scholarly journals Seizure disorders in pregnancy: an insight beyond eclampsia and epilepsy

2021 ◽  
Vol 10 (11) ◽  
pp. 4201
Author(s):  
Arti Sharma ◽  
Vineeta Gupta ◽  
Prashant Sarda ◽  
Parul Singh ◽  
Nikita Gupta ◽  
...  
Keyword(s):  
Birth Rate ◽  
Mode Of Delivery ◽  
Live Birth Rate ◽  
Fetal Outcome ◽  
Maternal Complications ◽  
Cerebral Malformation ◽  
Seizure Disorders ◽  
Common Causes ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Background: Seizures in pregnancy contribute to poor maternal and perinatal outcome. Though eclampsia and epilepsy are common causes of seizures in pregnancy but there are several other conditions apart from eclampsia and epilepsy which give rise to convulsions. Objective of this study was to evaluate fetomaternal outcome in patients with seizure disorders as well as to analyze the other causes of seizures in pregnancy apart from eclampsia and epilepsy.Methods: This prospective study was conducted in Shri. Guru Ram Rai institute of medical and health sciences, Dehradun, India over a period of 39 months from January 2017to March 2020, in all pregnant women with seizure disorders delivered in this hospital. In all cases demographic characteristics, causes of seizure with special attention on noneclamptic, non-epileptic conditions, maternal complications, mode of delivery and fetal outcome were noted.Results: Total 97 cases with seizure disorders were included in the study. Mostly seizures were due to eclampsia and epilepsy in 91.75% cases. Among other causes neurocysticercosis, cerebral malformation, posterior reversible encephalopathy syndrome, brain tumor, and cerebral infarcts contributed to seizures in pregnancy in 8.25%cases. Maternal complications were premature rupture of membranes, gestational diabetes mellitus, hypothyroidism, anaemia, jaundice and abruption observed in37.11% cases. Live birth rate was 76.28%, prematurity was present in 27.83% cases and fetal growth restriction was seen in 7.21% neonates. There were 5 (5.15 %) neonatal deaths.Conclusions: Seizure disorders in pregnancy are associated with significant increase in maternal and fetal risk. Maternal complications, cesarean section rate and neonatal complications are increased. Several other conditions apart from eclampsia, need to be considered in patients without epilepsy presenting with convulsions in pregnancy. 

scholarly journals Study of Maternal and Fetal Outcome in Pregnancy with Heart Disease

2017 ◽  
Vol 8 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Shifin Rijvi ◽  
Salma Akhtar ◽  
Benozir Haque ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Nyha Class ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Functional Class ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
In Pregnancy

Background: Heart disease complicating pregnancy is an important indirect cause of maternal mortality and morbidity. Maternal heart disease comprises .2%-2% of pregnancies and responsible for 10%-20% of maternal deaths1. Our study was done to evaluate fetomaternal outcomes in pregnancy with heart disease.Objectives: Evaluation of fetomaternal outcome in pregnant patients with cardiac disease. Materials andMethods: This observational study was done in Bangabandhu Sheikh Mujib Medical University and Anwer Khan Modern Medical College Hospital among 51 pregnant women with known or newly diagnosed heart disease from January 2013-january 2015. Baseline data recorded demographic character, NYHA functional class, maternal complications, mode of delivery and neonatal outcome.Results: Among 51 cardiac patients, 32 (63%) were primigravida. Mostly 46 (90.6%) belonging to NYHA Class I and II. Rheumatic heart disease seen in 45 (87%) and congenital heart disease in 10% subjects. Mitral stenosis was the most common, seen in 22 (41%) cases. 47.33% patients were delivered vaginally and LSCS done in 41% patients. The fetal outcome were live births in (96.6%) cases, (27.4%) babies required NICU admission.Conclusion: An improvement in modern techniques of monitoring, better understanding of pathophysiology of cardiac disease and multi disciplinary care can lead to substantial improvement in the feto maternal outcome.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 112-116

scholarly journals Outcome of induction of labour with dinoprostone at a teaching hospital in Nepal

2017 ◽  
Vol 6 (4) ◽  
pp. 1170
Author(s):  
Punita Yadav ◽  
Veena R. Shrivastava
Keyword(s):  
Gestational Age ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Induction Of Labour ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Care Visit ◽  
Common Causes ◽  
Vertex Presentation ◽  
In Pregnancy

Background: Induction of labour has now become a common practice; this study was conducted to find the outcome of induction of labour in pregnant women in relation to: induction delivery interval, mode of delivery, maternal complications and fetal outcome.Methods: It was a hospital based prospective study conducted from April 2012 to March 2013. Singleton pregnancy of gestational age ≥37 weeks, with vertex presentation and Bishops Score <6 were the cases included for induction. Dinoprostone (0.5mg) intracervically was used for induction. The different outcome parameters were analyzed.Results: Of 100 cases enrolled, majority 93% were below 30 years, mean gestational age of induction was 40.7± 0.7weeks and 58% were primi gravida. Ante natal care visit of ≥3 was present only in 66%. At induction 55% had bishop score of (0-3) and rest had score of (4-5). Postdated pregnancy (67%) followed by hypertension (13%) were the two most common causes for induction. 58% required second dose of dinoprostone, and the induction delivery interval was 24.3±9.6 hrs. 63% of the induced labour progress for vaginal delivery. Fetal distress (56.4%) was the commonest indication for caesarean section (CS). 6% of the cases had postpartum hemorrhage. 13% of the delivered neonate required NICU care, of which 53.8% was moderately asphyxiated. There was no maternal or neonatal death.Conclusions: In pregnancy undergoing induction of labour, CS is not uncommon, and there are few chances of maternal and neonatal morbidities. Therefore, obstetrician should be vigilant to avoid any untoward events.

scholarly journals An observational study of maternal and fetal outcome in pregnant women with Hepatitis E

2019 ◽  
Vol 8 (8) ◽  
pp. 3110
Author(s):  
Ranjana Mishra ◽  
Arun H. Nayak ◽  
Madhuri Mehendale
Keyword(s):  
Hepatic Encephalopathy ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Mode Of Delivery ◽  
Research Work ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Medical Complication ◽  
Neonatal Deaths ◽  
In Pregnancy

Background: Hepatitis E in pregnancy has been a subject of interest in the recent years as the available research work is very limited and conflicting especially in pregnant women as compared to infection in men and non- pregnant women in which the disease is usually self- limiting. The mechanism of liver injury in hepatitis E is not clear and no conclusive theories about the exact pathogenesis are available. This study was done to gain insight into the effects of hepatitis E virus on pregnancy in terms of maternal and fetal outcome.Methods: Total of 40 pregnant women with Hepatitis E Virus IgM antibodies was included in the study. Hepatitis cases due to other viral and non-infective causes were excluded. Maternal outcomes in terms of mode of delivery, complications like PPH, hepatic encephalopathy, fulminant hepatic failure, coagulopathy and maternal mortality was studied. Fetal outcomes in terms of intrauterine fetal deaths, stillbirth, live births, and neonatal deaths were studied.Results: This study showed high mortality rates (42.5%) in pregnant women with hepatitis E. The most common obstetric complication was IUFD (45%) followed by preterm labor (32.5%) and postpartum hemorrhage (22.5%). Hepatic encephalopathy (62.5%) was the commonest medical complication followed by coagulopathy (25%). A statistically significant association was found between the presence of medical complications and poor maternal outcome.Conclusions: Hepatitis E virus infection in pregnancy often has a fulminant course with poor maternal and fetal outcome. Its management therefore requires an early diagnosis, and a multidisciplinary approach.

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 Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey

2020 ◽  
Vol 105 (8) ◽  
pp. e2853-e2863 ◽  
Author(s):  
Christina Bothou ◽  
Gurpreet Anand ◽  
Dingfeng Li ◽  
Tina Kienitz ◽  
Khyatisha Seejore ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Fetal Outcome ◽  
Adrenal Crisis ◽  
Third Trimester ◽  
Maternal Complications ◽  
The Third ◽  
Addison Disease ◽  
Multicenter Survey

Abstract Context Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment. Objective Multicenter survey on current clinical approaches in managing AI during pregnancy. Design Retrospective anonymized data collection from 19 international centers from 2013 to 2019. Setting and Patients 128 pregnancies in 113 women with different causes of AI: Addison disease (44%), secondary AI (25%), congenital adrenal hyperplasia (25%), and acquired AI due to bilateral adrenalectomy (6%). Results Hydrocortisone (HC) was the most commonly used glucocorticoid in 83% (97/117) of pregnancies. Glucocorticoid dosage was increased at any time during pregnancy in 73/128 (57%) of cases. In these cases, the difference in the daily dose of HC equivalent between baseline and the third trimester was 8.6 ± 5.4 (range 1-30) mg. Fludrocortisone dosage was increased in fewer cases (7/54 during the first trimester, 9/64 during the second trimester, and 9/62 cases during the third trimester). Overall, an adrenal crisis was reported in 9/128 (7%) pregnancies. Cesarean section was the most frequent mode of delivery at 58% (69/118). Fetal complications were reported in 3/120 (3%) and minor maternal complications in 15/120 (13%) pregnancies without fatal outcomes. Conclusions This survey confirms good maternal and fetal outcome in women with AI managed in specialized endocrine centers. An emphasis on careful endocrine follow-up and repeated patient education is likely to have reduced the risk of adrenal crisis and resulted in positive outcomes.

scholarly journals Management and Outcome of Postdated Pregnancy at Rajshahi Medical College Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 50-53
Author(s):  
Most Merina Akhter ◽  
Mst Shaheen Nawrozy ◽  
Abu Hena Mostafa Kamal ◽  
Sahela Jesmin
Keyword(s):  
Perinatal Mortality ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Medical College Hospital ◽  
Maternal Complications ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College

Background: Postdated pregnancy complicates about 10% of all gestation and is associated with an increase in perinatal mortality and morbidity. This study was designed to observe fetal as well as maternal outcome in the management of postdated pregnancies admitted into Rajshahi Medical College Hospital. Methods: The study was carried out from July 2008 to June 2010. 100 cases of postdated pregnancies were included. Patients’ age, occupation, parity, mode of delivery, the indication of LUCS, fetal & maternal outcomes were recorded in a predesigned questionnaire. Results were expressed as Mean± SD, actual number and percentage of total where applicable. Results: Mean age (±SD) was 21.3 (±5.32) years. 90% were housewives, 5% were in service and 5% were in other occupations. 53% were nullipara, 21% para-2, 18% were para-3, 8% were para-4.57% of the study patients underwent caesarean section and 43% underwent vaginal delivery. Fetal distress (n=34), non-progression of labour (n=19), cord prolapse (n=1) & CPD (n=3) were the causes of LUCS. Regarding fetal outcome, healthy babies were 76%, meconium aspiration 13%, birth asphyxia 11%. Among birth asphyxia, neonatal death was 1% & still born was 2%. Maternal complications at delivery were tear in the genital tract 8%, PPH 5% & wound infection in 4% cases. Conclusion: Here, still-birth rate was 2% (normally about 1 in 3000 deliveries) and perinatal mortality rate is 3% (normally about 2-3 in 1000 deliveries). So, patients should be encouraged to attend regular antenatal check up to prevent postdated pregnancy and its complications. TAJ 2018; 31(2): 50-53

scholarly journals Polycystic ovarian syndrome and pregnancy outcome

2017 ◽  
Vol 6 (9) ◽  
pp. 3804
Author(s):  
Chaitra Shivananjaiah ◽  
Abinaya Kannan ◽  
Mridula Devi ◽  
. Jayanthi ◽  
Satish D. ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Polycystic Ovarian Syndrome ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Ovarian Syndrome ◽  
In Pregnancy

Background: Polycystic ovarian syndrome (PCOS) in the present generation is a very common reproductive disorder and the prevalence is on the rise. It is associated with typical features such as insulin resistance, hyperandrogenemia and obesity which has deep implications on the pregnancy outcomes as well as a long-term health of the woman.Methods: Prospective comparative study performed over 200 pregnant women in the ESIC medical college, Bangalore. 100 women diagnosed with PCOS were compared with that of 100 normal women. The method of conception in pcos was recorded. maternal outcome in the form of abortion, gestational diabetes mellitus, hypertensive disorder in pregnancy, mode of delivery, intrapartum and postpartum complication. Fetal outcome in the form preterm delivery, small-for-gestational-age (SGA) infants, large-for-gestational-age infants, apgar at 5 minute and admission to NICU.Results: Of the 100 women who were diagnosed with PCOS, 62 had spontaneous conception, 32 conceived with ovulation induction, 4 with artificial insemination and 2 needed IVF for conception. 18 women had spontaneous abortion, 58 were diagnosed with Gestational diabetes mellitus (GDM) predominantly between 24 – 28 weeks’ period of gestation, 16 women had hypertension complicating pregnancy. Fetal outcome in the form of preterm birth was noted in 14 patients, large for gestation was noted in 11 newborns, the rate of NICU admission was significantly higher in the PCOS women’s infants constituting 33%.Conclusions: The assistance needed for conception was significantly higher in women with PCOS. The complications associated with pregnancy such as spontaneous abortions, gestational diabetes, hypertensive disorder in pregnancy, preterm births, need of NICU care for the infants are much higher in women with PCOS.  Adult health education and the preconception diagnosis and appropriate management of PCOS is an important primary mode of prevention of these associated complications. 

P1526HOW TO DEAL WITH PREGNANCY IN DIALYSIS? A CENTER EXPERIENCE ABOUT 7 CASES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ramia BENHAMOU ◽  
Meriem Chettati ◽  
Wafaa Fadili ◽  
Inass Laouad
Keyword(s):  
Live Birth ◽  
Pregnancy Outcomes ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Fetal Outcome ◽  
The Mean ◽  
Adverse Pregnancy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Intensive Hemodialysis

Abstract Background and Aims Outcomes of pregnancy in patients with end-stage renal disease (ESRD) have long been considered to be extremely poor, and the literature concerning pregnancy while on dialysis is rather meagre. We reported our center experience about pregnancy management in patients on hemodialysis: how to deal with hypertension, ultrafiltration rate, dose dialysis in order to improve maternal and fetal outcome. Method We reported pregnancy outcomes of 7 pregnancies in the Tensift Region Pregnancy registry between March 2015 and March. 2019 The primary outcome was the live birth rate and secondary outcomes included gestational age and birth weight. Results We reported 7 pregnant women cases on hemodialysis. Mean age of our patients was 29,5 ±6,57 years. It was the first pregnancy for 3 patients (42,9%). In about half of patients dialysis was initiated during their pregnancy. The mean duration of pregnancy was 35±1,2 weeks and mean fetal weight was 1,950 ±0,353 kg. All patients were dialyzed over 20 hours per week. The mean urea value was 0,46 ±0,04g/L. Two patients needed anti hypertensive drugs (33,3%) mainly nicardipine. The live birth rate of our cohort (71,4%), all vaginal delivery, was significantly higher than the rate in the American cohort (61.4%). In your series we reported one fetal death at 28 SA explained by tocolysis failure for preterm labor. At 9 months all children had good cognitive and psychomotor involvement. Conclusion We conclude that pregnancy may be safe and feasible in women with ESRD receiving intensive hemodialysis. A multidisciplinary medical care with obstetricians is highly recommended. Despite a trend of increasing live birth rate over recent decades, pregnancies on dialysis high risk, with increased rates of adverse of adverse pregnancy outcomes including pregnancy loss.

scholarly journals ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

2017 ◽  
Vol 177 (2) ◽  
pp. R49-R58 ◽  
Author(s):  
K van der Weerd ◽  
C van Noord ◽  
M Loeve ◽  
M F C M Knapen ◽  
W Visser ◽  
...  
Keyword(s):  
Early Recognition ◽  
Case Series ◽  
Fetal Outcome ◽  
Fetal Mortality ◽  
Tertiary Referral Hospital ◽  
Common Causes ◽  
Alpha Blockade ◽  
Receptor Blockers ◽  
Dedicated Team ◽  
In Pregnancy

Pheochromocytoma in pregnancy is extremely rare. Early recognition is crucial as antepartum diagnosis can largely decrease maternal and fetal mortality rates. As symptoms of pheochromocytoma are rather similar to those of other far more common causes of hypertension during pregnancy, timely diagnosis is a challenge. In pregnant patients, similar to non-pregnant patients, increased plasma and/or 24-h urine (nor)metanephrine concentrations most reliably confirm the diagnosis of pheochromocytoma. MRI and ultrasound are the only imaging modalities that can be used safely during pregnancy to localize the tumor. During pregnancy, pretreatment consists of alpha blockade as usual. However, dosing of α-adrenergic receptor blockers during pregnancy is a challenge as hypertension must be treated while preserving adequate uteroplacental circulation. When the diagnosis is made within the first 24 weeks of pregnancy, it is generally recommended to remove the tumor in the second trimester, while resection is generally postponed till after delivery when the diagnosis is made in the third trimester and medical pretreatment is sufficient. Both during and after pregnancy, laparoscopic surgery is the preferred approach for resection of the tumor. There is no consensus in literature about the preferred route and timing of delivery. Therefore, in our opinion, decisions should be made on an individual basis by an experienced and dedicated multidisciplinary team. Over the last decades, maternal and fetal prognosis has improved considerably. Further increasing awareness of this rare diagnosis and treatment of these patients by a dedicated team in a tertiary referral hospital are critical factors for optimal maternal and fetal outcome.

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