scholarly journals PRETERM PRE LABOUR RUPTURE OF MEMBRANES;

2013 ◽  
Vol 20 (05) ◽  
pp. 765-771
Author(s):  
SAADIA YASIR, ◽  
BUSHRA KANT, ◽  
TAHIRA JABBAR
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Post Partum ◽  
Previous History ◽  
Latency Period ◽  
Study Objective ◽  
Gestational Age At Delivery ◽  
History Of ◽  
One Year ◽  
Foetal Lung

Study Objective: The objective of this study is to describe the maternal and perinatal outcome of conservative managementin PPROM. Design: Descriptive prospective study. Period: One year from August 2006 to August 2007. Setting: Maternal and child health(MCH) Centre PIMS Islamabad. Material and Methods: 50 patients between 28-36 weeks of gestation presenting with PPROM. Results:The mean age was 27+5.1 years, 14(28%) were having gestational age between 28to 32 weeks and 36 (72%) were between 33 to 36weeks of gestation. 34 (68.0%) of the mothers had no history of abortions while 10 (20.0%) had 1-2 abortions and 6 (12.0%) had 3 ormore abortions. Sixteen (32.0%) women had previous PRROM while 10 (20.0%) had previous history of preterm labor. Inversecorrelation was observed between latency period and gestational age. Among 14(28%) women with gestational ages between 28 to 32weeks 10 delivered within 48 hours and 4 after 48 hours. Among 36(72%) women with gestational ages between 33-36 weeks 31(62%)delivered in less than 48 hours and 5 (10 %) women delivered after 48 hours.14(28%) of the 50 babies were admitted in NICU withsepticemia, 7(14.0%) with RDS, hypoglycemia in 2(4.0%) and necrotizing enterocolitis in 3(6.0%). 3 neonates died from septicemia and2 from RDS. On first follow-up 34.0% mothers had infections and 8.0% had post-partum hemorrhage. Conclusions: Expectantmanagement till 36 weeks is a suitable option as gestational age at delivery and birth weight both affect neonatal survival and offer time toadminister corticosteroids to allow foetal lung maturity. Foetal deaths occurred due to septicaemia and RDS with direction co-relationshipwith low birth weight.

Comparison of oral Dydrogesterone and 17-α hydroxyprogesterone caprate in the prevention of preterm birth

2021 ◽  
Author(s):  
Fahimeh Alizadeh ◽  
Malihe Mahmoudinia ◽  
Masoumeh Mirteimoori ◽  
Lila Pourali
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Latency Period ◽  
Obstetric Care ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Gestational Age At Delivery

Abstract Background: Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB.Methods :In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30mg oral Dydrogesterone daily, 250mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery.Results: Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06±17.29 vs. 29.44±15.6 and 22.20±4.51 days, respectively; P<0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P<0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes.Conclusion: Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.

scholarly journals Outcome of Twin Pregnancy in a Periurban Hospital

2016 ◽  
Vol 27 (2) ◽  
pp. 57-62
Author(s):  
Saria Tasnim ◽  
FM Anamul Haque ◽  
Sameena Chowdhury
Keyword(s):  
Birth Weight ◽  
Twin Pregnancy ◽  
Perinatal Death ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Labor Pain ◽  
Maternal Complications ◽  
Management Options ◽  
History Of ◽  
Second Twin

Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62

scholarly journals Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia

2018 ◽  
Vol 24 (3) ◽  
pp. 162
Author(s):  
Cetin Kilicci ◽  
Cigdem Yayla Abide ◽  
Enis Ozkaya ◽  
Evrim Bostancı Ergen ◽  
İlter Yenidede ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Unit Admission ◽  
Neonatal Intensive Care Unit ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Apgar Scores ◽  
Gestational Age At Delivery

<p><strong>Objective:</strong> The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. </p><p><strong>Study Design:</strong> Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission.</p><p><strong>Results:</strong> Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission.</p><p><strong>Conclusion:</strong> Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia.</p>

scholarly journals Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

2016 ◽  
Author(s):  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Gestational Age ◽  
Post Partum ◽  
Severe Preeclampsia ◽  
Maternal Complications ◽  
History Of ◽  
Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/μl, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

scholarly journals Study of perinatal factors in children with developmental delay

2016 ◽  
Vol 4 (1) ◽  
pp. 182 ◽  
Author(s):  
Goli Sri Charan ◽  
Jayant Vagha
Keyword(s):  
Birth Weight ◽  
Developmental Delay ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Global Developmental Delay ◽  
Developmental Quotient ◽  
Birth History ◽  
History Of ◽  
Observational Descriptive Study ◽  
Birth Body Weight

Background: Birth history gives important information in children with developmental delay. Developmental challenge in children is an emerging problem across the globe, which is largely associated with improved neonatal survival. The present study highlights the importance of birth history in children with developmental delay in our hospital. The objective of this study was to study the perinatal events in children with developmental delay.Methods: Observational descriptive study was conducted on children between 6 months to 5 years who were admitted in Pediatric wards with suspected history of developmental delay. DDST II scale was performed on these children and children who failed on Denver II scale were recruited into the study. Birth history was noted in detail, if available, documentation of birth events was asked for and noted. Developmental history with developmental quotient (DQ), were noted in detail.Results: 135 children had developmental delay, 113 (83.70%) were born by vaginal delivery and 22 (16.30%) were born by caesarian section, 46 (34.18%) had no cry at birth and remaining 89 (65.92%) had normal cry at birth. 104 (77.04%) were born by term gestation and 31 (22.96%) were born preterm. Birth weight was normal in 78 (57.7%) children, LBW was seen 47 (34.81%) and 5 children each with VLBW and ELBW and 35 (25.93%) were IUGR. On comparing the children born gestational age and birth body weight with all four domains, there was no significant difference.Conclusions: Global developmental delay was more common in children born at preterm, low birth weight, IUGR and children who had birth asphyxia. Birth weight and gestational age did not significantly affect any particular domain of development. 

MO254PREGNANCY OUTCOMES AND COMPLICATIONS IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS*

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Elena Prokopenko ◽  
Aleksei Zulkarnaev ◽  
Irina Nikol`skaya ◽  
Andrey Vatazin ◽  
Daria Penzeva
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Preterm Delivery ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Multiple Pregnancy ◽  
Chronic Glomerulonephritis ◽  
Gestational Age At Delivery ◽  
Negative Effect ◽  
Adverse Pregnancy

Abstract Background and Aims Pregnancy in patients with chronic glomerulonephritis (CGN) is associated with higher risk of complications and unfavorable outcomes compared to the general population. The aim of the study was to determine the incidence of pregnancy complications and outcomes in patients with preexisting CGN. Method 126 pregnancies in 119 women with CGN and CKD 1-4 stages: 1 st. – 86 patients, 2 st. – 17, 3 st. – 20, 4 st. – 3 and 20 pregnancies in 20 age-matching healthy women were included. Patients with secondary CGN, multiple pregnancy, pregnancy after IVF were excluded. A kidney biopsy was performed in 18 of 119 (15.1%) women: 15 – before conception and 3 – after delivery. IgA-nephropathy was detected in 11 of 18 (61.1%) patients, MCD/FSGS – in 4 (22.2%), MPGN – in 3 (16.7%). The incidence of unfavorable pregnancy outcome, preeclampsia (PE), preterm delivery, cesarean section (CS), low birth weight (LBW &lt; 2500 g), small for gestational age (SGA) newborn (birth weight &lt; 10th percentile), mean term of delivery, mean birth weight, frequency of treatment in neonatal intensive care unit (NICU) and achieving of end-stage kidney disease in mothers after delivery were evaluated. Results CKD was first diagnosed during pregnancy in 34.1% women with CGN. The incidence of adverse pregnancy outcomes, preterm delivery, LBW, SGA, and treatment in the NICU did not differ between groups, while the frequency of PE and CS were higher, and mean gestational age at delivery, birth weight were lower in the CGN group compared to the healthy control (Table). Severe PE was observed in 6 of 32 (18.7%) patients with PE and CGN. The incidence of PE increased in advanced stages of CKD, but the differences were not significant: 19.8% - in CKD1, 35.3% - CKD2, 35% - CKD3, 66.7% - CKD4, p=0.112. The frequency of PE depended on the presence of baseline nephrotic-range proteinuria (NPU) and chronic arterial hypertension (AH): PE was observed in women w/o NPU and w/o AH in 8.3% cases, w/o NPU and with AH – in 39%, with NPU and w/o AH – in 44,4%, with NPU and with AH – in 43.8%, p=0.00048. Preterm delivery, CS and LBW were more common in women with chronic renal failure, and their frequency increased with increasing severity of CKD: CKD1 – 3.5%, 21.2%, 3.5% resp.; CKD2 – 6.7%, 53.3%, 20%; CKD3 – 40%, 70%, 40%; CKD4 – 100%, 100%, 100% (p&lt;0.0001, for all characteristics). We found differences in gestational age at delivery depending on the stages of CKD: in CKD1 it was 38.9 ± 1.3 wks, CKD2 – 38.2 ± 2.1 wks, CKD3 – 36.3 ± 3.5 wks, CKD4 – 32.4 wks (one child), p=0.00013. The proportion of newborns requiring intensive care was higher in mothers with CKD3 (30%) and CKD4 (100%) compared with CKD1 (0%) and CKD2 (13.3%), p&lt;0.0001. Five of 126 (4%) patients in CGN group achieved stage 5 CKD with average postpartum follow-up period of 92.6 ± 20.5 months; 4 women had CKD3 during pregnancy, one – CKD1. Now 2 patients are treated with regular hemodialysis, 3 - live with kidney transplant. Conclusion Chronic glomerulonephritis has a negative effect on pregnancy course, increasing the incidence of PE and CS and contributing to reduce gestational age and birth weight. Incidence of preterm delivery, CS, LBW and proportion of newborns treated in NICU were highest in patients with CKD 3-4.

scholarly journals Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days)

2017 ◽  
Vol 6 (2) ◽  
pp. 636
Author(s):  
Parag M. Hangekar ◽  
Anand Karale ◽  
Neelesh Risbud
Keyword(s):  
Side Effects ◽  
Preterm Labor ◽  
Mode Of Delivery ◽  
Previous History ◽  
Fetal Lung ◽  
Delivery Mode ◽  
Birth Complications ◽  
Gestational Age At Delivery ◽  
Nicu Admission ◽  
One Year

Background: Preterm birth is defined as birth between the age of viability and 37 completed weeks of gestation. The aim of this study is to evaluate the safety and efficacy of nifedipine, a calcium channel blocker, as a tocolytic in prolonging duration of pregnancy in case of preterm labor.Methods: This is a retrospective analytical study conducted in Department of Obstetrics and Gynaecology, SKNMC and GH, Pune, India conducted over a period of one year from June 2014 to May 2015. All uncomplicated, singleton preterm labor cases were given Cap. Nifedipine as tocolytic and Inj. Betamethasone for enhancing fetal lung maturity. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. Neonatal parameters studied were weight at birth, APGAR score at birth, complications at birth, NICU admissions, mortality.Results: Out of total 4478 deliveries from June 2014 to May 2015, 252 women with preterm labor were treated with nifedipine. 214 out of 252 delivered at term with overall success rate of 84.92%. Out of remaining 38 cases, 36 cases delivered as preterm normal deliveries and 2 required Caesarean section. No major side effects observed in mothers receiving nifedipine. As regards neonatal outcome, 12 babies required NICU admission and mortality was of 2.Conclusions: Nifedipine is safe and effective in prolonging preterm labor and has minimal maternal and neonatal side effects. It eliminates the need for intensive maternal monitoring as required in case of betamimetics.

scholarly journals The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Ceyda Sarıal ◽  
Abdulhamıt Tayfur ◽  
Beyza Kap ◽  
Dılara Donder ◽  
Ozum Melıs Ertuzun ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Previous History ◽  
Control Group ◽  
Balance Test ◽  
Balance Tests ◽  
Volleyball Players ◽  
History Of ◽  
One Year ◽  
The Right ◽  
The Impact

Objectives: To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players. Methods: Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests. Results: Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05). Conclusion: Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.

Correlation of abnormal upper tract cytology and tumor histology in patients who have undergone a nephroureterectomy for urothelial carcinoma with disease recurrence in the bladder.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 288-288
Author(s):  
Einar Freyr Sverrisson ◽  
Timothy Kim ◽  
Patrick Espiritu ◽  
Wade Jeffers Sexton ◽  
Julio Pow-Sang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Previous History ◽  
Tumor Grade ◽  
Disease Recurrence ◽  
Intravesical Therapy ◽  
Prior History ◽  
Upper Tract ◽  
History Of ◽  
One Year ◽  
Bladder Recurrence

288 Background: 15-50% of patients with upper tract urothelial carcinomas (UTUC) will have a bladder recurrence. Abnormal upper tract cytology (UTC) is an indicator of higher grade tumors but has not been associated with bladder recurrence. We were interested in investigating the role of UTC as a predictor of bladder cancer recurrences in patients with no prior history of bladder cancer presenting with UTUC. Methods: Of 67 patients who had an UTC collected prior to their nephroureterectomy (NU) in 2004-2012, we identified 17 patients with a recurrent disease in the bladder who met the criteria of having no previous history of bladder cancer at the time of their NU. UTC and histology were reviewed and analyzed with the bladder pathology data. Positive or suspicious cytology was defined as abnormal and atypical or reactive as benign. Results: 15 (88%) of 17 patients (11 men and 6 women) who met our criteria were diagnosed with bladder cancer within one year after their NU (average 7.5 months (range 2-26)). 10 (59%) of 17 patients had abnormal UTC with a calculated sensitivity and specificity of 59% and 22%, respectively. 7 (70%) of 10 patients with abnormal UTC compared to 5 (71%) of 7 patients with benign cytology had high grade (HG) bladder cancer (p=1.0). Muscle invasive tumors were found in 5 (29%) of 17 patients and 3 (60%) of those had abnormal UTC. All six women had HG bladder cancer compared to 6 of 10 men (p=0.23). HG tumors were slightly more common in the bladder compared to the upper tract (75% vs 65%, p=0.70) and 14 (87.5%) of 16 bladder tumors had the same tumor grade in the upper tract. Conclusions: Abnormal UTC is a poor predictor of bladder recurrence in patients with a history of UTUC. The majority of patients who developed bladder recurrence presented within one year from NU with HG disease which underscores the importance of aggressive surveillance and the consideration of prophylactic intravesical therapy at the time of NU in this patient cohort.

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