Perinatal outcomes in pregnant patients presenting with antepartum hemorrhage: Our experiences at a teaching hospital in Central Punjab.

Objectives: Antepartum Hemorrhage is bleeding from or into the genital tract from the period of viability of fetus (28 weeks) till the end of second stage of labor. Antepartum hemorrhage is associated with a very high perinatal mortality rate. We present our experience of perinatal outcomes in cases of antepartum hemorrhage with the aim of highlighting the cause of antepartum hemorrhage and the adverse outcomes. Study Design: Descriptive Cross sectional study. Setting: Department of Gynecology & Obstetrics, Sargodha Medical College, Sargodha. Period: Jan 2018 to Jun 2018. Material and Methods: Ninety six pregnant patients between ages of 15-45 years diagnosed as cases of antepartum hemorrhage were enrolled. Patients with coagulation disorders, twin pregnancies, abnormal lie or presentation, previous scar and any known congenital anomaly. Cause of antepartum hemorrhage and mode of delivery was recorded. Perinatal outcomes were determined in terms of frequencies of perinatal mortality, stillbirth and low birthweight babies. Results: The etiology of antepartum hemorrhage in our setup was placenta previa (43.75%); placental abruption (37.5%); Toxemia (10.41%) and unclassified causes in 8.33% patients. The perinatal mortality rate was 43.75% in our study. The overall frequency of low birthweight babies and stillbirth was 62.5% and 27.08% respectively. Conclusion: Antepartum hemorrhage is a major cause of perinatal mortality in our country. A prompt diagnosis of the cause followed by early cesarean section can help reduce the overall mortality.

Download Full-text

Prevalence and Perinatal Outcomes of Singleton Term Breech Delivery in Wolisso Hospital, Oromia Region, Southern Ethiopia: A Cross-Sectional Study

Journal of Environmental and Public Health ◽

10.1155/2017/9413717 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Temesgen Debero Mere ◽

Tilahun Beyene Handiso ◽

Abera Beyamo Mekiso ◽

Markos Selamu Jifar ◽

Shabeza Aliye Ibrahim ◽

...

Keyword(s):

Perinatal Mortality ◽

Perinatal Outcome ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Perinatal Outcomes ◽

Cross Sectional Study ◽

Fetal Weight ◽

Sectional Study ◽

Cross Sectional ◽

Breech Delivery

Background.Breech deliveries have always been topical issues in obstetrics. Neonates undergoing term breech deliveries have long-term morbidity up to the school age irrespective of mode of delivery.Objective. To determine prevalence and perinatal outcomes of singleton term breech delivery.Methods. Hospital based cross-sectional study was conducted on 384 participants retrospectively. Descriptive and analytical statistics was used.Result. A total of 384 breech deliveries were included. Prevalence of singleton breech deliveries in the hospital was 3.4%. The perinatal outcome of breech deliveries was 322 (83.9%). Adverse perinatal outcome of singleton term breech delivery was significantly associated with women’s age of greater than or equal to 35 years (AOR = 2.62, 95% CI = 1.14–6.03), fully dilated cervix (AOR = 0.48, 95% CI = 0.25–0.91), ruptured membrane (AOR = 5.11, 95% CI = 2.25–11.6), and fetal weight of <2500 g (AOR = 6.77, 95% CI = 3.22–14.25).Conclusion. Entrapment of head, birth asphyxia, and cord prolapse were the most common causes of perinatal mortality. Factors like fetal weight <2500 gm, mothers of age 35 years and above, those mothers not having a fully dilated cervix, and mothers with ruptured membrane were associated with increased perinatal mortality.

Download Full-text

Perinatal mortality: epidemiological profile, causes and avoidable factors at a reference public maternity hospital in the State of Santa Catarina, Brazil, 2011–2015

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0353 ◽

2020 ◽

Vol 48 (2) ◽

pp. 162-167

Author(s):

Carla Beatriz Pimentel Cesar Hoffmann ◽

Lidiane Ferreira Schultz ◽

Carla Gisele Vaichulonis ◽

Iramar Baptistella do Nascimento ◽

Caroline Gadotti João ◽

...

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Perinatal Death ◽

Maternity Hospital ◽

Cross Sectional Study ◽

Cross Sectional ◽

Perinatal Mortality Rate ◽

Avoidable Death ◽

International Statistical Classification ◽

Epidemiological Profile

AbstractBackgroundThis study aimed to identify the perinatal mortality coefficient, the epidemiological profile, causes and avoidable factors at a reference public maternity hospital in southern Brazil.MethodsIn this cross-sectional study, 334 medical records of postpartum women and newborns were evaluated between January 1st, 2011 and December 31st, 2015. The Expanded Wigglesworth Classification was used to assess the causes of perinatal mortality and the International Statistical Classification of Diseases and Related Health Problems (ICD-10/SEADE Foundation) was used for the preventable perinatal mortality analysis. Absolute numbers and percentages were used for data analysis. The perinatal mortality formula was used to calculate the perinatal mortality rate.ResultsThe perinatal mortality rate was 13.2/1000 total births, with a predominance of white race/color; mothers were 21–30 years of age, had experienced their first pregnancy and had completed their high school education.ConclusionThe main factors associated with perinatal death were antepartum fetal death in 182 (54.49%) cases, and avoidable death through appropriate prenatal care in 234 (70.05%) cases.

Download Full-text

FREQUENCY AND CAUSES OF PERINATAL MORTALITY IN A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

Gomal Journal of Medical Sciences ◽

10.46903/gjms/16.01.1637 ◽

2018 ◽

Vol 16 (1) ◽

pp. 15-19

Author(s):

Maimoona Qadir ◽

Sohail Amir ◽

Samina Jadoon ◽

Muhammad Marwat

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Age Groups ◽

Mortality Data ◽

Care Hospital ◽

Cross Sectional ◽

Medical Disorders ◽

Perinatal Mortality Rate

Background: Perinatal mortality rate indicates quality of care provided during pregnancy and delivery to the mother and to the neonate in its early neonatal period. The objective of this study was to determine the frequency and causes of perinatal mortality in a tertiary care hospital in Peshawar, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2016 to 31st December 2016. The inclusion criteria was all singleton gestation with gestational age of at least 24 weeks presenting with perinatal mortality. Data was collected for the following variables; age groups (up to 20 years, 21-30 years, 31-40 years and > 40 years), booking status (yes/ no), period of gestation (24-31+6, 32-36+6, 37-39+6 and > 40 weeks), Foetal weight ( 3.5 kg) and cause of perinatal mortality. Results: Out of 4508 deliveries there were 288 perinatal deaths, including 228 stillbirths and 60 neonatal deaths, so perinatal mortality rate was 63.8/1000 births. 90.28% women were unbooked. Most common cause was hypertensive disorders of pregnancy (27.78%) followed by antepartum haemorrhage (25.71%) and then mechanical causes (13.88%). Congenital anomalies comprised 11.8% cases, neonatal problems 10.07% and maternal medical disorders for 4.16% cases. Cause of 4.16% cases remained unexplained. Conclusion: Appropriate strategies like control of identifiable causes, proper antenatal and postnatal care, healthy delivery practices and availability of emergency neonatal care facilities can bring down perinatal mortality rates.

Download Full-text

Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

Birat Journal of Health Sciences ◽

10.3126/bjhs.v4i1.23926 ◽

2019 ◽

Vol 4 (1) ◽

pp. 582-585

Author(s):

Sweta Rani ◽

Pallab Kumar Mistri

Keyword(s):

Oxygen Saturation ◽

Perinatal Outcomes ◽

Sampling Technique ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Therapeutic Interventions ◽

Maternal Outcomes ◽

Sectional Study ◽

Cross Sectional ◽

Medical Disorders

Introduction: In preeclampsia, hypoxemia may result from a number of mechanisms. Preeclampsia remains a complex and poorly understood disease. Currently, there are no reliable predictors of preeclampsia for early diagnosis to avoid adverse maternal or perinatal outcomes. Objective: The objective was to evaluate the efficacy of oxygen saturation (SpO2) as a predictor of adverse maternal outcome in women with preeclampsia. Methodology: We conducted the cross-sectional study on 182 preeclamptic women selected by random sampling technique. They were divided into two groups on the basis of oxygen saturation: 29 preeclamptic women (Group L) having oxygen saturation 95% or below and 153 women (Group H) having oxygen saturation 96% or above. The groups were statistically compared with respect to age, gestational age, proteinuria, severity of hypertension and developing different adverse effect of preeclampsia. Women with any medical disorders were excluded. Results: After statistical analysis, it was seen that the women having Spo2 ≤ 95% (L-Group) had experienced more adverse 2 outcomes. They were more hypertensive and more proteinuric, had higher liver enzyme levels, lower platelet counts, and were more likely to have experienced cardio-respiratory symptoms. Women with adverse outcomes were also more likely to have had therapeutic interventions, including corticosteroids, antihypertensives, and magnesium sulphate. Conclusion: Women having SpO2 ≤ 95% (L-Group) had more adverse 2 outcomes in comparison to SpO2 ≥96%(H-Group).

Download Full-text

Maternal and perinatal outcome in Rh-Negative women

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v16i1.37619 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Munjal Yadav ◽

Gehanath Baral

Keyword(s):

Perinatal Death ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Fetal Distress ◽

Cross Sectional Study ◽

Cesarean Sections ◽

Sectional Study ◽

Cross Sectional ◽

Indirect Bilirubin ◽

Parity Mode

Aim: To find out the Maternal and perinatal outcomes in Rh-Negative mothers. Methods: This is a cross sectional study of all Rhesus negative mothers giving childbirth at Department of Obstetrics and Gynecology, Nobel Medical Col- lege Teaching Hospital from March 2020 to February 2021. Maternal variables like age, parity, mode of delivery, and complications were recorded. Fetal vari- ables like period of gestation, fetal outcomes, hemoglobin, indirect bilirubin, fetal weight were noted. Results: There were 108 cases of Rh negative pregnancy and 95 of them deliv- ered Rh positive fetuses. Prevalence of Rh negative pregnancy was 1.68%. Half of them (51; 53.6%) underwent caesarean section due to obstetric indications with 20 repeat cesarean sections and 9 (17.7%) cases for fetal distress. Gross perinatal death was 9; none of the patients received antepartum im- munoprophylaxis; and 86 received postpartum Anti-D Rh IgG. There was only one case of proven isoimmunisation presented as hydrops fetalis in a grand multiparous woman with positive Indirect Coomb Test; and two newborn re- ceived exchanged transfusion. Conclusion: Rhesus negative rate was 1.68% and proven isoimmunization rate was 1%.

Download Full-text

Fetal malposition and malpresentation: Mode of delivery and perinatal outcomes at Maternity Teaching Hospital in Erbil city

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2020.044 ◽

2020 ◽

Vol 24 (3) ◽

pp. 367-375

Author(s):

Shahen Kak Hussein ◽

Shahla Alalaf

Keyword(s):

Cesarean Section ◽

Teaching Hospital ◽

Neonatal Intensive Care ◽

Mode Of Delivery ◽

Perinatal Outcomes ◽

Breech Presentation ◽

Neonatal Morbidity ◽

Cross Sectional Study ◽

Cross Sectional ◽

Neonatal Deaths

Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-transverse deliveries, 2.2% ended with the death of the fetus (P = 0.360). An Apgar score of 7 was recorded after 5 minutes for 97.7% of the infants. Around 11% of the women had postpartum hemorrhage. Conclusion: Fetal malpresentation and malposition are not uncommon during labor, and most cases are delivered by cesarean section. Neonatal morbidity and mortality are dependent on the type of presentation and the mode of delivery. Keywords: Malposition; Malpresentation; Perinatal outcome; Breech presentation.

Download Full-text

Perinatal Mortality in Multiple Pregnancy Patients

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000003925 ◽

1988 ◽

Vol 37 (3-4) ◽

pp. 331-337 ◽

Cited By ~ 7

Author(s):

F.P. Meehan ◽

I.M. Magani ◽

G. Mortimer

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Low Birthweight ◽

Multiple Pregnancy ◽

Fetal Loss ◽

External Cephalic Version ◽

Elective Cesarean Section ◽

Regional Analgesia ◽

Perinatal Mortality Rate ◽

Second Twin

AbstractA study of perinatal mortality in multiple pregnancy over a period of 12 years, 1972 to 1984, showed prematurity and low birthweight as the major causes of fetal loss. The highest risk was found at 28 to 30 weeks gestation (306/1,000). There was a significantly greater risk to babies delivered by the breech (136/1,000), and likewise in the second twin when compared with the first, ratio 1:1.4. A significant drop in the perinatal mortality rate, from 98/1,000 to 39/1,000, was observed between 1972-1978 and 1979-1984. Ultrasound has facilitated the earlier diagnosis of twins and provides more accurate serial fetal assessment. Bedrest, more vigilant antenatal care, intrapartum surveillance and improved neonatal care, are required to maintain and further reduce the perinatal mortality rate. When regional analgesia was employed in labour, the number of babies lost was 41/1,000, vs 93/1,000 in patients not receiving regional analgesia. External cephalic version and vertex delivery of the second twin is preferable to internal version and breech extraction. It should also be contemplated, as an alternative to elective cesarean section for a transverse lie or brrech presentation of the second fetus.

Download Full-text

Effect of inter-pregnancy interval on maternal and fetal outcome

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v15i1.29343 ◽

2020 ◽

Vol 15 (1) ◽

pp. 58-61

Author(s):

Pravin Shrestha ◽

Vibha Mahato ◽

Smita Karmacharya

Keyword(s):

Placenta Previa ◽

Perinatal Outcomes ◽

Fetal Outcome ◽

Cross Sectional Study ◽

Chronic Hypertension ◽

Maternal Complications ◽

Cross Sectional ◽

Increased Risk ◽

The Impact ◽

Inter Pregnancy Interval

Aims: To explore the impact of inter-pregnancy interval on maternal and fetal health Methods: Descriptive cross sectional study conducted at Department of Obstetrics and Gynaecology, Manipal Teaching hospital, Pokhara, Nepal. Inter-pregnancy interval (IPI) was calculated as the time elapsed between the woman’s last delivery and the date of last menstrual period for the present second or higher order birth. Intervals were taken in weeks and then converted to months. IPI were categorized as <18months, 18-23, 24-59, >59 months. Results: Among the 550 pregnancies studied, the majority (57%) of them had an IPI of more than 59 months. Long IPI of >59 months had increased risk of maternal complications like preeclampsia (12.4%), postdate pregnancy (10.8%), PROM (4.4%), oligohydramnios (3.8%), placenta previa (2.5%), gestational diabetes mellitus (2.2%), chronic hypertension (1.5%), abruptio placenta (0.3%), IUFD (0.6%) and overt DM (0.3%). Increased preterm birth was seen in IPI <18 months (25%). Short IPI had also increased risk of IUGR (8.3%) and anaemia. Adverse maternal outcome was least when IPI was between 18-23 months. Conclusions: IPI shorter than 18 months and longer than 59 months were associated with increased risk of adverse maternal and perinatal outcomes. Keywords: fetal, inter-pregnancy, interval

Download Full-text

Low birthweight, prematurity, and intrauterine growth restriction: results from the baseline data of the first indigenous birth cohort in Brazil (Guarani Birth Cohort)

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03396-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Carla Tatiana Garcia Barreto ◽

Felipe Guimarães Tavares ◽

Mariza Theme-Filha ◽

Yasmin Nascimento Farias ◽

Lídia de Nazaré Pantoja ◽

...

Keyword(s):

Birth Cohort ◽

Intrauterine Growth Restriction ◽

Low Birthweight ◽

Perinatal Outcomes ◽

Cross Sectional Study ◽

Baseline Data ◽

Growth Restriction ◽

Prevalence Rates ◽

Cross Sectional ◽

Intrauterine Growth

Abstract Background Low birthweight (LBW) remains an important global health problem, associated with a range of adverse life-course health outcomes. Evidence suggests that LBW is a relevant determinant of morbidity and mortality in indigenous groups, who generally have limited access to public policies on health and nutrition. Knowledge of the prevalence of LBW and its underlying causes can contribute essential steps to the prevention of its health effects. The study aimed to estimate the prevalence rates of LBW, prematurity, and intrauterine growth restriction (IUGR) and to investigate their determinants in the first indigenous birth cohort in Brazil. Methods This cross-sectional study used baseline data collected from the first indigenous birth cohort in Brazil, the Guarani Birth Cohort. Brazil is one of the most ethnically diverse countries in the world, with 305 indigenous peoples and 274 native languages. The Guarani are one of the five largest ethnic groups, with villages located mostly in the southern region. All singleton births from June 1, 2014, to May 31, 2016, were selected in 63 Guarani indigenous villages in the South and Southeast regions. Hierarchical multiple logistic regression was performed. Results Prevalence rates for LBW, prematurity, and IUGR were 15.5, 15.6, and 5.7%, respectively. The odds of LBW were lower in newborns of mothers living in brick and mortar housing (OR: 0.25; 95%CI: 0.07–0.84) and were higher in children of mothers ≤20 years of age (OR: 2.4; 95%CI: 1.29–4.44) and with chronic anemia before pregnancy (OR: 6.41; 95% CI: 1.70–24.16). Prematurity was statistically associated with the type of energy source for cooking (wood-burning stove – OR: 3.87; 95%CI: 1.71–8.78 and bonfires – OR: 2.57; 95%CI: 1.31–5.01). IUGR was associated with primiparity (OR: 4.66; 95%CI: 1.68–12.95) and chronic maternal anemia before pregnancy (OR: 7.21; 95%CI: 1.29–40.38). Conclusions Maternal age, nutritional status, and parity, housing conditions, and exposure to indoor pollution were associated with perinatal outcomes in the Guarani indigenous population. These results indicate the need to invest in access to, and improvement of, prenatal care; also in strengthening the Indigenous Healthcare Subsystem, and in inter-sector actions for the development of housing policies and sanitation and environmental improvements adjusted to needs and knowledge of the indigenous people.

Download Full-text