scholarly journals Maternal and perinatal outcome in patients with preterm labor pains receiving tocolytic therapy

2021 ◽  
Author(s):  
Tanya Rajpal ◽  
Pooja Patil ◽  
Priyanka Sharma ◽  
Nishi Mitra
Keyword(s):  
Preterm Labor ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Ventilator Support ◽  
Neonatal Complication ◽  
Preterm Group ◽  
Threatened Abortion ◽  
Maternal And Neonatal Outcomes

Background: The objective of this study was to assess the maternal and neonatal outcomes in patients with preterm labor pains and also to correlate threatened abortion with preterm pains.Methods: The study conducted was a prospective observational study. 100 cases of preterm labor admitted to JK hospital, Bhopal over a period of 2 years with singleton gestation between 28 to 36+6 weeks were included.Results: Maximum preterm deliveries were in the late preterm group (80%). Correlation of preterm labor with threatened abortion was not significant (OR=1.03; p>0.05). 42% cases delivered vaginally and 58% by LSCS. Prolongation of pregnancy after tocolytic therapy was upto 12 hours in 35% cases, 12-24 hours in 40% cases and >24 hours in only 15% cases. The most commonly encountered neonatal complication was RDS, 37%, out of which 9% required resuscitation at birth and 8% required ventilator support followed by jaundice in 23%, sepsis in 3% cases and NEC in 4% cases. The association between gestational age and requirement of resuscitation at birth (X2=19.9; p=0.00), need of ventilator (X2=12.6; p=0.002) and neonatal RDS (X2=6.9; p=0.031) was found to be significant.Conclusions: Preterm births are major obstetric problem that have an extensive impact on neonatal morbidity and mortality.

scholarly journals The Association of Various Placental Lesions with Perinatal Outcome in Preterm Births

2021 ◽  
Vol 8 (5) ◽  
pp. 357-364
Author(s):  
Ashwini Sarode ◽  
Anil R Joshi ◽  
Anjali S Kulkarni
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Vascular Lesions ◽  
Placental Pathology ◽  
Tertiary Care Centre ◽  
Inflammatory Lesions ◽  
Clinical Records

Objective: Present study was designed to identify various lesions in placenta and investigate their impact on neonatal and perinatal outcome and also to determine the frequency of various inflammatory lesions in placenta. Materials and Methods: Placentae of 60 singleton nonanomalous preterm births were examined at Department of pathology at Tertiary care centre. Complete placental examination including both macroscopic and microscopic examination with the help of Haematoxylin and Eosin staining done. Thereafter placental lesions were classified according to Redline criteria for classification of placental pathology. Thereafter placental lesions were correlated with perinatal mortality and neonatal morbidity in early neonatal period. The relevant clinical details were collected from the obstetric clinical records and neonatal clinical records. Result: We found placental vascular processes as most frequent (73.33%) pathological lesion in our study. Most common inflammatory lesion in our study was chorioamnionitis (15%). Also among placentae of stillbirths, placental vascular lesions were predominant finding present in 85.7% of placentae of stillbirths. Other lesions found in placentae of stillbirths were Immune inflammatory lesions, maternal floor infarction and placenta accreta. Out of total placentae with vasculopathy, 19.2% cases developed neonatal sepsis, in chorioamnionitis group 66.6% live births were having sepsis. In present study we observed higher frequency of resuscitation in babies with placentae having chorioamnionitis. Discussion: This study revealed that the placental pathological findings appear to be correlated with perinatal mortality and early neonatal morbidity. So, examination of the preterm placentae gains importance in early determination of morbidity in infants. Placental findings can help neonatologist in routine diagnosis and management. Keywords: Placenta, Placental pathology, Preterm births, Perinatal outcome.

Maternal and neonatal outcomes following expectant management of preterm prelabour rupture of membranes before viability

2017 ◽  
Vol 45 (1) ◽  
Author(s):  
Winnie Huiyan Sim ◽  
Edward Araujo Júnior ◽  
Fabricio Da Silva Costa ◽  
Penelope Marie Sheehan
Keyword(s):  
Management Practices ◽  
Discharge Rate ◽  
Expectant Management ◽  
Intraventricular Haemorrhage ◽  
Neonatal Morbidity ◽  
Live Birth Rate ◽  
Neonatal Outcomes ◽  
Prognostic Indicators ◽  
Maternal And Neonatal Outcomes ◽  
The Common

AbstractAim:To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks’ gestation and to identify prognostic indicators of this morbid presentation.Methods:We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM.Results:Mean latency between PPROM and delivery ranged between 20 and 43 days. Women with PPROM <24 weeks had an overall live birth rate of 63.6% and a survival-to-discharge rate of 44.9%. The common neonatal morbidities were respiratory distress syndrome, bronchopulmonary dysplasia and sepsis. The majority of neonatal deaths within 24 h post birth were associated with pulmonary hypoplasia, severe intraventricular haemorrhage and neonatal sepsis. The common maternal outcomes were chorioamnionitis and caesarean sections. The major predictors of neonatal survival were later gestational age at PPROM, adequate residual amniotic fluid levels, C-reactive protein <1 mg/dL within 24 h of admission and PPROM after invasive procedures.Conclusion:Pregnancy latency and neonatal survival following previable PPROM has improved in recent years, although neonatal morbidity remains unchanged despite recent advances in obstetric and neonatal care. There is heterogeneity in management practices across centres worldwide.

scholarly journals COMPARATIVE STUDY OF CLINICAL VERSUS USG IN DIAGNOSIS OF EARLY TRIMESTER BLEEDING PV

2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana
Keyword(s):  
Statistical Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Common Cause ◽  
Clinical Method ◽  
Medical College ◽  
Threatened Miscarriage ◽  
Obstetrics And Gynaecology ◽  
Threatened Abortion ◽  
The Difference

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.

Correlation between Intrapartum Cardiotocogram findings and cord blood pH in term and preterm labors

2021 ◽  
Vol 17 ◽  
Author(s):  
Shubha Rao ◽  
Himanshi Jain ◽  
Anjali Suneel ◽  
Roopa Padavagodu Shivananda ◽  
Akhila Vasudeva
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Preterm Labor ◽  
Fetal Monitoring ◽  
Cord Blood Sample ◽  
Arterial Blood ◽  
Blood Ph ◽  
Preterm Group ◽  
Fetal Acidosis

Background: The purpose of intrapartum fetal monitoring by cardiotocograph (CTG) is to identify early signs of developing hypoxia so that appropriate action can be taken to improve the perinatal outcome. Although CTG findings are well known to monitor the progress of the labor due to the paucity of recommendations, there has always been a clinical dilemma as the term fetuses respond differently than a preterm fetus. However, umbilical cord blood pH can distinguish the infant at high risk for asphyxia and related sequel. Therefore, because of differences in fetal physiology in term and preterm fetuses, CTG findings vary, and hence the validity of CTG to determine fetal acidosis should be different. Aims and Objectives: This study aimed to correlate abnormal intrapartum CTG findings with umbilical cord blood pH in term and preterm labor and thus evaluate the success of CTG in predicting fetal acidosis during labor. Methods: The present study included 210 women in labor (70 preterm and 140 term) with abnormal intrapartum CTG that was classified as per 2015 revised International Federation of Gynecologists and Obstetrician (FIGO) guidelines. Immediately after delivery 2 ml Umbilical artery cord blood sample was taken in a pre-heparinized syringe for analysis, pH <=7.2 was taken as acidosis and pH >7.2 was taken as normal. The measured data were maternal general characteristics which included gravida status, associated comorbidities, method of induction and character of liquor, the intrapartum CTG tracings recorded the cord arterial blood pH and the neonatal characteristics such as APGAR score and neonatal outcome. Results: Data from 70 preterm labor was compared with 140 term labor. In this study, 20.9 % of the babies had acidosis. Suspicious CTG due to decreased variability were more common in the preterm group than in the term group (21.4% vs. 8.6% p<0.05). Positive predictive value (PPV) of abnormal CTG for fetal acidosis in the preterm group was found to be higher than that in term group, PPV of pathological CTG being even higher than suspicious CTG. Women with suspicious CTG had 82 % less risk of fetal acidosis as compared to pathological CTG. Women with Bradycardia had 5.9 times the risk of fetal acidosis as compared with normal and tachycardia. Conclusion: Abnormal CTG should be managed appropriately without any delay to prevent acidosis and cord blood pH should be done in all labors with abnormal CTG. However, our findings of a higher incidence of lower cord blood pH and suspicious CTG due to decreased variability alone, highlight the limitation of criteria currently used for interpretation of CTG in preterm labors.

scholarly journals Instrumental delivery: a comparative study in a tertiary care hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 1079
Author(s):  
Bhanu B. T. ◽  
Anitha G. S.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Care Hospital ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Maternal And Neonatal Outcomes ◽  
Vertex Presentation

Background: To compare maternal and neonatal outcomes of vacuum versus forceps application in assisted vaginal delivery.Methods: Women in labor with vertex presentation were delivered by indicated/propylactic vacuum or forceps. A total of 500 cases were included in this retrospective study. Maternal and neonatal morbidity were compared in terms of perineal lacerations, episiotomy extension, post-partum hemorrhage, Apgar score, neonatal jaundice, perinatal mortality, NICU admissions etc. Chi square test was used to analyze the data.Results: Maternal morbidity was significant in the forceps group. With regards to neonatal morbidity, in NICU admissions, statistically significant difference was noted.Conclusions: Vacuum and forceps should remain appropriate tools in the modern obstetrics. However, ventouse may be chosen first (if there is no fetal distress) as it is significantly less likely to injure the mother and decrease NICU admissions.

scholarly journals Amniotic fluid index versus maximum vertical pocket measurement in predicting perinatal outcome at 40 weeks or beyond

2018 ◽  
Vol 7 (12) ◽  
pp. 4887
Author(s):  
Nasreen Noor ◽  
Seema Amjad Raza ◽  
Shazia Parveen ◽  
Mohammad Khalid ◽  
Syed Manazir Ali
Keyword(s):  
Amniotic Fluid ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Amniotic Fluid Index ◽  
Institutional Ethics ◽  
Significant Difference ◽  
Baseline Demographic

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.

scholarly journals Use of Antiasthmatic Drugs during Pregnancy after the First Trimester and Maternal and Neonatal Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Bengt Källén ◽  
Birgitta Norstedt Wikner
Keyword(s):  
Preterm Births ◽  
First Trimester ◽  
Neonatal Hypoglycemia ◽  
Respiratory Problems ◽  
Medical Birth Register ◽  
Risk Increase ◽  
Increased Risk ◽  
Swedish Medical ◽  
Maternal And Neonatal Outcomes ◽  
Disease Effect

Background. Women with asthma using antiasthmatics during the later part of the pregnancy have an increased risk for obstetric complications and their infants of neonatal complications. Material and Methods. The study is based on a linkage between the Swedish Medical Birth Register and a register of prescribed drugs in Sweden for the years 2009–2011, identifying women who had filled prescriptions for antiasthmatics after the first trimester. Their characteristics, their obstetric history, and the neonatal conditions of their infants were compared with all other women who gave birth. Adjusted Mantel-Haenszel odds ratios were determined. Results. We found an increased risk for a number of maternal conditions but no risk increase for gestational diabetes (after adjustment for body mass index) or for premature rupture of membranes. There was an increase in preterm births for some drugs used at severe asthma and of low birth weight and small for gestational age for most drug combinations. An increased risk was seen for neonatal hypoglycemia, respiratory problems, and low Apgar score. Conclusions. There are many hazards associated with maternal asthma and use of antiasthmatic drugs. Most evidence suggests a disease effect. A careful control of the asthma during pregnancy is important.

scholarly journals A comparative study between nifedipine and isoxsuprine in the suppression of preterm labor pain

2020 ◽  
Vol 9 (7) ◽  
pp. 2886
Author(s):  
Susheela Khoiwal ◽  
Vandana Patidar ◽  
Radha Rastogi ◽  
Bharat Tailor
Keyword(s):  
Preterm Labor ◽  
Preterm Labour ◽  
Neonatal Morbidity ◽  
Labour Pain ◽  
Labor Pain ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Uterine Contractions ◽  
High Incidence ◽  
A Prospective Study

Background: A prospective study was conducted to compare the effectiveness of Nifedipine and Isoxsuprine in suppression of preterm labour pain as tocolytics drug. As preterm labour pain is major contributor for perinatal morbidity and mortality. The aims of this study were to assess the effect of nifedipine and isoxsuprine in threatened preterm labour with the aim of preventing preterm birth and its sequelae.Methods: This study was conducted on 100 patients coming to Pannadhay Rajkiya Mahila Chikitsalaya, RNT Medical College, Udaipur and attending OPD and IPD with complain of uterine contractions between 28-36 weeks of gestation.Results: Nifedipine was more effective than isoxsuprine hydrochloride as tocolytic agent.Conclusions: There is high incidence of preterm labour in India which leads to neonatal morbidity and mortality. Nifedipine is a better tocolytic drug compared to isoxsuprine hydrochloride.

Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births

2015 ◽  
Vol 40 (2) ◽  
pp. 141-149 ◽  
Author(s):  
Gali Garmi ◽  
Marina Okopnik ◽  
Yoram Keness ◽  
Noah Zafran ◽  
Elad Berkowitz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Outcome ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Retrospective Case ◽  
Delivery Methods ◽  
Main Determinant ◽  
Gestational Age At Delivery ◽  
The Impact

Aims: To examine the occurrence of chorioamnionitis and abruption among women who had a spontaneous preterm birth (SPTB), the correlation between clinical and placental findings, and the impact of these complications on neonatal outcome after delivery. Methods: This was a retrospective case-control study conducted between 2008 and 2012 at a single teaching hospital. The study group included all women who had an SPTB (23-36 weeks). Placentas were cultured and underwent histological examination. Results: A total of 478 women were included. The mean gestational age at delivery was 32.6 ± 3.1 weeks. Overall, 260 (54.4%) women had either clinical and/or histological abruption or chorioamnionitis. Clinical chorioamnionitis was diagnosed before birth in 14 (2.9%) women, while histological chorioamnionitis (HCA) in 84 (17.4%). Overall, 38 neonates had infection. Placental cultures were negative in 65.8% (25/38) of these neonates, and in 77.1% (27/38), HCA was ruled out. Logistic regression analysis revealed that neonatal morbidity and mortality were correlated with gestational age at delivery (p = 0.02), not with placental pathology (p = 0.08). Conclusions: Half of the women with PTB had clinical or histological abruption, chorioamnionitis or both. A partial correlation was found between clinical and placental findings. The main determinant of neonatal outcome was gestational age at delivery and not placental findings.

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