scholarly journals Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

2021 ◽  
Vol Volume 13 ◽  
pp. 627-637
Author(s):  
Christy Pylypjuk ◽  
Ladonna Majeau
2021 ◽  
Vol 17 ◽  
Author(s):  
Roopa Padavagodu Shivananda ◽  
Rekha Anbu ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Anjali Suneel Mundkur ◽  
...  

Background: The best method of estimation of amniotic fluid volume is a matter of ongoing debate. Objectives: To determine the perinatal & maternal outcomes in pregnant patients when the amniotic fluid volume was assessed by the amniotic fluid index (AFI) in comparison to the single deepest vertical pocket (SDVP). Methods: We studied abnormal Cardiotocograph, meconium stained amniotic fluid, birth weight <2.5kg, Apgar score at 5 min <7, cord blood pH <7.2 & necessity for NICU admission as perinatal outcomes. Rate of diagnosis of oligohydramnios, induction of labor for oligohydramnios & mode of delivery were observed in maternal outcomes. Results: Of the 697 pregnant patients recruited, 353 were in the AFI and 344 in the SDVP group. Perinatal outcomes were similar in both. In the AFI group, the number of women diagnosed with oligohydramnios was higher (p = 0.0333) & the rate of induction was also higher (p = 0.003378). Vaginal deliveries were more in the SDVP group. The Receiver Operating Characteristic curves showed statistically significant correlation with NICU stay, birth-weight, and mode of delivery. While an AFI of >5cm and SDVP of >1.9cm had good sensitivity in predicting babies with a birth weight of ≥ 2.5kg and avoiding NICU admissions, an AFI of > 5.8cm and an SDVP of > 1.9 cm had a sensitivity of around 80% in predicting successful vaginal deliveries. Conclusion: The SDVP method has a slight edge over the AFI in terms of lower inductions and higher vaginal deliveries with comparable perinatal outcomes.


Author(s):  
Jeyamani B. ◽  
Anurekha J. P. ◽  
Arun Daniel J.

Background: Oligohydramnios is the term coined for a condition where the amount of liquor amnii is less than 200 ml at term. Using an ultrasonogram, oligohydramnios can be deliberated when the vertical pocket of liquor is less than 2 cm or when amniotic fluid index (AFI) is less than 5 cm. Oligohydramnios is reported to occur in 1 to 5% of total pregnancies. It has been associated with adverse maternal and foetal outcomes.Methods: This hospital-based follow-up study was conducted among 540 pregnant women at 37 weeks attending to the Department of Obstetrics and Gynaecology for a period of 1 year from January to December 2018. All included pregnant women were subjected to routine ultrasound examination and assessment of amniotic fluid volume using Amniotic fluid index.Results: The incidence of oligohydramnios was 17.04% (n=92) among the included women and 62% (n=57) among them were primigravida. Among those women diagnosed with Oligohydramnios, the caesarean section rate was 56.5% (n=52), the common indications for LSCS being fetal distress 44. 2% (n=23) and IUGR 34.6% (n=18). The oligohydramnios pregnancies had more associated post-dated deliveries (28.3%), pregnancy induced hypertension (10.9%) and gestational diabetes (8.7%). It was also associated with higher incidence of low birth weight (27.2%), NICU admissions (32.6%), congenital anomalies (3.3%) and fetal deaths (5.4%).Conclusions: The study showed that an amniotic fluid index of less than 5 at term was associated with adverse maternal and perinatal pregnancy outcomes emphasizing the importance of amniotic fluid volume surveillance during the antenatal period.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James M. Edwards ◽  
Nora Watson ◽  
Chris Focht ◽  
Clara Wynn ◽  
Christopher A. Todd ◽  
...  

Background. Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease. Methods. A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease. Results. A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88). Conclusions. This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.


2014 ◽  
Vol 6 (3) ◽  
pp. 156-158
Author(s):  
J Jeanet ◽  
Santosh Joseph Benjamin ◽  
Jiji Elizabeth Mathews ◽  
Swati Rathore ◽  
Ajit Sebastian ◽  
...  

ABSTRACT Objectives The study was undertaken to determine the efficacy of routine estimation of amniotic fluid volume using the amniotic fluid index (AFI) as a means of predicting an adverse perinatal outcome in low-risk pregnancies. Materials and methods Five hundred and three singleton lowrisk pregnancies with cephalic presentation between 37 and 40 weeks and 6 days of gestation with intact or ruptured membranes had AFI estimations within 36 hours of delivery. Results The frequency of nonreassuring fetal heart patterns and perinatal outcomes among patients with oligohydramnios (<5 cm), borderline oligohydramnios (5 to 8 cm) and normal (>8 cm) liquor were compared and not found to be different. Cesarean section for nonreassuring fetal status was also similar in the three groups. Conclusion This study suggests that AFI estimation during labor in low-risk pregnancies does not predict adverse perinatal outcomes. Further studies are needed to verify this impression. How to cite this article Jeanet J, Benjamin SJ, Mathews JE, Rathore S, Sebastian A, Thomas E. Intrapartum Amniotic Fluid Volume Estimation in Low-risk Pregnancy as a Predictor of Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):156-158.


2016 ◽  
Vol 42 (12) ◽  
pp. 1680-1685 ◽  
Author(s):  
Masamitsu Nakamura ◽  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Shoko Hamada ◽  
Hiroko Takita ◽  
...  

2019 ◽  
Vol 47 (6) ◽  
pp. 625-630 ◽  
Author(s):  
Iñigo Melchor ◽  
Jorge Burgos ◽  
Ana del Campo ◽  
Amaia Aiartzaguena ◽  
Julieta Gutiérrez ◽  
...  

Abstract Background Obesity in pregnancy is increasing worldwide, reaching epidemic proportions in many countries and frequently creating challenges for obstetricians. We conducted this study to assess the effects of maternal obesity on maternal and perinatal outcomes. Methods A historical cohort study was performed on 16,609 women who delivered singleton babies in a 5-year period (2013–2017). Data were retrieved from the Cruces Perinatal Database (CPD) and only women whose prepregnancy body mass index (BMI) was known were included. Women were categorized according to the World Health Organization (WHO) classification: normal weight (BMI 20–24.9 kg/m2) and obesity (BMI ≥ 30 kg/m2). Obstetric, perinatal and neonatal outcomes were compared, and adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated using the normal-weight group as the reference. Results Compared to women of normal weight (n = 9778), obese women (n = 2207) had a higher risk of preeclampsia (aOR 2.199, 95% CI: 1.46–3.29), rectovaginal group B streptococcus colonization (aOR 1.299, 95% CI: 1.14–1.47), induction of labor (aOR 1.593, 95% CI: 1.44–1.75), cesarean section (aOR 2.755, 95% CI: 2.46–3.08), cesarean section in women with a history of cesarean delivery (aOR 1.409, 95% CI: 1.03–1.92), fetal weight ≥4000 g (aOR 2.090, 95% CI: 1.803–2.422) and admission to the neonatal intensive care unit (NICU) (aOR 1.341, 95% CI: 1.12–1.59). No association was found with preterm birth (aOR 0.936, 95% CI: 0.77–1.13), stillbirth (aOR 0.921, 95% CI: 0.41–2.02) or neonatal mortality (aOR 2.205, 95% CI: 0.86–5.62). Conclusion Maternal obesity is associated with a higher risk of adverse pregnancy and perinatal outcomes. Pregnancy in this population of women should be considered and managed as high risk.


2015 ◽  
Vol 122 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
M Hedegaard ◽  
Ø Lidegaard ◽  
CW Skovlund ◽  
LS Mørch ◽  
M Hedegaard

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 634-P
Author(s):  
MASANORI KANEKO ◽  
KAZUYA FUJIHARA ◽  
TAEKO OSAWA ◽  
MAYUKO HARADA ◽  
MASARU KITAZAWA ◽  
...  

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