scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

Reference range for amniotic fluid index measurements in a Brazilian population

2014 ◽  
Vol 42 (4) ◽  
Author(s):  
Edward Araujo Júnior ◽  
Wellington P. Martins ◽  
David Baptista Silva Pares ◽  
Claudio Rodrigues Pires ◽  
Sebastião Marques Zanforlin Filho
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Reference Range ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Brazilian Population ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Large Sample ◽  
The Mean

AbstractThe aim of this study was to determine the reference range for amniotic fluid index (AFI) measurements in a large sample of the Brazilian population.This was a retrospective cross-sectional study on 3837 normal singleton pregnancies between 18+0 and 38+6 weeks of pregnancy. The AFI was measured from the largest vertical pockets of amniotic fluid in the four quadrants of the uterine cavity. To assess the correlation between AFI and gestational age (GA), polynomial equations were calculated, with adjustments using the determination coefficient (The mean maternal age and gestational age were 27.01±6.57 years and 30.43±5.29 weeks, respectively. The mean AFI ranged from 12.2±2.6 cm at 18 weeks to 11.6±6.0 cm at 38 weeks of pregnancy. The correlation between AFI and GA was best represented by a linear equation: AFI=17.78–0.153*GA (We established the reference range for the AFI in a large sample of the Brazilian population. This reference range can be used to monitor deviations in the volume of amniotic fluid in fetuses at high risk for intrauterine growth disturbances.

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
South Eastern ◽  
Amniotic Fluid Volume ◽  
The Mean ◽  
Singleton Pregnancies

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.

scholarly journals Stillbirths - Determining the associated factors and causes according to relevant condition at death: an experience from Pokhara, Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 58-65
Author(s):  
Junu Shrestha ◽  
Rami Shrestha ◽  
Sonam Gurung
Keyword(s):  
Birth Weight ◽  
Antenatal Care ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Intrauterine Growth ◽  
Factors Associated ◽  
Relevant Condition ◽  
Cord Prolapse

Background: Stillbirth contributes significantly to perinatal mortality. This study was conducted with aim to determine various factors associated with it and to define the causes of stillbirth according to relevant condition at birth.Materials and Methods :This is prospective cross-sectional study conducted in the Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2015 to June 2017. All cases of stillbirth occurring during antenatal or intrapartum period after 28 weeks of gestation or fetus weighing 1000 grams or more were included. Detailed demographic parameters were noted. After delivery, fetus, placenta, umbilical cord and amniotic fluid were noted in detail. Data was entered in SPSS version 16 and analysis done.Results: The stillbirth rate was 22 per 1000 births. Low educational level of women, lack of antenatal care, multiparous status, gestational age less than 34 weeks, low birth weight and male gender of fetus were found to be significantly associated with stillbirths. The cause of fetal death could be identified according to relevant condition at death in 84% of cases. Only in 16%, the cause of stillbirth was not identified. Intrauterine growth restriction was the commonest cause of stillbirth (22%), followed by congenital anomalies (15%) and hypertensive disorders of pregnancy (14%). Other causes were abruptio (7%), intrapartum asphyxia (7%) and rupture uterus (5%). Other minor causes were anemia, diabetes, cord prolapse and amniotic fluid abnormalities.Conclusion :Low level of education, lack of quality antenatal care, multiparity, low gestational age and birth weight and male sex of fetus were factors associated with stillbirth. The cause of stillbirth was identified in most of the cases and largely was due to intrauterine growth restriction.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11, July-December 2017, 58-65

scholarly journals Discrimination by parity is a prerequisite for assessing induction of labour outcome – cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Branko Denona ◽  
Michael Foley ◽  
Rhona Mahony ◽  
Michael Robson
Keyword(s):  
Caesarean Section ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Previous Caesarean Section ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group 3

Abstract Background To demonstrate that studies on induction of labour should be analyzed by parity as there is a significant difference in the labour outcome among induced nulliparous and multiparous women. Methods Obstetric outcome, specifically caesarean section rates, among induced term nulliparous and multiparous women without a previous caesarean section were analyzed in this cross-sectional study using the Robson 10 group classification for the year 2016. Results In the total number of 8851 women delivered in 2016, the caesarean section rates among nulliparous women in spontaneous and induced labour, Robson groups 1 and 2A, were 7.84% (151/1925) and 32.63% (437/1339) respectively and among multiparous (excluding those women with a previous caesarean section), Robson group 3 and 4A were 1%(24/2389) and 4.37% (44/1005), respectively. Pre labour caesarean rates for nulliparous and multiparous women, Robson groups 2B and 4B (Robson M, Fetal Matern Med Rev, 12; 23–39, 2001) were 3.91% (133/3397) and 2.86% (100/3494), of the respective single cephalic cohort at term. Conclusion The data suggests that studies on induction of labour should be analyzed by parity as there is a significant difference between nulliparous and multiparous women.

scholarly journals Factors affecting the fetal & maternal outcome in a trial of labour after previous one caesarean section

2019 ◽  
Vol 10 (2) ◽  
pp. 1110-1117
Author(s):  
Aseel Ghazi Rifat
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Fetal Complications ◽  
History Of ◽  
Maternal Bmi

This study was designed to evaluate maternal and obstetrical factors associated with a successful trial of labour after one caesarean section (TOLAC) as well as evaluating the associated fetal and maternal outcomes and to determine the rate of vaginal delivery and repeated C/S. A prospective cross-sectional study was done on 237 women with previous one C/S then patients were selected for the trial of labour based on the department protocol. Those who were chosen for TOL were strictly monitored & observed for the progress of labour and the outcomes were recorded in terms of mode of delivery, maternal & fetal complications and were analysed and compared with those who had repeated C/S. Seventy-three (30.8%) patient was delivered by elective C/S without trial, 109 (46%) of the patients who were admitted to labour room delivered vaginally while 55 (23.2%) delivered by emergency C/S. It has been found that maternal BMI of (<25), history of vaginal birth after C/S (VBAC) and smaller gestational age were significantly associated with the success of TOL and can predict the outcome. Higher maternal & fetal complications rates were reported in cases delivered by emergency C/S compared to those who delivered vaginally or through elective C/S. The trial of labour after one caesarean section is a safe alternative to repeated C/S and decreases the associated morbidities with repeated C/S. The success rate of TOLAC reported in this study was (66.5%). A successful TOLAC is associated with normal maternal BMI, smaller gestational age and history of the previous VBAC.

scholarly journals Maternal and Perinatal Outcomes Among Pregnancies Complicated by Isolated Oligohydramnios Compared with Normal Amniotic Fluid Index

2017 ◽  
Vol 11 (2) ◽  
pp. 32-36
Author(s):  
Ramesh Shrestha ◽  
DK Uprety ◽  
A Thakur
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Caesarean Section Rate ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Labour Induction ◽  
Control Group ◽  
P Value ◽  
Amniotic Fluid Index

Aims: The study was aimed to compare the maternal and perinatal outcomes among pregnancies with isolated oligohydramnios compared to normal amniotic fluid volume  between 37-42 weeks.Methods: It was a prospective cohort study done among the singleton pregnancies between 37-42 weeks with isolated oligohydramnios taken as cases (n=100) and pregnancies with normal levels of amniotic fluid matched to cases by gestational age and parity in 2:1 ratio fulfilling the inclusion criteria were taken as controls (n=200). Both the mother and baby were followed up till discharge for outcomes.Results: Majority of the patients (n=300) were of  age group 20-30 years (79.0%). Most of them (n=300) were primigravida (74.0%). The overall caesarean section rate was 24.66% (n=300). In the oligohydramnios group, 43.0% had undergone induction of labour (p value<0.05), 63.0% had undergone caesarean section (p value=0.001) and the most common indication for caesarean section was non-reassuring NST (44.44%) (p value<0.05). 26.0% babies had low birth weight, 12% had birth defects, 10.0% were small for gestational age (p value<0.05). There were significantly more ICU admission (13.0% vs 3.5%), early neonatal death (6.0% vs 1.5%), fetal distress (6.0% vs 1.5%) in the oligohydramnios compared to control group ( p value<0.05).Conclusions: Patients with oligohydramnios have increased labour induction, increased operative interferences and increased neonatal mortality and morbidity compared to patients with normal fluid volume.

scholarly journals Clinical Study to Evaluate Prevalence of Congenital Anomalies in Polyhydramnios

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Dr. Girdhar Gopal Nagar ◽  
Dr. Sanjana Jourwal ◽  
Dr. Nishu Goyal
Keyword(s):  
Congenital Anomaly ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Congenital Anomalies ◽  
Amniotic Fluid Index ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Increased Risk ◽  
Excessive Accumulation

Polyhydramnios is defined as excessive accumulation of amniotic fluid in relation to gestational age usually more than 2000 ml. More recently when Amniotic Fluid Index is more than 95th and 97th percentile for the gestational age condition is called as polyhydramnios. It is frequently associated with congenital anomalies of the fetus. The aim of our study was to observe prevalence of congenital anomalies in polyhydramnios. The present study was carried out in the department of Obstetrics and Gynaecology Umaid Hospital attached to Dr. S. N. Medical College, Jodhpur. In this study patients of polyhydramnios with gestational age between 20 to 42 weeks with amniotic fluid index more than 24 were enrolled after taking informed written consent. Degree of polyhydramnios was graded as mild, moderate and severe. Detail study of fetus was done for possible congenital anomalies. Congenital anomalies were confirmed with post-natal findings. There were 196 pregnant women with amniotic fluid index (AFI) > 24 cm. Prevalence of polyhydramnios was 1.66%. Congenital anomalies were present in 16.84% out of total 196 cases of polyhydroamnios. In pregnant women with severe polyhydramnios 51.51 % and in moderate 45.45% had congenital anomalies. Most common congenital anomaly was anencephaly (3.57%) followed by Hydrops (3.57%), Central nervous system, gastrointestinal and skeletal anomalies. Polyhydramnios is associated with increased risk of congenital anomalies hence Intrauterine condition of fetus should be monitored by using various diagnostic facilities like USG, Doppler, Echo-cardiography, amniocentesis and cordocentesis for possible congenital anomalies.

Frequency of Asymptomatic Bacteriuria in Pregnant Women

2021 ◽  
Vol 15 (10) ◽  
pp. 3520-3523
Author(s):  
Muneeba Sadaf ◽  
Afshan Zaman ◽  
Fatima Bibi ◽  
Maria Tariq ◽  
Uzma Nayyer ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Gestational Age ◽  
Asymptomatic Bacteriuria ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Urinary Tract Stones ◽  
History Of ◽  
One Year ◽  
Age Range

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials & Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.

scholarly journals Prevalence of Congenital Anomalies in Polyhydramnios: A hospital based study from Western Nepal

2018 ◽  
Vol 8 (1) ◽  
pp. 25-29
Author(s):  
Subita Lalchan ◽  
Prakash Sharma ◽  
Sangeeta Devi Gurung
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Congenital Anomalies ◽  
Excessive Amount ◽  
Amniotic Fluid Index ◽  
Skeletal Anomalies ◽  
Increased Risk

Introduction: Polyhydramnios is excessive amount of amniotic fluid in relation to gestational age. It is frequently associated with congenital anomalies of the fetus. The aim of this study was to see the prevalence of congenital anomalies in polyhydramnios.Methods: Singleton pregnant irrespective of gestational age with amniotic fluid index more than 25 were included in the study. Degree of polyhydramnios was graded as mild, moderate and severe. Detail study of fetus was done for possible congenital anomalies. Congenital anomalies were confirmed with post-natal findings.Results: There were 39 pregnant women with amniotic fluid index (AFI) > 25 cm. Prevalence of polyhydramnios was 0.3%. Congenital anomalies were present in 31.6 % of pregnant women with polyhydramnios. In pregnant women with severe polyhydramnios; 66.6 % had congenital anomalies. Central nervous system, gastrointestinal and skeletal anomalies were the frequent anomalies associated with polyhydramnios.Conclusion: Polyhydramnios is associated with increased risk of congenital anomalies hence a detail survey of fetus should be done for possible congenital anomalies.

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