scholarly journals Evaluation of outcome of pregnancy in placenta accreta spectrum

2021 ◽  
Vol 10 (9) ◽  
pp. 3331
Author(s):  
Uma Veludandi ◽  
B. Aruna Suman ◽  
S. Nagamani ◽  
Medha Hothur
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Placenta Accreta ◽  
Intrauterine Device ◽  
Tertiary Care ◽  
Bladder Injury ◽  
Placenta Accreta Spectrum ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Background: Aim of the study was to evaluate the outcome of pregnancy in placenta accrete spectrum in third trimester pregnancy at tertiary care centreMethods: This hospital based retrospective study was carried out from 2017 to 2019.  The case records of all women identified as placenta accrete spectrum from the hospital registers were retrieved. A total of 166 patients with the diagnosis of placenta accrete spectrum were included in the study.Results: The incidence of morbidly adherent placenta is 5 per 10,000 deliveries with mean age being 32.4±4.2 (23-39) years. and showed its relation with risk factors such as previous caesarean section (CS), placenta praevia and multiparity. The mean duration of MICU stay in placenta previa was 6.7±1.9 days (range 2-12 days). With complications in 18 cases of which urinary bladder injury (3%), infection (9%), PPH and coagulopathy (4.2%). The placenta was removed successfully in 141 while 25 cases had caesarean hysterectomy (2.4%). In total 166 cases 26 (16.8%) cases are intrauterine device (IUD) and still births. 5 (3%) cases are very low birth weight, 24 cases (14.5%) are low birth weight babies, 76 (45.8%) cases had neonatal intensive care unit (NICU) admissions followed by 10 (6%) cases with <5 APGAR score.Conclusions: Placenta accreta spectrum can be identified antenatally with a high index of suspicion in the presence of known risk factors and proper radiological studies, allowing for planned attempts to avoid life-threatening haemorrhage and caesarean hysterectomy.

PLACENTA PREVIA AND PLACENTA ACCRETA SPECTRUM (PAS) DISORDER: INCIDENCE, RISK FACTOR AND FETOMATERNAL OUTCOME IN A TERTIARY CARE CENTER

2021 ◽  
pp. 15-17
Author(s):  
Ramona Perhar ◽  
Rubi Devi ◽  
Ruchi Patel ◽  
Jagriti Jagriti
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adherent Placenta ◽  
Placenta Accreta Spectrum

Introduction: Placenta Previa is characterised by Placental implantation into the lower uterine segment covering whole or part of the cervix . It complicates 0.4% of pregnancy at term The average incidence is 0.3% or 1 case per 300 to 400 deliveries. The presence of placenta previa can also increase a woman's risk for placenta accreta spectrum (PAS). This spectrum of conditions includes placenta accreta, increta, and percreta. Uncontrolled postpartum hemorrhage from placenta previa or PAS may necessitate a blood transfusion, hysterectomy thus leaving the patient infertile, admission to the ICU, or even death. Material and method: Study was conducted in department of obstetrics & gynecology , swaroop rani hospital, Allahabad for 1 year . A total of 102 pregnant women presenting to antenatal OPD or admitted in IPD with history of antepartum hemorrhage and conrmed case of PP or MAP in Ultrasonography were selected. The follow up till the fetomaternal outcome was done and risk factors were evaluated for 102 cases. Result: Out of the total 2342 deliveries in one year 95 patients had PP and the incidence was 4.04% and 7 patients had morbidily adherent Placenta which accounts to an incidence of 0.29%. Previous LSCS, Multiparity, increase maternal age, Dialatation and curettage were risk factors in both Placenta Previa and Morbidily Adherent Placenta. Antenatal complication were antepartum hemmorrhage , Anemia, preterm labor. Emergency LSCS is more common mode of delivery in cases of Placenta previa. Caesarean hysterectomy were done in 3.2% cases of Placenta Previa and all cases of Morbidily adherent placenta . Most common perinatal complications in both groups were prematurity and low birth weight. Conclusion: Now a days Placenta previa and Morbidily adherent placenta are very common. Incidence increases as the rate of cesaerean section or abdominal surgery were increases.Earlydiagnosis and pre plan mode of delivery will decrease the risk of prematurity and low birth weight.

scholarly journals Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

2019 ◽  
Vol 8 (6) ◽  
pp. 2240
Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Previous History ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

scholarly journals Clinical profile and factors determining outcome of intramural very low birth weight babies in a tertiary care centre: a retrospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Devi Meenakshi K. ◽  
Arasar Seeralar A. T. ◽  
Srinivasan Padmanaban
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Logistic Regression Analysis ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
P Value ◽  
Increased Risk

Background: Very low birth weight (VLBW) babies are at increased risk of a number of complications both immediate and late. Worldwide it has been observed that these babies contribute to a significant extent to neonatal mortality and morbidity. Aim of the study was to study the risk factors contributing to mortality in VLBW babies and to evaluate the morbidity pattern in these infants.Methods: A retrospective analysis of data retrieved from the case records of VLBW babies admitted in the NICU of Kilpauk Medical College between January 2015 to December 2015. Out of the 2360 intramural babies admitted during the study period, 99 babies were less than 1500 gms. The risk factors for these babies were analyzed for their association with the outcome. Data were statistically analyzed.Results: In present study, we found that sex of the baby, gestational age, obstetric score, birth asphyxia, pulmonary haemorrhage, ROP and presence of shock were found to be associated with increased mortality. By logistic regression analysis it was observed that birth weight of the baby (p value 0.002), duration of stay (p value 0.0006), presence of shock (p<0.0001), were the risk factors significantly associated with poor outcome.Conclusions: Among the maternal and neonatal factors analyzed in the study using logistic regression analysis, birth weight, duration of hospital stay and presence of shock were significantly related to poor outcome. Of these presence of shock was the single most important factor that predicted increased mortality.

scholarly journals Clinical Profile, Outcome and Risk Factors for Mortality of Neonates Requiring Mechanical Ventilation at Tertiary Care Centre of Central Gujarat, India

2021 ◽  
Vol 41 (1) ◽  
pp. 29-34
Author(s):  
Pareshkumar A Thakkar ◽  
Himanshu G Pansuriya ◽  
Sheela Bharani ◽  
Khushboo Kamal Taneja
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Pulmonary Haemorrhage ◽  
Adverse Outcomes ◽  
Clinical Profile ◽  
Care Hospital

Introduction: Mechanical ventilation is an important factor contributing to the reduced neonatal mortality in NICU. However, many ventilated babies are left with detrimental sequelae. This study was undertaken to know the prognostic predictors and survival outcome in the ventilated neonates. We assessed the clinical profile, outcome of mechanical ventilation and analysed the risk factors for mortality and complications resulting from mechanical ventilation. Methods: A prospective study was conducted at the NICU of a tertiary care hospital in India. The study period was from May 2015 to April 2016. Neonates who underwent mechanical ventilation and met the inclusion criteria were enrolled in the study. Their demographic profile, outcomes and risk factors were documented and analysed using appropriate statistical methods. Results: 285 neonates required mechanical ventilation during the study period. Among them, 190 were included in the study. Overall mortality was 99 out of the 190 enrolled (52%). The most common indications for mechanical ventilation were Respiratory Distress Syndrome (RDS), Meconium Aspiration Syndrome (MAS) and apnea. Risk factors contributing significantly to higher mortality of ventilated neonates were very low birth weight (VLBW), gestation of less than 32 weeks, shock, ventilator- associated complications like pneumothorax and pulmonary haemorrhage. In multiple regression analysis, very low birth weight, circulatory disturbances, pneumothorax, pulmonary haemorrhage, and higher initial FiO2 requirement were found to be independent risk factors of mortality. Conclusions: The commonest indications for mechanical ventilation were RDS and MAS. Significantly higher mortality was seen amongst VLBW, preterm neonates. Co-morbidities like circulatory disturbance, and complications like pneumothorax and pulmonary haemorrhage contributed to adverse outcomes.

scholarly journals Study on prevalence of maternal risk factors, morbidity and mortality in very low birth weight neonates

2021 ◽  
Vol 8 (6) ◽  
pp. 1027
Author(s):  
Ujjwala S. Keskar ◽  
Anjali H. Parekh
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Antenatal Steroids

Background: Very low birth weight babies with respiratory complications are the commonest reason for admission in NICU. We wanted to identify maternal risk factors associated with it and ways to prevent it. The objective of the current study was to study the prevalence of maternal risk factors, morbidity and mortality in VLBW babies admitted in tertiary care hospital NICU.Methods: Cross sectional observational study performed on all very low birth weight (VLBW) neonates admitted in neonatal intensive care unit of tertiary care hospital attached with Smt. Kashibai Navale medical college, Pune from January 2019 to March 2020.Results: In our study VLBW babies were 2.2% (78/3545). Mean gestational age was 31.15±3.21 weeks; mean birth weight was 1226.24±250.95 grams. Small for gestational age (SGA) babies were 41% and 96% were preterm. Maternal risk factors were present in 61.53% of deliveries, commonest were anaemia in 30.06 % and preeclampsia in 24.35%. Resuscitation at birth was required in 30.76% babies. Morbidity profile showed respiratory distress syndrome in 46.15%, neonatal sepsis in 19.23% and patent ductus arteriosus in 16.66% babies. Overall survival was 74.35%. Prematurity and its complications like RDS requiring surfactant therapy and mechanical ventilation were significant contributors for mortality but only 23.07% mothers were found to have received antenatal steroids in the hospital .Conclusions: Anaemia and preeclampsia were commonly found risk factors present in 61.53% of mothers of VLBW babies. Use of antenatal steroids in mothers should be made compulsory to decrease mortality in VLBW preterm newborns.

scholarly journals Assessment of Risk Factors Associated with Low-Birth-Weight Neonates in a Tertiary Care Teaching Hospital: A Case-Control Study

2021 ◽  
pp. 214-221
Author(s):  
Rajesh Hadia ◽  
Riya Gandhi ◽  
Padmja Dave ◽  
Niyati Patel ◽  
Dhaval Joshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Tertiary Care ◽  
Significant Risk ◽  
Case Control ◽  
Care Hospital ◽  
Factors Associated ◽  
Control Study

Background: Low birth weight (LBW) is still a significant public health problem globally and is associated with a range of both short- and long-term consequences. Overall, it is estimated that 15% to 20% of all births worldwide are low birth weight, representing more than 20 million births a year. Objective: We aimed the study to assess the risk factors associated with low-birth-weight neonates in a rural tertiary care hospital. Methodology: A prospective observational Case-Control Study was conducted in the Department of Pediatrics (Neonatal Intensive Care Unit) and Department of Obstetrics and Gynecology, Dhiraj Hospital, Vadodara with the sample of 240 women who were admitted for the delivery. The patient interview was done based on the questionnaires (Proforma). Results: Area of residence, Parent's education, Anaemia among pregnant women, Mid upper arm circumference (MUAC) less than 23 cm, Maternal age, and antenatal visits <4 were found as significant risk factors associated with low birth weight in the study. Study findings suggest that 91.3% of cases were from rural areas compared to 71% of controls from the same area. Similarly, Anaemia though prevalent in both case and control groups was seen as a significant predictor more in the case group. Other factors such as parity, spacing between babies, and consumption of drugs and alcohol by pregnant others were also recorded but were protective of LBW. Conclusions: The study concluded that delay age of first pregnancy, lacking iron/folic acid supplementation, not taking nutritional food during pregnancy, anemia and other factors were independently associated with LBW.

scholarly journals Study of risk factors leading to poor outcomes in severe pneumonia age 2M-60M in a tertiary care hospital

2019 ◽  
Vol 6 (3) ◽  
pp. 1270
Author(s):  
Mohammed Abdul Rahman ◽  
Sowjanya Bhanu Veera ◽  
Venkata Priyanka Dandugula
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Total Duration ◽  
Severe Pneumonia ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Poor Outcomes ◽  
Prospective Longitudinal

Background: Childhood pneumonia is the single leading cause of mortality in children aged less than 5 years. Most cases occur in India (43 million); pneumonia is responsible for about 19% of all deaths in children aged less than 5 years. According to Child Health and Epidemiology Reference Group (CHERG) latest estimates, Pneumonia was responsible for 0.397 million of a total estimated 1.682 million under-five deaths in India.Methods: A hospital based prospective longitudinal study. In the present study 200 cases belong to age group 2 months to 5 years  fulfilling WHO criteria for pneumonia who were  attended to the department of paediatrics, Siddhartha medical college  from January 2017 to January 2018 were evaluated the risk factors in relation to their outcomes after obtaining consentResults: Out of 200 children with severe pneumonia  11 risk factors are studied for significance against outcomes like Death of the patient, mechanical ventilation oxygen supplementation, hospital stay of patient and total duration of illness, Risk factors found to be significant are maternal literacy (p =0.0002617), malnutrition (p <0.00001), exclusive  breastfeeding (p <0.05), low birth weight (p <0.05), immunisation (p=0.01).Conclusions: Severe malnutrition, maternal illiteracy, exclusive breast feeding, improper immunization and low birth weight are having a significant association with poor outcomes in children with severe pneumonia. Proper preventive strategies to decrease the incidence of these risk factors can help in increasing the survival rate of children with severe pneumonia.

scholarly journals Maternal and Foetal Outcome in Cases of Placenta Previa, Accreta and Increta

2016 ◽  
Vol 22 (4) ◽  
Author(s):  
Fauzia Anjum ◽  
Rabia Bashir ◽  
Arooba Rahim
Keyword(s):  
Blood Loss ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Surgical Techniques ◽  
Bladder Injury ◽  
Placenta Increta ◽  
Foetal Outcome ◽  
Tertiary Care Hospitals ◽  
Placenta Accrete

<p><strong>Abstract</strong></p><p><strong>Objective:</strong><strong>  </strong>To evaluate the maternal and foetal outcome in cases of placenta previa, placenta accrete and placenta increta.</p><p><strong>Methods:</strong><strong>  </strong>Medical records of patients from 1 Feb 2014 to 28 Feb 2015 were checked and patients who underwent caesarean section with a diagnosis of placenta previa types III and IV (and placenta accreta, increta and percreta) were identified. Their medical record files were retrieved and data collected regarding patients age, parity, previous LSCS, D&amp;C, blood loss, bladder injury, hysterectomy and use of B-lynch technique were recorded. Neonatal statistics were also recorded regarding birth weight, gender, APGAR score and need for admission in NICU.<strong></strong></p><p><strong>Results:  </strong>In total 37 cases of major placenta previa were identified. These included 8 cases with placenta accrete including 2 cases of placenta increta. No maternal death occurred amongst the studied cases. Only one case of IUFD was identified. The incidence of placenta previa (major) was 29.95/1000 births. Average parity of patients with placenta accreta (PA) was signi-ficantly higher than cases of placenta previa (PP) (2.75 vs. 1.55, p = 0.04). Similarly average number of LSCS in cases of PA was significantly higher than cases of PP (2.25 vs. 0.86, p = 0.02). PA cases were delivered at a significantly earlier gestational age as compared to cases with PP (34.5 weeks vs. 37 weeks, p = 0.01). Hysterectomy was done in 6 (75%) cases of PA but in none with PP. Bladder injury occurred in 2(25%) cases of PA but in none with PP. Blood loss was also signi-ficantly higher in PA cases than PP cases (3975 ml vs. 1196 ml, p = 0.006).</p><p> </p><p><strong>Conclusion:</strong><strong>  </strong>At tertiary care hospitals, maternal and foetal outcomes for placenta previa and placenta accreta have improved owing to improved surgical techniques and better understanding of these conditions.</p>

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