scholarly journals Study of Maternal and Foetal Outcome in Abruptio Placentae

2021 ◽  
Vol 8 (01) ◽  
pp. 5208-5213
Author(s):  
Vikram Lokhande ◽  
Kunal Jadhav ◽  
Minal Kadam ◽  
Suresh Rawte
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Abruptio Placentae ◽  
Foetal Outcome ◽  
Obstetrical Emergency ◽  
Time Of Admission

Study of Maternal and Foetal outcome in Abruptio Placentae Introduction: Abruptio placentae (AP) is a significant obstetrical emergency and as per WHO 2009 maternal mortality rates reported due to AP worldwide was 2.1% and fetal perinatal mortality rate was 15%. AP cannot be prevented but maternal and perinatal morbidity and mortality due to AP can be reduced significantly by aggressive management.   Methods: The present prospective study was conducted to evaluate the outcome of treatment on the perinatal and maternal outcome in Abruptio Placentae patients in a tertiary care hospital from January 2015 to January 2016 amongst 54 pregnant women diagnosed to have abruptio placentae from 28 weeks of gestation and above and all babies delivered. Face-to-face interviews was conducted. Results: Maximum no. of abruptio placentae were unbooked - 37 (69%) and 85% of patients belonged to the less than 30 years of age group. An abruptio placenta was more common in multipara. Anaemia was seen in 21 patients (38%). Anaemia and PIH was seen in 12 patients (23%). 7 patients had fetal distress at the time of admission (13%). Regarding mode of delivery, 50% of patients delivered vaginally by artificial rupture of membrane (ARM) and oxytocin augmentation and 50% underwent caesarean section. Conclusion:  It was concluded that abruptio placentae is still a leading cause of maternal morbidity and mortality that can be reduced with modern management of abruptio placentae, but timely diagnosis and intervention is necessary. Key Words: Abruptio placentae, maternal mortality, fetal distress, anaemia

scholarly journals Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Archana Kumari ◽  
Avinash Chakrawarty ◽  
Abha Singh ◽  
Ritu Singh
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neurological Involvement ◽  
First Episode ◽  
Care Hospital ◽  
Spot Urine ◽  
High Dependency ◽  
Developed World

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia.Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality.Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR.Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

scholarly journals Feto-maternal outcome in pregnancy beyond 40 weeks

2017 ◽  
Vol 6 (2) ◽  
pp. 527 ◽  
Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Maternal Complications ◽  
Cross Sectional ◽  
In Pregnancy

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.

scholarly journals Eclampsia at a tertiary care hospital of Nepal: A five year study

2018 ◽  
Vol 6 (2) ◽  
pp. 14-21
Author(s):  
Shraddha Rana ◽  
Pramod Kattel
Keyword(s):  
Blood Pressure ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Mortality ◽  
Care Hospital ◽  
Cross Sectional ◽  
National Medical

Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital. Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets. Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%).  At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%. Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously. Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia

Feto-maternal Outcome in Pregnancies Complicated by Hypertensive Disorder: A Retrospective Study at a Tertiary Care Centre of Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1127-1131
Author(s):  
Gyanendra Man Singh Karki ◽  
Mona Priyadarshini ◽  
Tarun Pradhan
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Heart Rate Pattern

Introduction: Hypertensive disorder of pregnancy is one of the major cause of maternal and fetal morbidity and mortality. Objective: The objective of this study was to estimate the associated maternal and fetal outcome and complications in pregnancies complicated by hypertensive disorders at a tertiary care hospital in eastern Nepal. Methodology: This retrospective cross section observational study included purposely-selected one hundred thirty four pregnant women from April 2019 to April 2020 in the Department of Obstetrics and Gynaecology at Birat Medical College Teaching Hospital, Tankisinuwari, Morang, Nepal. Maternal age, gravidity, period of gestation at presentation, associated maternal comorbidities/ risk factors, mode of delivery, indication for surgery, maternal outcome and complications, fetal outcome was recorded and data was analysed using SPSS version 23 software. Result: Out of the 134 study population,35.8% of the mothers with hypertensive disorders were noted in the age group between 25-29 years and almost two third of the patients were multigravida. 55.2% patients had mild, while 44.8% had severe hypertension. About 83.6% of the hypertensive pregnant mothers delivered preterm between 33 to 36 weeks of gestation. 61.9% mothers underwent cesarean section with the most common indication being non-reassuring fatal heart rate pattern, while 34.3% women delivered vaginally. 86 out of 134 cases did not develop any complications while, postpartum haemorrhage was the most frequently encountered complication seen in 17.9% cases followed by eclampsia encountered in 13.4% patients. The mortality encountered was 0.7%. Neonatal complications were found in 50% cases, 15.7% neonates had low APGAR score and 8.2% had meconium aspiration, while 4.5% intrauterine deaths and 3% neonatal deaths were observed. Conclusion: There is adverse impact of hypertension during pregnancy over maternal and perinatal outcome. Hence, early identification and prompt referral to the well-equipped center is necessary to reduce the associated morbidity and mortality.

scholarly journals Study of maternal mortality in a tertiary care hospital (GMERS-Dharpur, Patan, Gujarat, India): a three-year review

2018 ◽  
Vol 7 (10) ◽  
pp. 4008
Author(s):  
Parul S. Jani
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Unwanted Pregnancy ◽  
Epidemiological Data ◽  
Care Hospital ◽  
Safe Abortion ◽  
Maternal Deaths ◽  
Risk Of Death

Background: Epidemiological data related to maternal mortality is valuable in each set up to design the progress to maternal mortality. This study was done to evaluate maternal death over period of 3 years at tertiary care centre of North Gujarat, India.Methods: This was retrospective study conducted at department of Obstetrics and Gynecology at GMERS medical college Dharpur, Patan (N.G.), India. Epidemiological data was collected from hospital register from January-15 to Dec-17 of maternal death in the hospital maternal age, parity, educational status, ANC registration, mode of delivery, admission death interval and direct and indirect causes and maternal deaths were noted and analyzed statistically.Results: There were 41 maternal deaths from Jan-15 to Dec-17. Maximum deaths were in 21-30 age group with multipara, unbooked and illiterate patients. Majority of maternal deaths are due to hemorrhage, eclampsia and sepsis.Conclusions: Many different factors interact in a complex way to increase the risk of death of pregnant women. Regular ANC, early identification of complication and timely referral, delivery by skill birth attendant and adequate post-partum case and follow up are required. To avoid maternal death unwanted pregnancy, too early pregnancy should be avoided adequate counseling and contraception facility also required for sepsis prevention, safe abortion services according to the law and quality post abortion care. There is a wide scope of improvement as most of the maternal deaths are preventable.

scholarly journals Maternal mortality in a tertiary care hospital: a five-year review

2017 ◽  
Vol 6 (11) ◽  
pp. 4953
Author(s):  
Manjeet Kaur ◽  
Manjit K. Mohi ◽  
Sangeeta Aggarwal ◽  
Balwinder Kaur
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care Hospital ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Causes Of Deaths

Background: This study was aimed at analyzing the maternal mortality ratio over five years, the causes leading to maternal deaths in a tertiary care hospital and factors which are preventable.Methods: The records of maternal death from August 2010 to July 2015 (5 years) were collected and analyzed. Various factors like maternal age, parity, literacy, place of residence, antenatal registration, admission-death interval, mode of delivery and causes of deaths were reviewed.Results: The mean maternal mortality ratio (MMR) was 1039. The direct causes of maternal mortality were hemorrhage (22.4%), eclampsia (21.2%), sepsis (18.78%) and amniotic fluid embolism (8.48%). Indirect obstetric deaths were due to hepatitis (10.9%), anemia (3.6%), respiratory diseases (6.06%), heart diseases (3.03%), CNS disease (5.45%).  Most of the deaths (69.7%) occurred in age group 20 and30 years. 63.6% were multigravida and 85.4% were unbooked cases.Conclusions: Antenatal care, screening and management of high risk pregnancies are most important to prevent complications and maternal deaths by timely detection and intervention.

FETOMATERNAL OUTCOME OF PREGNANCY WITH HEART DISEASE IN A TERTIARY CARE HOSPITAL OF KOLKATA IN EASTERN INDIA

2021 ◽  
pp. 21-23
Author(s):  
Kajal Kumar Patra ◽  
Dipnarayan Sarkar ◽  
Sukhamoy Saha
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Age Group ◽  
Normal Delivery ◽  
Heart Disease In Pregnancy ◽  
In Pregnancy

BACKGROUND: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India. METHODS: This study was a prospective observational study conducted in the IPGMER & SSKM Hospital, Kolkata, West Bengal from December 2020 to February 2021. 36 Pregnant women with heart disease were taken as study group. Multiple pregnancy and any other medical disorder like GDM, PIH, were excluded from study. Fetomaternal outcome, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared. Template was generated in MS excel sheet and analysis was done on SPSS software. RESULTS: Among 36 patients 14 (38.89%) patients belonged to age group 25-29 years and 2 (5.56) belonged to age group <20 years. 13 (36.11%) patients belonged to lower middle class and 17 (47.22%) belong to lower class. 19 (52.78%) patients were P and 9 (25%) were P parity group. 20 (55.56%) belong to gravida G1. 10 (27.78%) 0+0 1+0 patients had CHD and RHD. 20 (55.56%) were normal delivery. 13 (36.11%) of babies were underweight. Maternal death were 2 (5.56%). CONCLUSIONS: Feto-maternal outcome can be improved appreciably by antenatal care, early diagnosis and management.

scholarly journals Fetomaternal outcome in women with heart disease in urban population in a tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 3684
Author(s):  
Preeti Sharma ◽  
Renuka Malik
Keyword(s):  
Heart Disease ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Mortality ◽  
Delivery Mode ◽  
Care Hospital ◽  
Heart Disease In Pregnancy ◽  
In Pregnancy

Background: Heart disease in pregnancy is still a major problem worldwide, particularly in low resource country like India. Its reported incidence varies between 0.1 to 4%. Heart disease complicates 1% to 3% of all pregnancies and is responsible for 10% to 15% of maternal mortality. In India, the rheumatic heart disease (RHD) contributes to approximately 70% of heart disease seen in pregnancy. Heart disease in pregnancy is associated with adverse fetomaternal outcome and has re-emerged as one of the leading causes of maternal mortality. The maternal mortality rate in women with cardiac disease is 7% and morbidity is 30% during pregnancy in India.Methods: This study was a prospective observational study conducted in the department of obstetrics and gynaecology at PGIMER & Dr. RML hospital from Nov 2015 to March 2017. 35 Pregnant women with heart disease were taken as study group and 35 low risk pregnant patients were taken as control. Multiple pregnancy and any other medical disorder like GDM, PIH, IHCP and thyroid disorders were excluded from study. Fetomaternal outcome in terms of POG at delivery, mode of delivery, prematurity, LBW, NICU admission and maternal and neonatal mortality were compared between these two groups.Results: Vaginal delivery is still the common mode of delivery. Preterm delivery, prematurity, ICU admission, low birth weight is more common in pregnancy with heart disease than in normal pregnancy.Conclusions: Although maternal mortality and fetal mortality is reduced, pregnancy with heart disease still carries substantial risk to mother and child.

scholarly journals Fetomaternal outcome following labour induction in oligohydramnios and borderline liquor: a retrospective study in a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4615
Author(s):  
Jyothi Susan Thomas ◽  
Mary Daniel ◽  
Sangeetha Selvaraj
Keyword(s):  
Retrospective Study ◽  
Amniotic Fluid ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Labour Induction ◽  
P Value ◽  
Care Hospital ◽  
Parametric Data

Background: Amniotic fluid provides a protective milieu for the growing fetus in pregnancy and labour. A decrease in the amniotic fluid volume has been associated with increased maternal morbidity and fetal morbidity and mortality. The purpose was to compare the effect of labour induction on the fetomaternal outcome in women with oligohydramnios, borderline liquor and normal liquor at term.Methods: A retrospective study of all the labour induction in women with oligohydramnios, borderline liquor and normal liquor volume at 37-42 weeks gestation in a tertiary care teaching hospital. The demographic characteristics, maternal outcomes like mode of delivery, indication for operative delivery, meconium stained liquor and perinatal outcomes were compared in between the three groups. Parametric data was compared by chi-square test and non-parametric data by students’-test. A p-value less than 0.05 was taken as significant.Results: Among the 2338 deliveries during the study period, labour was induced in 266 women (11.3%). Out of which, 109 cases (40.9%) in oligohydramnios group, 111cases (41.7%) in borderline liquor group and 46 cases in normal liquor group. The incidence of meconium stained liquor, the number of operative deliveries and fetal distress was significantly higher and significantly lower birth weight (<2.5 kg) in the group with oligohydramnios and borderline liquor (p <0.05). Low Apgar score and admission to neonatal intensive care unit was higher in the oligohydramnios group (p<0.05).Conclusions: Induction of labour on detecting borderline liquor at term may help in reduction of maternal and fetal morbidity and mortality.

scholarly journals Maternal and perinatal morbidity and mortality in severe pre-eclampsia and eclampsia in a tertiary care hospital: a prospective study

2019 ◽  
Vol 8 (4) ◽  
pp. 1414
Author(s):  
Neeta Chaudhary ◽  
Natasha Tyagi ◽  
Smita Tyagi ◽  
Shivani Singhal
Keyword(s):  
Prospective Study ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Function Tests ◽  
Lower Segment Cesarean Section ◽  
A Prospective Study

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality worldwide. In India, they account for the third most important cause of maternal mortality. The objective of this study was to evaluate maternal and perinatal outcome and complications in cases with severe pre-eclampsia and eclampsia and measures to prevent them.Methods: A prospective study was carried out on 100 patients with severe pre-eclampsia and eclampsia in tertiary care referral hospital over a period of one year i.e. from November 2017 to October 2018. Only those cases with initial blood pressure reading of ≥160/110mmHg or presenting with eclampsia were in included in the study. Detailed history and examination was carried out. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed.Results: 48% of women were between 21-25 years age, 82% were from rural area, and 86% cases were unbooked, 68% cases were primigravida. Liver Function Tests were deranged in 18% of the patients and 19% had abnormal Renal Function Tests. Labetalol was the most commonly used antihypertensive. Lower segment cesarean section was the mode of delivery in 59% of the cases. Most common maternal complication was Eclampsia. There were 5 maternal deaths i.e. maternal death rate was 5%. 54.3% of live births needed NICU admission and out of these 50% were preterm deliveries.Conclusions: Accessible healthcare and health education and awareness regarding antenatal checkup for all women will lead to early detection of severe pre-eclampsia. Hence, early treatment and management of patient’s complications will certainly improve the maternal and perinatal outcome.

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