scholarly journals Maternal and fetal outcomes in pregnant patients with lupus nephritis

2021 ◽  
Vol 9 (3) ◽  
pp. 670
Author(s):  
Duminda B. Basnayake ◽  
Abdul W. M. Wazil ◽  
Nishantha Nanayakkara ◽  
Ayesha Nayanamali ◽  
Ruwina A. Deepani ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Clinical Presentation ◽  
Fetal Loss ◽  
Kidney Injury ◽  
Fetal Outcome ◽  
Neonatal Lupus ◽  
National Hospital ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Induced Hypertension

Background: Pregnancy in a woman with lupus nephritis (LN) carries a high risk of maternal and fetal morbidity and mortality. This study aims to analyze the effect of LN on maternal and fetal outcomes and lupus activity.Methods: In a single-center, cross-sectional observational study at national hospital Kandy, 32 pregnancies in 23 women with biopsy-proven LN between 2007 and 2019 were analyzed retrospectively.Results: Mean age at pregnancy was 28.4 years (SD=4.8, range 19–38 years). In six women, LN developed during pregnancy, 17 patients were already diagnosed with LN when they became pregnant. A renal biopsy performed 4.6 (SD=3.8) years before pregnancy, showed diffuse LN in 18 (78.3%) and focal LN in 5 (21.7%) cases. At conception, most patients were in complete (43.8%) or partial (21.9%) remission. Therapeutic abortion was performed in 8 pregnancies (indications: renal flares in 5, pre-eclampsia in 3) at a mean period of amenorrhea (POA) of 16.8 weeks (range 8-28 weeks). Spontaneous fetal loss occurred in one pregnancy. Among 23 live births, there were four pre-term deliveries (<36 weeks gestation) and 19 term deliveries. In term deliveries mean birth weight was 2.62 kg (SD=0.5) and in pre-term babies, it was 1.85 kg. Sixteen caesarian sections were performed in term deliveries, three as emergencies. All the pre-term babies were delivered by emergency caesarian sections. There was no statistically significant relationship (p>0.05) between LN histological type, initial clinical presentation and treated hypertension with fetal outcome. No case of neonatal lupus or congenital heart block was noted. During pregnancy, there were five (15.6%) renal flares and two acute kidney injury cases; all were reversible. Eight patients (25%) developed PIHConclusions: Pregnancy induced hypertension is a more commonly encountered complication in pregnancies with lupus nephritis. The fetal outcome is unfavorable in pregnancies with renal flares. 

scholarly journals An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199915
Author(s):  
Haymanot Mezmur ◽  
Nega Assefa ◽  
Tadesse Alemayehu
Keyword(s):  
Pregnant Women ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
World Health ◽  
Adult Women ◽  
Sectional Study ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Adverse Fetal Outcome

Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference ( P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.

Prevalence of Eclampsia and its Maternal-fetal outcomes at Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019. Retrospective study

2020 ◽  
Author(s):  
Addisu Yeshambel ◽  
Walellign Anmut
Keyword(s):  
Magnesium Sulfate ◽  
Addis Ababa ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
Memorial Hospital ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Sub Saharan

Abstract Background: Eclamptic disorder of pregnancy is one of the common problems in sub-Saharan countries and forms one of the deadly triads along with hemorrhage and infection which complicates maternal and fetal outcomes of pregnancy. To assess the prevalence of eclampsia and its maternal and fetal outcome in Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019.Methods: A descriptive retrospective cross-sectional study was used on randomly selected 185 women who attended delivery at Ghandi memorial Hospital from 1st of September 2017 to –last of August 2018. Data were analyzed using SPSS version 25 software. Descriptive statistics were used to calculate frequencies and percentages and data was presented using texts and, tables. Results: Out of the 2,973 deliveries, the prevalence of eclampsia was found to be 16.1%. About 89.7% had reported a history of prior pregnancy-induced hypertension and 73.5% induced their current pregnancy following eclampsia. From mothers required interventions to terminate the pregnancy by induction, 47.8% ended by cesarean section secondary to non-reassuring fetal status (29.2%). The majority (91.9%) had taken magnesium sulfate for the management of convulsion and 86.5% had taken hydralazine for hypertension management. Abruption of the placenta (96.2%), postpartum-hemorrhage (89.2%), and HEELP syndrome (83.8 %) were major maternal adverse outcomes reported, and 33% of pregnancy was ended as stillbirth followed by low birth weight (28.6%). Over 53.6% of delivered babies had an APGAR score of less 4 and 30.4% of neonates required admission to nursery/NICU referral. Conclusion: The prevalence of eclampsia was high, with corresponding high maternal and perinatal morbidity and mortality. Increasing early detection before pregnancy, antenatal screening, and use of magnesium sulfate to control convulsions will reduce the disorder and associated morbidity and mortality for both mother and fetus.

Placental pathology in antiphospholipid syndrome

Lupus ◽  
1998 ◽  
Vol 7 (2_suppl) ◽  
pp. 81-85 ◽  
Author(s):  
RA Levy ◽  
E Avvad ◽  
J Oliveira ◽  
LC Porto
Keyword(s):  
Differential Diagnosis ◽  
Antiphospholipid Syndrome ◽  
Fetal Loss ◽  
Fetal Outcome ◽  
Histopathological Study ◽  
Pregnancy Induced Hypertension ◽  
Placental Pathology ◽  
Induced Hypertension ◽  
Immunohistochemical Studies ◽  
Acute Atherosis

One of the major targets of antiphospholipid antibodies (aPL) is the placenta, the evolution of which during pregnancy has been well documented. Histopathological findings are related to gestational age, and several physiologic and pathologic alterations that occur during its development. The major findings in placentae from aPL positive patients are thrombosis, acute atherosis, a decreased number of syncytio-vascular membranes, increased number of syncytial knots and obliterative arteriopathy. These findings are not specific to the antiphospholipid syndrome (APS) and sometimes do not correlate with the fetal outcome. Histopathological study of placentae may elucidate mechanisms of action of aPL in fetal loss and other obstetric complications. In addition, it may assist in the investigation of the differential diagnosis between APS and pregnancy-induced hypertension. Immunohistochemical studies of local placental proteins contribute to this differential diagnosis.

scholarly journals The Effect of Lupus Nephritis on Pregnancy Outcome and Fetal and Maternal Complications

2010 ◽  
Vol 37 (4) ◽  
pp. 754-758 ◽  
Author(s):  
DAFNA D. GLADMAN ◽  
ANU TANDON ◽  
DOMINIQUE IBAÑEZ ◽  
MURRAY B. UROWITZ
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Pregnancy Outcome ◽  
Repeated Measures ◽  
Fetal Outcome ◽  
Pregnancy Induced Hypertension ◽  
Maternal Complications ◽  
Induced Hypertension ◽  
Fetal Complications ◽  
In Pregnancy

Objective.To evaluate the effect of lupus nephritis on pregnancy with respect to fetal outcome, maternal complications, and lupus activity.Methods.All pregnancies seen between 1970 and 2003 in the Lupus Clinic were evaluated for the 3 outcomes. Renal disease was defined as the presence of nephrotic syndrome, dialysis, renal transplant, serum creatinine > 120 mmol/l, proteinuria, sterile hematuria and pyuria, or the presence of casts. Fetal complications were evaluated in pregnancies resulting in either live births or stillbirths. Generalized estimating equations were used to test for differences in outcomes between pregnancies with and without the presence of active renal disease. Repeated measures adjustments were made in the model for multiple pregnancies in the same mother.Results.There were 193 pregnancies in 104 women. Of these, 81 occurred in the presence of active renal disease during the study period, defined as 6 months prior to conception until the date of pregnancy outcome. One hundred twelve pregnancies were defined as nonrenal. No statistical difference was found in pregnancy outcome. Fetal complications were not different between the 2 groups with the exception of low birth weight and congenital malformations, which were observed more frequently in the renal group. Pregnancy-induced hypertension was more frequent in pregnancies with renal disease. Lupus flares were also more likely to occur in pregnancies with renal disease compared to those without.Conclusion.Lupus nephritis in pregnancy does not lead to worsened pregnancy or fetal outcomes. Active renal disease, however, is associated with pregnancy-induced hypertension, as well as a flare of lupus activity during pregnancy.

scholarly journals Scrub typhus in pregnancy: Maternal and fetal outcomes

2016 ◽  
Vol 9 (4) ◽  
pp. 164-166 ◽  
Author(s):  
Sudha J Rajan ◽  
Sowmya Sathyendra ◽  
Alice J Mathuram
Keyword(s):  
Intensive Care ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Fetal Loss ◽  
First Trimester ◽  
Fetal Outcome ◽  
University Teaching ◽  
Intensive Care Treatment ◽  
Fetal Outcomes ◽  
Clinical Criteria

Scrub typhus is an important unrecognized cause for undifferentiated acute febrile illness in India associated with poor fetal outcomes. Maternal and fetal outcomes among pregnant patients with scrub typhus presenting to a tertiary care university teaching hospital from January 2010 to July 2012 were studied. Scrub typhus was diagnosed by clinical criteria along with scrub ELISA positivity or an eschar. In total, 33 of 738 patients (4.5%) who were diagnosed with scrub typhus were pregnant; 57.6% were in the third trimester, 27.3% in the second, and only 15.2% in the first trimester; 69.7% required admission to intensive care. Mortality was low (3%, n = 1) compared to 12.2% mortality reported previously. All patients were treated with Azithromycin. Poor fetal outcome was observed in 51.5% of these pregnancies with fetal loss occurring in 42.4% and preterm childbirth in 9.1%. Scrub typhus complicating pregnancy is associated with a poor fetal outcome despite treatment with Azithromycin. A majority require intensive care treatment for survival.

scholarly journals Fetoplacental Weight Relationship in Normal Pregnancy and Pregnancy Complicated by Pregnancy-Induced Hypertension and Abruption of Placenta among Mothers Who Gave Birth in Southern Ethiopia, 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Tsegaye Mehare ◽  
Daniel Kebede
Keyword(s):  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Normal Group ◽  
Southern Ethiopia ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Weight Relationship ◽  
Induced Hypertension ◽  
In Pregnancy

Introduction. Placenta is a complex multifunctional organ that maintains pregnancy and promotes normal fetal development. The fetal outcome is adversely influenced by pathological changes in the placenta because it is a mirror that reflects the intrauterine status of the fetus. Placental abnormalities are considered a leading cause of maternal and prenatal mortality. This study aimed to assess the fetoplacental weight relationship in pregnancy-induced hypertension and abruption placenta and compare with the normal one. Objective. This study designed to assess fetoplacental weight relationships in normal pregnancy and pregnancy complicated by pregnancy-induced hypertension and abruption of placenta among mothers who gave birth in Dilla University Referral Hospital, southern Ethiopia, 2018. Materials and Methods. Institution-based comparative cross-sectional study was used on 50 placentas from mothers with pregnancy-induced hypertension, 50 placentas from mothers with abruption of placenta, and 50 placentas from mothers with normal pregnancy (control) with an age range of 19–34 years. The weight of the placenta and newborn were taken and the fetoplacental ratio was calculated. Results. Placental index as well as the weight of the newborn shows statistically significant (p<0.001) difference in pregnancy-induced hypertension and abruption placenta group compared with the normal group. The mean of the fetoplacental ratio in the normal group was 5.52 ± 0.07, in pregnancy-induced hypertension was 5.15 ± 0.11, whereas the abruption placenta was 4.99 ± 0.82. Conclusion. Both PIH and abruption placenta were associated with remarkable changes in the placenta index such as small placental weight and diameter and results in different kinds of congenital anomalies and low birth weight of the baby. Hence, fetoplacental ratio was altered. The lowest fetoplacental ratio was 4.99 for abruption placenta, and the highest was for a normal group of the placenta which was 5.52. Therefore, an examination of the placenta before and after birth guarantees for feto-maternal health.

scholarly journals Comparison of fetal outcome in spontaneous versus induced labor in postdated pregnancy: a study in a tertiary care centre

2018 ◽  
Vol 7 (10) ◽  
pp. 4081
Author(s):  
Nikhil Anand ◽  
Hardik Shah
Keyword(s):  
Tertiary Care ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Spontaneous Onset

Background: Pregnancy lasting beyond 40 weeks is a known complication of normal delivery. Various studies have found incidence between 2-14%. Post-dated pregnancy carries specific hazards to both mother and fetus. While mothers are faced with problems like increased incidences of induced labour, instrumental delivery and LSCS with associated morbidities, fetuses are faced with morbidities ranging from IUGR to macrosomia. Authors tried to study fetal outcome in post-dated pregnancy present study. The objective is to compare fetal outcome in spontaneous versus induced labour in post-dated pregnancy.Methods: This is a prospective cross-sectional study done at a tertiary care hospital in obstetrics and gynecology in duration of 18 months. After screening according to inclusion criteria, all patients who were admitted in labour wards are selected and two groups were created according to clinical examination. First group consists of patients with spontaneous onset of labour and second group consists of patients with induction of labour. In each group USG, NST and BPP were performed, and labor monitored according to standard partograph. Fetal outcomes in both groups were studied.Results: Fetal outcomes were nearly same in both groups, induced and spontaneous onset of labour, except a few like thick meconium which was common in spontaneous onset group while rate of LSCS was more in induced group.Conclusions: Women with uncomplicated pregnancies should be offered induction of labour, while women with any complicating factors LSCS should be considered.

scholarly journals Renal Limited Lupus-Like Nephritis

2019 ◽  
Vol 14 (1) ◽  
pp. 29-34
Author(s):  
Jumana Amir ◽  
Salwa Sheikh ◽  
Abdulrazack Amir
Keyword(s):  
Acute Kidney Injury ◽  
Lupus Nephritis ◽  
Clinical Presentation ◽  
Kidney Injury ◽  
Rare Entity ◽  
Normal Complement ◽  
Elderly Female ◽  
Good Outcome ◽  
Biopsy Diagnosis

Biopsy diagnosis of lupus nephritis with no extra-renal features of SLE, normal complement levels, negative or weekly positive ANA and negative other serology is a rare entity known as “Renal Limited Lupus Like Nephritis”. So far, only 10 cases of RLLLN in adults have been reported in literature. The prognosis of these patients varied depending on their clinical presentation. Herein, we report a case of an elderly female with RLLLN who presented with massive proteinuria and acute kidney injury with crescents, however had a good outcome contrary to reported cases with similar presentations. We also reviewed all reported cases thus far.

scholarly journals Fetal Outcome in Premature Rupture of Membrane - A Study Done in the Tertiary Level Specialized Hospital in Bangladesh

2014 ◽  
Vol 3 (1) ◽  
pp. 25-28
Author(s):  
Sanchita Adhikary ◽  
Shaorin Tanira ◽  
Arifa Sultana ◽  
Feroza Wazed ◽  
Saleha Begum Chowdhury
Keyword(s):  
Birth Weight ◽  
Apgar Score ◽  
Fetal Loss ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Premature Rupture ◽  
Birth Process ◽  
Cross Sectional ◽  
Medical University

A descriptive cross-sectional study was done in the Department of Obstetrics and Gynaecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from February to July of 2008, on 50 pregnant women with more than 28 weeks of pregnancy both primigravid and multigravid with rupture of membranes prior to labor, to find out the effect of premature rupture of membrane on fetal outcome. 48 live births were observed and there were 2 fetal loss. Among those newborns, 28 (58.33%) were male and 20 (41.66%) were female. 54.16% of babies had APGAR score at 5 minutes after birth was >7 and those needed no treatment. APGAR score was 7 in 45.82% babies; all of them were treated and cured. Among the newborns, 52.08% babies had birth weight > 2500 gm, 45.83% had their birth weight in between 1500 and 2500 gm, while 1 (2.08%) was between 1000 and 1500 gm. However, 22 (45.83%) were affected by the consequences of PROM and birth process. Among them, 36.36% developed jaundice, 29.27% suffered from birth asphyxia, and RTI and neonatal sepsis were evident in 18.18% each. 15% babies were treated conservatively and 7% babies were treated in the neonatal ward being admitted into it. There was no neonatal loss. CBMJ 2014 January: Vol. 03 No. 01 P: 25-28

scholarly journals Histomorphometric Variations of the Placenta in Normal and Hypertensive Pregnancies

2020 ◽  
Vol 9 (4) ◽  
pp. 242-248
Author(s):  
Rizwan Ali Talpur ◽  
Samia Siddiqui ◽  
Sehar Khowaja ◽  
Naila Noor ◽  
Muhammad Saqib Baloch ◽  
...  
Keyword(s):  
Weight Ratio ◽  
Study Groups ◽  
Fetal Outcome ◽  
Control Group ◽  
P Value ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Histological Changes ◽  
Gynecology And Obstetrics ◽  
Induced Hypertension

Background: Pregnancy-induced hypertension is a leading cause of deleterious changes in the placenta resulting in decreased blood supply towards the placenta. The objective of the current study was to analyze the histo-morphometric variations in the placenta of women with or without known pregnancy-induced hypertension. Methods: Cross-sectional study was carried out in the Gynecology and obstetrics section of Nazeer Hussain Medical Complex, Hyderabad in collaboration with Isra University, Hyderabad from March 2019 to August 2019. A total of 100 placentae were selected and divided into two groups (control and study groups) based on the presence or absence of hypertension in pregnancy. The observations of the control group placenta were compared with the study group placentas. All placentae were observed for morphometric and histological changes. SPSS ver. 22 was used to analyze the collected data. Results: There was an increase in the mean weight of placentae among the control group as compared to the group having known hypertension cases and the difference was statistically significant (p-value <0.05). The fetoplacental weight ratio was increased among the hypertension group when compared to the statistically insignificant control group (p-value <0.05). Various gross (infarction, calcification) and histological changes (hyalinised villi, intervillous hemorrhage, decreased villous vascularity) were observed in the placentae of the hypertensive group as compared to the normal group. Conclusion: The findings of the study concluded that Preeclampsia/PIH poses harmful and serious histo-morphometric variations in the placental tissues that affect fetal outcome.

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