scholarly journals Tocolytic effect of combined sildenafil citrate and nifedepine versus nifedipine alone for management of preterm labour at a tertiary centre

2021 ◽  
Vol 10 (4) ◽  
pp. 1596
Author(s):  
Urmila Karya ◽  
Anupam Rani ◽  
Anshi Srivastava
Keyword(s):  
Preterm Labour ◽  
Nasal Congestion ◽  
Randomized Study ◽  
Perinatal Outcomes ◽  
Sildenafil Citrate ◽  
Combination Regimen ◽  
Singleton Pregnancy ◽  
Tertiary Centre ◽  
Future Potential ◽  
Nicu Admission

Background: This study was conducted to evaluate tocolytic effect of sildenafil citrate and nifedipine versus nifedipine alone for management of preterm labour.Methods: Prospective randomized study on 80 women aged 18-35 years with singleton pregnancy of 28-34 weeks gestation with preterm labour, fulfilling the inclusion criteria were randomly divided in two groups of 40 each. In regimen A women were given sildenafil citrate and nifedipine while in regimen B nifedipine alone for 72 hours as tocolysis.Results: Higher mean latency in sildenafil and nifedipine combination regimen compared to nifedipine alone regimen (28.23±18.3 versus 12.98±13.35 days, p<0.001). In regimen A, less days of hospital stay (3.23±0.92 versus 3.9±0.38 days, p<0.0001); improve perinatal outcomes in form of fewer deliveries during hospitalization or within 7 days after discharge (p=0.018); reduction in NICU admission (0.68±1.54 versus 3.18±4.61 days, p=0.002); improvement in birth weight (p<0.001) and fewer neonatal complications. Only minor side-effects like facial flushing (42.5% versus 22.5%, p=0.029), headache (40% versus 25%), dyspepsia (15% versus 2.5%, p=0.047), nasal congestion, palpitation, hypotension, constipation, nausea, dizziness were seen.Conclusions: Our study found combination of sildenafil citrate with nifedipine as superior and successful regimen with future potential as a tocolytic therapy. 

USE OF SLIDENAFIL CITRATE IN CASES OF INTRAUTERINE GROWTH RESTRICTION AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 23-24
Author(s):  
Anshu Anshu ◽  
Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Intrauterine Growth Restriction ◽  
Randomized Study ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Intrauterine Growth ◽  
Umbilical Artery Doppler ◽  
Doppler Indices ◽  
Antenatal Treatment

Objective: Intrauterine growth restriction (IUGR) is one of the most serious complications of pregnancy. Up to date, there is no evidence of achieving antenatal treatment of IUGR with abnormal placentation. Although, Sildenal citrate has shown promising results, there are no rm conclusion till now. The aim of our study is to evaluate the use of Sildenal citrate in the treatment of IUGR cases associated with impaired placental circulation. Materials And Methods: this was a prospective non-randomized study conducted at JLNMCH, Bhagalpur, Bihar starting from February 2019 to January 2020. The studied population included singleton pregnancy and suffering from IUGR associated with impaired placental circulation. Results: This study included 30 pregnant women. Cases were divided into two groups. The rst group received sildenal citrate and the second control group did not receive sildenal citrate. After 4 weeks after the 1st dose of Sildenal signicant decrease in umbilical artery Doppler indices. There was a statistically signicant difference in the mean birth weight at delivery and neonatal admission to the NICU in sildenal group. Conclusion: sildenale citrate treatment may present a new hope towards better perinatal outcomes for pregnancies complicated by IUGR and impaired placental circulation that may help to decrease neonatal admission to the NICU.

Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?

2018 ◽  
Vol 46 (9) ◽  
pp. 1028-1034 ◽  
Author(s):  
Paola Algeri ◽  
Matteo Frigerio ◽  
Maria Lamanna ◽  
Petya Vitanova Petrova ◽  
Sabrina Cozzolino ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Doppler Study ◽  
Umbilical Artery Doppler ◽  
Nicu Admission ◽  
Twin Pregnancies

Abstract Objective: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. Methods: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study. Results: We found that twin pregnancies with inter-twin estimated fetal weight (EFW) discordance ≥15% were significantly associated with a higher risk of preterm delivery before 32 (P=0.004) and 34 weeks (P=0.04). Similarly, twin pregnancies with inter-twin abdominal circumference (AC) discordance ≥30° centiles were associated with a higher rate of neonatal intensive care unit (NICU) admission (P=0.02), neonatal resuscitation (P=0.02) and adverse neonatal composite outcome (P=0.04). Of interest, when comparing twin pregnancies according to Doppler study, growth restricted twins had a higher rate of composite neonatal outcome and in multivariate analysis, an abnormal Doppler was an independent risk factor for this outcome. Conclusions: Our study associated growth discrepancy with specific pregnancy outcomes, according to defined cut-offs. In addition, we demonstrated that an abnormal umbilical artery Doppler is independently associated with a composite neonatal adverse outcome in growth restricted fetuses.

Maternal and perinatal outcomes following peripartum hysterectomy from a single tertiary centre

2013 ◽  
Vol 53 (6) ◽  
pp. 561-565 ◽  
Author(s):  
Bryony Jones ◽  
Eko Zhang ◽  
Aisha Alzouebi ◽  
Tanya Robbins ◽  
Sara Paterson-Brown ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Peripartum Hysterectomy ◽  
Tertiary Centre

Comparison of Amniotic Fluid Index and Single Deepest Vertical Pocket

2021 ◽  
Vol 17 ◽  
Author(s):  
Roopa Padavagodu Shivananda ◽  
Rekha Anbu ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Anjali Suneel Mundkur ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Maternal Outcomes ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Vaginal Deliveries ◽  
Nicu Admission

Background: The best method of estimation of amniotic fluid volume is a matter of ongoing debate. Objectives: To determine the perinatal & maternal outcomes in pregnant patients when the amniotic fluid volume was assessed by the amniotic fluid index (AFI) in comparison to the single deepest vertical pocket (SDVP). Methods: We studied abnormal Cardiotocograph, meconium stained amniotic fluid, birth weight <2.5kg, Apgar score at 5 min <7, cord blood pH <7.2 & necessity for NICU admission as perinatal outcomes. Rate of diagnosis of oligohydramnios, induction of labor for oligohydramnios & mode of delivery were observed in maternal outcomes. Results: Of the 697 pregnant patients recruited, 353 were in the AFI and 344 in the SDVP group. Perinatal outcomes were similar in both. In the AFI group, the number of women diagnosed with oligohydramnios was higher (p = 0.0333) & the rate of induction was also higher (p = 0.003378). Vaginal deliveries were more in the SDVP group. The Receiver Operating Characteristic curves showed statistically significant correlation with NICU stay, birth-weight, and mode of delivery. While an AFI of >5cm and SDVP of >1.9cm had good sensitivity in predicting babies with a birth weight of ≥ 2.5kg and avoiding NICU admissions, an AFI of > 5.8cm and an SDVP of > 1.9 cm had a sensitivity of around 80% in predicting successful vaginal deliveries. Conclusion: The SDVP method has a slight edge over the AFI in terms of lower inductions and higher vaginal deliveries with comparable perinatal outcomes.

Perinatal outcome in gestational diabetes according to different diagnostic criteria

2019 ◽  
Vol 47 (5) ◽  
pp. 553-557 ◽  
Author(s):  
Lina Salman ◽  
Anat Pardo ◽  
Eyal Krispin ◽  
Galia Oron ◽  
Yoel Toledano ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Challenge Test ◽  
Perinatal Outcomes ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Neonatal Hypoglycemia ◽  
Glucose Challenge ◽  
Nicu Admission

Abstract Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014–2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.

Prenatal Care Adherence and Neonatal Intensive Care Unit Admission or Stillbirth among Women with Gestational and Preexisting Diabetes Mellitus

2017 ◽  
Vol 35 (02) ◽  
pp. 103-109 ◽  
Author(s):  
Jeffrey Sperling ◽  
Lindsay Maggio ◽  
Phinnara Has ◽  
Julie Daley ◽  
Amrin Khander ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prenatal Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Nicu Admission ◽  
Glycemic Monitoring ◽  
Lower Adherence

Objective To determine if there was an association between prenatal care adherence and neonatal intensive care unit (NICU) admission or stillbirth, and adverse perinatal outcomes in women with preexisting diabetes mellitus (DM) and gestational DM (GDM). Materials and Methods This is a retrospective cohort study among women with DM and GDM at a Diabetes in Pregnancy Program at an academic institution between 2006 and 2014. Adherence with prenatal care was the percentage of prenatal appointments attended divided by those scheduled. Adherence was divided into quartiles, with the first quartile defined as lower adherence and compared with the other quartiles. Results There were 443 women with DM and 499 with GDM. Neonates of women with DM and lower adherence had higher rates of NICU admission or stillbirth (55 vs. 39%; p = 0.003). A multivariable logistic regression showed that the lower adherence group had higher likelihood of NICU admission (adjusted odds ratio: 1.61 [1.03–2.5]; p = 0.035). Those with lower adherence had worse glycemic monitoring and more hospitalizations. Among those with GDM, most outcomes were similar between groups including NICU admission or stillbirth. Conclusion Women with DM with lower adherence had higher rates of NICU admission and worse glycemic control. Most outcomes among women with GDM with lower adherence were similar.

scholarly journals Evaluation of quantitative fFn test in predicting the risk of preterm birth

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Michela Centra ◽  
Giuliana Coata ◽  
Elena Picchiassi ◽  
Luisa Alfonsi ◽  
Samanta Meniconi ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Preterm Labour ◽  
Signs And Symptoms ◽  
Singleton Pregnancy ◽  
Fetal Fibronectin ◽  
Prediction Risk ◽  
Risk Categories

AbstractObjective:To evaluate diagnostic accuracy of quantitative fetal fibronectin (qfFN) test in predicting preterm birth (PTB) risk <34 weeks’ gestation or within 14 days from testing. We explored the predictive potential of the test in five-predefined PTB risk categories based on predefined qfFN thresholds (<10, 10–49, 50–199, 200–499 and ≥500 ng/mL).Methods:Measurement of cervicovaginal qfFN with Rapid fFN 10Q System (Hologic) in 126 women with singleton pregnancy (23–33 weeks’ gestation) reporting signs and symptoms indicative of preterm labour (PTL).Results:For PTB prediction risk <34 weeks’ gestation, sensitivity decreased from 100% to 41.7% and specificity increased from 0% to 99.1% with increasing fFN thresholds. Positive predictive value (PPV) increased from 9.5% to 83.3% with increasing qfFN thresholds, while negative predictive value (NPV) was higher than 90% among the fFN-predefined categories. Diagnostic accuracy results showed an area under a receiving operator characteristic (ROC) curve of 84.5% (95% CI, 0.770–0.903). For delivery prediction within 14 days from the testing, sensitivity decreased from 100% to 42.8% and specificity increased from 0% to 100% with increasing fFN thresholds. Diagnostic accuracy determined by the ROC curve was 66.1% (95% CI, 0.330–0.902).Conclusions:The QfFN thresholds of tests are a useful tool to distinguish pregnant women for PTB prediction risk <34 weeks’ gestation.

scholarly journals Obstetric and perinatal outcomes in women with multiple pregnancy in Altai region

2019 ◽  
Vol 4 (3) ◽  
pp. 27-33
Author(s):  
S. V. Barinov ◽  
A. A. Belinina ◽  
I. V. Molchanova ◽  
O. V. Kolyado
Keyword(s):  
Preterm Birth ◽  
Ultrasound Examination ◽  
Multiple Pregnancy ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Altai Region ◽  
Cervical Pessary ◽  
Somatic Diseases

Aim. To study complications and perinatal outcomes of multiple pregnancy in women of the Altai Region.Materials and Methods. We recruited 678 consecutive pregnant women, including 378 with multiple pregnancy, with the subsequent analysis of clinical and ultrasound examination data as well as perinatal outcomes.Results. Women with multiple pregnancy were characterised by a significantly higher rate of gynecological and somatic diseases including pregnancy-related anemia (20.2% versus 4.3% in women with multiple and singleton pregnancy, respectively, OR = 6.0, 95% CI = 3.2-11.3). Further, multiple pregnancy was a significant risk factor for preterm birth (62.26% and 21.82%, respectively, OR = 5.9, 95% CI = 4.2-8.4, p ≤ 0.001). Application of cervical pessary was able to prolong the multiple pregnancy for 4 weeks.Conclusion. Prevention of threatening preterm birth in women with a multiple pregnancy using a cervical pessary improves perinatal outcomes. 

scholarly journals Which growth standards should be used to identify large- and small-for-gestational age infants of mothers with type 1 diabetes? A pre-specified analysis of the CONCEPTT trial

2020 ◽  
Author(s):  
Claire L Meek ◽  
Rosa Corcoy ◽  
Elizabeth Asztalos ◽  
Laura Caroline Kusinski ◽  
Esther Lopez ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Outcomes ◽  
Neonatal Hypoglycaemia ◽  
Growth Standards ◽  
Who Standards ◽  
Nicu Admission

Abstract Background Offspring of women with type 1 diabetes are at increased risk of accelerated fetal growth which is associated with perinatal morbidity. Growth standards are used to identify large- or small- for gestational age (LGA, SGA) infants. Our aim was to examine which growth standards identify infants at risk of perinatal complications during the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT). Methods This was a pre-specified analysis of CONCEPTT involving 225 pregnant women from 31 international centres. Infants were weighed immediately at birth and GROW, INTERGROWTH and WHO centiles calculated. Unadjusted logistic regression identified the associations between different growth standards and perinatal outcomes including preterm delivery, Caesarean delivery, neonatal hypoglycaemia, hyperbilirubinaemia, respiratory distress, neonatal intensive care unit (NICU) admission and a composite neonatal outcome. Results Accelerated fetal growth was common, with mean birthweight percentiles of 82.1, 85.7 and 63.9 and LGA rates of 62%, 67% and 30% using GROW, INTERGROWTH and WHO standards respectively. Corresponding rates of SGA were 2.2%, 1.3% and 8.9% respectively. All standards were associated with some but not all perinatal outcomes studied. Infants born >97.7 th centile were at highest risk of complications. Conclusions WHO standards underestimated birthweight centile. GROW and INTERGROWTH standards identified similar numbers of infants as LGA and SGA with GROW showing stronger associations with neonatal hypoglycaemia, hyperbilirubinaemia and NICU admission. Infants with suspected birthweight >97.7th centile according to any standard may require extra surveillance. Definitions of LGA and SGA should be re-evaluated in diabetic pregnancy.

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