scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Author(s):  
Mohammad Yakoob
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective: Previously, we have published univariate analyses on a cohort of all singleton, very preterm infants (N=101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report Odds Ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results: The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (Cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P≤0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete-case multivariate analyses, only gestational age (per week) was associated with survival (OR=2.5, 95% CI: 1.1–5.5, P=0.03); birth-weight (per 100 grams) and C-section were not associated-1.2, 0.88–1.6, P=0.26 and 2.4, 0.48–12.2, P=0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohammad Yawar Yakoob
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective Previously, we have published univariate analyses on a cohort of all singleton, very preterm infants (N = 101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report odds ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P ≤ 0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete-case multivariate analyses, only gestational age (per week) was associated with survival (OR = 2.5, 95% CI 1.1–5.5, P = 0.03); birth-weight (per 100 g) and C-section were not associated-1.2, 0.88–1.6, P = 0.26 and 2.4, 0.48–12.2, P = 0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Author(s):  
Mohammad Yakoob
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective: Previously, we have published univariate analyses on a cohort of all singleton, very preterm infants (N=101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report Odds Ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results: The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (Cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P≤0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete-case multivariate analyses, only gestational age (per week) was associated with survival (OR=2.5, 95% CI: 1.1–5.5, P=0.03); birth-weight (per 100 grams) and C-section were not associated-1.2, 0.88–1.6, P=0.26 and 2.4, 0.48–12.2, P=0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

scholarly journals Predictors of very preterm births (born between 23 and 29 weeks’ gestation) at a tertiary care center in Karachi, Pakistan: additional multivariate analyses on data from primary cohort

2019 ◽  
Author(s):  
Mohammad Yakoob
Keyword(s):  
Gestational Age ◽  
Multivariate Analyses ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
University Hospital ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Antenatal Steroids ◽  
Univariate Analyses

Abstract Objective: Previously, we have published univariate analyses on a cohort of all singleton very preterm infants (N=101) born between 23 and 29 weeks of gestation during January 01, 1998 to June 30, 2003 at The Aga Khan University Hospital in Karachi, Pakistan. Our main objective was to extend these analyses to multivariate logistic regression models and report Odds Ratios (ORs) for univariate and multivariate analyses. All variables in univariate were included in multivariate models. Results: The survival incidences were 0% at 23, 16.7% at 24, 40.0% at 25, 30.0% at 26, 33.3% at 27, 68.8% at 28 and 83.9% at 29 weeks of gestation. In univariate analyses, gestational age, birth-weight and mode of delivery (Cesarean-section had higher survival compared to vaginal) were statistically significant predictors of survival (P≤0.001 each). Other variables that also included antenatal steroids did not achieve significance. However, in complete case multivariate analyses, only gestational age (per week) was associated with survival (OR=2.5, 95% CI: 1.1–5.5, P=0.03); birthweight and C-section were not associated-1.2, 0.88–1.6, P=0.26 and 2.4, 0.48–12.2, P=0.28. Antenatal steroid use, maternal age, year of birth, parity, history of preterm delivery, hemoglobin levels, complications and time of birth remained not associated.

scholarly journals Intrauterine fetal demise: a retrospective study in tertiary care center in India

2018 ◽  
Vol 7 (8) ◽  
pp. 3069
Author(s):  
Anand Karale ◽  
Kunaal K. Shinde ◽  
Hemant Damle
Keyword(s):  
Gestational Age ◽  
Maternal Age ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Maternal Complications ◽  
Fetal Demise ◽  
Maternal Risk ◽  
Intrauterine Fetal Demise

Background: An Intrauterine Fetal Demise (IUFD) is a major obstetrical catastrophe at any gestational age but the emotional pain and distress caused by this event increases in direct relation to the duration of pregnancy. The objective of the present study was to determine the incidence and possible causes of Intrauterine Fetal Demise (IUFD), and to determine preventive measures.Methods: Retrospective observational study was done from Jan 2015 to Dec 2017 at Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune. Inclusion criteria were all the pregnant women with IUFD delivered at the centre, at or above 24 weeks of gestation. The methodology followed were parameters of assessment for analysis were maternal age, parity, probable causes for IUFD, booked or unbooked cases, mode of delivery, maternal complications, and placental histopathology. Statistical data were analyzed using SPSS version 25.Results: The incidence of IUFD at authors’ hospital was 27/1000 live births. The IUFD rate was similar in maternal age <20years and >30years (p value 0.26). The incidence of IUFD increased with decreasing gestational age which was statistically significant (p value 0.001). IUFD incidence was higher in multiparous women compared to primiparous women (p value 0.036 with OR of 1.6 and 95% CI 1.02 to 2.54). The rate of IUFD was similar when sex of the baby was analyzed. 49.4% of fetuses had signs of maceration. The major cause of IUFD was severe preeclampsia (48.1%) which included HELLP syndrome, IUGR, Abruption. Maternal anemia (20.4%), GDM (3.8%), SLE (2.5%), APLA positive (2.5%), anhydramnios (6.3%) were some of the other important causes of IUFD.Conclusions: This study was conducted to determine the incidence of IUFD and associated maternal risk factors. By understanding the contributing factors, we can seek ways of avoiding recurrence of IUFD by proper antenatal care and early diagnosis of obstetric complications and its appropriate management.

scholarly journals TO STUDY THE PREVALENCE OF RETINOPATHY OF PREMATURITY IN PRETERM INFANTS: AN HOSPITAL BASED OBSERVATIONAL STUDY.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Binit Singh ◽  
Rizwan Haider ◽  
Ved Prakash Gupta
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Inclusion Criteria

Background: Premature infants have avascular or incompletely vascularized retina at birth and ROP evolves over 4-5 weeks after birth. The aim of this study is to know the prevalence of retinopathy of prematurity in preterm infants, with birth weight ? 1500 grams and/or gestational age ?32 weeks in a tertiary care center. Material and methods: The study was conducted in a tertiary care center of Bihar region India The sample size is 145 babies. All preterm infants admitted with a birth weight of ?1500 grams and/or ? 32 weeks of gestation and baby those at risk of ROP. Results: 145 babies have enrolled during the study period of which 124 babies fulfilled the inclusion criteria and completed this prospective study.15 babies could not complete the follow-up protocol and 6 babies died before full vascularization of the retina. 124 babies who fulfilled the inclusion criteria were screened and 33 babies were found to have ROP. The prevalence of ROP in this study is 26.6%. Conclusions: Among the preventable causes of blindness in children, ROP figures very high on the agenda. Low birth weight and gestational age were found to be the most important risk factors for the development of ROP. Keywords: Low birth weight, Prematurity in preterm infant, Retinopathy, Oxygen therapy

scholarly journals A study on maternal factors affecting low birth weight in institutional deliveries

2020 ◽  
Vol 9 (10) ◽  
pp. 4245
Author(s):  
Chaithra A. ◽  
Mahantappa A. Chiniwar ◽  
Sharada B. Menasinkai
Keyword(s):  
Socioeconomic Status ◽  
Birth Weight ◽  
Middle Class ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Maternal Education ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Morbidity And Mortality ◽  
School Level

Background: Low birth weight is defined as birth weight below 2500 mg. WHO states prevalence of LBW is 26%. LBW babies are more prone for neonatal morbidity and mortality. 1) To assess various factors like maternal age, height, education, socioeconomic status on the birth weight of the baby. 2) To assess obstetric factors like parity, gestational age, antenatal care, anemia, hypertension on the birth weight of the newborn.Methods: A hospital bound cross sectional study done at the tertiary care centre. Study was done for a period of 2 months from 1st June to 30th July 2019 in Adichunchanagiri Institute of Medical Sciences and Research Hospital a rural medical college in Karnataka. Maternal data were collected and baby weight was recorded soon after birth on weighing scale.Results: There were 65 births during the study period. There were 13 babies weighing less than 2500 gm. Prevalence of LBW was 20%. 43.47% mothers were aged between 18 to 25 years and 7.14% were more than 25 years. 30.4% mother’s height was between 140 to 150 cm and 14.2% were more than 150 cm. Regarding maternal education, 15.3% degree, 24.1% PUC, 15% High school and 33.3% were primary school level. Regarding socioeconomic status 22.2% low, 25% lower middle, 18.7% middle class, 18.7% belonged to upper middle class. Regarding gestational age 50% were <37 weeks, 15.5% between 37-42 weeks, 10% were 42 weeks.73.8% women had normal BP, 21.5% were prehypertensive, 4.6% had PIH.Conclusions: Low birth weight is one of the important factors in infant morbidity and mortality. Maternal health was important factor in delivery of low birth babies. Maternal height, sex of baby, mode of delivery has no role in low birth weight babies.

scholarly journals Intrauterine Foetal Death and Its Probable Causes: Two Years Experience in Dhulikhel Hospital – Kathmandu University Hospital

2014 ◽  
Vol 10 (4) ◽  
pp. 44-48 ◽  
Author(s):  
SR Tamrakar ◽  
CD Chawla
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Care Center ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
University Hospital ◽  
World Health ◽  
Control Group ◽  
P Value ◽  
Health Care Center

Background World health Organization definition of intrauterine foetal demise encompasses any abortion or fetal demise prior to expulsion from its mother, and recommends different protocols according to gestational age. However, conventionally and also in our institution, foetal demise prior to 28 weeks of gestation is managed as abortion in a manner different from foetal demise post 28 weeks of gestation. Objective To find the incidence and characteristics of pregnancies that resulted in stillbirths. Methods A retrospective study, done in Dhulikhel Hospital, Kathmandu University Hospital in the year 2010 and 2011, among 4219 deliveries and 97 fetal deaths. Cases of multiple pregnancy and fetal death diagnosed by ultrasound before the 28th week of gestation were excluded. The included intrauterine foetal demise cases (n=90) were compared with a control group of randomly selected pregnancies (n = 537) delivered during the same time period. Assumed predictors of stillbirth were examined through inferential ways (Chi square, t test) using SPSS Version 13.0 for Windows. Results Incidence of intrauterine foetal demise was 2.13% in the year 2010 and 2011. Mothers in the stillbirth group were slightly older than mothers of live-born infants (25.47±5.64 years vs 23.62±4.31 years, p value=0.000). A slightly higher proportion of women in the stillbirth group were of Tamang ethnic origin and primiparous (p = 0.011, 0.000) . Foetus expelled after IUFD had lower weight compared to live births, (2925.14±444.14gram vs 2182.78±821.04gram, p=0.000) for gestational age. The stillborn babies were generally born at an earlier gestational age, as would be expected (p=0.000). Incidence of intrauterine foetal demise gradually decreases as parity advances. The incidence was higher in patients receiving antenatal care outside Dhulikhel Hospital, Kathmandu University Hospital. Conclusions While comparing the subject with the theme of the national conference of Nepal Society of Obstetricians and Gynaecologist, most of the cases were mother not receiving antenatal care or those receiving antenatal care in the periphery, There is no denying that there would be a massive improvement in women’s health if the co-ordination between the peripheral health care center and tertiary care center was to be improved. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10994 Kathmandu Univ Med J 2012;10(4):44-48

PLACENTA PREVIA AND PLACENTA ACCRETA SPECTRUM (PAS) DISORDER: INCIDENCE, RISK FACTOR AND FETOMATERNAL OUTCOME IN A TERTIARY CARE CENTER

2021 ◽  
pp. 15-17
Author(s):  
Ramona Perhar ◽  
Rubi Devi ◽  
Ruchi Patel ◽  
Jagriti Jagriti
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adherent Placenta ◽  
Placenta Accreta Spectrum

Introduction: Placenta Previa is characterised by Placental implantation into the lower uterine segment covering whole or part of the cervix . It complicates 0.4% of pregnancy at term The average incidence is 0.3% or 1 case per 300 to 400 deliveries. The presence of placenta previa can also increase a woman's risk for placenta accreta spectrum (PAS). This spectrum of conditions includes placenta accreta, increta, and percreta. Uncontrolled postpartum hemorrhage from placenta previa or PAS may necessitate a blood transfusion, hysterectomy thus leaving the patient infertile, admission to the ICU, or even death. Material and method: Study was conducted in department of obstetrics & gynecology , swaroop rani hospital, Allahabad for 1 year . A total of 102 pregnant women presenting to antenatal OPD or admitted in IPD with history of antepartum hemorrhage and conrmed case of PP or MAP in Ultrasonography were selected. The follow up till the fetomaternal outcome was done and risk factors were evaluated for 102 cases. Result: Out of the total 2342 deliveries in one year 95 patients had PP and the incidence was 4.04% and 7 patients had morbidily adherent Placenta which accounts to an incidence of 0.29%. Previous LSCS, Multiparity, increase maternal age, Dialatation and curettage were risk factors in both Placenta Previa and Morbidily Adherent Placenta. Antenatal complication were antepartum hemmorrhage , Anemia, preterm labor. Emergency LSCS is more common mode of delivery in cases of Placenta previa. Caesarean hysterectomy were done in 3.2% cases of Placenta Previa and all cases of Morbidily adherent placenta . Most common perinatal complications in both groups were prematurity and low birth weight. Conclusion: Now a days Placenta previa and Morbidily adherent placenta are very common. Incidence increases as the rate of cesaerean section or abdominal surgery were increases.Earlydiagnosis and pre plan mode of delivery will decrease the risk of prematurity and low birth weight.

scholarly journals Maternal and neonatal outcome of twin pregnancy at a tertiary care center

2021 ◽  
Vol 10 (12) ◽  
pp. 4545
Author(s):  
Vaishali Chaudhary ◽  
Kamalpriya Thiyagarajan ◽  
Yogini Patil ◽  
Vijaykumar Gawali
Keyword(s):  
High Risk ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
World Health ◽  
Tertiary Care Center ◽  
Lower Segment Cesarean Section ◽  
Twin Pregnancies

Background: Twin pregnancies occurs in 2 to 4% of the total number of births. Also the perinatal mortality and morbidity associated with it is five to six times higher in comparison with singleton pregnancy. In developing countries, 287,000 annual maternal deaths and 3 million neonatal deaths contributes to 99% of such mortality as per records of the World Health Organization (WHO) estimates that 99% of the world's annual occur in developing countries.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and neonatal characteristics in twin deliveries at a tertiary care center were analyzed. High risk factors and it’s association with maternal and perinatal outcomes was analyzed.Results: Pregnancy induced hypertension (32%) was the commonest, Preterm rupture of membranes (PROM, 22%) was in the next order. Invitro fertilization (44%), malpresentation (26%) main indicators for lower segment cesarean section. Mean weight of first twin was 1.9±0.43 kg and for second twin it was 1.89±0.47kg (Table 1). Most of twins were diamniotic dichorionic (78%).Conclusions: Twin pregnancies are hazardous to both for the mother and the neonate. It is certainly high risk factor which needs early identifications of complications and timely management. Perinatal outcome largely depends on gestational age, birth weight, presentation, mode of delivery.

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