scholarly journals Multiple gestation and perinatal outcome in the Federal Medical Centre, Yenagoa, South-South, Nigeria: A 5-year review

2021 ◽  
Vol 3 (1) ◽  
pp. 001-011
Author(s):  
Peter Chibuzor Oriji ◽  
Dennis Oju Allagoa ◽  
Datonye Christopher Briggs ◽  
Judith Isioma Adhuze ◽  
Tornubari Romeo Mbooh ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Medical Centre ◽  
Morbidity And Mortality ◽  
High Rate ◽  
Gravid Uterus ◽  
Categorical Variables ◽  
Multiple Gestation ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Risk Pregnancy

Background: Multiple gestation occurs when the gravid uterus harbours more than one foetus. It is a high-risk pregnancy, because of the associated adverse pregnancy outcomes culminating in some cases, in a high rate of maternal and perinatal morbidity and mortality. Objective: To determine the incidence of multiple gestation, and maternal and perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, South-South, Nigeria, over a five-year period. Materials and Methods: This retrospective study was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved and entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables. Results: One hundred and sixty-three women had multiple gestation in the period under review, out of a total of 4,571 pregnancies, which represented a case incidence rate of 35.6 multiple gestations per 1,000 deliveries in the Centre. Incidence rates for twins and triplets were 32.5 and 3.5 per 1,000 deliveries, respectively. About 51.5% were unbooked for antenatal care in the index pregnancy. The most common (47.2%) complication was preterm delivery. There were 342 neonates from 163 multiple gestations. There was death of 20 (5.8%) babies. Conclusion: The significant maternal and perinatal morbidity and mortality associated with multiple gestation can be reduced by early diagnosis, specialized antenatal care, skilled intrapartum, postpartum and neonatal care in centres with a full complement of skilled obstetricians, anaesthetists and neonatologists.

scholarly journals MATERNAL COMPLICATIONS OF MULTIPLE GESTATIONS IN SECOND AND THIRD TRIMESTER OF PREGNANCY.

1969 ◽  
Vol 5 (1) ◽  
pp. 591-596
Author(s):  
SAIMA KHATTAK ◽  
MUHMMAD BILAL AWAN ◽  
MUHMMAD DANYAL AWAN
Keyword(s):  
Twin Pregnancy ◽  
Reproductive Technologies ◽  
High Order ◽  
Multiple Gestation ◽  
Third Trimester ◽  
Triplet Pregnancy ◽  
Maternal Complications ◽  
Multiple Gestations ◽  
Risk Pregnancy

BACKGROUND: In recent times, the incidence of multiple pregnancies has significantly increased dueto medication for induced ovulation and other reproductive technologies. The present study is designedto see the maternal complication of multiple gestations in pregnancy.OBJECTIVE: To determine the maternal complications associated with multiple gestation in secondand third trimester of pregnancy.METHODOLOGY: This descriptive study was carried out in the department of obstetrics andGynaecology unit at Lady Reading Hospital Peshawar. Duration of the study was 06 months from 1stJanuary 2012 to 1st July 2012. All patients with twin gestations, triplets and high order multiples visitingobstetrics and Gynaecology unit at Lady Reading Hospital Peshawar and who were admitted in wardwere included in the study and after taking informed consent their characteristics were recorded byfilling proforma.RESULTS: Sixty patients with multiple gestations were included in the study. Fifty four (90%) of themhad twin pregnancy and 06 (10%) had triplet pregnancy. The antenatal complications detected in thesepatients were preterm labour 23(32.3%), anaemia 18(30%), pregnancy induced hypertension, preeclamptic toxaemia, eclampsia 13(21.7%), Malpresentation 13(21.7%), Antepartum Haemorrhage 5(8.3%), 5 patients (8.3%) had PROM, 4 (6.7%) had polyhydramnios, 3(5%) had miscarriages, 5 (8.3%)had postpartum haemorrhage, 44(73.3%) patients had spontaneous vaginal delivery and 15(25%)underwent caesarean section. In 28(46.7%) patients cephalic/cephalic was the most commonpresentation.CONCLUSION: Multiple gestation is a high risk pregnancy and is associated with both maternal andfetal complications. Patient needs to be educated about the importance and advantages of early antenatalbooking and regular antenatal follow-up to reduce the risks to the mother and the babies.KEY WORDS: Twin pregnancy, Triplets, High-order multiplets; Complications-Second Trimester,Third trimester.

Maternal and Perinatal Outcome in Severe Pre-eclampsia and Eclampsia

2009 ◽  
Vol 1 (3) ◽  
pp. 25-28 ◽  
Author(s):  
Anshu LNU ◽  
Deepika LNU
Keyword(s):  
Pulmonary Embolism ◽  
Antenatal Care ◽  
Pulmonary Edema ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Perinatal Complications ◽  
Function Tests

ABSTRACT Background Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. Present study was planned to find the maternal and perinatal outcome in patients of severe pre-eclampsia and eclampsia. Methodology It is a prospective study, carried out on 100 pregnant women admitted with severe pre-eclampsia and eclampsia at a tertiary care referral unit. Detailed history and examination was carried out. Investigations like complete hemogram, liver function tests, renal function tests, coagulation profile, fundus and 24 hours urine for protein were done. Obstetric management was done as per existing protocol in the department, magnesium sulphate was the drug of choice for controlling convulsions, and blood pressure was controlled either by oral nefidipene or methyl dopa. Maternal and perinatal complications were noted down. Results The majority of the patients was unbooked (82%), belonged to lower socioeconomic status (84%) and had rural background (84%). Headache was the most common antecedent symptom (44%) followed by epigastric pain (20%), oliguria (9%), blurring of vision (8%) and ascitis (5%). There was high incidence of maternal complications like PPH (31%), abruption placentae (11%), renal dysfunction (8%), pulmonary edema (8%), pulmonary embolism (4%), HELLP syndrome (2%) and DIC (2%). Maternal mortality was 8% and the causes were pulmonary embolism in four women, DIC in two, HELLP and pulmonary edema in one each. Perinatal complications were also high 71.43% were low birth weight, 66% had preterm delivery, 52.4% babies had birth asphyxia and 28.57% were still born. Maternal and perinatal outcome was much poorer in eclampsia as compared to severe pre-eclampsia. Conclusion There is a very high maternal and perinatal morbidity and mortality and 82% patients had no antenatal care. Good antenatal care could have been prevented severe pre-eclampsia and eclampsia to some extent. Thus it is suggested that developing countries have to go a long way to create awareness about importance of antenatal check ups and take measures for implementation.

scholarly journals Prevention of Preeclampsia

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sammya Bezerra Maia e Holanda Moura ◽  
Laudelino Marques Lopes ◽  
Padma Murthi ◽  
Fabricio da Silva Costa
Keyword(s):  
Secondary Prevention ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Nutritional Supplementation ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Primary And Secondary Prevention ◽  
Care Change

Preeclampsia (PE) affects around 2–5% of pregnant women. It is a major cause of maternal and perinatal morbidity and mortality. In an attempt to prevent preeclampsia, many strategies based on antenatal care, change in lifestyle, nutritional supplementation, and drugs have been studied. The aim of this paper is to review recent evidence about primary and secondary prevention of preeclampsia.

scholarly journals Caesarean Section in a Tertiary Hospital in South-South, Nigeria: A 3-year Review

2021 ◽  
Vol 3 (2) ◽  
pp. 122-127
Author(s):  
Dennis O. Allagoa ◽  
Peter C. Oriji ◽  
Ebiye S. Tekenah ◽  
Lukman Obagah ◽  
Onyekachi S. Ohaeri ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Elective Caesarean Section ◽  
Tertiary Hospital ◽  
Medical Centre ◽  
High Rate ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Life Saving ◽  
Foetal Membranes

Background: Caesarean section is the delivery of the foetus, placenta, and foetal membranes through an incision on the abdominal and uterine walls after the age of foetal viability. It is a life-saving surgical procedure, which has helped reduce maternal and perinatal morbidity and mortality over the years. Objective: To determine the rates, indications, outcomes, and complications of Caesarean section at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. Materials and Methods: This research was carried out at the Department of Obstetrics and Gynaecology, Federal Medical Centre (FMC), Yenagoa, Bayelsa State, South-South, Nigeria between 1st January 2018 and 31st December 2020. It was a retrospective study. Data was retrieved from the labour ward records, delivery register, theatre records, and patients’ folders during the period under review, and entered into a pre-designed proforma. Data were analysed with IBM SPSS version 23.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: About 959 women had Caesarean section (CS) out of 2,263 deliveries, giving a Caesarean section rate of 42.4%. The commonest indication for emergency Caesarean section was cephalopelvic disproportion (36.0%), while that for elective Caesarean section was repeat Caesarean section (19.6%). Conclusion: The Caesarean section rate in our Centre is extremely high, almost three times the acceptable upper limit set by the WHO. Encouraging vaginal birth after Caesarean section as a means to reduce this high rate is recommended as it was noted that previous Caesarean section was a leading indication for surgeries.

scholarly journals Diagnostic efficacy of biophysical tests and cerebral-umbilical index when assessing fetal oxygenation

2013 ◽  
Vol 66 (7-8) ◽  
pp. 292-296
Author(s):  
Branka Cancarevic-Djajic ◽  
Rade Vilendecic
Keyword(s):  
Antenatal Care ◽  
Diagnostic Procedure ◽  
Statistical Significance ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Colour Doppler ◽  
Biophysical Profile ◽  
Doppler Evaluation ◽  
Fetal Oxygenation ◽  
Fetal Acidosis

Introduction. Perinatal morbidity and mortality are the ultimate indicators of antenatal care today, whose responsible task is to assess the respiratory function of the placenta, fetal growth and placental maturation in order to provide conditions for the delivery of a living and viable newborn. The diagnostic procedures of antenatal care tested within this study were the biophysical tests of cardiotocography and the fetal biophysical profile, along with the colour doppler evaluation of the cerebral-umbilical ratio. The objective of this study was to determine the most effective diagnostic procedure when assessing fetal oxygenation. Materials and Methods. The prospective study included 119 pregnant women. They all underwent cardiotocography, biophysical profile and colour doppler evaluation of the cerebral-umbilical ratio. The babies? umbilical artery blood pH was determined in the first minute upon birth, along with the Apgar score. Results. The results were processed statistically and the most effective diagnostic procedure for the evaluation of fetal oxygenation was selected, after which the rates of perinatal morbidity and mortality were calculated. The findings revealed that cardiotocography was the most sensitive antepartal predictor of fetal acidosis, while the fetal biophysical profile proved the most specific. The rates of perinatal morbidity and of perinatal mortality were 24.37% and 1.68%, respectively. Conclusion. The findings analysis revealed a high statistical significance of both biophysical tests and the cerebral-umbilical ratio evaluation as predictors of the fetal distress syndrome. The analysis of the cerebral-umbilical ratio and biophysical tests showed that the cerebral-umbilical ratio evaluation not only was more sensitive as a parameter compared to biophysical tests but it was also more specific than cardiotocography. Cardiotocography is the most sensitive antepartal predictor of fetal acidosis, followed by the cerebral-umbilical ratio, and the biophysical profile as the least sensitive. The biophysical profile proved to be the most specific, followed by the cerebral-umbilical ratio, and cardiotocography as the least specific.

scholarly journals ASSESSMENT OF NEONATAL OUTCOMES IN ECLAMPTIC MOTHERS ADMITTED TO NMCH, PATNA, BIHAR

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Samiksha Sharma ◽  
Girijanand Jha ◽  
Binod Kr Singh ◽  
Saroj Kumar
Keyword(s):  
Neonatal Morbidity ◽  
Perinatal Loss ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Pregnancy Induced Hypertension ◽  
Perinatal Morbidity ◽  
Medical College ◽  
Risk Pregnancy ◽  
Induced Hypertension ◽  
Prevention Of Prematurity

Hypertension during pregnancy is a highly variable disorder unique to pregnancy and a leading cause of maternal and fetal/neonatal morbidity and mortality. Pregnancy-induced hypertension is the general classification for hypertension diseases during pregnancy, which include pregnancy-induced hypertension usually after 20th week of gestation (without proteinuria), pre-eclampsia (with proteinuria), and eclampsia (pre-eclampsia with convulsions). This disease is responsible for high maternal and perinatal morbidity and mortality rates, and is one of the main public health problems. Hence based on above findings the present study was planned for Assessment of Neonatal Outcomes in Eclamptic Mothers Admitted to NMCH, Patna, Bihar. The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from March 2019 to October 2019. In the present study 50 females admitted with eclampsia or with pre-eclampsia but subsequently developing eclampsia were enrolled. Also the control females were also evaluated for comparative evaluation. The data generated from the present study concludes that Prevention of prematurity, treatment of morbidities & prevention of infection among infants should be done to reduce the PMR and improve perinatal outcome. Thus High risk pregnancy should be identified prospectively and then given special care, perhaps a major impact on overall perinatal loss could be reduced.     Keywords: Eclamptic Mothers, Patna, Bihar, etc.

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

scholarly journals Mortality and Conversion Rate to Below Knee or Above Knee Amputation Following Transmetatarsal Amputation

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0011
Author(s):  
D. Anthony Barcel ◽  
Susan M. Odum ◽  
Taylor Rowe ◽  
Jefferson B. Sabatini ◽  
Samuel E. Ford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conversion Rate ◽  
Significant Risk ◽  
High Rate ◽  
Administrative Database ◽  
Categorical Variables ◽  
Diabetic Patients ◽  
Knee Amputation ◽  
History Of ◽  
Transmetatarsal Amputation

Category: Midfoot/Forefoot; Diabetes; Other Introduction/Purpose: Non-traumatic lower extremity amputations (LEA), especially those performed in dysvascular and diabetic patients, are known to have poor long-term prognosis. Perioperative mortality has been reported at between 4 and 10%, and the 1 and 5 year mortality rates range between 22-33% and 39-69%, respectively. While poor outcomes in these patients have been described, there is no consensus as to the predictors of mortality. The purpose of the study is to determine the percentage of patients who had a complication following transmetatarsal amputation (TMA) and identify associated risk factors for complications and mortality. Methods: We queried our institution’s administrative database to identify 247 TMA procedures performed in 229 patients between January, 2002 and December, 2016. Electronic health records were reviewed to document complications defined as reoperation, amputation and mortality. Mortality was also verified using the National Death Index. Additionally, we recorded risk factors including diabetes, A1c level, end stage renal disease (ESRD), cardiovascular disease (CVD), peripheral vascular disease (PVD), history of revascularization, contralateral amputation, and neuropathy. The majority of the study patients were males (157, 69%) and the average age was 57 years (range 24-91). The median BMI was 28 (range 16-58) and 29% of the study patients were obese with a BMI ≥ 30. Fishers Exact tests were used to compare categorical variables. Kruskal-Wallis and Independent T-tests were used to compare numeric data. All data were analyzed using SAS/STAT software version 9.4 (Carey, NC) and a 0.05 level of significance was defined apriori. Results: The conversion rate to below (BKA) or above knee amputation (AKA) was 26% (64 of 247). Males (p=.0274), diabetics (p=.0139), patients in ESRD (p=.019), and patients with a history of CVD (p=.0247) or perioperative revascularization (p=.022) were more likely to undergo further amputation following an index TMA. BMI was significantly higher in patients requiring BKA/AKA (p=.0305). There were no significant differences in age (p=.2723) or A1c levels (p=.4219). The overall mortality rate was 35% (84 of 229). Diabetes (p=.0272), ESRD (p=.0031), history of CVD (p<.0001) or PVD (p=.0179) were all significantly associated with mortality. Patients who died were significantly older (p=.0006) and had significantly higher A1c levels (p=.0373). BMI was not significantly associated with mortality. Twenty-two patients who had 23 further amputations subsequently died. Conclusion: In our series of patients undergoing TMA, 26% underwent further amputation and 35% of patients died. Conversion rate to BKA or AKA occurred at a high rate regardless of preoperative revascularization or the use of tendo-achilles or gastrocnemius lengthening procedures. Male sex, diabetes, ESRD, history of CVD or revascularization are significant risk factors for further amputation. ESRD, diabetes, history of CVD or PVD, older age and higher A1c levels are significant risk factors for mortality. These data provide useful insight into risk factors to be emphasized when counseling patients and their families to establish realistic postoperative expectations.

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