scholarly journals Fetomaternal outcome in fibroid complicating pregnancy: a retrospective study

2021 ◽  
Author(s):  
Suneela Mullakkal Sankaran ◽  
Jayasree Sukumara Pillai
Keyword(s):  
Retrospective Study ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Reproductive Age ◽  
Ultra Sound ◽  
Government Medical College ◽  
Medical College ◽  
Increased Risk

Background: Fibroids are the commonest benign tumour arising from the smooth muscle from uterus. Effects of fibroids on pregnancy and the effects of pregnancy on fibroids are a frequent clinical concern since these tumors are common in women of reproductive age. Most pregnant women with fibroids do not have any complications during pregnancy related to the fibroids. Pain is the most common problem and there may be a slightly increased risk of obstetrical complications like miscarriage, preterm labor and delivery, malpresentation and placental abruption.Methods: A retrospective study was carried out to study the fetomaternal complications in fibroid complicating pregnancies. Duration of study period was one year. Study was from 1 January 2019 to 31 December 2019 in government medical college, Kozhikode. Patients beyond 28 weeks of gestational age with fibroid complicating pregnancies were included. Case records were reviewed from medical records library government medical college, Kozhikode. Detailed review of patients including history, examination and ultrasound scan reports, mode of delivery, antepartum, intrapartum, postpartum complications and details of babies were also taken.Results: During the study period a total of 112 cases of fibroid complicating pregnancies were included in the study out of 15875 total number of deliveries. Majority of patients belonged to age group between 30 to 35 years (40.17%) and 28.1% belonged to between 35 and40 years. 63.39% of patients were multies. In most of the cases fibroid was diagnosed by the first trimester ultra sound itself. Size of uterus remained corresponding to gestational age in more than half of cases (56.25%). There was increased incidence of caesarean delivery (56.25%), preterm delivery (7.2%) and placenta praevia (2.8%) postpartum haemorrhage (10.71%) in the studied cases.Conclusions: Fibriod complicating pregnancies are associated with higher incidence of obstetric complications during all the phases of pregnancy. Proper antenatal care and assessment can reduce the adverse outcomes to a greater extent.

scholarly journals A COMPARATIVE STUDY OF MATERNAL OUTCOME IN FIRST-TRIMESTER VAGINAL BLEEDING IN THE DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Savita Meena ◽  
Suniti Verma ◽  
R N Sehra ◽  
Suman Choudhary
Keyword(s):  
Gestational Age ◽  
Vaginal Bleeding ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Control Group ◽  
Case Group ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: The outcome of ongoing pregnancies after first trimester vaginal bleeding is of relevance to women and obstetricians for planning antenatal care and clinical interventions in pregnancy. Hence, this study was conducted to identify the risks associated with first trimester bleed which may facilitate decision making regarding mode, place and timing of delivery during management, which may improve maternal and neonatal outcome. Methods: Hospital based comparative prospective study conducted at Department of Obstetrics and Gynaecology, SMS Medical College & associated Hospitals, Jaipur. Results: APH was found in 4 (8.00%) patients of case group and nil in control group. So, APH was found to be more in the case group than control group but was statistically not significant. Pre-eclampsia was found in 4 (8.00%) in case group and 3 (6.00%) in control group with statistically insignificant difference between the two groups.  26 (52.00%) delivered at the gestational age of ?37 weeks, whereas only 8 (16%) of control group delivered at ?37 weeks. So, the gestational age at delivery of control group subjects was found to be higher as compared to case group subjects and the difference was statistically significant (p=0.001). Conclusion: Threatened miscarriage in early pregnancy increases the risk of adverse pregnancy outcome. In our study, these patients were found to be at an increased risk of preterm delivery, PPROM. Keywords: PROM, Miscarriage, Gestational age

Association between Obesity and Miscarriage among Females of Reproductive Age

2021 ◽  
Vol 15 (8) ◽  
pp. 2127-2129
Author(s):  
Erfa Sehar Anis ◽  
Fozia Liaquat ◽  
Uzma Altaf ◽  
Uzma Aziz ◽  
Alia Akbar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Spontaneous Abortion ◽  
Gestational Age ◽  
Recurrent Miscarriage ◽  
First Trimester ◽  
Reproductive Age ◽  
Obese Patients ◽  
Increased Risk ◽  
The Mean

Objective: To determine the association between obesity and miscarriage among females of reproductive age. Methodology: This cohort study was carried out in Department of Obstetrics & Gynaecology, Jinnah Hospital, Lahore for 6 months (15-08-2013 to 15-12-2014). The females were divided in two group on the basis of their BMI i.e. obese (>30kg/m2) or normal (18-24.9kg/m2). Then females were followed-up in OPD till 12 weeks of gestation. Females counseled and advice to present in hospital, if they develop indications for miscarriage. If any female had spontaneous abortion, miscarriage was labeled. Relative risk was calculated to measure the association between obesity and miscarriage. RR>1 was considered as significant. Results :The mean age of patients was 30.48±5.64 years and the mean gestational age was 7±0.81 weeks. The miscarriage was occurred in 63(31.50%) patients in which 47 cases were obese and 16 cases were normal. Statically there is 4.65 times greater risk of miscarriage was observed in obese patients than to normal i.e. RR=4.65 [2.39-9.038]. Conclusion: It has been proved in our study that Obesity is associated with increased risk of first trimester and recurrent miscarriage among females of reproductive age. Keywords: First Trimester, Miscarriage, Reproductive, Fetus, Obesity

scholarly journals Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Chi Square ◽  
Increased Risk ◽  
Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

scholarly journals Pregnancy Complications in Women with PCOS

2019 ◽  
Vol 3 (5) ◽  
Keyword(s):  
Pregnancy Loss ◽  
Polycystic Ovarian Syndrome ◽  
First Trimester ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Proper Understanding ◽  
Life Styles ◽  
Reproductive Age Women ◽  
Increased Risk ◽  
Ovarian Syndrome

The Polycystic ovarian syndrome affects 6-15 % of reproductive age women worldwide. And recently the changing life styles and rising obesity worldwide have contributed to a rise in the incidence of PCOS. Though there are many issues with PCOS post conception. PCOS women are at increased risk of early pregnancy loss which is approx. three fold as compared to the women without PCOS. After successfully crossing the first trimester, they are at risk of developing pre- eclampsia, GDM, preterm birth and birth of small for gestational age infant. Also higher incidence of multiple pregnancies is there and the risks associated with them. All these leading to higher rate of c -section delivery. So, proper understanding of these risks, informing and counseling the patients regarding them facilitate closer maternal and fetal surveillance and help improving the outcome of pregnancy.

scholarly journals Exercise During the First Trimester and Infant Size at Birth: Targeted Maximum Likelihood Estimation of the Causal Risk Difference

2019 ◽  
Vol 189 (2) ◽  
pp. 133-145 ◽  
Author(s):  
Samantha F Ehrlich ◽  
Romain S Neugebauer ◽  
Juanran Feng ◽  
Monique M Hedderson ◽  
Assiamira Ferrara
Keyword(s):  
Maximum Likelihood ◽  
Maximum Likelihood Estimation ◽  
Gestational Age ◽  
Weight Status ◽  
Likelihood Estimation ◽  
First Trimester ◽  
Normal Weight ◽  
Targeted Maximum Likelihood Estimation ◽  
Increased Risk ◽  
Targeted Maximum Likelihood

Abstract This cohort study sought to estimate the differences in risk of delivering infants who were small or large for gestational age (SGA or LGA, respectively) according to exercise during the first trimester of pregnancy (vs. no exercise) among 2,286 women receiving care at Kaiser Permanente Northern California in 2013–2017. Exercise was assessed by questionnaire. SGA and LGA were determined by the sex- and gestational-age-specific birthweight distributions of the 2017 US Natality file. Risk differences were estimated by targeted maximum likelihood estimation, with and without data-adaptive prediction (machine learning). Analyses were also stratified by prepregnancy weight status. Overall, exercise at the cohort-specific 75th percentile was associated with an increased risk of SGA of 4.5 (95% CI: 2.1, 6.8) per 100 births, and decreased risk of LGA of 2.8 (95% CI: 0.5, 5.1) per 100 births; similar findings were observed among the underweight and normal-weight women, but no associations were found among those with overweight or obesity. Meeting Physical Activity Guidelines was associated with increased risk of SGA and decreased risk of LGA but only among underweight and normal-weight women. Any vigorous exercise reduced the risk of LGA in underweight and normal-weight women only and was not associated with SGA risk.

High Fetal Fraction on First Trimester Cell-Free DNA Aneuploidy Screening and Adverse Pregnancy Outcomes

2019 ◽  
Vol 37 (01) ◽  
pp. 008-013 ◽  
Author(s):  
Lydia L. Shook ◽  
Mark A. Clapp ◽  
Penelope S. Roberts ◽  
Sarah N. Bernstein ◽  
Ilona T. Goldfarb
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
First Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Aneuploidy Screening ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Fetal Fraction

Abstract Objective To test the hypothesis that high fetal fraction (FF) on first trimester cell-free deoxyribonucleic acid (cfDNA) aneuploidy screening is associated with adverse perinatal outcomes. Study Design This is a single-institution retrospective cohort study of women who underwent cfDNA screening at <14 weeks' gestation and delivered a singleton infant between July 2016 and June 2018. Women with abnormal results were excluded. Women with high FF (≥95th percentile) were compared with women with normal FF (5th–95th percentiles). Outcomes investigated were preterm birth, small for gestational age, and hypertensive disorders of pregnancy. Results A total of 2,033 women met inclusion criteria. The mean FF was 10.0%, and FF >16.5% was considered high (n = 102). Women with high FF had a greater chance of delivering a small for gestational age infant <fifth percentile, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.1–4.8, p = 0.039). There was no significant association between high FF and either preterm birth or hypertensive disorders of pregnancy. Conclusion Women with a high FF in the first trimester are at increased risk of delivering a small for gestational age infant <fifth percentile. Further investigation into the clinical implications of a high FF is warranted.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals A first trimester prediction model for large for gestational age infants: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesca Monari ◽  
Daniela Menichini ◽  
Ludovica Spano’ Bascio ◽  
Giovanni Grandi ◽  
Federico Banchelli ◽  
...  
Keyword(s):  
Prediction Model ◽  
Gestational Age ◽  
Predictive Accuracy ◽  
First Trimester ◽  
University Hospital ◽  
Large For Gestational Age ◽  
Aneuploidy Screening ◽  
Maternal Characteristics ◽  
Targeted Interventions ◽  
Increased Risk

Abstract Background Large for gestational age infants (LGA) have increased risk of adverse short-term perinatal outcomes. This study aims to develop a multivariable prediction model for the risk of giving birth to a LGA baby, by using biochemical, biophysical, anamnestic, and clinical maternal characteristics available at first trimester. Methods Prospective study that included all singleton pregnancies attending the first trimester aneuploidy screening at the Obstetric Unit of the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 503 consecutive women were included in the analysis. The final prediction model for LGA, included multiparity (OR = 2.8, 95% CI: 1.6–4.9, p = 0.001), pre-pregnancy BMI (OR = 1.08, 95% CI: 1.03–1.14, p = 0.002) and PAPP-A MoM (OR = 1.43, 95% CI: 1.08–1.90, p = 0.013). The area under the ROC curve was 70.5%, indicating a satisfactory predictive accuracy. The best predictive cut-off for this score was equal to − 1.378, which corresponds to a 20.1% probability of having a LGA infant. By using such a cut-off, the risk of LGA can be predicted in our sample with sensitivity of 55.2% and specificity of 79.0%. Conclusion At first trimester, a model including multiparity, pre-pregnancy BMI and PAPP-A satisfactorily predicted the risk of giving birth to a LGA infant. This promising tool, once applied early in pregnancy, would identify women deserving targeted interventions. Trial registration ClinicalTrials.gov NCT04838431, 09/04/2021.

scholarly journals A PROSPECTIVE AND COMPARATIVE STUDY OF ESTIMATION OF FOETAL BIRTH WEIGHT CLINICALLY AND SONOGRAPHICALLY AND ITS CORRELATION WITH ITS ACTUAL BIRTH WEIGHT

2021 ◽  
pp. 1-3
Author(s):  
Chhote Lal Paswan ◽  
Debarshi Jana
Keyword(s):  
Birth Weight ◽  
Comparative Study ◽  
Large Scale ◽  
Low Cost ◽  
Mode Of Delivery ◽  
Fetal Weight ◽  
Actual Weight ◽  
Medical College ◽  
Increased Risk ◽  
Newborn Complications

Background: Knowledge of fetal weight in utero is vital for the obstetrician in deciding whether to deliver the fetusas well as in fixing the mode of delivery. Both low birth weight and excessive fetal weight at delivery are associated with increased risk of newborn complications during labor and the puerperium. During the last decade, estimated fetal weight has been incorporated into the standard routine antepartum evaluation of high-risk pregnancies and deliveries. Objective of present study was to assess the fetal weight in term pregnancies by Clinical and Sonographic and to compare the methods after knowing the actual weight of the baby after birth. Methods: It is a prospective and comparative study of 100 women at term pregnancy at Obstetrics and Gynaecology Department of Madhubani Medical College and Hospital, Madhubani, Bihar from 20th March 2020 to 31st October 2020. Patients within 7 days from their Expected Date of Delivery were included in the study. The formulas used in this study are: Johnson's formula, Dare’s formula and Hadlock's formula using ultrasound. Results: Results vary in terms of accuracy with various methods employed for estimating the fetal weight. This studyshowed that Dare’s Formula was the best indicator among all other methods assessed followed by Hadlock's formula by ultrasonographic method. Conclusions: SFH measurement continues to be used in many countries on large scale because of its low cost, ease ofuse and need for little training as the setup for ultrasonographic evaluation is not readily available in rural setups.

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