Study of Fetomaternal Outcome in Elderly Pregnancy in Tertiary Care Center, Kakinada

2021 ◽  
Vol 8 (38) ◽  
pp. 3360-3365
Author(s):  
Akkamamba Basa ◽  
Srujana Palavalasa ◽  
Geetasree Vanapalli
Keyword(s):  
High Risk ◽  
Gestational Diabetes ◽  
Preterm Delivery ◽  
Maternal Age ◽  
Elderly Women ◽  
Care Center ◽  
Tertiary Care ◽  
Advanced Maternal Age ◽  
Tertiary Care Centre ◽  
Fetal Complications

BACKGROUND Advanced maternal age generally signifies age after 35 years at the time of delivery. Maternal age is an important determinant of the outcome of pregnancy. Elderly women are at a high risk of several complications like abortion, ectopic pregnancy, preterm labour, hypertension, gestational diabetes, malpresentation and instrumental deliveries. Older the women, higher the fetal complications like Downs syndrome, preterm baby, low birth weight (LBW) babies and intrauterine growth restriction (IUGR). The purpose of this study was to assess the fetomaternal outcome in elderly pregnancy at a tertiary care centre. METHODS This study was a prospective hospital-based study of 100 elderly pregnant women aged 35 years and above admitted in OBG Department, Government General Hospital, Kakinada, Andhra Pradesh, from June 2020 to May 2021. The labor ward register and case records were used for all elderly gravida women admitted and delivered and details of these patients was recorded in the proforma. RESULTS In this study, 68 % were in 35 - 37 years, 32 % were in 38 - 40 years age group. 36 % were primigravida and 64 % were multigravida. 76 % women were housewives and 24 % women were employed. 32 % of women had history of previous abortions. Hypertensive disorders were observed in 42 % of patients, gestational diabetes was observed in 28 % of patients, antepartum haemorrhage was observed in 24 % of patients, IUGR was noted in 20 % of patients and preterm delivery was noted in 10 % of patients. 46 % of patients were delivered by vaginal route and 40 % of patients were delivered by caesarean section. 7.69 % were intrauterine devices (IUDs), 3.85 % had congenital anomalies. CONCLUSIONS Elderly women are at a high risk of developing several maternal and fetal complications. Many of these complications can be successfully managed with improved health services, pre-conceptional counselling and frequent antenatal visits. KEYWORDS Advanced Maternal Age, Maternal Complication, Caesarean, Preterm Delivery

scholarly journals Does advanced maternal age influence obstetric outcome: a study in a tertiary care centre

2019 ◽  
Vol 8 (4) ◽  
pp. 1313
Author(s):  
Jose C. V. ◽  
Lissiamma George ◽  
Sunitha Sukumaran
Keyword(s):  
High Risk ◽  
Gestational Diabetes ◽  
Maternal Age ◽  
Tertiary Care ◽  
Advanced Maternal Age ◽  
Chronic Hypertension ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Younger Women ◽  
Medical Disorders

Background: Advanced maternal age defined as age 35 years and older at estimated date of delivery has become increasingly common in last two to three decades. The International Federation of Gynaecology and Obstetrics in 1958 recommended that all women going through their first pregnancy over the age of 35 years should be considered high risk for pregnancy and included in this category 1.Methods: A one-year prospective observational study conducted in a tertiary care hospital after institutional ethical clearance. All 165 women above 35yrs who delivered during this period were taken as Cohort 1. Same number of women aged between 20 and 34 years were randomly selected as comparison group (Cohort 2). Both the groups were compared in terms of preexisting medical disorders, obstetrical morbidities, antenatal complications, intrapartum complications.Results: Older and younger women had similar antenatal booking, occupational and socioeconomic status. The main reason for pregnancy at advanced age group was late marriage. The risk of chronic hypertension, gestational diabetes mellitus, pre-existing medical disorders were higher in advanced maternal age.Conclusions: Increasing maternal age is associated with elevated risks for pregnancy complications. They are at high risk for gestational diabetes, cesarean section and to have low birth weight babies. Since these women are at higher risk of complications, they should be advised to adhere to frequent antenatal visits and close supervision.

scholarly journals A prospective study on gestational diabetes mellitus in a tertiary care center

2018 ◽  
Vol 7 (12) ◽  
pp. 4972
Author(s):  
Poovathi M. ◽  
S. Gayathri Devi
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Care Center ◽  
Tertiary Care ◽  
International Diabetes Federation ◽  
Intrauterine Death ◽  
Maternal Complications ◽  
Increased Risk ◽  
Fetal Complications

Background: Gestational Diabetes Mellitus is defined as any degree of glucose intolerance identified for the first-time during pregnancy. Gestational Diabetes Mellitus is a highly prevalent metabolic disorder among pregnant woman with rising incidence in recent years. Various risk factors are associated with this disorder leading to maternal and neonatal mortality. About 5% of the pregnancies are complicated by Gestational Diabetes Mellitus. The International Diabetes Federation estimates that one in six live birth (16.8%) are to women with some form of hyperglycemia in pregnancy. The prevalence of GDM in present study is 4.326%. Not only obesity but also overweight women have greatly increased risk of developing gestational diabetes.Methods: This includes study all cases of gestational diabetes mellitus admitted in the Department of Obstetrics, Government Mahatma Gandhi Memorial Hospital attached to K.A.P.V medical college, Trichy. This study has been conducted from January 2018 to June 2018.Fetal complications in infants born to diabetic mothers were studied. Maternal complications related to Gestational diabetes were also studied.Results: The total deliveries during this period were found to be 4085 of which 175 patients where diagnosed to have Gestational Diabetes Mellitus, thus the incidence accounts for 4.326%.The incidence in 20 to 25 years age group was around 67 which accounted for 37.3%. Most cases less than 20 years were found to be pregestational diabetes mellitus. The prevalence of GDM in present study is 4.326%. The maternal complications like vaginal infections accounted to 11.4%, gestational hypertension accounts to 14.3%, polyhydramnios to 17.1%. Regarding the fetal complications incidence of intrauterine death at term was around 8% and neonatal complications included hyperbiliribinemia 11.4%, hypoglycaemia, 6.7%, respiratory distress syndrome 5.75%.Conclusions: Gestational diabetes was associated with increased adverse maternal and perinatal outcomes.

scholarly journals Efficiency of non-invasive prenatal screening in pregnant women at advanced maternal age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Zhu ◽  
Xiaoxiao Jin ◽  
Yuqing Xu ◽  
Weihua Zhang ◽  
Xiaodan Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Predictive Value ◽  
Trisomy 21 ◽  
Maternal Age ◽  
Prenatal Screening ◽  
Advanced Maternal Age ◽  
Youden Index ◽  
Non Invasive ◽  
Sensitivity Specificity

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

scholarly journals Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marta Claramonte Nieto ◽  
Eva Meler Barrabes ◽  
Sandra Garcia Martínez ◽  
Mireia Gutiérrez Prat ◽  
Bernat Serra Zantop
Keyword(s):  
Risk Factor ◽  
Gestational Diabetes ◽  
Maternal Age ◽  
Placenta Previa ◽  
Significant Risk ◽  
Advanced Maternal Age ◽  
Obstetric Outcomes ◽  
Chronic Hypertension ◽  
Mediterranean Population ◽  
Confounding Factors

Abstract Background Women of advanced maternal age (AMA) are a growing population, with higher obstetric risks. The Mediterranean population has specific characteristics different from other areas. Thus, the objective of this study was to establish a cut-off to define AMA in a selected mediterranean population coming from a tertiary referral private/mutual health hospital in Barcelona. Methods Retrospective cohort of euploid singleton pregnancies delivered from January 2007 to June 2017. Main maternal outcomes were: gestational diabetes, preeclampsia, placenta previa, c-section and prolonged hospitalization (≥ 7 days). Main adverse perinatal outcomes were: stillbirth, prematurity, preterm prelabor rupture of membranes, low birth weight, need of admission at a neonatal intensive care unit and perinatal mortality. Adjustment for confounding factors (smoking, previous comorbilities, parity, assisted reproductive techniques (ART) and obesity) was performed. Results A total of 25054 pregnancies were included. Mean maternal age was 34.7 ± 4.2 years, with 2807 patients in the group of age between 40 and 44 years (11.2%) and 280 patients ≥45 years (1.1%). Women at AMA had higher incidence of previous comorbilities (compared to the reference group of women < 30 years): prior c-section, chronic hypertension and obesity. In addition, they were more likely to use ART. After adjusting for confounding factors, maternal age was an independent and statistically significant risk factor for gestational diabetes (OR 1.66/2.80/3.14) for ages 30–39, 40–44 and ≥ 45 years respectively, c-section (OR 1.28/2.41/7.27) and placenta previa (OR 2.56/4.83) for ages 40–44 and ≥ 45 years respectively, but not for preeclampsia (neither early-onset nor late-onset). Risk of emergency c-section was only increased in women ≥45 years (OR, 2.03 (95% CI, 1.50–2.74). In the other groups of age, the increase in c-section rate was because of elective indications. Age ≥ 45 years was associated with iatrogenic prematurity < 37 weeks (OR 2.62, 95% CI 1.30–5.27). No other relevant associations between AMA and maternal or neonatal outcomes were found. Conclusions Maternal age is an independent risk factor for adverse obstetric outcomes. Age ≥ 40 years was associated to relevant increased risks and reveals to be an adequate cut-off to define AMA in our population.

scholarly journals Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vani Chandrashekar
Keyword(s):  
Entamoeba Histolytica ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

scholarly journals Postpartum follow up of gestational diabetes in a Tertiary Care Center

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
C. A. Cabizuca ◽  
P. S. Rocha ◽  
J. V. Marques ◽  
T. F. L. R. Costa ◽  
A. S. N. Santos ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Thyroid status and Treatment Response of Hypothyroid Infertile Women in Tertiary Care Center of Bangladesh

2017 ◽  
Vol 31 (2) ◽  
pp. 86-89
Author(s):  
Farzana Deeba ◽  
Parveen Fatima ◽  
Jesmine Banu ◽  
Shakeela Ishrat ◽  
Nurjahan Begum ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Early Stage ◽  
Care Center ◽  
Tertiary Care ◽  
Target Population ◽  
Fertility Treatment ◽  
Tertiary Care Centre ◽  
Infertile Women ◽  
The Mean ◽  
Tsh Levels

Objective(s): Aim of this study was to find out the prevalence of hypothyroidism in infertile women as well as to assess their response to treatment.Materials and methods: This descriptive study was conducted in Infertility unit of Department of Obstetrics and Gynecology, Bangabandhu Sheikh Mujib Medical University, Bangladesh, a tertiary care centre from January 2014 to December 2014. Four hundred women who visited infertility clinic of the department for fertility treatment were the target population for this study. Routine investigations such as CBC, Blood sugar 2 hours postparandial or GTT, TSH and Prolactin was done. Subclinical hypothyroidism was diagnosed when there was increased TSH and normal FT4. Hypothyroid patients were given Levothyroxin depending upon TSH levels and continued until end of the study. Patients were followed up for six months even if pregnancy was attained.Results: Out of 400 women 55% were primary and 45% were secondary subfertility. Mean duration of infertility was 4.5 ± 1.2 years. Ninety two (23%) patients were hypothyroid. Among them 66 (16.5%) were subclinical hypothyroid and 26 (6.5%) were frank hypothyroid. The mean TSH levels were 7.34 ± 2.13 ìIU/ml, and the mean PRL levels were 52.46 ± 11.17 ng/ml. Out of 92 infertile women diagnosed as hypothyroidism 75 (81.52%) women conceived after treatment with drugs for hypothyroidism (dose depending upon severity of hypothyroidism, i.e. TSH levels). More than 90% women had regular ovulation for consecutive three cycles after initiation of treatment.Conclusion: The normal TSH levels are the pre-requisite for fertilization. The decision to initiate thyroid replacement therapy in both clinical and subclinical hypothyroidism at early stage is justified in infertile women.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 86-89

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