scholarly journals Impact of Maternal Obesity on Pregnancy Outcome

2018 ◽  
Vol 14 (2) ◽  
pp. 18-22
Author(s):  
K Sinha ◽  
S Pandey ◽  
C R Das
Keyword(s):  
Pregnancy Outcome ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
College Teaching ◽  
Hypertensive Disorder ◽  
Obesity Class ◽  
Medical College ◽  
Puerperal Infection ◽  
Obese Class ◽  
Class 1

Background: Maternal obesity increases the risk of complications of pregnancy, labor, and neonate. It has been associated with gestational hypertension, eclampsia, pre-eclampsia, gestational diabetes, cesarean delivery, instrumental delivery, abortion, postpartum haemorrhage, puerperal infection and perinatal outcome like macrosomia, still birth and congenital anomaly, birth asphyxia.Aims: To evaluate the effect of maternal obesity on pregnancy outcome.Methods: The hospital based observational study conducted in the department of Obstetrics & Gynaecology at Nepalgunj Medical College Teaching Hospital Kohalpur between September 2015 to August 2016.Results: Mean age of participant's in the study group was 28 ± 5.77 and youngest participant's age was 19 yrs and oldest participant was 45 yrs. Among the fifty five ladies, 10 were grand multigravida, 30 were multi and 15 were primigravida. 63.6% delivered by cesarean section,1.8% delivered by forceps with episiotomy, 9.1% delivered by svd, 20% by svd with episiotomy and 5.5% by vacuum with episiotomy. Ten participants (18.18%) had hypertensive disorder during pregnancy. The mean BMI was 33±2.4. Under obese class 1 and class 2 were 49.1% and 50.9% respectively. Among the study population 56.36% had complications. Mean BMI was 33 minimum being 30 and maximum was 39.81. Regarding body weight maximum was 90 kgs. and 2 2. minimum was 68 kgs and mean weight being 78 kgs. Regarding maternal height maximum was 2.7 m , minimum was 2.01 m and 2 mean was 2.33 m . Total 7 newborn (13%) were macrosomic. Among 55 cases 27 fall under obesity class 1, 11 ladies with complication and among 28 ladies under obesity class 2, 22 had complications.Conclusion: The obesity has adverse effects on pregnancy outcome both for mother and the foetus.JNGMC, Vol. 14 No. 2 December 2016, Page: 18-22

scholarly journals Near miss maternal morbidity and maternal mortality at Kathmandu Medical College Teaching Hospital

1970 ◽  
Vol 8 (2) ◽  
pp. 222-226 ◽  
Author(s):  
NS Shrestha ◽  
R Saha ◽  
C Karki
Keyword(s):  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Scoring System ◽  
College Teaching ◽  
Near Miss ◽  
Hypertensive Disorder ◽  
Maternal Deaths ◽  
Medical College ◽  
Obstetric Morbidity

Background: Maternal mortality traditionally has been the indicator of maternal health all over the world. More recently review of the cases with near miss obstetric events has been found to be useful to investigate maternal mortality. Cases of near- miss are those in which women present with potentially fatal complication during pregnancy, delivery or the puerperium, and survives merely by chance or by good hospital care. Objectives: The objective of this study is to determine the prevalence and nature of near miss obstetric cases and maternal deaths at Kathmandu Medical College Teaching Hospital. Material and methods: This was a descriptive study done for the period of 24 months (1 January 2008 to 31 December 2009). Cases of severe obstetric morbidity were identified during daily morning meetings. All the cases were followed during their hospital stay till their discharge or death. Five factor scoring system was used to identify the near miss cases from all the severe obstetric morbidity. For each case of maternal death, data were collected from records of maternal death audit. Results: During the study period, 1562 women delivered at the institution and 36 women were identified as near-miss obstetrical cases. The prevalence of near miss case in this study was 2.3%. Five maternal deaths occurred during this period, resulting in a ratio of maternal death of 324 maternal deaths per 100,000 live births. Of the five maternal deaths three were due to pregnancy complicated with hepatitis E infection, one each due to Eclampsia and amniotic fluid embolism. Fifteen cases of near miss were due to haemorrhage (41.66%) and hypertensive disorder of the pregnancy was the cause in 10 (27.77%). Dystocia was the cause in 1(2.77%) case and infections in 7(19.4%) cases. Rare causes like anaesthetic complications were the cause in one case and dilated cardiomyopathy was the cause in two cases. Conclusion: The major causes of near-miss cases were similar to the causes of maternal mortality of Nepal. Need for the development of an effective audit system for maternal care which includes both near-miss obstetric morbidity and mortality is felt. Key words: Near-miss obstetric morbidity; Maternal mortality; Five factor scoring system DOI: 10.3126/kumj.v8i2.3563 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 222-226

scholarly journals Maternal Obesity and Its Associated Factors and Outcomes in Klang Valley, Malaysia: Finding from National Obstetric Registry

2021 ◽  
Vol 16 (3) ◽  
pp. 56-67
Author(s):  
Nurul Farehah Shahrir ◽  
Rohana Abdul Jalil ◽  
J Ravichandran R Jeganathan ◽  
Shamala Devi Karalasingam ◽  
Noraihan Mohd Nordin ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Associated Factors ◽  
Maternal Obesity ◽  
Multiple Logistic Regression Analysis ◽  
Class I ◽  
Hypertensive Disorder ◽  
Class Iii ◽  
Cross Sectional ◽  
Obese Class ◽  
Klang Valley

Introduction: Maternal obesity presents significant health risks to mothers and their fetuses. This study aimed to determine the proportion, associated factors and outcomes of maternal obesity among pregnant women in Klang Valley, Malaysia. Methods: A retrospective cross-sectional study was conducted between January 2018 and March 2018 using secondary data from the Malaysian National Obstetric Registry (NOR) for the year 2015. All pregnant women with first-trimester booking at 12 weeks and below that were registered with the NOR and met the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were used. Data were analysed using SPSS version 22.0. A total of 2113 respondents were included in this study to determine the proportion, associated factors and outcomes of maternal obesity. Regarding the univariate and multivariate analyses, respondents were classified into two groups: normal and obese. The obese group comprised overweight and obese mothers. The underweight group was excluded in the subsequent analysis. Results: Out of the 2113 respondents, 7.1% were underweight, 41.7% were of normal weight, 28.6% were overweight, 15.9% were in obese class I, 4.6% were in obese class II, and 2.1% were in obese class III according to the WHO (1995) reference. However, when the MOH (2003) cutoff point was used, there was a marked increase in the proportion of respondents in the overweight categories by 2.7% and obesity class I by 12.8%. The Indian (AdjOR 2.06, 95% CI: 1.11, 3.83, p=0.021) and Malay (AdjOR 1.75, 95% CI: 1.02, 3.00, p=0.040) ethnicities, as well as both multiparity (AdjOR 1.46, 95% CI: 1.23, 1.73, p <0.001) and grand multiparity (AdjOR 2.41, 95% CI: 1.78, 3.26, p <0.001), were significantly associated with maternal obesity. There were significant association between maternal obesity with hypertensive disorder in pregnancy (p=0.025), caesarean section delivery (p=0.002) and macrosomic infant (p <0.001). Conclusion: The identification of risk factors for maternal obesity is important to facilitate intervention programmes focused on improving the pregnancy outcomes for a high-risk group of women.

scholarly journals Cardiometabolic Phenotypic Differences in Male Offspring Born to Obese Preeclamptic-Like BPH/5 Mice

2021 ◽  
Vol 9 ◽  
Author(s):  
Kalie F. Beckers ◽  
Viviane C. L. Gomes ◽  
Kassandra J. Raven Crissman ◽  
Daniella M. Adams ◽  
Chin-Chi Liu ◽  
...  
Keyword(s):  
Adult Male ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Female Offspring ◽  
Left Ventricular ◽  
Male Offspring ◽  
Hypertensive Disorder ◽  
Male And Female ◽  
Similar Body ◽  
The Impact

Preeclampsia (PE) is a hypertensive disorder of pregnancy occurring in approximately 10% of women worldwide. While it is life threatening to both the mother and baby, the only effective treatment is delivery of the placenta and fetus, which is often preterm. Maternal obesity is a risk factor for PE, and the effects of both on offspring are long standing with increased incidence of cardiometabolic disease in adulthood. Obese BPH/5 mice spontaneously exhibit excessive gestational weight gain and late-gestational hypertension, similar to women with PE, along with fetal growth restriction and accelerated compensatory growth in female offspring. We hypothesized that BPH/5 male offspring will demonstrate cardiovascular and metabolic phenotypes similar to BPH/5 females. As previously described, BPH/5 females born to ad libitum-fed dams are overweight with hyperphagia and increased subcutaneous, peri-renal, and peri-gonadal white adipose tissue (WAT) and cardiomegaly compared to age-matched adult female controls. In this study, BPH/5 adult male mice have similar body weights and food intake compared to age-matched control mice but have increased inflammatory subcutaneous and peri-renal WAT and signs of cardiovascular disease: left ventricular hypertrophy and hypertension. Therefore, adult male BPH/5 do not completely phenocopy the cardiometabolic profile of female BPH/5 mice. Future investigations are necessary to understand the differences observed in BPH/5 male and female mice as they age. In conclusion, the impact of fetal programming due to PE has a transgenerational effect on both male and female offspring in the BPH/5 mouse model. The maternal obesogenic environment may play a role in PE pregnancy outcomes, including offspring health as they age.

Abstract P217: Phenotypic Difference Exist Between Bph/5 Offspring In A Sex-dependent Manner

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Kalie Beckers ◽  
Viviane Gomes ◽  
Kat Robillard ◽  
Chin-CHi Liu ◽  
Andrea Johnston ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Female Offspring ◽  
Hypertensive Disorder ◽  
Dependent Manner ◽  
Obesogenic Environment ◽  
Maternal Weight ◽  
Phenotypic Analysis ◽  
Phenotypic Differences ◽  
In Pregnancy

Preeclampsia (PE) is a hypertensive disorder of pregnancy occurring in ~10% of women worldwide. Maternal obesity is a risk factor for PE and the effects on offspring are long-standing with increased incidence of cardiometabolic disease into adulthood. The maternal obesogenic environment may play a role in pregnancy outcomes and offspring in a sex-dependent manner; however, in the context of superimposed PE, it is not completely understood. Obese BPH/5 mice spontaneously exhibit late-gestational hypertension, fetal demise and growth restriction, and excessive gestational weight gain, similar to PE. We hypothesized that phenotypic differences exist between female and male BPH/5 offspring and maternal weight loss in BPH/5 during pregnancy would influence these phenotypic differences. Obese BPH/5 dams were calorie restricted via pair-feeding (PF) to match the food intake of C57 dams for the first 9 days of pregnancy. Offspring were fed an ad libitum (lib) diet until phenotypic analysis. Body weights (BW), visceral peri-gonadal and peri-renal white adipose tissue (WAT), hearts, and livers were recorded in BPH/5 and control C57 age-matched adult females and males born to ad lib fed and PF dams. Values are reported as mean ± standard error of the mean. As previously described, BPH/5 females born to ad lib fed dams are overweight with increased peri-renal and gonadal WAT, cardiomegaly, and hepatomegaly (1308 ±13.3 vs 979.9 ±82.3g in C57, p<0.05). BPH/5 male mice are underweight (23.8±1.6 vs C57: 27.9±1.6g) with increased peri-renal WAT (158± 23 vs C57: 53.25±10.3mg, p<0.05), and cardiomegaly (heart: BW 8.1±0.5 vs C57: 5.7±1.1, p<0.05). Without altering BPH/5 male or female offspring BW, peri-renal adiposity (males: 103.5±13mg, females: 73.2±10.3mg, p<0.05), cardiomegaly (males: 5.74±0.5, females: 6.03±0.4, p<0.05), and female hepatomegaly (1149.8 ±58.1mg, p<0.05) are significantly attenuated in PF BPH/5 dams. To conclude, reduction in the maternal obesogenic environment may play a role in BPH/5 sex-dependent phenotypic differences. Future investigations are necessary to understand the differences observed in BPH/5 male versus female mice into adulthood as well as the transgenerational impact of attenuated maternal obesity in pregnancy.

scholarly journals Pregnancy Outcome in Gestational Diabetes Mellitus

2015 ◽  
Vol 3 (3) ◽  
pp. 107-112 ◽  
Author(s):  
Anu Bajracharya ◽  
Rachana Saha ◽  
Archana Shakya
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Hypertension ◽  
Perinatal Outcomes ◽  
College Teaching ◽  
Maternal Diabetes ◽  
Neonatal Complications ◽  
Medical College ◽  
Good Glycaemic Control

Background: Gestational diabetes mellitus is a metabolic disorder defined as glucose intolerance with the onset or fi rst recognition during pregnancy. Gestational diabetes mellitus is associated with higher incidence of maternal diabetes mellitus later in life. It poses a risk to the pregnant woman and to the fetus. Hence, it is imperative for an early detection and management of the disease to ensure better maternal and foetal outcomes. Objective: To assess the prevalence of gestational diabetes mellitus and to analyze the maternal and perinatal outcomes of gestational diabetes mellitus patients who delivered in the hospital during the study period. Methods: A hospital based descriptive observational study was conducted at Kathmandu Medical College Teaching Hospital for a period of one year from 1st January 2013 to 31st December 2013. All the cases of gestational diabetes mellitus were included in the study. Patients were followed from the time of admission to the time of discharge after delivery. Pertinent information obtained were demography, gestational age at diagnosis and delivery, pregnancy complications, intervention and perinatal morbidity and mortality. Results: Out of 2845 deliveries, 45 patients were diagnosed as gestational diabetes mellitus and admitted during the period of study. The prevalence of gestational diabetes mellitus was 1.58% in this hospital. The most common maternal and neonatal complications were gestational hypertension (20%), hypoglycemia (8.89%) and macrosomia (8.89%) respectively. Conclusion: This study is important in providing information about the maternal and neonatal outcomes of gestational diabetes. By proper monitoring and good glycaemic control during the antenatal period, the adverse maternal and neonatal complications of gestational diabetes mellitus can also be reduced.DOI: http://dx.doi.org/10.3126/jkmc.v3i3.12246Journal of Kathmandu Medical CollegeVol. 3, No. 3, Issue 9, Jul.-Sep., 2014, Page: 107-112

scholarly journals Spot protein/creatinine ratio as a marker for fetomaternal outcome in hypertensive disorder of pregnancy

2019 ◽  
Vol 8 (12) ◽  
pp. 5014
Author(s):  
Ashima Taneja ◽  
Gagandeep Kaur ◽  
Manpreet Kaur ◽  
Muskan Chaudhary ◽  
Kulvir Kaur
Keyword(s):  
Gestational Hypertension ◽  
Negative Likelihood Ratio ◽  
Urinary Protein ◽  
Hypertensive Disorder ◽  
Creatinine Ratio ◽  
Medical College ◽  
Protein Excretion ◽  
Hypertensive Disorder Of Pregnancy ◽  
Alternative Test ◽  
Protein Versus

Background: Gestational hypertension is defined as systolic BP level of > 140 mmHg or a diastolic BP of > 90 mmHg that occur after 20 weeks of gestation. Pre-eclampsia is the hypertensive disorder of pregnancy, associated with adverse fetomaternal complications. It is assosciated with proteinuria. 24 hours urine collection is cumbersome, time consuming and potentially misleading if collected inaccurately. The spot P/C ratio has been considered equivalent to 24-hour urinary protein for predicting proteinuria. Aim of study was to compare spot P/C ratio to 24 hours urinary protein in patients of pre-eclampsia and to determine the fetomaternal outcome in the patients admitted in Dayanand Medical College and Hospital, Ludhiana.Methods: A prospective simple random study. It included 100 hypertensive pregnant women being evaluated for pre-elampsia, regardless of the alerting signs or symptoms. The main measures were the urinalysis of patients which included urinary spot P/C and 24 hours urinary protein excretion and the fetomaternal outcome in these patients. The data was statistically analyzed.Results: A good positive correlation existed between the P/C ratio and 24 hours protein excretion, with a correlation coefficient (r) of 0.912. The sensitivity and specificity of 24 hours urinary protein versus spot P/C ratio ranged between 86.29%-99.51% and 8.35%-99.95% respectively. The positive and negative likelihood ratio of 24 hours urinary protein versus spot P/C ratio was 48 (ranged between 6.89-334) and 0.04 (ranged between 0.01-0.16) respectively. The positive and negative predictive value of 24 hours urinary protein versus spot P/C ratio was 97.96% and 96.08% respectively. Our data showed that urine spot P/C ratio above 3.9/mg strongly predicts significant proteinuria of more than 4 gram/day.Conclusions: Spot urinary P/C ratio with suspected preeclampsia can be used as a rapid alternative test to 24 hours urinary protein.

SIGNIFICANCE OF PLACENTAL HISTOPATHOLOGICAL FINDINGS IN PRETERM/TERM BIRTH

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang
Keyword(s):  
Preterm Birth ◽  
Comparative Study ◽  
Pregnancy Outcome ◽  
Neonatal Morbidity ◽  
Research Centre ◽  
College Hospital ◽  
Cross Sectional ◽  
Chorionic Villi ◽  
Term Birth ◽  
Medical College

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

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