scholarly journals Identifying the risk factors of antepartum haemorrhage and to evaluate the feto maternal outcome in antepartum haemorrhage cases

2021 ◽  
Vol 10 (10) ◽  
pp. 3786
Author(s):  
Reeta Singh ◽  
Vani Aditya ◽  
Sakshi Agarwal ◽  
Garima Maurya ◽  
Ankita Kumari ◽  
...  
Keyword(s):  
Risk Factor ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Team Work ◽  
Morbidity And Mortality ◽  
Major Risk Factor ◽  
Antepartum Haemorrhage ◽  
Medical College ◽  
Abruptio Placenta

Background: Antepartum haemorrhage is an obstetric emergency contributing to a significant percentage of perinatal and maternal morbidity and mortality. Approximately 30% of maternal deaths are caused by ante-partum haemorrhage. In spite of a lot of improvement in antenatal care and intrapartum surveillance, antepar-tum haemorrhage has not reduced. Present study was conducted to assess the causes of APH and to compare the fetomaternal outcome among placenta previa and abruptio placenta group.Methods: The study was conducted in BRD medical college Gorakhpur, over a period of 1 year (October 2019 to September 2020) in which 100 cases of APH were taken and classified into placenta previa and abruptio placenta group and their fetomaternal outcome were compared.Results: In our study, out of 100 cases of APH 69% cases were of placenta previa followed by abruptio placen-ta in 29% cases and rest 2% cases were unclassified APH. Multigravida is the major risk factor in both placenta previa and abruptio placenta group. Second major risk factor in placenta previa group was h/o LSCS and in abruptio placenta group was HDP. Stillbirth was significantly seen in abruptio placenta group whereas Low birth weight babies (1.5-2.5 kg) were more in placenta previa group. Though the maternal outcome is poor in placenta previa group but the fetal outcome is worse in abruptio placenta group.Conclusions: APH neither can be reliably predicted nor can be prevented but only a comprehensive focused experienced team work can reduce maternal and perinatal morbidity and mortality.

scholarly journals Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 2210
Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Medical College ◽  
Abruptio Placenta

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.

scholarly journals Incidental amniocele in a case of antepartum haemorrhage

2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Sheree C. Gray ◽  
Jacobus A. Pienaar ◽  
Zelia Sofianos ◽  
Jacob Varghese ◽  
Ilonka Warnich
Keyword(s):  
Case Report ◽  
Early Identification ◽  
Uterine Rupture ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Severe Morbidity ◽  
Antepartum Haemorrhage ◽  
Threatening Condition ◽  
Life Threatening

An amniocele, or contained uterine rupture, is a phenomenon in which there is herniation of the amniotic sac through a uterine defect, secondary to various causes. It is associated with severe morbidity and mortality. This case presents the findings in a 36-year-old female at 29 weeks gestation who was initially managed as antepartum haemorrhage secondary to placenta previa, based on ultrasound. Upon further imaging, an amniocele was diagnosed. This case report illustrates the importance of early identification of this life-threatening condition.

scholarly journals Prospective observational study of risk factors and maternofetal outcome of placenta previa at LMICs

2020 ◽  
Vol 7 (9) ◽  
pp. 3488
Author(s):  
Manju Lata Verma ◽  
Uma Singh ◽  
Vandana Solanki ◽  
Amrita Singh ◽  
Rekha Sachan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Placenta Previa ◽  
Fetal Outcome ◽  
Team Work ◽  
Chi Square ◽  
Exact Test ◽  
Qualitative Variables ◽  
Operative Findings

Background: This study was conducted to assess incidence, risk factors, maternal and fetal outcome in patients of placenta previa (PP).Methods: Department of Obstetrics and Gynecology, King George Medical University, Lucknow. Hospital based prospective observational study. Patients attending to the antenatal outdoor patient unit with diagnosis of PP and patients coming to emergency with the complaints of antepartum hemorrhage (APH) because of placenta previa. Detailed history, clinical examination, imaging by transabdominal ultrasound, antenatal complications, per-operative findings, maternal and fetal outcome were assessed. Qualitative variables were compared using Chi square test/ Fisher’s exact test as appropriate. Statistical analysis was done using SPSS version 21.Results: Incidence of PP was 2.8% (271/9404). Mean age was 28.23±4.58 years. 37.3%, delivered between 28-33.6 weeks. 229 (84.5%) had emergency LSCS. 205 (75.6%) cases of placenta previa had active bleeding. 53 (19.6%) cases had PPH and 2 maternal mortalities occurred due to hemorrhagic shock.Conclusions: Placenta previa is associated with definitely poor maternal and fetal outcome which can be better managed with multidisciplinary team work.

scholarly journals Study of fetomaternal outcomes in antepartum haemorrhage at tertiary care centre

2021 ◽  
Vol 10 (4) ◽  
pp. 1509
Author(s):  
Faaizah Husain Ghanchibhai ◽  
Sharda Goyal ◽  
Nalini Sharma ◽  
Ankita Pargee
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Abruptio Placenta

Background: Antepartum haemorrhage (APH) is a challenge to obstetrician as it involves a question of life and death to mother and fetus. Antepartum hemorrhage is the 2nd most common cause of maternal mortality and morbidity as sepsis and obstructed labour has decreased now. The aim of the study is to find the prevalence of APH. And to study foeto-maternal outcomes in patients with antepartum haemorrhage, association of comorbidities and risk factors.Methods: This study was conducted at Geetanjali Medical College and Hospital, Udaipur after obtaining approval from institutional research ethical board and written informed consent during the period of February 2019 to July 2020. This was prospective observational study, sample size was 60 patients. All the APH patients who were admitted at GMCH Obstetrics and Gynaecology department after 28 weeks of gestation were included in study. Extrauterine or bleeding due to general pathology was excluded. Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%.Results: Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%. According to maternal complications rate, It was 66.66 % in abruptio placenta, 37.03 % in placenta previa and jointly 53.33%. In placenta previa group 100% patients discharged with good GC, In abruptio placenta group 96.96% patients discharged with good GC and 3.04% patients discharged with poor GC. Perinatal mortality was zero in placenta previa group and in abruptio placenta, it was 27.27% (24.24% IUD, 3.03% neonatal death).Conclusions: The main cause of APH was abruption which was seen in 33 (55%) of patients and placenta previa was seen in 27 (45%) of patients. Maternal and neonatal complications, both were very high in abruption group as compared to placenta previa group. Overall maternal mortality rate was 53.33% and perinatal mortality rate was zero in placenta previa group while in abruption placenta group, it was 27.27%. There was no maternal complications in booked placenta previa cases only there were very few complications in emergency cases. In abruptio placenta group also complications were more in emergency cases, irregular booked and uncontrolled pregnancy pathology cases. 

scholarly journals Maternal Outcome of Anemic Pregnant Mother at Private Hospitals in Dhaka City

2021 ◽  
Vol 33 (2) ◽  
pp. 102-107
Author(s):  
Muhammad Zahangir
Keyword(s):  
Pregnant Women ◽  
Total Sample ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Dhaka City ◽  
College Hospital ◽  
Private Hospitals ◽  
Medical College ◽  
Medicine Today ◽  
In Pregnancy

Introduction: The study carried out among the pregnant women who had anemia during pregnancy with the objectives to determine their maternal outcome at private hospitals in Dhaka city. Materials and Methods: The total sample size was 110. Data was collected by interviewing the respondents with a structured pre-tested questionnaire. The study was conducted in pregnant women with anemia at or after 28 weeks of gestation and had delivered at Obstetrics Department of Ad-Din Barrister Rafique ul-Huq Hospital, Jurain and Bashundhara Ad-Din Medical College Hospital South Keranigonj. Results: Most of the respondents (38.2%) belonged to the age group between 16-20 years. The mean age was 23.74±5.127 years. Almost (49.1%) up to primary & (38.2%) were up to secondary/higher secondary level. Most of the respondents were homemaker (87.3%); Monthly income means was 19340.91±12459.647. Most (90.9%) of the respondents had received ANC and 79.1% respondent’s hemoglobin level was below 10 gm. /dl. Among them 90.9% of the respondent’s fetal outcome were healthy & alive baby. More than half (51.8%) of the respondent’s baby were _ 2.5 kg birth weight. Study also shows that 55.5% respondents had anemia after delivery, 28.2% had sickness and 22.7% were sulfured with complications after delivery. There was a significant relationship with low birth weights (LBW) to less high education. Conclusion: All women should be given advice regarding diet in pregnancy with details of foods rich in iron. Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary. Medicine Today 2021 Vol.33(2): 102-107

scholarly journals Accidental haemorrhage in third trimester: maternal and fetal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1633
Author(s):  
Niranjan N. Chavan ◽  
Vibhusha Rohidas ◽  
Hanumant Waikule
Keyword(s):  
Risk Factor ◽  
Mortality Rate ◽  
Post Partum ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Health Care Facilities ◽  
Warning Signs ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Abruptio Placenta

Background: Abruptio placenta or accidental haemorrhage is one of the obstetrical emergencies and is truly accidental with few warning signs. Present study is planned to study the maternal and fetal outcome in patients of abruption placenta in a tertiary care referral hospital in a rural set up which is helpful to plan management strategies and to decrease mortality and morbidity.Methods: A prospective observational study was conducted at Department of Obstetrics and Gynaecology at tertiary care centre during September 2015 to August 2019. A total of 270 cases of abruptio placenta coming to the labor ward and delivered were included in the study. The information collected regarding maternal and fetal parameters were recorded in a master chart in Microsoft Excel 2010 and analyzed using the statistical package for the social sciences software (SPSS) version 20.0.Results: In the present study there were a total of 29887 deliveries with 270 cases of abruptio placenta, incidence being 0.9%. Bleeding per vagina is the most common presentation (85.6%) followed by pain abdomen (70.7%). Common risk factors for accidental hemorrhage were: Pre-eclampsia (39.6%) and anaemia (32.2%). Rate of cesarean section was 40.7% (n-110) while rate of forceps delivery was 4.8% (n-13). Associated maternal complications include: post-partum hemorrhage (18.9%), DIC (10%), acute renal failure (4.1%) and puerperal sepsis (1.9%) while maternal mortality rate was 1.9%. Low birth weight (<2.5kg) was observed in 74.8% cases while still birth and neonatal mortality rate was 35.2% and 12.6% respectively.Conclusions: Abruptio placenta or accidental hemorrhage is major risk factor for maternal and perinatal morbidity and mortality, thus efforts should be taken to reduce risk factor for abruptio placenta. Strengthening of antenatal care, anticipation and evaluation of associated high-risk factor and prompt management of complication can improve maternal and perinatal outcome in these cases. Abruptio placenta should be managed in centers where there is advanced maternal and neonatal health care facilities are available.

scholarly journals Etiological factors and maternal outcome in pregnancies with malpresentation: an observational study

2020 ◽  
Vol 9 (4) ◽  
pp. 1407
Author(s):  
S. Shruthi ◽  
A. Anisha Apollo
Keyword(s):  
Observational Study ◽  
Placenta Previa ◽  
Post Partum ◽  
Breech Presentation ◽  
Maternal Outcome ◽  
Obstructed Labor ◽  
Etiological Factors ◽  
Medical College ◽  
Hospital Study ◽  
Transverse Lie

Background: The most common presentation of the fetus is malpresentation. These include breech, face, brow, shoulder and compound presentations. Malpresentations of fetus complicate labor in about 5% of pregnancies. To find out the incidence of malpresentation, to analyze etiological factors of malpresentation, to evaluate the maternal outcome in cases with a malpresentation.Methods: This prospective observational study was done in, Chengalpattu Government medical college and hospital. Study period from October 2018 to September 2019. Pregnancies with malpresentation presenting to the department of obstetrics and gynecology at CMCH were included in the study.Results: A total of 680 malpresentation were admitted in this period were included in this study. The incidence of malpresentation during the study period was 7.72%. The incidence of the breech was 4.38%, transverse lie 1.11%, face 0.28%, brow 0.05% and compound presentation 0.13%. The common causes were prematurity, multiple gestations, grand multiparty, IUGR, oligohydramnios, anomalies of uterus, polyhydramnios, contracted pelvis, placenta previa, hydrocephalus, prematurity was reported as the commonest cause of breech presentation and multiparty for transverse lie, face and brow presentations. The most common complication was obstructed labor 6.9% followed by post-partum hemorrhage 3.65%. There was no maternal death due to malpresentation during the period of study.Conclusions: Early diagnosis and timely management can prevent the complications of labor associated with a malpresentation. Delivery should be planned at centers which have expertise in conducting vaginal delivery in malpresentation with good intrapartum monitoring and with facilities for cesarean section for the better feto-maternal outcome.

scholarly journals Abruptio placenta: a retrospective study on maternal and perinatal outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4389
Author(s):  
Subha Sivagami Sengodan ◽  
Mohana Dhanapal
Keyword(s):  
Retrospective Study ◽  
Fetal Outcome ◽  
Age Group ◽  
Third Trimester ◽  
College Hospital ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Abruptio Placenta

Background: Abruptio placenta is separation of a normally situated placenta after 20 weeks of gestation and prior to the birth of the fetus. It is an important cause of antepartum haemorrhage and presents as an acute abdomen in the third trimester of pregnancy. Obstetrical haemorrhage is one of the triad (Haemorrhage hypertension and infection) of causes of maternal deaths in both developed and underdeveloped countries.Methods: This is a retrospective study of Abruptio Placenta cases carried out between January 2015 and December 2015 at Government Mohan Kumaramangalam Medical College Hospital, Salem and about its perinatal and maternal outcome.Results: Incidence of Abruptio placenta is 0.5%. It is most common in the women of age group 26-30yrs. 67% of cases were associated with severe pre-eclampsia. Live births were 69.8% while stillbirths were 30.2%. PPH occurred in 19.6% of cases. DIC accounts for 16.7% of the complication.Conclusions: Abruptio placenta is associated with poor maternal and fetal outcome. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.

Feto-maternal Outcome in Pregnancies Complicated by Hypertensive Disorder: A Retrospective Study at a Tertiary Care Centre of Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1127-1131
Author(s):  
Gyanendra Man Singh Karki ◽  
Mona Priyadarshini ◽  
Tarun Pradhan
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Heart Rate Pattern

Introduction: Hypertensive disorder of pregnancy is one of the major cause of maternal and fetal morbidity and mortality. Objective: The objective of this study was to estimate the associated maternal and fetal outcome and complications in pregnancies complicated by hypertensive disorders at a tertiary care hospital in eastern Nepal. Methodology: This retrospective cross section observational study included purposely-selected one hundred thirty four pregnant women from April 2019 to April 2020 in the Department of Obstetrics and Gynaecology at Birat Medical College Teaching Hospital, Tankisinuwari, Morang, Nepal. Maternal age, gravidity, period of gestation at presentation, associated maternal comorbidities/ risk factors, mode of delivery, indication for surgery, maternal outcome and complications, fetal outcome was recorded and data was analysed using SPSS version 23 software. Result: Out of the 134 study population,35.8% of the mothers with hypertensive disorders were noted in the age group between 25-29 years and almost two third of the patients were multigravida. 55.2% patients had mild, while 44.8% had severe hypertension. About 83.6% of the hypertensive pregnant mothers delivered preterm between 33 to 36 weeks of gestation. 61.9% mothers underwent cesarean section with the most common indication being non-reassuring fatal heart rate pattern, while 34.3% women delivered vaginally. 86 out of 134 cases did not develop any complications while, postpartum haemorrhage was the most frequently encountered complication seen in 17.9% cases followed by eclampsia encountered in 13.4% patients. The mortality encountered was 0.7%. Neonatal complications were found in 50% cases, 15.7% neonates had low APGAR score and 8.2% had meconium aspiration, while 4.5% intrauterine deaths and 3% neonatal deaths were observed. Conclusion: There is adverse impact of hypertension during pregnancy over maternal and perinatal outcome. Hence, early identification and prompt referral to the well-equipped center is necessary to reduce the associated morbidity and mortality.

A PROSPECTIVE STUDY OF MATERNALAND FETAL OUTCOME IN PREECLAMPSIAAND ECLAMPSIA

2021 ◽  
pp. 60-61
Author(s):  
Naveed Tamboli ◽  
Hemant Murdeshwar ◽  
Gulafroz SK Samad
Keyword(s):  
Prospective Study ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Severe Preeclampsia ◽  
Morbidity And Mortality ◽  
Haematological Parameters ◽  
Coagulation Status ◽  
Mild Preeclampsia ◽  
A Prospective Study

Introduction- Pre eclampsia and eclampsia is one of the leading cause of maternal and fetal morbidity and mortality. This study was undertaken to correlate coagulation prole in patients with pre-eclampsia and eclampsia with maternal and fetal outcome. Materials And Methods- A prospective study was conducted on 164 cases and 70 controls over a period of 2 years. The coagulation prole was carried out on the semiautomated TRINITY coagulometer. The haematological parameters were assessed on fully automated 3 part haematological analyser- TRIVITRON Model-CELLENIUM-19. The patients were classied into mild preeclamptic, severe preeclamptic and eclamptic based on the clinical and haematological parameters. Observations- The maternal and the foetal outcomes were studied and correlated with the coagulation prole. All the cases of mild preeclampsia had favourable maternal and fetal outcome. Out of total 102 cases of severe preeclampsia and eclampsia, 78 had normal coagulation prole and 24 had deranged prole. Thus out of 24 patients with deranged coagulation prole, 21 (87.5%) women had adverse maternal outcome and 24 (100%) had unfavourable fetal outcome. Conclusion- Deranged coagulation prole in preeclampsia and eclampsia is signicantly associated with adverse maternal and fetal outcome. Thus suspecting a deranged coagulation status early in the course of the disease will guide us in management before the patient goes into complications.

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