scholarly journals To evaluate the tests of antepartum fetal surveillance for predicting adverse perinatal outcome in pregnancy with IUGR

2021 ◽  
Vol 8 (2) ◽  
pp. 235-239
Author(s):  
Mahesh Babu ◽  
Bhavya H U ◽  
Shyam Sundar S
Keyword(s):  
Doppler Ultrasound ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Amniotic Fluid Index ◽  
Tertiary Care Centre ◽  
Adverse Perinatal Outcome ◽  
Biophysical Profile ◽  
Fetal Surveillance ◽  
Sensitivity Specificity ◽  
In Pregnancy

IUGR is one of the most common pregnancy complications which substantially increase risk of adverse neonatal outcome. The sequelae of IUGR include stillbirth, neuro-developmental delay in childhood and high risk of diseases like hypertension, diabetes in adulthood. Therefore, IUGR in pregnancy warrants intensive antepartum fetal surveillance to ensure optimal perinatal outcome.To evaluate the tests of antepartum fetal surveillance like AFI, BPS and Doppler ultrasound, alone and in combination for predicting adverse perinatal outcome in pregnancy with IUGR.This was a prospective observational study done on 100 pregnant IUGR women > 34weeks of gestation, at a tertiary care centre in Karnataka, from June 2017 till December 2018. They were monitored by tests of fetal surveillance like Amniotic Fluid Index (AFI), Bio Physical score (BPS) and Doppler ultrasound. Tests done within 48 hours before labour and its relation to perinatal outcome were assessed. Continuous data such as age, height, weight were described by mean and standard deviation. The sensitivity specificity, positive and negative predictive value were calculated for each test.The statistical difference between the normal and abnormal tests of antepartum fetal surveillance in relation to perinatal outcome was significant. Diagnostic accuracy of Doppler was 67%, BPS and AFI was 69%. In case of combination of findings of BPS and Doppler, the accuracy rose to 75%.Biophysical profile was most reliable diagnostic method than Doppler in predicting adverse outcome. Sensitivity increased when BPS and Doppler was combined which is beneficial in predicting perinatal outcome.

scholarly journals Perinatal outcome associated with oligohydramnios at term

2020 ◽  
Vol 9 (9) ◽  
pp. 3576
Author(s):  
Nikita Gandotra ◽  
Neha Mahajan ◽  
Aakriti Manhas
Keyword(s):  
Birth Weight ◽  
Prospective Study ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Common Complication ◽  
Amniotic Fluid Index ◽  
Fetal Surveillance ◽  
A Prospective Study ◽  
In Pregnancy

Background: Oligohydramnios is a severe and common complication of pregnancy and its incidence is reported to be around 1 to 5% of total pregnancies. The aim of this study was to perinatal outcome of oligohydramnios (AFI <5) at term.Methods: A prospective study was conducted in which 200 patients at term with oligohydramnios AFI <5 cm with intact membranes were analyzed for perinatal outcome.Results: There were increased chances of FHR decelerations, thick meconium, increased LSCS, low Apgar score at 5 minutes, birth weight <2.5 kg, admission to NICU in pregnancy with oligohydramnios.Conclusions: An amniotic fluid index (AFI) of <5 cm detected after 37 completed weeks of gestation is an indicator of poor perinatal outcome. Determination of AFI can be used as an adjunct to other fetal surveillance methods that helps to identify those infants at risk of poor perinatal outcome.

scholarly journals Perinatal outcome in pregnancy complicated with oligohydramnios at term

2018 ◽  
Vol 7 (10) ◽  
pp. 3936 ◽  
Author(s):  
Abhijeet Kumar ◽  
P. S. Rao ◽  
Sanjeev Kumar ◽  
Binay Mitra
Keyword(s):  
Perinatal Outcome ◽  
Fetal Distress ◽  
Acoustic Stimulation ◽  
Labour Induction ◽  
Chi Square ◽  
Adverse Perinatal Outcome ◽  
Significant Difference ◽  
Fetal Wellbeing ◽  
Sensitivity Specificity ◽  
In Pregnancy

Background: Oligohydramnios is defined as AFI of less or equal to five cm. Various methods like NST, acoustic stimulation, and fetal Doppler velocimetry are helpful in assessment of fetal wellbeing and identifying those pregnancies at risk of adverse perinatal outcome. This study was undertaken to know the adverse perinatal outcome in pregnant women with oligohydramnios at term and to evaluate the value of AFI in predicting the subsequent fetal dis-tress and caesarean delivery.Methods: Analysis of pregnancy outcome in 50 cases with diagnosis of oligohydramnios by USG after 37 completed weeks of gestation compared with 50 controls with no oligohydramnios and matched for other variables. There were some inclusion and exclusion criteria used. The results were statistically analysed using parameters like mean, standard deviation and chi square test sensitivity, specificity, PPV, NPV were used.Results: There was significant difference between two groups in occurrence of non-reactive and re-active NST pattern. There is increased incidence of labour induction in women with AFI ≤5cm as compared with women with AFI >5cm. Increased occurrence of LBW (≤2.5kg) in women with oligohydraminos and increased LSCS rates in pregnancy complicated by oligohydramnios were observed.Conclusions: An AFI of ≤ 5cm detected after 37 weeks of gestation is an indicator of adverse perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. AFI is a valuable screening test for predicting fetal distress in labour requiring caesarean section.

scholarly journals The role of modified biophysical profile in predicting perinatal outcome in high risk pregnancies

2018 ◽  
Vol 7 (6) ◽  
pp. 2287
Author(s):  
Jankidevi S. Borade ◽  
Sushma P. Sharma
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Stress Test ◽  
Neonatal Resuscitation ◽  
Amniotic Fluid Index ◽  
Biophysical Profile ◽  
Fetal Surveillance ◽  
The Impact

Background: The goal of antepartum fetal surveillance is early identification of the compromised fetus and timely intervention when the fetus is at risk, but still in an uncompromised state. Modified Biophysical Profile (MBPP) includes Amniotic Fluid Index (AFI) and non stress test (NST). AFI is a marker of long term placental function and NST is a marker of short term fetal condition. The aim of this study is to assess the role of Modified Biophysical Profile in high risk pregnancies and assess perinatal outcome and to study the impact of NST and AFI individually in high risk pregnancies.Methods: 100 ANC patients with high risk factors were evaluated with modified biophysical profile 37 week onwards with non stress test (NST) for 20 mins and amniotic fluid index (AFI) with 4 quadrant technique. High risk pregnancies include preeclampsia, IUGR, oligohydramnios, postdated pregnancy, etc. and various parameters were assessed to determine perinatal and maternal morbidity. All parameters were statistically analyzed.Results: The above study states that need for LSCS, intrapartum fetal distress, meconium stained liquor, APGAR score, need for neonatal resuscitation and perinatal morbidity were definitely higher in cases with abnormal MBPP.Conclusions: Thus MBPP is an easy, cost effective and time saving measure and hence can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.

scholarly journals Significance of obstetric Doppler studies in prediction of perinatal outcome in pregnancy induced hypertension

2017 ◽  
Vol 6 (6) ◽  
pp. 2354 ◽  
Author(s):  
Pradip R. Gaikwad ◽  
Manisha R. Gandhewar ◽  
Nity Rose ◽  
Vidyadhar Suryakar
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Pregnancy Induced Hypertension ◽  
Doppler Studies ◽  
Uterine Artery Doppler ◽  
Adverse Perinatal Outcome ◽  
Induced Hypertension

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel color Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler studies in PIH and to analyse its role in predicting perinatal outcome.Methods: This was a prospective study of 106 singleton pregnancies in the third trimester with PIH. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study specificity and diagnostic accuracy of all Doppler ultrasound parameters was high in predicting adverse perinatal outcome. Cerebroplacental ratio showed highest specificity (98.55%), PPV (94.44%) and diagnostic accuracy (80.19%) in predicting adverse perinatal outcome and it is better than MCA PI and UA PI alone. Uterine artery Doppler evaluation also gives additional information in predicting adverse perinatal outcome.Conclusions: Amongst various Doppler parameters cerebroplacental index (MCA/UA PI) is best predictor of adverse perinatal outcome.

H1N1 in Pregnancy: A Tertiary Care Centre Experience

2011 ◽  
Vol 33 (7) ◽  
pp. 698-704 ◽  
Author(s):  
Ann Kinga Malinowski ◽  
Allison McGeer ◽  
Julie Robertson ◽  
Mathew Sermer ◽  
Dan Farine ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
In Pregnancy

scholarly journals Modified biophysical profile in antepartum fetal surveillance of high risk pregnancies

2017 ◽  
Vol 6 (5) ◽  
pp. 1854
Author(s):  
K. P. Sowmya ◽  
S. R. Mudanur ◽  
Padmasri R. ◽  
Lalitha S.
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Stress Test ◽  
Fluid Volume ◽  
Prospective Clinical Study ◽  
Amniotic Fluid Volume ◽  
Risk Pregnancy ◽  
Biophysical Profile ◽  
Fetal Surveillance

Background: Fetal biophysical profile is a well-established method of antepartum surveillance in high risk pregnancy. Classical biophysical profile with all parameters (fetal breathing movements, fetal tone, fetal gross body movements, amniotic fluid volume and non-stress test) needs two phase testing by ultrasound and external Doppler monitor to record fetal heart rate, is more cumbersome, time consuming and expensive.Methods: This study was a prospective clinical study which consisted of 70 patients having pregnancy with high risk factors. The patients were evaluated with the modified biophysical profile consisting of NST recording for 20mins, followed ultrasound assessment of amniotic fluid volume, using four quadrant technique.Results: When the Modified biophysical profile is normal, it gives reassurance that the fetal status is good with good perinatal outcome. When the MBPP is abnormal there is increased incidence of perinatal morbidity as well as mortality.Conclusions: Modified biophysical profile is an effective primary antepartum fetal surveillance test in high risk pregnancies in predicting perinatal outcome.

scholarly journals High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan

2019 ◽  
Vol 36 (ICON-Suppl) ◽  
Author(s):  
Aisha Syed Wali ◽  
Raheela Rafique ◽  
Sundus Iftikhar ◽  
Rakhshinda Ambreen ◽  
Mohammad Yawar Yakoob
Keyword(s):  
Diabetes Mellitus ◽  
Early Detection ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Family History Of Diabetes ◽  
Overt Diabetes ◽  
Missed Opportunity ◽  
In Pregnancy

Objectives: To determine the frequency of diabetes in pregnancy (DIP), namely pre-gestational, gestational (GDM) and overt diabetes mellitus (DM) in women registered for delivery. Methods: A retrospective chart review of antenatal women registered between January 01 to August 31, 2017 was performed. Gestational age, diagnosis of DIP, glucose levels at diagnosis and other relevant data was extracted. The effect of various fasting blood glucose (FBG) thresholds for diagnosis of DIP was assessed. Results: DIP was diagnosed in 21.8% women (pre-gestational: 2%, GDM: 81.2%, overt DM: 16.8%). In early registrants, 30.2% were detected through screening. However, 55.3% of women registered late. Women with pre-gestational DM were older, had more miscarriages, and greater personal and family history of diabetes versus GDM and overt DM. Raising the diagnostic threshold of FBG from 92 mg/dl to 95 mg/dl missed three women (0.1%) and to 105 mg/dl, missed six women (0.2%). Conclusion: We observed a high proportion of overt DM. In early registrants, almost one third of DIP was diagnosed in the first half of pregnancy, an opportunity missed in late registrants. Altering diagnostic thresholds of DIP affected only a small proportion of women. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723 How to cite this:Wali AS, Rafique R, Iftikhar S, Ambreen R, Yakoob MY. High proportion of overt diabetes mellitus in pregnancy and missed opportunity for early detection of diabetes at a tertiary care centre in Pakistan. Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S38-S43. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1723 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.

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