate ◽  
Pain Relief ◽  
Pain Score ◽  
Gestational Age ◽  
Perinatal Asphyxia ◽  
Newborn Infants ◽  
Blood Sampling ◽  
Clinical Indication ◽  
P Value ◽  
Medical College

Background: Aim of this study was to study effect of oral 25% dextrose for pain relief in newborns undergoing venepuncture.Methods: This is a case control study conducted in NICU, Cheluvamba hospital attached to Mysore medical college and research institute during the period between September 2018 to November 2018. Babies with gestational age between 34 to 40 weeks of gestation who had clinical indication for blood sampling were included in the study. Neonates who are critically ill, suffered perinatal asphyxia and having congenital anomalies were excluded from the study. Hundred newborn babies admitted to NICU who had clinical indication for blood sampling were enrolled in the study. Study population were divided into 2 groups, dextrose (cases) and non-dextrose group (controls). The data analysis included gestational age, postnatal age, weight, sex, heart rate, oxygen saturation, crying time and behavioural pain assessment.Results: Mean pain score, crying time and heart rate at 5 minutes of venepuncture were studied in both the groups. Mean pain score in dextrose group was 2.68 and in non-dextrose group was 7.18 with significant p value of 0.0062. Mean crying time in dextrose group was 8.98 minutes and in non-dextrose group was 42 minutes with significant p value of 0.001. Mean heart rate in dextrose group was 142 beats/minute and in non-dextrose group was 146bpm with p value of 0.08.Conclusions: Pain in the newborns should be recognised and adequately treated. Lingual 25% dextrose can be used as safe and effective analgesia in neonates undergoing minor invasive procedures like venepuncture.

scholarly journals FETOMATERNAL OUTCOME IN POST DATED PREGNANCY: A RETROSPECTIVE STUDY

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Sudesh Agrawal ◽  
Angurbala Patidar ◽  
Satish Kumar
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Maternal Morbidity ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
P Value ◽  
Term Pregnancy ◽  
Gestational Length ◽  
Post Term Pregnancy

Introduction: Postdated pregnancy is defined as pregnancy extended beyond 40 weeks of gestation or 280 days. FIGO and WHO defined post term pregnancy as a pregnancy which has gestational length of 294 days or more, Post term pregnancy is defined as pregnancy that has extended to or beyond 42 weeks of gestation, or estimated date of delivery (EDD)+14 days. Therefore we conducted this study to evaluate fetomaternal outcome in post dated pregnancies. Material & Methods: This was a retrospective hospital based study conducted on 400 pregnant women beyond 40 weeks of gestational age from the period of November 2018 to October 2019. A detailed history and clinical examination were recorded in performa from hospital records. Data pertaining to the onset of labour, mode of delivery, caesarean section due to fetal distress/ meconium stained liquor birth weight, Apgar score at 1minute and 5minute,NICU admission and perinatal death were analysed. The data obtained were entered in Microsoft excel and were analysed using appropriate statistical test (chi square test). P value of <0.05 was taken as significant. Results: Majority of cases belonged to rural area where total 57.3% cases were found while 171(42.7%) cases belonged to urban area. 184(46%) cases were booked and 216(54%) cases were unbooked. 260(65%) cases were referred from other centers, 140(35%) cases were not referred. 253(63.3%) cases were primigravida, 87(21.8%) cases were second gravida and 14.9% cases were multigravida.As a induction of labour oxytocin was used in 126(31.5%)cases, CP gel was used in 73(18.3%) of cases while miso was used in 26(6.5%) of cases. Conclusion: Maternal morbidity increased in the form of emergency LSCS, postpartum hemorrhage, instrumental deliveries, as the gestational age increased beyond 40 weeks. Maternal and fetal morbidity and mortality can be reduced by electively inducing pregnant women at 40 weeks as allowing them to continue beyond this gestational age has shown adverse feto-maternal outcomes. Keywords: Fetomaternal, LSCS, Maternal Morbidity

scholarly journals A study to find out the association between duration of preterm premature rupture of the membrane’s delivery interval and maternofetal complications

2020 ◽  
Vol 10 (1) ◽  
pp. 112
Author(s):  
Anusree Saraswathy ◽  
Ajitha Ravindran ◽  
Jayshree V. Vaman ◽  
Mayadevi Brahmanandan
Keyword(s):  
Latent Period ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Latency Period ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Neonatal Deaths ◽  
Membrane Rupture ◽  
Preterm Premature Rupture

Background: The main maternal complications of preterm premature rupture of the membranes (PPROM) are chorioamnionitis, puerperal pyrexia, abruption and the neonatal complications are neonatal sepsis, congenital pneumonia, neonatal ICU stay and neonatal death. The aim of the study is to find out the association between duration of latent period in PPROM i.e. the time period between rupture of membrane to delivery and maternofetal complications.Methods: The present study was a Prospective observational study conducted on 240 preterm antenatal women with PPROM in the Department Obstetrics and Gynecology, SATH, GMC, Thiruvananthapuram. The gestational age at rupture of membranes, latent period from time rupture of membranes to delivery, gestational age at time of delivery and the maternal and neonatal outcome were compared and subjected to statistical analysis.Results: Maternal chorioamnionitis in the group with PPROM delivery interval between 2-7 days (79.3%) whereas there were (13.8%) in which PPROM delivery interval was less than 24 hrs. Puerperal pyrexia in 2-7 days delivery interval was 11.3% and in <24 hrs were 2.6%. Neonatal sepsis in 2-7 days was 28.3% and 12.5% in<24 hrs. Congenital pneumonia in 2-7 days was 16.9% and in<24 hrs was 11.6%.Conclusions: In the present study membrane rupture between 28-34 weeks gest age and latency period. 2-7 days were associated with high incidence of maternal chorioamnionitis, puerperal pyrexia congenital pneumonia, early onset neonatal sepsis and neonatal death. Undue prolongation of pregnancy may increase the risk of chorioamnionitis, neonatal sepsis and neonatal deaths.

scholarly journals Therapeutic amnioinfusion in oligohydramnios during pregnancy (excluding labor)

2017 ◽  
Vol 6 (10) ◽  
pp. 4577
Author(s):  
Mahvish Qazi ◽  
Najmus Saqib ◽  
Abida Ahmad ◽  
Imran Wagay
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Latency Period ◽  
Fluid Volume ◽  
P Value ◽  
Normal Delivery ◽  
Neonatal Deaths ◽  
Amniotic Fluid Volume ◽  
The Mean

Background: Oligohydramnios is a serious complication of pregnancy that is associated with a poor perinatal outcome and complicates 1-5% of pregnancies. The purpose of this study was to evaluate the role of antepartum transabdominal amnioinfusion on amniotic fluid volume/latency period in pregnancies with oligohydramnios.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Sher-i-Kashmir Institute of Medical Sciences Soura Srinagar. In this study, a total of 54 pregnant women with ultrasonographically diagnosed oligohydramnios i.e. AFI < 5 cm and gestational age of >24 weeks were taken for therapeutic amnioinfusion and its effects on amniotic fluid volume were studied. Statistical Software SPSS (Version 20.0) and Microsoft excel were used to carry out the statistical analysis of data. P-value less than 0.05 was considered statistically significant.Results: Mean age of patients in our study was 27.5±3.19 years and gestational age group of 28-34 weeks. The mean AFI pre and post amnioinfusion was found to be 3.3 cm and 8.8 cm respectively. The difference was found to be statistically significant with a p value of <0.001. There was increase in the latency period in the studied patients with a mean latency period of 42.8±14.94 days. Mean number of transabdominal amnioinfusions in our study was 1.48±0.64. In our study, majority of patients i.e. 33 (61.1%) delivered at 38-40 weeks with a mean age at delivery 37.4±1.92 weeks. In our study, maximum number of patients i.e. 32 (59.3%) were delivered by full term normal delivery and only 15 (27.8%) required caesarean section. 78% of newborns weighed >2.5kg. The mean weight of newborn was 2.9±0.59 kgs. The incidence of newborn admissions to NICU was 20.4%. Number of neonatal deaths in our study was 5.6%. There was reduction of neonatal admission to NICU and neonatal deaths after transabdominal amnioinfusion.Conclusions: Antepartum transabdominal amnioinfusion is a useful procedure to reduce complications resulting from decreased intra-amniotic volume. It significantly raises the amniotic fluid especially useful in preterm pregnancies, where the procedure allows for a better perinatal outcome by significantly prolonging the duration of pregnancy, increasing birth weight, preventing fetal distress and thereby reducing operative intervention. Optimizing the selection of patients who are good candidates for the procedure is a prerequisite.

scholarly journals A study of feto-maternal outcome in cases of pre-labour rupture of membranes

2017 ◽  
Vol 6 (10) ◽  
pp. 4473
Author(s):  
Koothan U. T. ◽  
Nina V. Kate ◽  
Anuradha V.
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Maternal Morbidity ◽  
Latency Period ◽  
Neonatal Morbidity ◽  
Management Issue ◽  
Inclusion Criteria ◽  
Membrane Rupture ◽  
Study Participants

Background: Prelabour rupture of membranes is a common obstetric problem and the assessment of women with possible membrane rupture is a management issue faced in every day practice. The diagnosis and treatment of Prelabour rupture of membranes depends upon the facilities available. Unrecognized and inadequately treated conditions can lead to various maternal and neonatal complications.Methods: The present prospective study was conducted on 200 pregnant women satisfying the inclusion criteria after getting consent for participation. Pregnant women between the gestational age of 28 – 40 weeks who presented with Prelabour rupture of membranes to casualty were enrolled into the study.Results: 76.5% of the study participants were between 37-40 weeks of gestation and the remaining 23.5% belonged to the preterm population. Maternal morbidity was found to be 68% among the study participants with latency period more than 24 hrs. 37.5% of the neonates developed morbidity and the neonatal mortality was 2%.Conclusions: Prelabour rupture of membranes contributes significantly to maternal morbidity, neonatal morbidity and perinatal mortality.

scholarly journals A study on clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome

2019 ◽  
Vol 6 (6) ◽  
pp. 2346
Author(s):  
Manivannan V. ◽  
Jegan Murugan R. ◽  
Devandiran R. S.
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Strong Association ◽  
Fetal Distress ◽  
Meconium Aspiration Syndrome ◽  
College Hospital ◽  
Meconium Aspiration ◽  
Medical College

Background: Aim of the study was to understand the factors causing meconium aspiration syndrome (MAS) in relation to gestational age and birth weight and their immediate outcome.Methods: This study was done on babies admitted in the neonatal intensive care unit (NICU) of Thanjavur medical college hospital, who fulfilled the criteria of MAS. Babies born with meconium stained amniotic fluid (MSAF), were resuscitated as per NRP guidelines. The babies with complications of MAS were admitted to NICU and were observed for their immediate outcome in the hospital.Results: MAS occurred most commonly in babies having fetal distress and in mothers with history of PIH. It is seen more commonly in babies born through caesarean section and in term babies with mean gestational age of 38-40 weeks of gestation and mean birth weight of 2.71 kg. Most babies were depressed at birth and most common cause of mortality was hypoxic ischemic encephalopathy (HIE stage III), significantly contributing 37.5% of cases of MAS. There was significant and strong association between the birth weight and mortality. Thick MSAF was significantly associated with need for mechanical ventilation and subsequently higher mortality. Babies born through caesarean section with MAS also had significantly poor outcome.Conclusions: MAS is an entity which is commonly seen in term and post term babies with birth weight >2.5 kg. There is a significant correlation between the birth weight and outcome in MAS. When thick meconium stained liquor is noted prior to birth, anticipation is necessary and non vigorous babies need aggressive management and possibly early ventilation. Asphyxiated babies should be followed up astutely. Continuous monitoring and early intervention, followed by due resuscitation as per guidelines can reduce the morbidity, complications and the mortality in MAS.

scholarly journals Determine the frequency of peripartum hystrectomy in placenta previa

2021 ◽  
Vol 9 (4) ◽  
pp. 961
Author(s):  
Amna Usman ◽  
Quratulain Shabbir ◽  
Falak Naz ◽  
Attiya Yasmeen ◽  
Mubashra Naz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Conservative Management ◽  
Postpartum Haemorrhage ◽  
Placenta Previa ◽  
Cross Sectional ◽  
Peripartum Hysterectomy ◽  
Medical College ◽  
Caesarean Birth ◽  
Obstetrics And Gynaecology ◽  
Life Saving

Background: Peripartum hysterectomy is one of the life saving procedure performed after vaginal delivery or caesarean birth or in the immediate postpartum period in cases of intractable haemorrhage due to uterine atony, rupture uterus and placental disorders and it is usually reserved for the situations where conservative measures fail to control the haemorrhage. The objective of the study was to determine the frequency of peripartum hysterectomy in placenta praevia.Methods: The study was cross-sectional. It was conducted at the Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated Hospital, Faisalabad. Study was carried out over a period of six months from October 2010 to March 2011. Total 130 cases of placenta praevia undergone caesarean section were included in this study. In cases of primary postpartum haemorrhage conservative management was done first in the form of intramuscular syntometrine (Oxytocin 5 IU/ergometrine 0.5 mg). Intravenous infusion syntocinon (40 IU in 500ml 0.9% saline over 4-6 hours).Results: Mean age of the patients was found to be 30.9±6.7 years. Distribution of cases by gestational age shows, 52 (40.0%) patients had gestation of 28-36 weeks and 78 (60.0%) patients had gestation of 37-41. Mean gestational age was observed 37.5±3.4 weeks. Parity distribution was as follows: 76 (58.5%) patients had parity 0-3, 34 (26.1%) patients had parity 4-6 and 20 (15.4%) patients had parity > 6 with mean parity of 3.2±1.9. Conservative management was done in 129 patients (99.3%). Peripartum hysterectomy was found to be in 1 patient (0.7%).Conclusions: Placental pathology is the leading cause of postpartum hemorrhage and the main indications of peripartum hysterectomy. Timely operation minimizes the morbidity and mortality.

scholarly journals ASSOCIATION OF LOW VITAMIN D WITH PRE ECLAMPSIA

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Nazia Tufail ◽  
Sadia Shafiq ◽  
Qudsia Nawaz ◽  
Nosheen Bano ◽  
Munazzah Bashir ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Key Words ◽  
Gestational Age ◽  
Control Group ◽  
P Value ◽  
Medical College ◽  
Pregnant Females ◽  
And Control ◽  
Duration Of Gestation

Objective: To determine the association of preeclampsia and vitamin D deficiency. Study design: Cohort study. Place and duration of study: Gynecology Department, Khwaja Muhammad Safdar Medical College, during 01-07-2018 to 31-12-2018. Material and Methods: In this study the pregnant females irrespective of their gravida and parity status and having gestational age more than 20 weeks were included. The cases that had vitamin D level lower were labelled as cases and those with normal levels as controls. They these cases were followed monthly until delivery and during this period they were followed for protein urea and BP to label pre eclampsia. Results: In this study 100 cases were selected. 50 in each group. Mean age in case and control group was 29.57±4.57 vs 28.43±3.79 years and mean duration of gestation at presentation was 26.43±5.11 vs 27.42±5.23 weeks. There were 39 vs 41 multigravida and 37 vs 38 uneducated females in cases and control group respectively. Preeclampsia was seen in 4 (08%) of control and 14 (28%) cases with odd ration of 4.47 (1.35 to 14.75) with p value 0.01. Conclusion: There is significant association of low vitamin D level and risk of pre eclampsia. Key words; pre eclampsia, vitamin D, Hypertension.

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