scholarly journals Neonatal and maternal outcome in oligohydramnios: a prospective study

2018 ◽  
Vol 5 (4) ◽  
pp. 1409
Author(s):  
Rizwan Ahmar ◽  
Sadia Parween ◽  
Smita Kumari ◽  
Manish Kumar
Keyword(s):  
Maternal Morbidity ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Operative Morbidity ◽  
Increased Risk ◽  
A Prospective Study

Background: Oligohydramnios presents a threat to the fetus and has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores and congenital abnormities. It is associated with perinatal morbidity and mortality and maternal morbidity in a significant number of cases. Therefore, early detection of oligohydramnios and its management is important. Aim of this study was to know the fetal and maternal outcome in oligohydramnios.Methods: 90 patients in third trimester of pregnancy with Oligohydramnios were selected after satisfying inclusion and exclusion criteria. A detailed history and examination were done. All required investigation done. Oligohydramnios confirmed by measuring Amniotic fluid index (AFI).Results: Mean maternal age-26.1 years. Incidence of oligohydramnios was more in primipara (64.4%) in our study. And operative morbidity was also more in primipara (51.7%). Most common cause of Oligohydramnios was idiopathic (44.44%). Operative morbidity was significantly higher in Non-reassuring FHR (80%) than reassuring FHR (32%). 7 patients (7.78%) were found with fetoplacental insufficiency on Doppler study.Conclusions: Oligohydramnios is frequent occurrence and demands intensive fetal surveillance and proper antepartum and intrapartum care so that perinatal morbidity and mortality and maternal morbidity can be reduced.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

scholarly journals A study on maternal and perinatal outcome in premature rupture of membranes at term

2017 ◽  
Vol 6 (12) ◽  
pp. 5368 ◽  
Author(s):  
Sailaja Surayapalem ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Salicheemala
Keyword(s):  
Gestational Age ◽  
Maternal Morbidity ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Well Being ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture

Background: Premature rupture of membranes is defined as rupture of foetal membranes before the onset of labour. Management of cases of PROM still remains as one of the most difficult and controversial problems in obstetrics. PROM can cause maternal complications like chorioamnionitis, increased operative procedures, puerperal sepsis and neonatal morbidity and mortality. The present study is undertaken to study the labour outcome, maternal morbidity and perinatal morbidity and mortality in term PROM.Methods: 200 Cases of spontaneous rupture of membranes with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. Parameters of maternal and foetal well being were recorded. All study groups received prophylactic antibiotics. Single pelvic examination done, and maternal vitals recorded fourth hourly. All the data was analyzed and statistical significance was calculated using Chi-square test.Results: PROM was common in age group of 20-24 years (35%) with mean age of 22.6 years and SD of 2.8 years, and common in primigravida. Majority of women were admitted within six hours of PROM (41.5%) and Mean duration of induction to delivery interval was 12.9 hours. The mean duration between PROM to delivery was 20.2 hours which was statistically significant. Cesarean sections were more among primigravidas. Failure to progress was the common indication. Maternal morbidity was significant (17.5%). No maternal mortality in the study. Perinatal mortality was 1.5%. Birth asphyxia was the commonest cause. Perinatal morbidity was seen in 26%. Escherichia coli was common organism found in cervical swab culture.Conclusions: In present study, majority was primigravidas and the most common age group was 20-24 years belonging to low socioeconomic status. Maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery and infection of the female genital tract with pathogens. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy.

scholarly journals Preterm premature rupture of membranes: maternal and perinatal outcome

2018 ◽  
Vol 7 (11) ◽  
pp. 4499
Author(s):  
Shweta Avinash Khade ◽  
Amarjeet Kaur Bava
Keyword(s):  
Maternal Morbidity ◽  
Care Center ◽  
Tertiary Care ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Singleton Pregnancy ◽  
Preterm Premature Rupture

Background: This is an observational analytical study carried out in department of obstetrics and Gynecology, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis and complications in preterm premature rupture of membrane cases.Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 2837 weeks gestation with singleton pregnancy, from 1st March 2013 to 28th February 2014. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.Results: In this study maternal morbidity was 16%. Perinatal morbidity was 33% and most common causes were hyperbilirubinemia (23%), RDS (21%).  Perinatal mortality was seen in 15% and mainly due to RDS (53%). Twenty-five (25%) neonates were delivered by cesarean. The main indications for cesarean being malpresentation (36%) followed by fetal distress (24%).Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.

scholarly journals Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

2018 ◽  
Vol 7 (11) ◽  
pp. 4604
Author(s):  
Mahantappa A. Chiniwar ◽  
Joe Kaushik M. ◽  
Sharada B. Menasinkai
Keyword(s):  
Amniotic Fluid ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Research Centre ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Chi Square

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

scholarly journals Influence of the Human Development Index on the Maternal–Perinatal Morbidity and Mortality of Pregnant Women with SARS-CoV-2 Infection: Importance for Personalized Medical Care

2021 ◽  
Vol 10 (16) ◽  
pp. 3631
Author(s):  
Yolanda Cuñarro-López ◽  
Santiago García-Tizón Larroca ◽  
Pilar Pintado-Recarte ◽  
Concepción Hernández-Martín ◽  
Pilar Prats-Rodríguez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Human Development ◽  
Human Development Index ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Country Of Origin ◽  
Morbidity And Mortality ◽  
Inverse Association ◽  
Perinatal Morbidity ◽  
Development Index

Coronavirus disease-19 (COVID-19) is perhaps the most worrisome pandemic in the 21st century, having entailed devastating consequences for the whole society during the last year. Different studies have displayed an existing association between pregnancy and COVID-19 severity due to the various physiological changes that occur during gestation. Recent data identified maternal country of origin as an important determinant of COVID-19 presentation in pregnant women. However, the explanation of this fact remains to be fully elucidated. Therefore, the purpose of this work is to analyze the possible relationship between Human Development Index (HDI) of maternal country of origin with the morbimortality of pregnant women and their newborns. Here, we conducted a multicentric, ambispective, observational case-control study (1:1 ratio) and compare with the HDI of each country (group 1—very high HDI, group 2—high HDI, group 3—medium HDI, and group 4—low HDI). In total, 1347 pregnant women with confirmed SARV-CoV-2 infection (cases) were enrolled, and each was paired with one control to give a total number of 2694 participants from 81 tertiary care centers. Among the women with SARS-CoV-2 infection, more cases were produced of perinatal mortality, overall maternal morbidity, COVID-19 maternal morbidity, C-sections, hypertensive maternal morbidity, and perinatal morbidity. Our results described an inverse association between HDI and maternofetal morbidity and mortality. Moreover, the countries with an HDI lower than 1 showed higher rates of patients with maternal COVID-19-related morbidity (6.0% vs. 2.4%, p < 0.001), a need for oxygen therapy (4.7% vs. 1.8%, p < 0.001), and maternal ICU admission (2.6% vs. 1.0%, p = 0.007). Compared to other risk factors such as overweight, obesity, preexisting and obstetric comorbidities, HDI emerged as an independent risk factor explaining much of the increased maternal–perinatal morbidity and mortality detected in our group of cases. Further research is needed to establish to confirm the real impact of this factor and its components on pregnancy outcomes.

Prolonged pregnancy

2020 ◽  
pp. 389-394
Author(s):  
Kate F. Walker ◽  
Jim G. Thornton
Keyword(s):  
Caesarean Section ◽  
Pregnancy Loss ◽  
Expectant Management ◽  
Induction Of Labour ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Increased Risk ◽  
Oxytocin Infusion ◽  
Prolonged Pregnancy ◽  
Overall Risk

Prolongation of gestation beyond 42+0 weeks (or 294 days) affects about 6% of pregnancies. It is associated with an increased risk of perinatal morbidity and mortality; the overall risk of pregnancy loss (stillbirth plus death occurring up to the age of 1 year) increases eightfold between 37 weeks and 43 weeks. Since trials comparing induction of labour with expectant management suggest that induction does not increase the rate of caesarean section, many clinicians offer it for pregnancies beyond 41 weeks. Induction of labour is usually performed using prostaglandin ripening followed, if necessary, by amniotomy and oxytocin infusion.

scholarly journals Study of amniotic fluid index and its pregnancy outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4727
Author(s):  
Manisha M. Parmar ◽  
Sandeep M. Parmar
Keyword(s):  
Amniotic Fluid ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Well Being ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Neonatal Deaths ◽  
Still Births ◽  
Tertiary Teaching ◽  
Nicu Admission

Background: Amniotic fluid is vital to the well-being of the fetus. Severe oligohydramnios and polyhydramnios are associated with increased maternal morbidity and perinatal morbidity and mortality.Methods: This was prospective observational study conducted at tertiary teaching institute from July 2012 to July 2013. Total 200 patients were included in the study. On the basis of amniotic fluid index (AFI), patients were categorized in 3 groups, Normal AFI (8-24 cm), oligohydramnios (AFI <5cm) and polyhydramnios (AFI > = 25 cm). Results were analysed in the form of incidence, mode of delivery and perinatal outcome which includes preterm, low birth weight, still births, NICU admissions and neonatal deaths in all the 3 groups.Results: Out of 200 patients, there was 150 cases of normal AFI, 39 cases of oligohydramnios and 11 cases of polyhydramnios. Incidence of oligohydramnios was 4.1% and polyhydramnios was 1.1%. PIH was the most common etiological factor found in oligohydramnios (30.7%) and in polyhydramnios congenital anomalies (36.3%) followed by idiopathic cause (27.2%) was most common. Incidence of caesarean section was 58.9% in oligohydarmnios and 17.3% in normal AFI group. Incidence of NICU admission was 25.6% in oligohydramnios and 50% in polyhydramnios group in comparison to 9.3% in normal AFI group.Conclusions: Amniotic fluid index is an important part of antepartum fetal surveillance. Abnormalities of AFI are associated with high perinatal morbidity and mortality and maternal morbidity.

scholarly journals Serum beta hCG in early second trimester as a predictor of gestational hypertension

2018 ◽  
Vol 7 (6) ◽  
pp. 2355
Author(s):  
Aparna Rajesh ◽  
Vandana Muralidharan
Keyword(s):  
Gestational Hypertension ◽  
Screening Tests ◽  
Perinatal Morbidity ◽  
Singleton Pregnancy ◽  
Beta Hcg ◽  
Medical Academy ◽  
Increased Risk ◽  
Β Hcg ◽  
A Prospective Study

Background: Hypertensive disorders of pregnancy complicate upto 10% of pregnancies worldwide, and constitute one of the greatest causes of maternal and perinatal morbidity and mortality. The goal of this study is to evaluate the serum beta hCG levels in pregnant women as a predictor of gestational hypertension.Methods: This is a prospective study done at K. S. Hegde Medical Academy during the month of November 2015 to January 2017. Serum beta hCG was estimated between 14-20 weeks of gestation in 90 women with singleton pregnancy irrespective of parity. Regular follow up of the cases were done till delivery. Results were analysed statistically.Results: Out of 90 women, 81 women were followed till term and 12 (14.8%) cases developed gestational hypertension. β HCG levels (Mean±SD) were higher (69808.66±54764.7 vs. 38126.49±97419.2; p<0.28) in subjects who developed gestational hypertension. Serum beta hCG (median >32726 mIU/ml) has a sensitivity of 75%, specificity of 72.5% and accuracy of 72.8%.Conclusions: Our study indicate an increased risk of gestational hypertension in women with elevated levels of serum beta hCG. As yet there are no practically acceptable and reliable screening tests for gestational hypertension, serum beta hCG seems to be good noninvasive early predictor for the development of gestational hypertension.

scholarly journals Study of maternal and perinatal outcome in abruptio placentae

2020 ◽  
Vol 9 (5) ◽  
pp. 1882
Author(s):  
Krupa Patel ◽  
Jaydeep Bhatu ◽  
Swati Patel
Keyword(s):  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Abruptio Placentae ◽  
Medical Facilities ◽  
Maternal Morbidity And Mortality ◽  
Future Management

Background: Abruptio placentae is very frequently seen in our population. Few studies have reported maternal and fetal morbidity and mortality associated with this condition. No work has been done on abruptio placentae in our setup. The data generated will help to improve maternal and fetal morbidity and mortality by planning prompt management of future cases of placental abruption. Objective of this study was to study possible etiological factors of abruptio placentae, analyse maternal outcome, perinatal outcome in the form of maternal morbidity and mortality and discuss possible preventive measures and future management optionMethods: The retrospective observational study it was included all cases presenting with ante partum haemorrhage during the study period. Subjects selected for the study were all cases diagnosed as having abruptio placentae. All other causes of APH like placenta previa and other extraplacental causes were excluded.Results: In the present study incidence of abruptio placentae is higher in 25-30 year that were 42.5% and more in 2nd gravida patient. PIH was accounting for 50%, most of the patients (95%) were anaemic at admission and majority of them required blood transfusion.one maternal mortality (2.5%) occurred, perinatal mortality was 75%.Conclusions: Abruptio placentae serious condition with manifestation of significant maternal and perinatal morbidity and mortality. Complications can be reduced by provisional antenatal care to every woman and with improvement in medical facilities, availability of blood transfusion, proper management of shock. With liberalization of caesarean section, the rate of maternal morbidity and mortality is gradually on the decline.

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