Evaluation of the maternal and fetal outcome in multiple pregnancies in third trimester at tertiary care center

2021 ◽  
Vol 20 (1) ◽  
pp. 21-25
Author(s):  
V Uma ◽  
Author(s):  
Aditi V. Joshi ◽  
Michelle N. Fonseca ◽  
Deepali S. Kharat-Kapote

Background: Peripartum cardiomyopathy is an idiopathic and reversible form of dilated cardiomyopathy. The aim of the study was to study the mean age of presentation of peripartum cardiomyopathy in pregnant patients over a period of 1 year in a tertiary health care and study the maternal and fetal outcome of patients with peripartum cardiomyopathy.Methods: A retrospective observational study with total of 22 patients with peripartum cardiomyopathy was diagnosed in a total of 10,279 deliveries conducted at LTMMC, Sion hospital between September 2014 to February 2016.Results: Our study revealed that most of the affected patients were young with the mean age at presentation being 26.8±4.29 years. Most of the patients were diagnosed in the postpartum period (63.6%). the most common risk factor was pre-eclampsia (22.7%) followed by anemia (18.2%). The mean Ejection fraction at the time of presentation was 25.3±9.8%. There were 2 (9.1%) intrauterine fetal deaths and 1 neonatal death.Conclusions: There is a need for more multi-centric studies in order to understand the underlying pathogenesis and to determine the possible early interventions to help provide better pregnancy outcome.


Author(s):  
Rumi Bhattacharjee ◽  
Nitin Raithata ◽  
Molina Patel ◽  
Smruti Vaishnav

Background: Peri-partum cardiomayopathy (PPCM) in pregnancy has a potential to adversely affect both mother and fetus. Severe cases can be associated with life threatening complications unless managed promptly by multidisciplinary team. The objective was to study maternal and fetal outcome of PPCM patients.Methods: An observational cohort over 4 years (2012 to 2015) was conducted in a Rural tertiary care center. Consecutive antenatal and postpartum women with PPCM were studied for medical and obstetric complications, deliveries, fetal outcome and maternal mortality.Results: The incidence of PPCM was 0.3% and Most patients presented with typical signs and symptoms of heart failure. 55.5% were in NYHA 3 and 4 and 50% had ejection fraction below 30%. 83.3% required ICU admissions of varying length and Maternal mortality was in 1 patient (5.56%). PPCM occurred in 55.5% of ante partum against 44.4% of postpartum patients. Obstetric complications like PPH occurred in 11.1% while poor fetal outcome like preterm deliveries occurred in 50% while still births in 16.67%.Conclusions: The low incidence and rarity of PPCM presents itself with diagnostic dilemma. Obstetrician should have high index of suspicion in patients with heart failure and high risk factors. Early diagnosis and prompt treatment can only improve the outcome.


2017 ◽  
Vol 3 (2) ◽  
pp. 41-44
Author(s):  
R Nagarathnamma ◽  
C Sarojamma ◽  
P Sneha

ABSTRACT Introduction Cardiac disease in pregnancy is a major problem worldwide, particularly in developing countries. It often poses a difficult clinical scenario with the responsibility of the treating obstetrician also extending to the unborn fetus. In the present study, we aim to know the maternal and fetal outcomes in pregnancies complicated by cardiac disease. Materials and methods All pregnant patients with cardiac disease who delivered at our institution during 2014 to 2016 were evaluated to look for the final pregnancy outcomes. Results Out of 36 study cases, 44.44% had no maternal complications, while 88.89% had good fetal/neonatal outcome. The commonest maternal cardiac complication was sustained tachyarrhythmia/bradycardia followed by pulmonary edema, while intrauterine growth restriction was encountered in fetal outcome. Conclusion Multidisciplinary team management of cardiac disease, led by an experienced obstetrician and cardiologist, reduces the adverse outcomes in pregnancies complicated by cardiac diseases. How to cite this article Sneha P, Sarojamma C, Nagarathnamma R. Cardiac Disease complicating Pregnancy: A Tertiary Care Center Experience. J Med Sci 2017;3(2):41-44.


2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Atit Poudel ◽  
Ganesh Dangal ◽  
Madhu Shrestha

Introduction: Urinary incontinence is an involuntary passage of urine. The aim of the study was to find the prevalence of urinary incontinence among pregnant women in the third trimester of pregnancy at a tertiary care center. Methods: This descriptive cross-sectional study was conducted in a tertiary care center fromMarch 2021 to May 2021. Ethical approval was obtained from the Institutional Review Board(reference number: 854/2077/78). Convenience sampling method was used. A descriptive analysis of socio-demographic profile and urinary incontinence symptoms were recorded on International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form questionnaire and analysis were done using Statistical Package for Social Sciences 27. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 277 pregnant women admitted in the antenatal ward, urinary incontinence was present in 26 (9.4%) (95% Confidence Interval= 5.96-12.84). Among them, stress urinary incontinence 16 (61%) was most common followed by mixed incontinence 6 (23%). Majority of them 18 (69.3%) had small leaks with almost all 25 (96.2%) having only a mild to moderate impact on the quality of life. Majority 197 (71.2%) had features of lower urinary tract syndrome. Conclusions: Our study showed similar prevalence of urinary incontinence compared to other international studies.


Author(s):  
Prabha Agrawal ◽  
Rahul Agrawal ◽  
Ganshyam Jagathkar

The outbreak of coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally at an accelerated rate. A serious public health threat, it has caused a major impact on health care systems with a significantly high mortality and morbidity. Physiological changes and immuno-compromised state make pregnant women vulnerable during infectious disease outbreaks and hence need a more cautious approach. With this report we aim to share our experience regarding clinical characteristics, management and outcomes of 10 diagnosed COVID-19 pregnant women undergoing cesarean section at Medicover hospital, a tertiary-care center in Hyderabad, India between July to September 2020. All 10 pregnant women were referred in their third trimester with diagnosis of COVID-19. 2 out of 10 patients had severe COVID-19 and were managed in the ICU. All patients underwent emergency cesarean sections and none of the infants were infected with COVID-19. At discharge, all patients and the newborns were in a clinically stable condition. Effective management strategies incorporating integrated team approach, early cesarean section and low-threshold for mechanical ventilation has been shown to be associated with favorable outcomes for mothers diagnosed with COVID-19 and their infants. Also, the present data does not support any evidence of vertical transmission of SARS-CoV-2 virus in those manifesting during the third trimester of pregnancy.


Author(s):  
Prachi Singh ◽  
Namrata Saxena ◽  
Vineeta Gupta ◽  
Neeta Bansal ◽  
Yashika Pehal

Background: Incidence of heart disease in pregnancy is about 1%. Pregnant patient with cardiac disease can present with lot of challenges for the obstetrician, paediatrician and the cardiologist. With improvement in diagnostic, medical, surgical management, more patient with cardiac diseases especially congenital are able to reach reproductive age. Therefore, still a cardiac disease remains a significant cause of maternal death. Maternal and fetal prognosis both is affected by the care given and the skills used in the treatment of the individual patient. Hospital has resulted in majority of cardiac disease patient being managed in a tertiary care center and this provide an opportunity to report on clinical experiences of pregnancy with cardiac disease, their management and obstetrical outcomes.Methods: This was a retrospective study, with all the patients detailed demographic information, diagnosis, course in the hospital, management, maternal and fetal outcome was obtained from the medical records and files.Results: Incidence of cardiac disease was found to be 0.7%, 47% of pregnant women fell in age group of 26-30 years, 38.2% were primigravida, only 23.53% were booked, and half of them belonged to NYHA II class. 73.5% had Rheumatic heart disease and the most common obstetrics complications were preterm labor and anemia. LSCS was done in 29.4% cases and 38.2% of the newborns were premature.Conclusions: Prematurity anaemia, IUGR, are the common obstetrical complication in pregnant patient with cardiac disease which can be taken care with increased awareness and pre-conceptional counselling especially in patient with congenital heart disease. For optimization of maternal and neonatal outcomes in these patients, dedicated team of obstetrician, fetal medicine specialist, pediatricians, cardiologist and anesthesiologist is the prime requirement.


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