scholarly journals A study of bacteriological profile and outcome of babies born to mother with Premature rupture of membrane and its correlation with blood and gastric culture

2019 ◽  
Vol 6 (6) ◽  
pp. 2654
Author(s):  
Milind B. Kamble ◽  
Ramchandra Nagargoje ◽  
Sagar G. Chopde
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Specific Treatment ◽  
Active Management ◽  
Care Hospital ◽  
Membrane Rupture ◽  
Early Onset Sepsis ◽  
History Of

Background: PROM, a condition that occurs when fetal membranes are ruptured at least one hour before onset of labor. While PROM is observed in 10% of all pregnancies, 60-80% of PROM is observed in term and 20-40% in pregnancies less than 37th gestational week. PROM is the most significant reason for preterm labor. The three causes of neonatal death associated with PROM are prematurity, sepsis and pulmonary hypoplasia. Infants born with sepsis have a mortality rate four times higher than those without sepsis. Objective of the study was correlation of blood and gastric culture positive sepsis in PROM newborns. It helps to find out the incidence of PROM in our locality.Methods: This retrospective study enrolled 90 neonates born to healthy mothers with history of PROM more than 18 hours duration, admitted in SNCU/ward at a tertiary care hospital for six months duration from 1st January 2017 to 30 June 2017. Clinical profile of these Newborn with history of PROM was noted such as birth weight, gender, gestation, duration of membrane rupture, history of maternal fever. For all newborns with PROM, sepsis screen had been sent. The neonatal outcome was also recorded, and the data was collected and analyzed by using frequency and percentages.Results: Gram negative bacilli were the commonest cause of neonatal sepsis and male neonates were more prone to infection. PROM and low birth weight especially, ELBW and VLBW are the common high-risk factors for early onset sepsis. Most common organisms isolated in blood and gastric culture were Klebsiella and Staphylococcus aureus respectively.Conclusions: PROM is a high-risk obstetric condition. Active management is needed to enable delivery within 24 hours of PROM as it offers better neonatal outcome. Morbidity and mortality increase as the duration of PROM increases. This can be reduced by early diagnosis, specific treatment and strict infection control practices in neonatal units.

scholarly journals A study of the prevalence of gestational diabetes mellitus and its maternal and fetal outcomes in a tertiary care hospital

2017 ◽  
Vol 6 (9) ◽  
pp. 4011 ◽  
Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.

scholarly journals Active versus expectant management of preterm premature rupture of membrane before 34 weeks and neonatal outcome

2021 ◽  
Vol 8 (3) ◽  
pp. 501
Author(s):  
Gouda A. P. Kartikeswar ◽  
Dhyey I. Pandya ◽  
Siddharth Madabhushi ◽  
Vivek M. Joshi ◽  
Sandeep Kadam
Keyword(s):  
Gestational Age ◽  
Neonatal Outcome ◽  
Tertiary Care ◽  
Expectant Management ◽  
Active Management ◽  
Respiratory Support ◽  
Care Hospital ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference

Background: Preterm premature rupture of membranes (PPROM) predisposes the mother for chorioamnionitis, endometritis, bacteremia and neonate to preterm delivery related complication. There is often dilemma regarding the management of PPROM in mothers with gestational age (GA) <34 weeks.Methods: A retrospective cohort study conducted in a tertiary care hospital over two year period. Neonates delivered before 34 weeks were enrolled and categorized into active management (AM) and expectant management (EM) group. Associated risk factors, duration of PPROM and latency period, Neonatal outcomes like sepsis, morbidity, duration of respiratory support, duration of NICU stay compared between groups.Results: Out of total 197 cases, AM group had 91 babies. Active management resulted in earlier delivery [mean GA (SD): 30.88(1.8) VS 31(2.1) weeks], higher number of caesarian section (76.9% versus 53.8%), lesser birth weight {1233.6 (±282.9) versus 1453.39 (±380.6) gm} and more ELBW babies (23.1% versus 7.5%). EM resulted in significantly higher antenatal steroid cover (73.6% in AM versus 89.6% in EM) and lesser need of surfactant for RDS [42.9% versus 28.3%]. Significant difference was found for NICU stay days {mean (SD): 25.46 (16.8) versus 20.94 (17.5)}. No difference found between respiratory support days [median (IQR) 2 (0, 6) versus 2 (0, 7)]. No significant differences found in incidence of maternal chorioamnionitis, NEC, sepsis, BPD and ROP. Early delivery resulted in higher mortality though that was statistically not significant.Conclusions: Gestational age at delivery is more important predictor of neonatal outcome then PPROM in early preterm. 

scholarly journals Profile of neonatal dermatoses in a tertiary care teaching hospital of Haryana

2018 ◽  
Vol 6 (3) ◽  
pp. 955
Author(s):  
Poonam Marwah ◽  
Ashish Marwah ◽  
Sunil Kumar ◽  
Rajesh Kumar
Keyword(s):  
Birth Weight ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Normal Vaginal Delivery ◽  
Care Hospital ◽  
Age Group ◽  
Common Skin ◽  
History Of ◽  
Recorded Data

Background: To assess the incidence and profile of neonatal dermatoses in a tertiary care hospital of Haryana and study its association with various perinatal risk factors.Methods: All inborn neonates (<28 days of life) including those seen in the outpatient department on follow up between November 2016 to April 2017 formed the baseline population and babies with skin lesions were included in the study. A detailed perinatal history and newborn examination of the baby was done by a pediatrician and all relevant details were recorded. Data was analyzed, and inferences were drawn using tables.Results: In our study, a total of 2760 newborn (1506 (54.6%) males and 1254 (45.4%) females) were studied. The incidence of neonatal dermatoses was found to be 94.1%. There were 1849 (66.9%) term, 853 (30.9%) preterm, and 58 (2.1%) post term neonates. 1901 (68.8%) had birth weight >2.5kg while 859 (31.1%) had birth weight ≤2.5kg. 1223 (44.3%) were born to primipara while 1537 (55.6%) were born to multipara mothers. Mothers of 54 (1.9%) neonates were < 20 years of age; 1157 (41.9%) in the age group of 20-25 years; 1324 (47.9%) in the age group of 25-30 years and 225 (8.1%) in the age group >30 years. 1806 (65.4%) neonates were born by normal vaginal delivery and 954 (34.6%) neonates were born by cesarean section. In 13 (0.5%) neonates, history of consanguinity was present while it was absent in 2747 (99.5%) neonates. Most common skin lesions observed were transient skin lesions among which Mongolian spots (62.9%), epstein pearls (48.8%), erythema toxicum (41.8%), milia (40.6%) and miniature puberty (35.9%) were the most common.Conclusions: Incidence of neonatal dermatoses was found to be higher (54.6%) among males as compared to females (45.4%); among term babies; those with birth weight >2.5kg; those born to multipara mothers; those born via normal vaginal delivery and those with maternal age 25-30 years.

scholarly journals A study of risk score assessment in antenatal women and their neonatal outcome in a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 212-219
Author(s):  
Amit Kumar ◽  
P. Sindhusha ◽  
P.J.N. Satyavathi ◽  
N. Pragnasai ◽  
P. Deepika ◽  
...  
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Neonatal Outcome ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Group ◽  
Risk Category ◽  
Study Group ◽  
Care Hospital ◽  
Maternal Complications

A high-risk pregnancy is any condition associated with a pregnancy where there is an actual or potential risk to the mother or fetus. Risk assessment is a key component of antenatal care (ANC) and has demonstrated benefits in improving maternal and perinatal outcomes. To assess maternal complications that occurs in antenatal women and their neonatal outcomes in a tertiary care hospital.200 antenatal women, admitted to obstetrics & gynaecology department from 16-09-2020 to 15-03-2021 were evaluated. Antenatal women with maternal complications (Gestational hypertension, preeclampsia, Gestational diabetes, Hypothyroid, Anaemia, Asthma and oligohydramnios) were taken into study group and women with no complications were taken into control group. The risk factors were assessed and risk scores were determined by Dutta and Das scoring system and Hobel risk scoring system. It was found that there was a significant association between poor neonatal outcome and high-risk pregnancies. The incidence of preterm births is higher in the study group (34.1%) when compared with the control group (13.7%). Mode of delivery was predominantly by caesarean section in the study group (p&#60;0.005). Neonatal complications were significantly more (p&#60;0.05) in study group and fetal distress was exclusively seen in the study group (p&#60;0.0005). Maternal complications such as eclampsia correlated significantly with the risk score (p=0.005). Neonatal outcomes such as Low birth weight (p&#60;0.0001) were higher in the high-risk category when compared to the low risk and moderate risk category. There was a significant correlation between high-risk antenatal and poor neonatal outcome. Scoring systems, such as the one used in our study, can be adopted at primary and rural health centres even by a non-medical counsellor as a screening tool to predict pregnancies at high risk for poor neonatal outcome, thereby facilitating early referral of these women to tertiary care centres.

scholarly journals TO ASSESS THE MATERNAL ANAEMIA, INTRA-UTERIAN GROWTH RESTRICTION AND NEONATAL OUTCOME IN TERTIARY CARE HOSPITAL, BIHAR

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Rashmi Kumari ◽  
Usha Kumari ◽  
Krishna Sinha
Keyword(s):  
Birth Weight ◽  
Neonatal Outcome ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Growth Restriction ◽  
Care Hospital ◽  
Maternal Anaemia ◽  
Medical College ◽  
Adverse Neonatal Outcomes

Aim: To assess the maternal anaemia, intra-uterian growth restriction and neonatal outcome. Materials and methods: a prospective, observational study conducted in Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar India. A total of 240 consecutive clinically suspected cases of IUGR with singleton pregnancies at 34-40 weeks of gestation were included in the study.  Their socio-demographic profile and hemoglobin levels were recorded. A descriptive analysis of the data was performed. Results: Of 240 study subjects with IUGR at 34-40 weeks, 70.4% were anaemic, (48.8% had mild, 20.8% had moderate, 0.83 % had severe anaemia) while 29.6% were not anaemic. Significantly, the ratio of anaemic to non anaemic in antenatal IUGR pregnancies was 2.48:1. A birth weight of less than 2.5 kgs was recorded in 84% of pregnancies with moderate anaemia and 83.8% pregnancies with mild anaemia. Out of the 240 clinically diagnosed cases of IUGR 71.25% (n=171) were from the rural background and 28.75% (n=69) were urban area. Conclusion:  Mild to severe anaemia in IUGR may increase the chances of low birth weight and adverse neonatal outcomes but larger studies with standardized definitions and measurements of exposure outcomes to bring about uniformity are required to determine an accurate assessment of association between low maternal hemoglobin and IUGR

Maternal and Fetal Outcome of Preterm Prelabor Rupture of the Membranes in a Tertiary Care Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 1-9
Author(s):  
Mst Rokeya Khatun ◽  
Nasrin Akter ◽  
Md Nowshad Ali
Keyword(s):  
Birth Weight ◽  
Antenatal Care ◽  
Gestational Age ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Membrane Rupture ◽  
Co Morbidity ◽  
The Mean

Objective: To describe the clinical presentation and feto-maternal outcome of preterm prelabor rupture of the membrane of patients admitted in a tertiary care hospital of Bangladesh. Methods and Material: This is a cross-sectional observational type study carried out in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the year 2019 in the Department of Obstetrics and Gynecology. Sixty pregnant women with preterm prelabor rupture of the membrane (gestational age 28 to 37 weeks) were included in this study. Results: The mean age of the women was 27.03±6.13 years. Forty (66.7%) of them were from rural area. Majority were studied up to primary school (33.30%). Sixty five percent were house wife. Thirty seven (61.7%) women were multi gravid. Mean gestational age of the patient was 34.43±2.75 weeks. Antenatal care of the women was low. Most of the women have associated one or more diseases like anemia (35%), Urinary tract infection (28.33%), Pregnancy induced hypertension (20%), Lower genital infection (13.33 %,), gestational diabetes mellitus (10%) and heart disease (3.33%). The mean time interval between membrane rupture and delivery was 29±9 hours. Thirty one patients (51.7%) were delivered by caesarian section. Twenty eight (46.7%) women did not experience any complication and other suffered from wound infection (20%), PPH (10%), puerperal sepsis (8.33%) and chorioamnionitis (11.7%). Mean birth weight of the newborns was 2.16±0.42 Kg. Thirty eight (63.33%) newborn suffered from complications like neonatal asphyxia (30%), respiratory distress syndrome (13.3%), neonatal jaundice (11.7%) and neonatal sepsis (3.3%). Neonatal death was noticed in three (5%) cases. Fetal outcome was found significantly (p< 0.001) associated with low gestational age. Conclusion: Women with low education, associated co-morbidity, long latency and neonate with low birth weight have unfavorable outcome. Antenatal care is an important tool to prevent preterm prelabor rupture of the membrane by identifying the risk factors and its management. Optimum obstetric and medical care is essential for the reduction of these devastating complications. TAJ 2020; 33(2): 1-9

scholarly journals Prevention of Diabetic Foot Ulcer in High Risk Patient: The Role of Internist in Providing Adequate Foot Care

2021 ◽  
Author(s):  
Ida Ayu Kshanti ◽  
Nanang Soebijanto ◽  
Nadya Magfira ◽  
Marina Epriliawati ◽  
Jerry Nasarudin ◽  
...  
Keyword(s):  
High Risk ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetes Duration ◽  
Care Practice ◽  
Care Hospital ◽  
Foot Care ◽  
History Of

ABSTRACTBackground and aimThe awareness and practice of diabetes foot prevention by internist through routine examination and patient education remains less than optimal. This study aimed to evaluate the quality of care of internist in performing foot care in high-risk patients.MethodsA cross sectional study was conducted in a tertiary care hospital in Jakarta, Indonesia. Type 2 diabetes mellitus subjects with high-risk foot complication were included in this study. Each subject filled-in a questionnaire investigating whether they had received information about proper foot care practice and whether they have ever had their feet examined by an internist at their present consultation. Multivariate logistic regression were performed.Results368 patients were recruited, 130 of them (35.3%) treated by endocrinologists. 71.20% patients did not received any information on foot care and 54.08% patients did not received any foot examination. Foot care information was 1.6 times more frequently provided to patient with longer diabetes duration and 2 times more frequently provided to those who had history of diabetic foot ulcer. Meanwhile, foot examination was 1.5 times more frequently provided to those with longer diabetes duration and had a history of Lower Extremity Amputation. Compare to non-endocrinologist internist, endocrinologists tend to provide foot education and perform foot examination 2.2 to 2.5 times more frequently than non-endocrinologists.ConclusionMost of patients with high risk foot problems were not offered adequate foot care. It is necessary to develop strategies to improve the care and awareness among health professionals treating patients with diabetes especially internist.

Does Placental Weight Affects Perinatal Outcome? A Prospective Case-control Study

2020 ◽  
Vol 16 (1) ◽  
pp. 52-59
Author(s):  
Naina Kumar ◽  
Himani Agarwal
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Perinatal Outcome ◽  
Case Control Study ◽  
Neonatal Outcome ◽  
Case Control ◽  
Placental Weight ◽  
Tertiary Center ◽  
Control Study ◽  
Prospective Case Control Study

Background: Placenta plays a very important role in the growth and development of fetus. Objective: To know the correlation between placental weight and perinatal outcome in term antenatal women. Methods: Present prospective case-control study was conducted in the rural tertiary center of Northern India over one year (January-December 2018) on 1,118 term (≥37-≤42 weeks) antenatal women with singleton pregnancy fulfilling inclusion criteria with 559 women with high-risk pregnancy as cases and 559 low-risk pregnant women as controls. Placental weight, birth weight was measured immediately after delivery and compared between the two groups along with gestation, parity, fetal gender, and neonatal outcome. Statistical analysis was done using SPSS 22 version. Results: Mean placental weight [481.98±67.83 gm vs. 499.47±59.59 gm (p=.000)] and birth weight [2.68±0.53 Kg vs. 2.88±0.4 Kg (p=.000)] was significantly lower in high risk as compared to lowrisk participants, whereas placental birth weight ratio was higher in high-risk cases [18.35±2.37 vs. 17.41±1.38 (p=.000)] respectively. Placental weight was positively correlated with birth weight and placental weight and birth weight increased with increasing gestation in both cases and controls. Male neonates had higher placental weight [492.74±68.24 gm vs. 488±58.8 gm (p=0.224)] and birth weight [2.81±0.5 Kg vs. 2.74±0.45 Kg (p=0.033)] as compared to females. Neonatal Intensive Care Unit admission was significantly associated with low placental and birth weight (p=.000). Conclusion: There is a significant correlation between placental weight, birth weight and neonatal outcome, hence placental weight can be used as an indirect indicator of intrauterine fetal growth.

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