scholarly journals Ultrasound evaluation of pregnancies with oligohydramnios in third trimester and their feto-maternal outcome at tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3292
Author(s):  
Awdhut Tiparse ◽  
Bhumika Kalathiya ◽  
Preeti Bajaj
Keyword(s):  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Third Trimester ◽  
Amniotic Fluid Index ◽  
Exclusion Criteria ◽  
Ultrasound Evaluation ◽  
Increased Risk ◽  
Group Rate ◽  
Nicu Admission

Background: Oligohydramnios presents a threat to the fetus due to increased risk of the umbilical cord getting compressed and resulting in impaired blood flow to the fetus. The objective of the study was to find out the significance of oligohydramnios during third trimester of pregnancy.Methods: A hospital based prospective study was conducted in the Department of Radiodiagnosis and Obstetrics and Gynaecology, Sir T. Hospital, Bhavnagar. Amniotic fluid index (AFI) estimation was done on 60 pregnant women in third trimester, who were selected after screening for inclusion and exclusion criteria. Women with AFI < 5 cm were taken as cases while women with AFI > 5 cm as controls.Results: Maximum number of the patients were belonging to 20-25-year age group in normal AFI, oligohydramnios and borderline oligohydramnios group. Incidence of malpresentation was significantly higher in oligohydramnios (20%), borderline oligohydramnios (17.5%). In oligohydramnios common, etiological factors were PIH (27.5%), idiopathic factor (27.5%), postdatism (12.5%) and IUGR (7.5%), while borderline oligohydramnios group is commonly associated with idiopathic factors (52.5%) followed by PIH (17.5%). Incidence of caesarean section was significantly higher in oligohydramnios group (67.5%) than normal AFI (18%). In borderline oligohydramnios group rate is significantly higher (45%) than normal AFI, but it is less as compared to oligohydramnios.Conclusions: Identification of oligohydramnios can be done by a good clinical examination and confirmed by measuring AFI on ultrasonography. Poor fetal outcome in the form of preterm, IUD, LBW, low APGAR score at 5 minute and increased chances of still birth, NICU admission and neonatal death are seen with oligohydramnios in third trimester and more so if it is detected in early third trimester. Chances of induction of labour and risk of LSCS also increase. Thus, detection of oligohydramnios helps in proper management of the cases so that maternal and perinatal outcome can be improved.

scholarly journals Incidence of umbilical cord around the neck and its effects on mode of delivery and fetal outcome at tertiary care hospital

2021 ◽  
Author(s):  
S. Nandhini ◽  
C. R. Anuradha ◽  
S. Renuka ◽  
K. Vijayalakshmi ◽  
R. Sailatha
Keyword(s):  
Umbilical Cord ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Fetal Membranes ◽  
Control Group ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Nuchal Cord

Background: Umbilical cord is one of the fetal membranes. It is developed from the yolk sac. Umbilical cord is tubular structure. Approximate length of the cord is 50 cm. Umbilical cord around the neck is called as the nuchal cord. The aim of the study is to find out the incidence of umbilical cord around the neck at the time of delivery and its fetal outcomes.Methods: It is a retrospective observational study. This study was conducted in the department of obstetrics and gynecology at a tertiary care hospital over a period of 6 months (Feb-Jul 2020). Out of 542 patients, 388 were enrolled in this study after the inclusion and exclusion criteria, of which 101 were delivered with umbilical cord and the remaining were 287 patients in control group.Results: Present study showed 38.4% incidence of umbilical cord at the time of delivery. Incidence is more among the primigravida and it is statistically significant. Both intrapartum and postpartum risks are not related to umbilical cord around the neck. Mean length of the cord in patients delivered with cord around the neck is more when compared to the control group and has significant p value.Conclusions: This study concludes that the presence of umbilical cord, alone is not an indication for caesarean section. Umbilical cord with 3 loops was associated with increased operative delivery and low Apgar score, proper intrapartum surveillance and portogram leads to good fetal outcome.

scholarly journals Oligohydramnios at third trimester and perinatal outcome

1970 ◽  
Vol 11 (1) ◽  
pp. 33-36 ◽  
Author(s):  
N Nazlima ◽  
B Fatima
Keyword(s):  
Heart Rate ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
P Value ◽  
Third Trimester ◽  
Amniotic Fluid Index ◽  
Increased Risk ◽  
Nicu Admission

Objectives: The purpose of this study to assess the effect of oligohydramnios on perinatal outcome especially at third trimester of pregnancy. Methods: This prospective and observational study was conducted in a private specialized hospital at Dhaka city from January to December 2009. In this study 78 singleton pregnant females with gestational age from 28 - 42 weeks with less amniotic fluid index (AFI) were analyzed for perinatal outcome. Data were expressed as number (percentage). Proportion test was performed for comparison between two groups , P value <0.05 was taken as level of significance. Results:Women with oligohydramnios were significantly associated with an abnormal antepartum fetal heart rate (FHR), meconium stained fluid, Apgar score less than 7 or NICU admission. Also subjects with AFI of 5.0 cm or less had a higher rate of cesarean section for fetal distress. Conclusions: Antepartum oligohydramnios is associated with an increased risk of fetal heart rate abnormalities. Although in our population it is not predictive of adverse perinatal outcome as measured by low apgar score and NICU admission, yet this may be reflective of the aggressive antepartum and intrapartum management that these patients received. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9820 BJMS 2012; 11(1): 33-36

scholarly journals A STUDY OF THIRD TRIMESTER OLIGOHYDRAMINOS AND ITS MATERNALAND FETAL OUTCOME

2020 ◽  
pp. 1-2
Author(s):  
Saila Khatri ◽  
Megha S. Patel ◽  
Pankti Jaiswal ◽  
Prakruti Patel
Keyword(s):  
Congenital Anomaly ◽  
Apgar Score ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Third Trimester ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increase Rate ◽  
Nicu Admission

Background: Oligohydramnios is defined as amniotic fluid index <5cm sonographically.5 Various complications to fetus like meconium stained liquor, IUGR, cord around neck, fetal distress, congenital anomaly, low birth weight, low Apgar score which leads to increase NICU admissions are seen. Increase rate of caeserian section compared to vaginal birth exposes mother to further operation related complications.6,7 Methodology: A cross sectional study was carried out among 124 patients who presented with oligohydraminos and got admitted in obstetric ward. Result: Oligohydraminos seen more in gestational age from 36.1 to 42 weeks(51%) and less from 28.1 to 32 weeks(15%). 62% AFI is between 3-5cm and 38% <3cm. Complications like meconium stained liquor(19%), IUGR(18%), cord around neck(15%), fetal distress(21%) also checked in form of low Apgar score (23%),congenital anomaly(4%), NICU admission(62%), increased rate of LSCS(76%) than vaginal delivery(24%) seen.

scholarly journals A study of pregnancy specific dermatoses and their effect on the outcome of pregnancy

2017 ◽  
Vol 3 (2) ◽  
pp. 182
Author(s):  
Anju S. Nair ◽  
George Kurien ◽  
V. G. Binesh
Keyword(s):  
Gestational Diabetes ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Third Trimester ◽  
Skin Conditions ◽  
Kerala State ◽  
Twin Pregnancies ◽  
Adverse Fetal Outcome

<p class="abstract"><strong>Background:</strong> Pregnancy being a complex state, the interactions of multiple factors result in a number of cutaneous findings that can be separated into physiologic changes, pre-existing dermatoses that can be aggravated or improved during pregnancy and dermatoses that are specific to pregnancy. Dermatoses specific to pregnancy are important to recognise because they may be pruritic or painful to the mother and may pose significant risk to mother, her fetus or both. Early identification of the condition may go a long way in preventing morbidity and mortality<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Antenatal women attending dermatology outpatient for dermatologic problems or referred from Obstetrics and Gynaecology, department for skin conditions in a tertiary care hospital in Kottayam, Kerala state were taken up for the study. Pregnancy related dermatoses or physiologic changes due to pregnancy if present were noted. The patients were followed up till delivery and the pregnancy outcome recorded. The results were analyzed using SPSS.<strong></strong></p><p class="abstract"><strong>Results:</strong> 94.3% of the patients had physiological changes, hyperpigmentation being the commonest. Specific pregnancy dermatoses were present in 38.3%. 94% of pregnancy dermatoses occurred during third trimester. The most common specific dermatoses observed was pruritic urticarial papules and plaques of pregnancy (PUPPP)-63.6%. It is more common in primi gravida (30/42), in   twin pregnancies, in mothers of babies with more birth weight, male babies and those with gestational diabetes mellitus. None of the specific dermatoses produced adverse fetal outcome<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Pregnancy dermatoses usually manifest in the third trimester. PUPPP is the commonest pregnancy dermatosis. PUPPP is more common among mothers with increased body weight, gestational diabetes, in twin pregnancy and in mothers with male babies. Most of the common pregnancy dermatoses have no adverse effect on the fetus<span lang="EN-IN">.</span></p>

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

2018 ◽  
Vol 7 (11) ◽  
pp. 4706
Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Perinatal Complications ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

scholarly journals Predictors of Disseminated Intravascular Coagulation in Patients with Septic Shock

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Diana J. Kelm ◽  
Juan Carlos Valerio-Rojas ◽  
Javier Cabello-Garza ◽  
Ognjen Gajic ◽  
Rodrigo Cartin-Ceba
Keyword(s):  
Septic Shock ◽  
Antiplatelet Therapy ◽  
Disseminated Intravascular Coagulation ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Intravascular Coagulation ◽  
Early Goal Directed Therapy ◽  
Increased Risk

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, P<0.001). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC (P<0.001). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC (P<0.001). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.

scholarly journals Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Simi Fayaz Ghaffar
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Creative Commons ◽  
Increased Risk ◽  
Mortality Ratio ◽  
Public Health Challenge

Background and Objective: Maternal death measurement is essential to a country’s wellbeing and development status. In emerging countries like Pakistan, it remains an intimidating and failed public health challenge. Objectives of our audit were to estimate trends and causes of maternal demise in Lady Reading Hospital, Peshawar, Pakistan. Methods: Between January 2013 to December 2017, a retrospective study was carried out at Medical Teaching Institute, Lady Reading Hospital, Peshawar. A structured proforma was used to collect data from the medical records. To detect trends in mother demise maternal mortality ratio was calculated for each year and for all five years, Spss version 23 was used for data analysis. Results: In the five-year periods 134 deaths were recorded. The maternal mortality during the study period was 431/100,000 live births. An unstable trend in mortality with two crowning periods in 2013 and 2017 was observed. Hemorrhage persisted as the foremost cause of maternal death over the five years period, accounting for 47.76% deaths followed by hypertension, accounting for 25.37% deaths. An increased risk of 35.08% was observed among women aged 25-29 years, followed by 26.11% in 20-24 years and 23.88% in >30 years. Conclusion: There is a decreasing trend of maternal death from 2013 to 2016 but a slight increase was noted in 2017. Hemorrhage was the top cause responsible for the maternal death. doi: https://doi.org/10.12669/pjms.35.4.1091 How to cite this:Rafiq S, Syed W, Ghaffar SF. Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1091 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

2020 ◽  
Vol 8 (1) ◽  
pp. 35
Author(s):  
Hetal N. Jeeyani ◽  
Rutvik H. Parikh ◽  
Sheena Sivanandan ◽  
Harsh J. Muliya ◽  
Shivam N. Badiyani ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
Prescribing Indicators ◽  
Inappropriate Use ◽  
Increased Risk ◽  
The Mean

Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

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