scholarly journals Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy In a Tertiary Hospital of Kathmandu

2018 ◽  
Vol 6 (4) ◽  
pp. 145-149
Author(s):  
Narayani Paudel ◽  
Santoshi Shrestha ◽  
Puspa Parajuli
Keyword(s):  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Normal Vaginal Delivery ◽  
Hypertensive Disorders Of Pregnancy ◽  
Medical College ◽  
Medical Disorders ◽  
Hypertensive Disorders ◽  
Elevated Liver Enzymes ◽  
Increased Risk

Background: Hypertensive disorders of pregnancy are considered to be a major worldwide health problem causing an increased risk of perinatal and maternal morbidity and mortality. Hypertensive disorders are the most common medical disorders encountered during pregnancy.Objective: This study aimed to assess the maternal and perinatal outcome of hypertensive disorders in pregnancy.Methods: A hospital based prospective study was conducted in Obstetrics ward of Kathmandu Medical College Teaching Hospital. Total one hundred pregnant women admitted in antenatal ward with the diagnosis of hypertensive disorders in pregnancy were included in the study. A structured questionnaire was designed and data collection was done through one- to- one interview technique during the period of December 2015 to January 2017. The collected data were analyzed by using Statistical Package for Social Science version 20.Results: Among 100 hypertensive disorders; 80% respondents had gestational hypertension, 16% had preeclampsia and two percent had eclampsia. Of total, 52% respondents had normal vaginal delivery followed by 46% caesarian section. One respondent had ante-partum hemorrhage, 11% had post-partum hemorrhage and one had developed hemolysis, elevated liver enzymes low platelets counts syndrome. Fortunately, no maternal mortality was occurred. Regarding perinatal outcome, 17% babies were born preterm, 13% babies had low birth weight and seven percent babies had birth asphyxia. Total fi ve were stillbirths and one percent had early neonatal death.Conclusion: Maternal outcome was good except few morbidities but perinatal outcome was found to be adverse. Proper management of hypertensive disorders is required to reduce perinatal morbidities and mortalities.Journal of Kathmandu Medical College,Vol. 6, No. 4, Issue 22, Oct.-Dec., 2017, Page: 145-149

scholarly journals Analysis of Cardiotocography Findings in Pregnancy with Less Fetal Movement and Its Association with Perinatal Outcome

2018 ◽  
Vol 30 (1) ◽  
pp. 19-22
Author(s):  
Ummay Salma ◽  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Dilruba Akhter
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Perinatal Outcome ◽  
Neonatal Death ◽  
Birth Asphyxia ◽  
Fetal Movement ◽  
Neonatal Unit ◽  
Normal Vaginal Delivery ◽  
Early Neonatal Death ◽  
Medical College

Less fetal movement affects perinatal outcome. To examine association between antenatal CTG findings and perinatal outcome in women with less fetal movement. This prospective observational study was conducted in the department of Obstetrics and Gynecology, Kumudini Women's Medical College and Hospital, Mirzapur, Tangail over a period of six months from January 2015 to June 2015. It included 100 pregnant women after 34 weeks of gestation. They underwent a cardiotocogram (CTG) test. Data were collected by face-to-face interview, observation and document review. The mean age of the women was 24.37±4.62 (SD) years and mean gestational age was 38.48±2.15 weeks. In this study, 82.0% of the cases presented at term pregnancy, 42.0% of the women were primi gravida and rest falls between 2nd to 4th gravida. Normal vaginal delivery was in 59.0% cases and rest were undergone caesarean sections (41.0%). Late deceleration with decreased variability was (23.5%) most common. Incidence of low birth weight was 16.0% & macrosomia was 5.0%. Birth asphyxia was found in 52.0% cases, 49.0% needed immediate resuscitation, 35.0% were admitted into neonatal unit and early neonatal death was 8.0%. Birth asphyxia was significantly higher in non-reassuring [37(72.5%)] than reassuring [15(30.6%)] on CTG. Incidence of low birth weight was higher in non-reassuring [11(21.6%)] than in reassuring [5(10.2%)] on CTG (p>0.05). Early neonatal death was more in respondents with non-reassuring [5(9.8%)] on CTG than reassuring [3(6.1%)] on CTG (p>0.05). Twenty six (51.0%) neonatal of the non-reassuring were admitted into neonatal unit whereas only 9 (18.4%) neonatal of the reassuring were admitted into neonatal unit. It can be concluded that CTG may be the first line investigation for ante and intrapartum fetal assessment.Medicine Today 2018 Vol.30(1): 19-22

scholarly journals Study of obstetric patients admitted to Intensive Care Unit (ICU) at Kathmandu Medical College Teaching Hospital

2014 ◽  
Vol 2 (4) ◽  
pp. 196-200 ◽  
Author(s):  
Rachana Saha ◽  
Archana Shakya
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Caesarean Section ◽  
College Teaching ◽  
Hypertensive Disorders Of Pregnancy ◽  
Medical College ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage ◽  
Morbid Conditions

Background: Pregnancy though physiological and uneventful can be associated with major maternal morbidity with potential catastrophic consequences requiring utilization of facilities of Intensive Care Unit (ICU). Reports regarding such admissions are few from developing countries.Objective: To study the indication for admission, intervention and outcome of obstetric patients admitted to intensive care unit at Kathmandu Medical College Teaching Hospital and also to identify risk factors for admission to intensive care unit.Methods: A hospital based descriptive observational study was conducted from 1st January 2012 to 31st December 2013. All obstetric admissions to the ICU up to 42 days postpartum were included. Data obtained included demography, obstetric history, pre- existing medical problems, indication for ICU admission, intervention in ICU and outcome. Risk factors were assessed by comparing cases with control which included women who delivered before and after the indexed cases.Results: A total of 50 obstetric patients required ICU admission during the study period. This accounts for 0.87% of total hospital deliveries and 4.32% of all ICU admissions. Forty-two percent of the patients were admitted due to hypertensive disorders of pregnancy. Sixteen percent patients were of obstetric haemorrhage. Heart diseases topped the list with 16% in non-obstetric group. Risk factors for admission included lesser gestational age, Caesarean section, blood loss and co-morbid conditions of the patient. Mean age was 24.5±4.8 years; average length of stay in ICU was 3.44±3.7 days. Inotropic support was received by six patients (12%), CVP monitoring was done in three patients (6%). Ventilator support was needed in six (12%). There were three cases (6%) of mortality which accounts for 2.09% of total ICU mortality. Seventeen patients (34%) were referred from other centres.Conclusion: Hypertensive disorders of pregnancy, Obstetric haemorrhage and Heart disease were the most common indications of ICU admissions. Risk factors for admission included lesser gestational age, caesarean section, blood loss, and co- morbid conditions of the patients. Optimal outcome was achieved with combined effort of multidisciplinary team.DOI: http://dx.doi.org/10.3126/jkmc.v2i4.11777Journal of Kathmandu Medical CollegeVol. 2, No. 4, Issue 6, Oct.-Dec., 2013Page: 196-200 

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

scholarly journals A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

2018 ◽  
Vol 7 (11) ◽  
pp. 4706
Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Perinatal Complications ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

scholarly journals STUDY OF PREVALENCE OF HYPERTENSIVE DISORDERS OF PREGNANCY AND THEIR MATERNAL AND PERINATAL OUTCOME AT GOVERNMENT VICTORIA HOSPITAL, VISAKHAPATNAM

2019 ◽  
Vol 6 (31) ◽  
pp. 2097-2100
Author(s):  
Chodavarapu Sailaja ◽  
Badam Rajani Kumari ◽  
Dongabanti Hemalatha Devi ◽  
Badugu V. V. Chandra Satya Vani ◽  
Maddela Yamuna
Keyword(s):  
Perinatal Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals The Role of HIV Infection in the Pathophysiology of Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy

2021 ◽  
Vol 8 ◽  
Author(s):  
Wendy N. Phoswa
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Hiv Infection ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Post Exposure Prophylaxis ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hiv Aids

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

High Fetal Fraction on First Trimester Cell-Free DNA Aneuploidy Screening and Adverse Pregnancy Outcomes

2019 ◽  
Vol 37 (01) ◽  
pp. 008-013 ◽  
Author(s):  
Lydia L. Shook ◽  
Mark A. Clapp ◽  
Penelope S. Roberts ◽  
Sarah N. Bernstein ◽  
Ilona T. Goldfarb
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
First Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Aneuploidy Screening ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Fetal Fraction

Abstract Objective To test the hypothesis that high fetal fraction (FF) on first trimester cell-free deoxyribonucleic acid (cfDNA) aneuploidy screening is associated with adverse perinatal outcomes. Study Design This is a single-institution retrospective cohort study of women who underwent cfDNA screening at <14 weeks' gestation and delivered a singleton infant between July 2016 and June 2018. Women with abnormal results were excluded. Women with high FF (≥95th percentile) were compared with women with normal FF (5th–95th percentiles). Outcomes investigated were preterm birth, small for gestational age, and hypertensive disorders of pregnancy. Results A total of 2,033 women met inclusion criteria. The mean FF was 10.0%, and FF >16.5% was considered high (n = 102). Women with high FF had a greater chance of delivering a small for gestational age infant <fifth percentile, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.1–4.8, p = 0.039). There was no significant association between high FF and either preterm birth or hypertensive disorders of pregnancy. Conclusion Women with a high FF in the first trimester are at increased risk of delivering a small for gestational age infant <fifth percentile. Further investigation into the clinical implications of a high FF is warranted.

scholarly journals The presence of coexisting sleep-disordered breathing among women with hypertensive disorders of pregnancy does not worsen perinatal outcome

PLoS ONE ◽  
2020 ◽  
Vol 15 (2) ◽  
pp. e0229568 ◽  
Author(s):  
Danielle L. Wilson ◽  
Mark E. Howard ◽  
Alison M. Fung ◽  
Fergal J. O’Donoghue ◽  
Maree Barnes ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Sleep Disordered Breathing ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Disordered Breathing

scholarly journals Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

2019 ◽  
Vol 8 (8) ◽  
pp. 3117
Author(s):  
Kushla Pathania ◽  
S. K. Verma ◽  
Shaina Chamotra ◽  
Ankit Chaudhary
Keyword(s):  
Case Control Study ◽  
Homocysteine Level ◽  
Perinatal Outcomes ◽  
Case Control ◽  
Unknown Etiology ◽  
Intrauterine Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Control Study

Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although pregnancy induced hypertension (PIH) is still regarded as a disease of theories and unknown etiology, elevated homocysteine level has been hypothesized as a key risk factor. Abnormally raised homocysteine has been significantly associated with increased risk of PIH, abruption, intrauterine growth restriction, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present case control study was conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of ascertaining the role of homocysteine in pregnancy related hypertensive disorders. Socio-demographic, clinical, biochemical including homocysteine level, laboratory and ultrasonographic parameters of all the participants were documented.Results: The mean homocysteine level of cases (18.30±10.81) was significantly higher than the controls (8.70±2.64).  About 62.2% cases had abnormally raised homocysteine level (>15 µmol/L), while only 1.1% controls had such level. The odds of a case having abnormally elevated homocysteine level were 146.6 (CI: 19.52-1101) times to that of controls. Eclamptics had the highest homocysteine level followed by preeclamptics and controls.Conclusions: The present study significantly associates the abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and demands much needed robustly designed studies to further explore the phenomenon. A simple intervention like estimating the much neglected homocysteine levels prior to pregnancy can definitely aid in predicting and preventing perinatal outcomes.

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