scholarly journals Feto-maternal outcome of oligohydramnios in tertiary care hospital

2021 ◽  
Vol 10 (11) ◽  
pp. 4101
Author(s):  
Shetal Prajapati ◽  
Sakina Johar
Keyword(s):  
Cesarean Section ◽  
Neonatal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Outcome ◽  
Care Hospital ◽  
Maternal Complications ◽  
Risk Pregnancy ◽  
Fetal Surveillance ◽  
Nicu Admission

Background: The importance of amniotic fluid volume as an indicator of fetal wellbeing has made its assessment an important part of antenatal fetal surveillance. Oligohydramnios complicates 0.5% to 8% of pregnancies and the prognosis for pregnancies complicated by oligohydramnios is dependent on the gestational age and the underlying aetiology. This study aims to determine the feto-maternal outcome of oligohydramnios in a tertiary care hospital.Methods: In this study, we included 100 patients of oligohydramnios, with AFI ≤5 cm with a singleton pregnancy with intact membranes. The maternal outcome was accessed by mode of delivery and maternal complications and the neonatal outcome was studied by birth weight, APGAR score, NICU admission and perinatal mortality.Results: PIH was the most common risk factor in 38% of cases followed by IUGR in 29%, doppler changes in 24%. The reduced diastolic flow was the most common abnormal doppler finding in the 23% abnormal doppler cases, from which 39% underwent cesarean section, 9% required NICU admission and 61% had neonatal death. 53% delivered by cesarean section of which 13% had neonatal death. NICU admission is required in 64% of cases.Conclusions: We conclude that oligohydramnios is a high-risk pregnancy and proper antepartum care, intensive fetal surveillance and intrapartum care are required in a patient with oligohydramnios. Every case of oligohydramnios needs careful antenatal evaluation, parental counselling, individualization, decisions regarding time and mode of delivery. Continuous intrapartum fetal monitoring and good neonatal care are necessary for a better perinatal outcome.

scholarly journals To study pattern of obstetric cases referred at tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2370
Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Central India ◽  
Maternal Outcome ◽  
Child Health Services ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Diagnosis ◽  
Mode Of Transport

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals A prospective study of intrauterine death cases at a tertiary care hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 638
Author(s):  
Nabila N. Tai ◽  
Rinku Mulchandani ◽  
Dipti A. Modi ◽  
Bijal Rami
Keyword(s):  
Prospective Study ◽  
Fetal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intrauterine Fetal Death ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Risk Pregnancy ◽  
A Prospective Study ◽  
Death Cases

Background: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise.

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.

scholarly journals Maternal and Perinatal Outcomes of Singleton Term Breech Vaginal Delivery at a Tertiary Care Center in Nepal: A Retrospective Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tulasa Basnet ◽  
Baburam Dixit Thapa ◽  
Dipti Das ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Care Hospital ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

scholarly journals Study of maternal and fetal outcome in postdate pregnancy in tertiary care hospital

2020 ◽  
Vol 9 (9) ◽  
pp. 3585
Author(s):  
Patel Yogeshkumar Pransukhbhai ◽  
Poonam Londhe
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Vaginal Deliveries

Background: Fetal, neonatal and maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study was conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: This was a prospective cross-sectional study of 70 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital B. J. Medical College, Ahmedabad, Gujarat, India.Results: Out of 70 patients, majority of the subjects belongs to 26-30 years of age (50%). The gestational age of 90% of patients were between 40-42 weeks. About 42-44% of the foetus had a birth weight of 2.5-3.5 kgs. Maximum patients underwent vaginal deliveries in spontaneous group (57%) and 64% underwent LSCS in induced group. Mode of delivery is significantly associated with presence of adequate liquor.Conclusions: With regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up.

scholarly journals Study of fetomaternal outcome in twin pregnancy

2019 ◽  
Vol 8 (12) ◽  
pp. 4762
Author(s):  
Bijal D. Rami ◽  
Somika Kaul
Keyword(s):  
High Risk ◽  
Twin Pregnancy ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
High Risk Pregnancy ◽  
Maternal Complications ◽  
Lower Segment Cesarean Section ◽  
Risk Pregnancy ◽  
Fetal Complications

Background: Twin pregnancy being one of the causes of high-risk pregnancy is associated with both maternal and fetal complications. This study aims at analysing the fetal and maternal outcome in such cases. All cases were studied according to their parity, maternal age, fetal presentation, mode of delivery and gestational age.Methods: This prospective study was conducted at one of the tertiary care teaching institutes over a period of one year from January 2018 to December 2018. Out of a total number of 7295 deliveries, 130 were twin pregnancy. It included all women admitted in labour room with clinical or ultrasound diagnosis of twin pregnancy after 20 weeks of gestation.Results: In the present study incidence of twin pregnancy was 1.78%. We observed the highest incidence of twins in the age group of 20-29 years. The least incidence was below the age of 20 years. Incidence of twin pregnancy in our study in primipara was 47.7% and in multipara was 52.3%. Most of the patients (43%) delivered at 32-36 weeks of gestation. Maternal complications were noticed as anemia in 29.2% patients, pregnancy induced hypertension in 55.4% patients, post-partum hemorrhage in 4.6% patients, polyhydramnios in 3.1% patients, premature rupture of membranes in 8.5% patients, gestational diabetes in 0.8% patients and urinary tract infection in 2.3% patients. Majority of the patients delivered vaginally (60.8%), others by lower segment cesarean section (LSCS). In this study 95.8% babies were low birth weight. There were 34 neonatal deaths (13%).Conclusions: Twin pregnancy is a high-risk pregnancy associated with significantly increased maternal morbidity, neonatal morbidity and mortality. Such pregnancies require good antenatal care, early detection of maternal and fetal complications and timely referral to a centre well equipped for management of such cases. 

scholarly journals Role of cardiotocography in high risk pregnancy and its correlation with increase cesarean section rate

2016 ◽  
Vol 6 (1) ◽  
pp. 168 ◽  
Author(s):  
Manisha Gupta ◽  
Punit Gupta
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
High Risk Pregnancy ◽  
Cesarean Section Rate ◽  
Reactive Group ◽  
Risk Pregnancy ◽  
Nicu Admission

Background: FHR monitoring plays the most important role in management of labouring patient when incidence of fetal hypoxia and progressive asphyxia increases. Now a day’s cardiotocography (CTG) become a popular method for monitoring of fetal wellbeing and it is assisting the obstetrician in making the decision on the mode of delivery to improve perinatal outcome. The aim of the study was to assess the effect of cardiotocography on perinatal outcome and its correlation with caesarean section rate.Methods: In this prospective observational study 201 gravid women with high risk pregnancy in first stage of labour were taken. Result was assessed in the form of Apgar score at five minute, NICU admission, perinatal mortality and mode of delivery. Statistical analysis is done by using Chi square test and p<0.05 is considered as statistically significant.Results: Perinatal morbidity in the form of NICU admission is higher in nonreactive group as compare to reactive group (75.7% v/s 22.8%). Cesarean section rate for fetal distress were higher in nonreactive group (87.8%) in comparison to reactive group (20.5%). So this study suggest that there is significant difference in mode of delivery with increasing chances of caesarean section in cases belong to non-reactive traces (p<0.001).Conclusions: Admission test is non-invasive and the best screening test to evaluate the fetal health and to predict the perinatal outcome but it also associated with increase caesarean section rate.

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