scholarly journals Relationship of the Findings of Colour Doppler and Non-Stress Test with the Perinatal Outcome among the Cases of Intra-Uterine Growth Restriction

2016 ◽  
Vol 3 (2) ◽  
pp. 115
Author(s):  
Anand R. Tambat ◽  
Ankita Chauhan

<strong>Introduction:</strong> Intrauterine growth restriction is the second most common cause of perinatal mortality and morbidity after prematurity. Etiologies can be maternal, fetal or placental. The correct detection of compromised IUGR fetus to allow timely intervention is a main objective of antenatal care. Many of IUGR patients presents in their third trimester for the first time for antenatal examination. Such patients warrant a highly sensitive and specific diagnostic test which can be noninvasively applied on a large scale. Apart from various other non-invasive tests like USG, NST, Doppler flow studies give us vital information regarding the fetus in utero. Hence the present study is aimed at exploring the association of colour Doppler and non-stress test findings with the perinatal outcome in the fetuses with IUGR. <strong>Aim:</strong> To study relationship of Doppler and NST with perinatal outcome in IUGR cases. <strong>Material and Methods:</strong> A Prospective observational study was conducted on 70 patients of IUGR from August 2013 to November 2015 in Department of Obstetrics and Gynaecology , Dr. Vasantrao Pawar Medical College, Hospital &amp; Research Center. Inclusion criteria: Patients with diagnosed singleton pregnancies with IUGR at gestational age more than 32weeks not in labour. Exclusion criteria: Patients with congenital anomalous fetus, diabetes or acute placental insult. Patients were followed up with serial Umbilical artery Doppler and NST. Perinatal outcome was correlated with the last Doppler and NST within 7days prior to delivery. <strong>Results:</strong> Perinatal outcome is worst in patients with both NST and Doppler are abnormal and best among patients with both normal NST and Doppler. <strong>Conclusion:</strong> Doppler predicts fetal compromise earlier as compared to NST.

1970 ◽  
Vol 23 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Irin Parveen Alam ◽  
Sayeba Akhter

Objectives: The study was done with the objective to find the perinatal outcome in eclampsia patients and also to find out preventable causes of perinatal mortality and morbidity which are related to eclampsia. Materials & methods: This was a cross sectional observational study carried out in the Eclampsia unit in the Department of Obstetrics and Gynaecology in Dhaka Medical College Hospital during the period from February 2001 to July 2001. Results: Three hundred patients were selected for study. Three hundred mother's delivered 311 babies (11 sets of twins). Perinatal death(PND) which included stillbirth (SB) and early neonatal death (END) was 29%; stillbirth rate was 158/1000 live birth and early neonatal death rate was 132/1000 live births; 71% babies were born healthy. Maternal and fetal conditions were assessed and its relation with perinatal outcome was analyzed. Convulsion delivery interval > 12 hours, diastolic BP > 110mm Hg and Proteinuria > 3+ had significant higher perinatal death. (P<0.001, <0.01 and <0.001, respectively). Seventy percent babies had low birth weight. Among the live born neonates (n=262) 27.5% had jaundice, 34.7% had no complication and 15.6% had early neonatal death. Pre-maturity was common cause of early perinatal death (54%) and 39% death was due to asphyxia. Conclusion: Still birth, prematurity and birth asphyxia are important causes of perinatal loss in eclampsia, so early referral of eclampsia patients, early resuscitative measures and good neonatal care can improve perinatal outcome.   doi: 10.3329/bjog.v23i1.3053   Bangladesh J Obstet Gynaecol, 2008; Vol. 23(1) : 20-24


Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.


1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125


2020 ◽  
Vol 7 (1) ◽  
pp. 91-99
Author(s):  
Priyanka Roy ◽  
◽  
Indranil Dutta ◽  
Subhendu Dasgupta ◽  
Mahamud Khan ◽  
...  

2014 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Tania Mahbub ◽  
Md. Nizamuddin Chowdhury ◽  
Ferdous Jahan ◽  
Aparna Das ◽  
Md. Motlabur Rahman ◽  
...  

Background: Worldwide haemodialysis(HD) is the mostly used method of renal replacement therapy. Arteriovenous fistula use is on rise due to Fistula First Initiative due to least complications of fistulae than catheters.But they are also subjected to many complications. Thereby appropriate surveillance of the fistulae is important.Objectives: To measure the blood flow as well as fistula related complications in study population. Materials and Methods: This was a cross sectional study, conducted in the department of Nephrology, Dhaka Medical College Hospital during September 2010 to December 2011.Total 118 subjects were included in the study. Besides visualization technique colour Doppler ultrasonogram of fistula and  echocardiography were performed for each patients. Results: Most of the patients had adequate fistula flow. Aneurysm was most common complication. Many subjects were suffered from primary and secondary fistula failure. Conclusion: Arterio-Venous fistula is subjected to many complications and appropriate surveillance should be launched to detect complications and to prevent fistula failure.DOI: http://dx.doi.org/10.3329/jom.v15i2.20681 J MEDICINE 2014; 15 : 110-113


Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.


1970 ◽  
Vol 37 (2) ◽  
pp. 52-55
Author(s):  
Sahin Akhter Jahan Habib ◽  
Sayeeda Sultana

Objective: The purpose of this study was to determine whether there is a shift in the timing of eclampsia in relation to delivery and whether traditional symptoms precede impending postpartum eclampsia. Study Design: A cross - sectional hospital - based study conducted at Gynae Unit, Dhaka Medical College Hospital from January 2006 - December 2007. Data was collected regarding the relationship of the patient's first seizure to delivery prodromal symptoms, neuroimaging studies, use of magnesium sulfate, antihypertensive therapy and follow up medical care. The analysis focused on women who had late postpartum eclampsia. Result: During the study period 178 patients were diagnosed with eclampsia. Fifty eight women (33%) had postpartum eclampsia, of which 46 women (79%) had late onset (> 48 hrs.). Interestingly only 10 of these 46 women (22%) had been previously diagnosed with preeclampsia. Forty two pt.(91%) with late postpartum eclampsia had at least 1 prodromal symptom, and 24 pt. (52%) had> 1 symptom that heralded the seizure : 40 women (87%) had headache , 20 women (44%) had visual changes, 10 (22%) had nausea or vomiting and 4 (9% ) experienced epigastric pain. Only 14 of this 42 women (33%) sought care for their symptoms , of whom 12 women (86%)had clinical evidence of preeclampsia that was not considered by the treating physician. Among all patients with eclampsia there were 14 cases of aspiration pneumonia,6 cases of pulmonary edema, 6 cases of pleural effusion 4 cases of DIC and no cases of maternal death. Conclusion: Current obstetric treatment has a resulted in a shift of eclampsia toward the postpartum period with most cases being seen as late postpartum. To reduce the rate of the postpartum eclampsia, efforts should be directed to the education of the health care providers and patients regarding the importance of prompt reporting and evaluation of symptoms of preeclampsia during the postpartum period.   DOI: 10.3329/bmj.v37i2.3594 Bangladesh Medical Journal 37(2) 2008 52-55


Author(s):  
Bhargavi Rangarajan ◽  
Lalithambica Karunakaran

BACKGROUND: Fetal Growth Restriction (FGR) is the largest contributing factor to perinatal morbidity, mortality and impaired neurodevelopment. This research strives to elucidate the perinatal outcomes of stage based management of fetal growth restriction using Obstetric Doppler and its  association with maternal sociodemographic profile.METHODS: The research was  conducted among 320 antenatal women whose Estimated Fetal weight was  <10th centile. Periodic follow up with Doppler was done and managed as per the stage of FGR. Perinatal outcomes were compiled.RESULTS: The incidence of FGR in T.D Medical College, Alappuzha  was 15.23%. SGA  accounted for 47 %.  The proportion of early and late onset FGR was  10.3%    &   89.7%    respectively.  57.18% of the newborns were admitted to NICU.  The common complications were: Low birth weight – 47.8% ARDS – 21% , Sepsis – 9.6%, Necrotizing enterocolitis – 4%, Hyperbilirubinemia – 4.9%. The incidence of Neonatal death and stillbirth were 1.56% and 0.3% respectively. Mothers who were underweight, inadequate weight gain during pregnancy and short inter pregnancy interval had increased risks. Hypertensive disorders of pregnancy was the commonly associated medical condition. CONCLUSION: Prolongation of pregnancy  even by one day results in 2% increased chances of survival of the newborn. Hence, it becomes imperative to identify the benign forms of FGR  to prevent iatrogenic prematurity. Antenatal women should be screened for risk factors and undergo vigilant antepartum surveillance to bring about favourable perinatal outcome. 


1970 ◽  
Vol 22 (1) ◽  
pp. 59-63
Author(s):  
MA Nowshad ◽  
A Moshtaque ◽  
R Hafizur

Background: Intussusception is one of the major causes of bowel obstruction in infancy and childhood. Proper diagnosis and effective management have significantly reduced its mortality and morbidity in developed country. Aim: To document the mode of presentation and treatment outcome of Intussusception at Rajshahi Medical College Hospital. Patients and Methods: Thirty three consecutive cases of this condition seen at paediatric surgical ward over one year period were prospectively studied. Details of symptoms and signs, pre-hospital care, treatment and outcome were documented. Result: The triad of abdominal pain, bloody mucoid stools and palpable abdominal mass was seen in 24 (72%) of the cases. Twenty one (63%) had been admitted and treated with intravenous fluids in peripheral health centre for an average of 3 days before referral to this hospital. Prolonged mean duration of recognizable symptoms of 3 days accounted for a 58% bowel resection rate. Wound infection occurred in 11 (33.3%) and burst abdomen in 07 (21.2%) of cases. Faecal fistulae developed in 02 (06%) and incisional hernia developed in 03 (09%) of the patients. Overall, mortality rate was 09%. Conclusion: the early symptoms of Intussusceptions would seem to be missed by primary health workers, with consequently high morbidity and mortality. There is an urgent need to re- emphasize these symptoms to the first line healthcare providers and parents through public enlightenment campaigns. DOI: 10.3329/taj.v22i1.5020 TAJ 2009; 22(1): 59-63


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