scholarly journals Umbilical cord coiling index as a marker of perinatal outcome

2021 ◽  
Vol 8 (3) ◽  
pp. 323-327
Author(s):  
Pragati Jain ◽  
Monika Aggarwal ◽  
Meenu V Ahuja ◽  
Surbhi Gupta
Keyword(s):  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Ponderal Index ◽  
Amniotic Fluid Index ◽  
Meconium Staining ◽  
Nicu Admission ◽  
In Pregnancy

The umbilical cord is very important for the well-being and survival of the fetus, however this is susceptible to compressions, kinking, traction and torsion which may influence the perinatal outcome and an abnormal umbilical coiling index has been related to adverse fetal and pregnancy outcomes. To determine the umbilical cord coiling index (UCI) and compare its association with perinatal outcome in normal and complicated pregnancies.It was a prospective observational study done on 200 patients at term (after 37 weeks) pregnancy, delivered either vaginally or by cesarean section. The umbilical cord coiling index was calculated. The mean coiling index of our study was 0.256+0.07 per cm. The outcomes measured were maternal age, parity, body mass index, hypertension in pregnancy, diabetes in pregnancy, amniotic fluid index, meconium staining of liquor, neonatal birth weight, Apgar score at birth, ponderal index, NICU admission. The coils were then divided into three categories on the basis of UCI and their association with the maternal and fetal outcomes were analyzed. Hypocoiled cords were those having UCI less than 10th centile, and hypercoiled cords those having UCI more than 90th centile. Statistical analysis was done by chi square test, Fishers exact test and the t test where applicable. Hypocoiled cords (UCI <10th centile) were associated with pregnancy induced hypertension (PIH), diabetes mellitus, meconium staining of liquor, low Apgar score, growth restricted fetus and NICU admission. Hypercoiled cords were associated with liquor abnormalities and low ponderal index. Abnormal umbilical cord coiling index was associated with adverse perinatal outcomes.

scholarly journals Obstetric Cholestasis: Comparison of Maternal and Perinatal Outcome of Ursodeoxycholic Acid versus Placebo

2020 ◽  
pp. 28-33
Author(s):  
Faiza Safdar ◽  
Shabana Kalsoom ◽  
Noreen Majeed ◽  
Khair-un Nisa ◽  
Shazia Rafique ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Parallel Group ◽  
Acid 500Mg ◽  
Serum Transaminases ◽  
Meconium Staining ◽  
Nicu Admission

Objectives: Objective: To compare the maternal and perinatal outcomes of ursodeoxycholic acid with placebo in obstetric cholestasis. Method: It was an open randomized parallel-group study with convenient sampling, conducted at Pakistan ordinance factories hospital (POF Hospital) Wah Cantt, from 1st June 2016-30th May 2019. Patients with obstetric cholestasis of pregnancy, diagnosed between 24-34 weeks of gestation, were randomized to receive either ursodeoxycholic acid 500mg twice daily or placebo one capsule twice daily for 4 weeks. The data was collected on a pre-designed proforma. The data of 84 patients, who full fill the inclusion criteria were analyzed using SPSS vs 19. Maternal outcomes measured were a relief in pruritus and a decrease in hepatic alanine aminotransferase levels (ALT) at the end of 2 weeks and 4 weeks of treatment. The mode of delivery was noted. Fetal outcomes measured were meconium staining of amniotic fluid and the need for neonatal intensive care unit (NICU) admission. Results: The results showed significant improvement in maternal itch score (P=0.001) and serum transaminases level (p=0.001) in patients using UDCA as compared to placebo. Although there were less number of caesarean sections (p=0.36), meconium-stained liquor (p=0.29) and NICU admissions (P=0.33) in the UDCA group the differences were not statistically significant. Conclusion: Treatment with UDCA in obstetric cholestasis improved maternal complaint of itching and decreased raised transaminases levels but did not affect significantly the mode of delivery, incidence of meconium-stained liquor and NICU admissions. Keywords: Obstetric cholestasis, Ursodeoxycholic acid, perinatal outcome, Pruritus.

Perinatal outcome associated with oligohydramnios in term pregnancies

2018 ◽  
Vol 1 (01) ◽  
pp. 25-30
Author(s):  
Deepa Chudal ◽  
Keshang Diki Bista ◽  
Neelam Pradhan
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Well Being ◽  
Fetal Outcome ◽  
University Teaching ◽  
Amniotic Fluid Index ◽  
Prelabor Rupture Of Membranes

Introduction: Amniotic fluid is a complex substance essential to fetal well-beingand dynamic milieu that changes as pregnancy progresses andsurrounds developing fetus providing an ideal environment for normal fetal growth and development. Amniotic fluid volume is fetal well being which varies with gestational age and depends on a dynamic interaction between placenta, fetus and maternal components. Methods: This was a hospital based descriptive study conducted at Tribhuvan University Teaching Hospital, from 14th April 2013 to 13th April 2014(2070) which consisted of singleton, term (37-42weeks) pregnancies admitted with ultrasonographicfinding of Amniotic Fluid Index≤ 5 with delivery within one week of ultrasonographicfinding. A prefixed questionnaire was used to fill maternal and fetal outcome parameters like age, parity, period of gestation, Amniotic Fluid Index, associated maternal conditions, mode of delivery, indication of Cesarean section, color of liquor and perinatal outcomes. Results: Total 115 cases of oligohydramnioswere noted accounting for an incidence of 2.4%. 92 women were term, giving incidence of term oligohydramnios to be 2%. Out of 92 cases, 77(83.6%) underwent emergency caesarean section and 15 (16.3%) were delivered vaginally. Low birth weight of < 2.5 kg was noted in 14 (15.2%) babies and meconium stained liquor was present in 12 (13%) of oligohydramnios cases. APGAR score of < 7 at 1 minute and 5 minute was seen in 13 (14.13%) and 3 (3.26%) cases respectively. . Among 92 cases, 44 (47.8%) were associated with Prelabor Rupture of Membranes followed by post dated pregnancies and Intrauterine Growth Retardation accounting for 12 (13.1%) cases in each group Conclusion: Prelabor Rupture of Membranes was  most common cause of term oligohydramnios resulting in high risk of caesarean delivery in oligohydramnios cases. Cesarean Section for oligohydramnios has been associated with good perinatal outcome.

scholarly journals Relationship between Amniotic Fluid Index and Perinatal Outcome

2015 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
S Pradhan ◽  
A Adhikary ◽  
P Pradhan ◽  
S Pradhan
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Fetal Distress ◽  
Amniotic Fluid Index ◽  
Significant Difference ◽  
Low Birth Weight Babies ◽  
Meconium Staining

Aims:  This study was done to evaluate the predictive value of low amniotic fluid index (AFI) of < 5 cm for adverse perinatal outcome in term of caesarean section for fetal distress, birth weight, meconium stained liquor and APGAR scores. Methods: This was a prospective study of 200 antenatal women booked at Nepal Medical College Teaching Hospital during the year 2013-2014 with gestational age between 34 and 41 weeks. Patients history and clinical examination were recorded and AFI was measured and the perinatal outcome was compared between two groups i.e AFI <5 cm and >5 cm. Results: The caesarean section (C/S) rate for fetal distress and low birth weight babies (<2.5 kg) was higher in patients with low AFI (p=0.048, 0.001 respectively). There was no significant difference in meconium staining, APGAR score at 5 minutes between the two groups (p=0.881, 0.884 respectively). Conclusions: Caesarean section for fetal distress and low birth weight babies was significantly associated with low amniotic fluid index. There was no significant difference in meconium staining liquor, APGAR score at 5 minutes between the two groups.  

scholarly journals Comparative Study of Nonstress Test and Fetal Acoustic Stimulation Test in Assessment of Fetal Well-being

2011 ◽  
Vol 3 (1) ◽  
pp. 6-9
Author(s):  
Zakia Arshad ◽  
Imam Bano ◽  
Nasreen Noor ◽  
Lata Motwani
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Fetal Distress ◽  
Well Being ◽  
Acoustic Stimulation ◽  
Stimulation Test ◽  
Operative Interference ◽  
Meconium Staining

ABSTRACT Objectives To compare and evaluate the role of nonstress test and acoustic stimulation test on the perinatal outcome. Materials and methods Around 100 patients above 34 weeks of gestation were selected and subjected to nonstress test (NST) and acoustic stimulation test (AST) on weekly basis to find whether fetus is reactive or nonreactive, and followed till delivery to find out the perinatal outcome. Results When comparison of reactive NST and reactive AST was done, the incidence of meconium staining was 8 (9%) and 9 (9.6%), clinical fetal distress 16 (18.8%) and 18 (19.3%), operative interference for fetal distress 17 (19.3%) and 20 (21.5%), low Apgar score at 5 minutes 1 (1.1%) and 1 (1%), neonatal deaths 3 (3.3%) and 3 (3.2%), low birth weight 27 (30.6%) and 29 (31.1%), and NICU admission 13 (14.7%) and 13 (13.9%) respectively. While the incidence of meconium staining was 4 (33.3%) and 3 (42.8%), clincal fetal distress 8 (66.6%) and 6 (85.7%), operative interference 6 (50%) and 3 (42.8%), low Apgar score at 5 minutes 3 (25%) and 3 (42.8%), neonatal death 4 (33.3%) and 4 (57.1%), low birth weight 7 (58.3%) and 5 (71.4%) respectively in nonreactive NST and nonreactive AST groups.

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 Perinatal outcome in pregnant females at term having low amniotic fluid index.

2021 ◽  
Vol 28 (09) ◽  
pp. 1358-1364
Author(s):  
Nadia Sharif ◽  
Ayesha Qasim
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Multiple Pregnancy ◽  
Amniotic Fluid Index ◽  
Pregnant Females ◽  
Case Series Study ◽  
Nicu Admission

Objectives: To determine the frequency of perinatal outcome in pregnant females at term having low amniotic fluid index. Study Design: Descriptive, Case Series study. Setting: Department of Obstetrics & Gynecology, Independent University Hospital, Faisalabad. Period: 1st October 2019 to 31st March 2020. Materials & Methods: A total of 90 women having singleton pregnancy with cephalic presentation having 37-40 weeks of gestation with AFI <8cm, 20 to 35 years of age were included. Patients with multiple pregnancy, ruptured membrane, fetal anomaly, gestational diabetes and Rh Incompatibility were excluded. Cesarean delivery, meconium stained liquor, low birth weight, NICU admission and APGAR score <7 at 5 min were assessed by consultant gynecologist. Results: Age range in this study was from 20 to 35 years with mean age of 28.92 + 4.45 years. Majority of the patients 43 (47.77%) were between 31 to 35 years of age. Mean gestational age was 38.31 + 1.20 weeks. Mean parity was 2.72 + 1.02. In this study, frequency of perinatal outcome in pregnant females at term having low amniotic fluid index was as follows; cesarean section was performed in 60 (66.67%), low birth weight was observed in 58 (64.44%) patients, APGAR score <7 at 5 minutes in 56 (62.22%), meconium stained liquor in 24 (26.67%) and NICU admission in 17 (18.89%) patients. Conclusion: This study concluded that proper antenatal monitoring and management should be done in these high risk patients in order to reduce the morbidity and mortality of the fetus.

scholarly journals PREDICTION OF SHORT-TERM PERINATAL OUTCOME IN OLIGOHYDRAMNIOS AT TERMROLE OF UMBILICAL CORD ARTERIAL BLOOD LACTATE LEVELS

2021 ◽  
Vol 71 (3) ◽  
pp. 966-70
Author(s):  
Amera Tariq ◽  
Afeera Afsheen ◽  
Bushra Iftikhar ◽  
Rabiah Anwar ◽  
Rizwana Bashir Kiani ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Umbilical Cord ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Delivery Mode ◽  
Amniotic Fluid Index ◽  
Arterial Blood ◽  
Low Weight ◽  
Meconium Staining ◽  
Lactate Levels

Objective: Investigating the perinatal outcome in pregnant patients with oligohydramnios at term. Study Design: Prospective observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pakistan Naval Ship (PNS) Shifa Hospital Karachi, from Mar to Oct 2020. Methodology: The investigation comprised of 60 parturient ladies with gestational amenorrhoea of 37-42 weeks and no associated medical illnesses. Collection A consisted of 30 patients with maximum vertical pocket (MVP) <2cm or amniotic fluid index (AFI) ≤5cm. Collection B involved 30 pregnant women having normal amniotic fluid index >5cm. The 2 collections were tallied with respect to demographic characteristics and perinatal outcome particularly low birth weight, delivery mode, poor APGAR score, umbilical artery acidosis and meconium staining. Neonatal future stands upon evaluation of levels of lactate found in umbilical cord arterial blood. Results: According to our findings, commonest mode of childbirth 37 (61.7%) was Caesarean section. No statistical difference was found between the two aggregations of low weight at birth i.e. 4 (13.3%). Based on our study, meconium staining at birth was prevalent in 8 (13.3%) of neonates however no meconium aspiration was seen, umbilical artery acidosis was apparent in 27 (45%) and only 5 (8.3%) accounted for poor APGAR scores. Conclusion: Detrimental pregnancy aftermath and elevated perinatal morbidity correlates with oligohydramnios.

scholarly journals Doppler Cerebroplacental Ratio and Adverse Perinatal Outcome

2014 ◽  
Vol 6 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Anita Singh ◽  
Shaheen LNU ◽  
Imam Bano ◽  
Ibne Ahmad
Keyword(s):  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Predictive Values ◽  
Adverse Perinatal Outcome ◽  
Cerebroplacental Ratio ◽  
Adverse Perinatal Outcomes ◽  
Meconium Staining ◽  
Nicu Admission

ABSTRACT Objective This study was done to assess the Doppler cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome especially in growth restricted pregnancies. Materials and methods In this study, 62 antenatal women were subjected to Doppler studies at 34 to 42 weeks of gestations. CPR was calculated and less than 1 was taken as predictor of adverse perinatal outcome. Adverse perinatal outcomes was evaluated by mode of delivery, meconium staining, 1 and 5-minute Apgar scores, birth weight, admission to NICU and other neonatal complications. Results Of 62 antenatal women, with an abnormal CPR had higher incidence of meconium, clinical fetal distress, operative delivery, low Apgar score (5 mins), NICU admission and neonatal death, 42.88, 47.62, 26.57, 76.19, 66.17 and 66.67% respectively as compared to women with normal CPR who had 4.88, 2.88, 2.88. 2.88, 12.19, 17.07 and 0% respectively. With the use of an abnormal CPR, the sensitivity, specificity, and positive and negative predictive values for predicting an adverse outcome were 62, 80, 62 and 80%, respectively, with an odds ratio (95% confidence interval). Conclusion An abnormal CPR is associated with adverse perinatal outcomes, especially in growth-restricted fetuses. How to cite this article Shaheen S, Bano I, Ahmad I, Singh A. Doppler Cerebroplacental Ratio and Adverse Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(1):25-27.

scholarly journals Study of perinatal outcomes in normal and borderline oligamnios

2019 ◽  
Vol 9 (1) ◽  
pp. 279
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Amniotic Fluid Index ◽  
Meconium Staining

Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.

Evaluation of Perinatal Outcome Using Individualized Growth Assessment: Comparison With Conventional Methods

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 36-42
Author(s):  
Yasuhide Ariyuki ◽  
Toshiyuki Hata ◽  
Manabu Kitao
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Perinatal Outcomes ◽  
Ponderal Index ◽  
Maternal Complications ◽  
Birth Characteristics ◽  
Meconium Staining ◽  
Growth Assessment

Objective. To evaluate individualized growth assessment using the Rossavik growth model for detection of growth-retarded neonates with poor perinatal outcomes. Methods. Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 154 singleton neonates. Individual fetal growth curve standards for head and abdominal circumference and weight were determined from the data of two scans obtained before 25 weeks' menstrual age and separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index and the Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes (mechanical delivery, low Apgar score, abnormal fetal heart rate [FHR] patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit admission, and maternal complications), using NGAS, were compared with those by the traditional birth weight-for-gestational age method and the ponderal index, respectively. Results. Of the 154 fetuses studied, 120 had normal growth outcomes at birth; 18 showed evidence of intrauterine growth retardation; and 16 had macrosomia, based on NGAS. According to birth weight-for-gestational age classification, 32 fetuses were small for gestational age; 118 were appropriate for gestational age; and only 4 were large for gestational age. According to the ponderal index, 55 fetuses had growth retardation, 99 showed appropriate growth and there was no macrosomia. There was a significant increase in mechanical deliveries in cases of growth-retarded neonates, determined using the NGAS classification, when compared with events related to normally grown or macrosomic neonates. However, there were no significant differences in mechanical deliveries among the groups by birth weight classification or ponderal index. Both birth weight classification and NGAS classification showed a significant increase in the low Apgar score, abnormal FHR patterns, and neonatal acidosis in infants classified as growth retarded when compared with appropriately grown or macrosomic infants. However, there were no significant differences in the low Apgar score, abnormal FHR patterns, and neonatal acidosis between growth-retarded and appropriately grown infants when they had been so classified by ponderal index. Three growth category classification methods failed to reveal significant differences in meconium staining of amniotic fluid, neonatal intensive care unit admission, and maternal complications among the groups. Conclusion. We do cast doubt on the usefulness of the ponderal index for detection of growth-retarded neonates with poor perinatal outcomes, and individualized growth assessment seems to perform at least as well as the traditional birth weight-for-gestational age method.

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