scholarly journals High risk scoring in pregnancy using modified Coopland’s scoring system and its association with perinatal outcome

2021 ◽  
Vol 10 (4) ◽  
pp. 1608
Author(s):  
Shobha S. Pillai ◽  
Swapna Mohan
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Perinatal Outcome ◽  
Risk Group ◽  
Cost Effective ◽  
High Risk Group ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Significant Difference ◽  
Risk Scoring

Background: High-risk pregnancy is one in which the mother, foetus or the newborn has an elevated risk of experiencing an adverse outcome. These high-risk women form a special vulnerable cohort that can be identified in the antenatal period using a simple, easy to use, cost-effective tool- a maternal risk scoring system. Early identification of these high-risk mothers will facilitate effective intervention strategies to deal with the complications.Methods: This study was carried out on 300 pregnant women with gestational age more than 28 weeks. Detailed history, examination and necessary investigations were done and then using the Modified Coopland scoring system, each pregnant woman was assigned a risk score and stratified into 3 risk groups- low risk (0-3), moderate risk (4-6) and high risk (≥7) and followed up till delivery and 7 days postpartum. Subsequently, the maternal and perinatal outcomes were compared with their respective scores.Results: In this study, 14.66% patients belonged to the high-risk category. Statistically, a significant difference was noted in the number of low-birth-weight babies, in 5 minutes APGAR score <7 and in NICU admissions in the high-risk group compared to the low-risk group. Overall perinatal mortality was 13.33/1000 live births. In the high-risk group, a significant difference was seen in the occurrence of PPH and the need for operative delivery.Conclusions: Significant association between high-risk pregnancy and the poor maternal and perinatal outcome was noted. Therefore, a simple, cost-effective high-risk pregnancy scoring system such as the one proposed in this study can be used to identify potential high-risk pregnancies, provide them with tertiary care facilities and also corrective measures can be undertaken to prevent or minimize the complicating factors.

scholarly journals Identifying High Risk Pregnancy and Its Effectiveness in determining Maternal and Perinatal Outcome

2021 ◽  
Vol 6 (2) ◽  
pp. 1565-1572
Author(s):  
Junu Shrestha ◽  
Sangeeta Devi Gurung ◽  
Anjali Subedi ◽  
Chandani Pandey
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Scoring System ◽  
Perinatal Outcome ◽  
Risk Group ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Risk Pregnancy

Introduction: Identification of high risk pregnancy can be done by using various scoring systems which is highly predictive in determining maternal and perinatal outcome. Objectives: The objectives of the study were to identify high- risk pregnancy and to compare the maternal and perinatal outcome of high-risk with low-risk pregnancies. Methodology: This study was conducted in the department of obstetrics and gynaecology, Manipal Teaching Hospital, Pokhara, from 1st August 2020 to 31st January 2021. Study included pregnant women coming for delivery after 28 weeks of gestation.  Antenatal scoring system involving various risk factors, was used to stratify women as low-risk (score 0-3), high-risk (score 4-6) and extremely high-risk group ( score ≥7). All women were followed up in intrapartum and postpartum period and complications noted. Neonates were also followed up. Maternal and perinatal outcome of three groups were compared. Results: There were 67.3% women in low-risk, 20% in high-risk and 12.7% in  extremely high-risk groups. Operative deliveries were 89.9% in extremely high- risk, 77.9% in high- risk as compared to 51% in low- risk group. Maternal complications, total amount of blood loss and duration of hospital stay was more in extremely high-risk and high-risk pregnancies. Low birth weight was more common in extremely high risk (60%) and high-risk (26%) pregnancies compared to low- risk pregnancies (15%). Neonates with low Apgar scores at 1 and 5 minutes were more in high-risk pregnancies. Thirty-two percent neonates in extremely high-risk pregnancy required neonatal intensive care admission which was significantly higher as compared to high-risk and low-risk pregnancies. Perinatal deaths were more frequent in extremely high-risk pregnancies. Conclusions: Identifying high risk pregnancy using scoring system is useful to identify women at risk of developing maternal and perinatal complications. 

scholarly journals Anxiety and depression in women hospitalized due to high-risk pregnancy: An integrative quantitative and qualitative study

2021 ◽  
Author(s):  
Martina Smorti ◽  
Francesca Ginobbi ◽  
Tommaso Simoncini ◽  
Federica Pancetti ◽  
Alessia Carducci ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
High Risk ◽  
Risk Group ◽  
Depression Scale ◽  
High Risk Group ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
Anxiety And Depression ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

AbstractLiterature has shown that hospitalized women with high-risk pregnancy tend to develop anxious and depressive symptoms. Research has used quantitative or qualitative methods. By integrating both quantitative and qualitative methods, this study aims to analyze: a) the level of depression, anxiety, and pregnancy-related anxiety in a group of women hospitalized with high-risk pregnancy (hospitalized high-risk) compared with a group of non-hospitalized women with low-risk pregnancy; b) the content of hospitalization-related emotions in a high-risk group. A cross-sectional study was conducted on 30 hospitalized high-risk pregnant women and 32 women with low-risk pregnancy. Participants completed the Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (Anxiety), and Pregnancy Related Anxiety Questionnaire. The hospitalized high-risk group also completed open-ended questions about emotions experienced during hospitalization. Univariate Analysis of Covariance showed that the hospitalized high-risk group reported higher general anxiety and depression than the low-risk pregnancy group. Low-risk group reported higher level of concerns about own appearance than high-risk group. Narratives showed that the anxious and depressive symptoms of hospitalized women are related to the loneliness of being away from family. Despite attempts to understand hospitalization, they express concerns about pregnancy. Psychological support for hospitalized pregnant women should be provided to facilitate the communication of emotions that leads women to elaborate the experience of hospitalization to better adapt and cope with the critical condition.

scholarly journals A study of high-risk factors in ante-natal women at a tertiary care centre

2020 ◽  
Vol 9 (7) ◽  
pp. 2959
Author(s):  
Sonia Dahiya ◽  
Smriti Anand ◽  
Vandana Rani ◽  
Sarika Gautam ◽  
Smiti Nanda
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Gestational Age ◽  
Risk Group ◽  
Tertiary Care ◽  
High Risk Group ◽  
High Risk Pregnancy ◽  
Early Screening ◽  
High Risk Factors ◽  
Risk Pregnancy

Background: High-risk pregnancy refers to any condition in pregnancy that increases risk for morbidity or mortality in mother, fetus and neonate. Globally, nearly 5,29,000 women die due to pregnancy related complications. In India, 20-30% of the pregnant patients contribute to high risk group. This study was conducted to determine different high-risk factors prevalent in antenatal women in Haryana. Objective of this study was to find out prevalence of different high-risk factors in antenatal women.Methods: Data of all antenatal high-risk patients attending OPD during one year was taken from hospital record registers. Maternal characteristics such as age, gravida/parity, gestational age, and gestational age at the time of first visit were noted. High risk factors identified were noted.Results: The records of total 10073 antenatal women were analyzed, 1283 were included in the high-risk group. Most prevalent high-risk factors found were previous cesarean section (31.04%), anaemia (31.02%), malpresentation (12.93%) and thyroid disorders (13.09%).Conclusions: Antenatal surveillance for the high-risk factors complicating pregnancy may prevent or treat most of the complications. Authors should develop strategies for early screening of high-risk pregnancy cases to prevent maternal and perinatal mortality and to improve the maternal and perinatal outcome.

scholarly journals HIGH RISK PREGNANCY DETECTION USING TELEHEALTH-BASED SCREENING

2021 ◽  
Vol 1 (3) ◽  
pp. 20-31
Author(s):  
Fatmawati Fatmawati ◽  
◽  
Yulia Silvani ◽  
Mustika Dewi ◽  
Ningrum Paramita S ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Continuous Monitoring ◽  
Risk Group ◽  
High Risk Group ◽  
High Risk Pregnancy ◽  
High Rate ◽  
Risk Detection ◽  
Risk Pregnancy ◽  
In Pregnancy

High-risk pregnancy is a pregnancy that is likely to cause harm or complications to the mother and fetus. Given the high rate of disease transmission, the use of telehealth technology can be an effective and efficient way to deal with the spread of the virus. Telehealth is one solution to overcome the problem of access to health, with telehealth it can perform screening to detect high-risk pregnancies early, so that pregnant women can get continuous monitoring. Telehealth can operate as a filter that is able to expand and facilitate access to services, especially in the examination and screening of risks in pregnancy and can apply high risk detection instruments in pregnancy in applications, so as to facilitate decision making. Telehealth can detect high-risk pregnancies early, so that pregnant women can get continuous monitoring. The purpose of this activity is to conduct and determine the effectiveness of telehealth-based high-risk detection in pregnant women. The method of activity is in the form of community service through webinars and screenings which are carried out within 6 months online. The result of the activity is an increase in the knowledge of webinar respondents with an average pre-test value of 120 and post-test 157 out of a total of 200. Based on the results of screening using the SIBIDAN application, from 25 pregnant women in trimesters 1,2, and 3 who became respondents, the results were 52%, low risk group, 32% high risk group, and 16% very high-risk group. Therefore, further assistance, monitoring, and referral are needed to minimize pregnancy complications.

scholarly journals Obstetric and neonatal outcome among women presenting with reduced fetal movements in third trimester

2017 ◽  
Vol 7 (1) ◽  
pp. 88 ◽  
Author(s):  
Vidyashree G. Poojari ◽  
Sahan S. Kumar ◽  
Akhila Vasudeva
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Risk Group ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
High Risk Women ◽  
Reduced Fetal Movements ◽  
Risk Pregnancy ◽  
Fetal Movements

Background: Reduced maternal perception of fetal movements allows early identification, timely evaluation and intervention for fetuses at risk of adverse outcome. The primary objective of this study was to assess the pregnancy characteristics and outcomes of pregnant women presenting to hospital with reduced fetal movements (RFM).Methods: Prospective observational study, recruiting all women with singleton pregnancy at or beyond 28 weeks of gestation presenting with a subjective perception of RFM from April 2015 to December 2016. Maternal characteristics, antenatal risk factors, management pathways and perinatal outcome studied.Results: 47% belonged to high risk pregnancy. Among high risk women, although only 39% showed poor BPP at the first presentation, 58% were delivered irrespective of their gestational age, out of which 32.75% had poor neonatal outcome. Among low risk who had >2 episodes of RFM, 50% had poor neonatal outcome. 7% among high risk pregnancies and 18% among low risk, presented with RFM within 48 hours following steroid prophylaxis.24% of high risk women showed liquor volume abnormalities as compared to low risk (6.3%).Conclusions: Significant proportion of those with RFM belonged to high risk pregnancy. Among high risk group, there were high rates of stillbirth and poor BPP at the time of admission when compared to low risk group. Due to early approach to the hospital and timely intervention, significant women with abnormal BPP had good perinatal outcome. All those fetuses who were delivered on first episode of RFM in low risk group did not show evidence of compromise at birth, probably indicating unnecessary delivery. More than 2 episodes of RFM even among low risk group seems significant as good number of fetuses were compromised at birth. Steroids prophylaxis for the fetal lung maturity causes transient changes in BPP, hence unnecessary delivery should be avoided especially those among low risk pregnancy.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

scholarly journals A model for predicting carotid instability plaque in high risk group of stroke individuals

2019 ◽  
Author(s):  
Junxiong Yin ◽  
Chuanyong Yu ◽  
Hongxing Liu ◽  
Mingyang Du ◽  
Feng Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Predictive Model ◽  
Doppler Ultrasound ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
High Risk Population ◽  
Auc Value ◽  
Validation Set

Abstract Objective: To establish a predictive model of carotid vulnerable plaque through systematic screening of high-risk population for stroke.Patients and methods: All community residents who participated in the screening of stroke high-risk population by the China National Stroke Screening and Prevention Project (CNSSPP). A total of 19 risk factors were analyzed. Individuals were randomly divided into Derivation Set group and Validation Set group. According to carotid ultrasonography, the derivation set group patients were divided into instability plaque group and non-instability plaque group. Univariate and multivariable logistic regression were taken for risk factors. A predictive model scoring system were established by the coefficient. The AUC value of both derivation and validation set group were used to verify the effectiveness of the model.Results: A total of 2841 high-risk stroke patients were enrolled in this study, 266 (9.4%) patients were found instability plaque. According to the results of Doppler ultrasound, Derivation Set group were divided into instability plaque group (174 cases) and non-instability plaque group (1720 cases). The independent risk factors for carotid instability plaque were: male (OR 1.966, 95%CI 1.406-2.749)，older age (50-59, OR 6.012, 95%CI 1.410-25.629; 60-69, OR 13.915, 95%CI 3.381-57.267;≥70, OR 31.267, 95%CI 7.472-130.83) , married(OR 1.780, 95%CI 1.186-2.672)，LDL-c(OR 2.015, 95%CI 1.443-2.814), and HDL-C(OR 2.130, 95%CI 1.360-3.338). A predictive scoring system was created, range 0-10. The cut-off value of prediction model score is 6.5. The AUC value of derivation and validation set group were 0.738 and 0.737.Conclusion：For a high risk group of stroke individual, We provide a model that could distinguishing those who have a high probability of having carotid instability plaque. When resident’s predictive model score exceeds 6.5, the incidence of carotid instability plaque is high, carotid artery Doppler ultrasound would be checked immediately. This model can be helpful in the primary prevention of stroke.

scholarly journals Clinical and Biological Prognostic Factors in Follicular Lymphoma Patients During Treatment

2021 ◽  
Author(s):  
Ádám Jóna ◽  
Anna Kenyeres ◽  
Sándor Barna ◽  
Árpád Illés ◽  
Zsófia Simon
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Follicular Lymphoma ◽  
Risk Group ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
High Risk Group ◽  
Pet Ct ◽  
Significant Difference ◽  
Biological Prognostic Factors

Abstract Introduction: Follicular lymphoma (FL) is an indolent yet heterogeneous B-cell lymphoproliferative disorder. Most people respond to treatment well. However, a particular group of patients has a poor prognosis, and these patients are difficult to define.Patients and methods: We retrospectively analyzed FL patients treated at the University of Debrecen in the past 20 years. We investigated prognostic factors that may influence the survival of FL patients.Results: We found a standardized uptake value (SUV)max cut-off value of 9.85 at the staging PET/CT to significantly separate FL patients’ progression-free survival (PFS) (p=0.0003, HR: 0.2560, 95%CI: 0.1232-0.5318). Lymphocyte/ monocyte (Ly/Mo) ratio of 3.45 drawn at diagnosis also significantly predicted PFS (p=0.0324, HR: 1.806, 95% CI: 1.051-3.104). Combining patients’ with staging SUVmax >9.85 and Ly/Mo < 3.45 a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1033, 95%CI: 0.03719-0.2868). Similarly, a significant difference was shown with a SUVmax cut-off of 3.15 at the interim PET/CT (p<0.0001, HR: 0.1535, 95%CI: 0.06329-0.3720). Combining patients with staging SUVmax >9.85 and interim SUVmax >3.15, a high-risk group of FL patients can be identified (p<0.0001, HR: 0.1037, 95%CI: 0.03811-0.2824). The PFS difference is translated into overall survival advantage (p=0.0506, HR: 0.1187, 95%CI: 0.01401-1.005).Discussion: Biological prognostic factors, such as the Ly/ Mo ratio, may improve the prognostic assessment of staging PET/CT. Nevertheless, PFS difference is translated into OS when using a combination of staging and interim SUVmax. We consider investigating additional biological prognostic factors while currently highlighting PET/CT's role in FL.

scholarly journals Determination of Risk Factors for Venous Thromboembolism by an Adapted Caprini Scoring System in Surgical Patients

2019 ◽  
Vol 9 (3) ◽  
pp. 36 ◽  
Author(s):  
Bui My Hanh ◽  
Le Quang Cuong ◽  
Nguyen Truong Son ◽  
Duong Tuan Duc ◽  
Tran Tien Hung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Scoring System ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Assessment Model ◽  
Surgical Patients ◽  
Risk Scoring

Venous thromboembolism (VTE) is a frequent preventable complication among surgical patients. Precise risk assessment is a necessary step for providing appropriate thromboprophylaxis and reducing mortality as well as morbidity caused by VTE. We carried out this work to define the rate of VTE postoperatively, following a Caprini score, and to determine VTE risk factors through a modified Caprini risk scoring system. This multicenter, observational, cohort study involved 2,790,027 patients who underwent surgery in four Vietnamese hospitals from 01/2017 to 12/2018. All patients who were evaluated before surgery by using a Caprini risk assessment model (RAM) and monitored within 90 days after surgery. The endpoint of the study was ultrasound-confirmed VTE. Our data showed that the 90-day postoperative VTE was found in 3068 patients. Most of VTE (46.97%) cases were found in the highest risk group (Caprini score > 5). A total of 37.19% were observed in the high risk group, while the rest (15.84%) were from low to moderate risk groups. The likelihood of occurring VTE was heightened 2.83 times for patients with a Caprini score of 3–4, 4.83 times for a Caprini score of 5–6, 8.84 times for a score of 7–8, and 11.42 times for a score of >8, comparing to ones with a score of 0 to 2 (all p values < 0.05). Thus, the frequency of postoperative VTE rises substantially, according to the advanced Caprini score. Further categorizing patients among the highest risk group need delivering more appropriate thromboprophylaxis.

Chemotherapy-associated thrombosis in cancer outpatients: Risk factors and decision making of a prophylactic approach.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20647-e20647
Author(s):  
Martina Torchio ◽  
Benvenuto Franceschetti ◽  
Carla Cavali ◽  
Sonia Zanirato ◽  
Angelo Olgiati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
High Risk ◽  
Scoring System ◽  
Risk Group ◽  
Venous Catheter ◽  
Risk Groups ◽  
High Risk Group ◽  
Factors Analysis ◽  
Negative Predictor

e20647 Background: Venous thromboembolism (VTE), is a negative predictor of survival in pts with advanced cancer. International guidelines don’t recommend routine prophlaxis but suggest to consider pts, undergoing chemotherapy (CT), with high risk of VTE. Many clinical risk factors for cancer-associated VTE have been evaluated in a 5 parameter-based (body mass index, platelet and leucocyte counts, hemoglobin value and tumor site) scoring system, the Khorana score, utilized to indicate a prophylactic approach. We prospectively applied this score in cancer outpts beginning CT and an implementation based on 6 addictional factors analysis (sex, age, central venous catheter, CT-agents, antiangiogenetic drugs, erithropoiesis stimulating agent) to evaluate their impact in pts assignment into risk groups. Methods: We studied adult pts, followed at our Department from August 2011 to December 2012, with advanced cancers (breast, NSCLC, colorectal, pancreatic/gastric, urogenital, LNH, Hodgkin's disease, HD, and MM), receiving a first or second line standard CT. We stratified pts into three risk groups (score 0= low; score 1-2=intermediate; score 3-4-5=high) considering both the Khorana scoring system and its implementation. Results: We analyzed 169 pts (103F/66M, median age 62.3, range 35-80 yrs), pt population included: 38 breast, 32 colorectal, 31 LNH, HD and MM, 27 urogenital, 22 NSCLC and 19 pancreatic/gastric. With the Khorana score 49 pts were assigned to the low risk, 87 pts to the intermediate risk (57 with score=1, 28 with score=2), 16 pts (9.4%) to the high risk group (9 with score=3, 4 with score=4, 3 with score=5). When we considered 11 parameters 37 pts (21.8%) were assigned to the high risk group. Conclusions: A more comprehensive quantification of VTE risk, also considering new independent factors, is mandatory for a correct decision making of an antithrombotic-prophylactic approach.

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