scholarly journals Intrauterine Foetal Death: A Hospital Based Study

2022 ◽  
Vol 19 (1) ◽  
pp. 89-91
Author(s):  
Kamar Jahan ◽  
Binod Kumar Mahaseth
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Fetal Death ◽  
Well Being ◽  
Intrauterine Fetal Death ◽  
Exclusion Criterion ◽  
Foetal Death ◽  
Medical College ◽  
Associated Risk Factors ◽  
Age Range

Introduction: Foetal death at any stage of pregnancy is not just a tragic event but also a more traumatic for the mental well-being of a mother. It is one of the most wrenching events in the field of obstetrics. Aims: The study was done to determine the probable risk factors of intrauterine foetal death and role of antenatal care in its prevention. Methods: The study was conducted  in Obstetrics and Gynecology department at Nepalgunj Medical college from July 2018 to July 2020 .Inclusion criteria were  intrauterine fetal death  of >28 weeks of gestation and baby weighing  1000 grams or more . An exclusion criterion was molar pregnancy. Results: There were 115(3.52%) intrauterine fetal death during the study period, making it 35 per 1000 cases. In 17(14.78%) the cause of intrauterine fetal death was not known. The other common associated risk factors were prematurity in 14(12.17%) and hypertension in 13(11.30%). Similarly anemia and antepartum hemorrhage were seen in 13(11.30%) each. 11(9.56%) patients had oligohydramnios. Mal presentation was found in 8(6.95%) patients while polyhydromnios in 6(5.21%).The commonest age range in whom intrauterine fetal death was seen was 20-30 (73.90%). 28 (24.34%) patients were at preterm pregnancy ranging between 28-30 weeks whereas 17(14.78) intrauterine fetal death occured at  32-34 weeks. 77 foetuses were preterm and their birth weight was between 1 - 1.5 kg  with the mean wt of  1175.73 gms. Conclusion: Intrauterine fetal death is still common inspite of the improving awareness in importance of regular antenatal care. In majority, the cause of intrauterine fetal death is still unknown. However, where the cause was known prematurity was the commonest.

scholarly journals Evaluation of clinicopathological profile of subjects with intrauterine fetal death

2018 ◽  
Vol 7 (5) ◽  
pp. 1742
Author(s):  
Sunil Kumar Pandey ◽  
Surabhi Porwal
Keyword(s):  
Prospective Observational Study ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
Fibrinoid Necrosis ◽  
Foetal Death ◽  
Laboratory Findings ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Clinicopathological Profile ◽  
Laboratory Profile

Background: Intrauterine foetal death is an immense emotional burden for everyone concerned specially in the last trimester. Therefore, it is very important to find out, what has happened. Evaluation of clinical and pathological profile of women presenting with intrauterine foetal death has evoked great interest among the obstetricians.Methods: The prospective observational study was conducted in the department of Obstetrics and Gynaecology N.S.C.B. Medical College Jabalpur during 1st June 2012 to 31st October 2013. A total of 155 intrauterine foetal death subjects admitted during this period were evaluated. Clinically and laboratory profile of subjects done.  Histomorphology of placenta was performed in each case. Full HPR finding were then correlated with clinical and laboratory findings of subjects.  Results: Poor vascularity of villi and fever were significantly associated (p<0.01). Hypertension and Convulsion and fibrinoid necrosis, syncytial knot and placental infarcts were significantly associated (p<0.001) Premature placenta is associated with cytotrophoblastic layer (p<0.01). Conversely post mature placenta is associated with calcification and infarction.  (p<0.01).  Conclusions: All placentae associated with foetal death have either gross or microscopic abnormalities. Present study is a step towards understanding and extrapolating the already known causes of intrauterine foetal death in the perspective of Jabalpur and its adjoining districts.

scholarly journals Risk factors of intrauterine fetal death: a case control study at the maternity of Yaoundé Central Hospital

2019 ◽  
Vol 8 (6) ◽  
pp. 2149
Author(s):  
Romaric Joel Tetsiguia Momo ◽  
Jeanne Hortence Fouedjio ◽  
Florent Ymélé Fouelifack ◽  
Robinson Enow Mbu
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Fetal Death ◽  
Resistive Index ◽  
Well Being ◽  
Sub Saharan Africa ◽  
Intrauterine Fetal Death ◽  
Poor Countries ◽  
Sub Saharan ◽  
Weekly Assessment

Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.

scholarly journals Study on Etiology and Maternal Complications of Intrauterine Fetal Death

2019 ◽  
Vol 18 (1) ◽  
pp. 23-26
Author(s):  
Adiba Malik ◽  
Tahera Begum ◽  
Serajun Noor
Keyword(s):  
Risk Factors ◽  
Antenatal Care ◽  
Fetal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Antenatal Visits

Background : Management of pregnancy with good fetal and maternal outcome is a challenge to the obstetrician which can be achieved by screening the risk factors of Intra Uterine Fetal Death (IUFD) and thereby prevent, control and treat them by quality preconceptional and antenatal care. Materials and methods: This cross-sectional study, done in a tertiary care hospital during a period of two years where 100 pregnant women with history of intrauterine fetal death were included after informed written consent. Intrauterine fetal death was confirmed by Ultrasonogram. Different risk factors and maternal complications were observed. Then data was analyzed with the help of SPSS-20. Results: Among 100 women, maximum patients were aggregated between age group 26-35 years (45%) and next to which was 16-25 years (35%) primipara was 32% and multipara was 31%. Regarding Antenatal care (ANC) 32% patients attended two antenatal visits and 28 % patients had no antenatal visits and 18% patients completed > 5 visits. Regarding causes of IUFD, 34% due to hypertension in pregnancy, 14% mother was severely anemic, 13% mother had Diabetes Mellitus (DM) abruptio placenta was found in 15% mother, maternal gastroenteritis 05%, maternal fever 09%, cord accident 3% and in 19% cases no causes were identified. Regarding maternal complications, blood transfusion needed in 28% patients, PPH occurred in 12% patients, Sepsis 08%, caesarean section needed in 07 % cases, ARF 4%, DIC in 03% cases and maternal mortality 01%. Mean ± SD of total hospital stay was 4 ± 1.5 days. Conclusion: There are different risk factors of IUFD which if identified earlier,then by treating the correctable etiologies, recurrence of IUFD and its related maternal complications can be prevented or reduced. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 23-26

scholarly journals Role of Combined Mifepristone and Misoprostol Verses Misoprostol Alone in Induction of Labour in Patients with Intrauterine Foetal Death - a Randomized Comparison Between their Outcome

2017 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Mohammad Noor A Alam ◽  
Suha Jesmin ◽  
Md Mahmudur Rahman Siddiqui ◽  
...  
Keyword(s):  
Fetal Death ◽  
Research Work ◽  
Medical College Hospital ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
College Hospital ◽  
Medical College ◽  
Misoprostol Group ◽  
Group A ◽  
Group B

Background: Intrauterine fetal death is means- intrapartum death after the fetus has reached the age of viability8. As in IUFD journey, labor pain will be fruitless. So, it is of utmost importance to search for the method which can reduce hours of pain in labor of IUFD cases.Metarials Methods: In this research work patients divided in two groups. Induction of labour in one group was given by combination of mifepristone and misoprostol other group by misoprostol only and we try to find out the best method. To compare the effectiveness, induction to delivery interval, safety and side effects of combination of mifepristone and misoprostol versus conventional use of misoprostol alone in induction of labour in patients with intrauterine fetal death. It is a Prospective randomized comparative study in Anwer Khan Modern Medical College Hospital and Dhaka Medical College Hospital among 70 patients with IUFD after 28 weeks of gestation during January 2014- January 2016.Result: We allowed the patients up to third gravid and after 28 weeks of gestation. Patients were grouped as Group A(35) & Group B (35). In Group A Induction was given by single oral dose of 200 mg mifepristone, and after 48 hours, tab. Misoprostol in post. fornix started if <34 weeks-100 ?gm dose and >34 weeks-50 ?gm dose. Doses were repeated every 6 hourly intervals if required. In Group B Induction was given by 100 ?gm misoprostol at 6 hourly interval in post. Fornix. In both groups we allowed misoprostol maximum 600 ?gm. Oxytocin was given for augmentation if needed. The two study groups did not differ demographically. Induction to delivery time was shorter with combined regimen group (P<0.001). Induction to delivery interval ranges from 10-12 hours in mifepristone plus misoprostole group.In only misoprostol group it was about 24-26 hours. Doses of misoprostol was lower in combined group (P<0.001). 4 patients need Oxytocin for augmentation in only misoprostol group. In combined group oxytocin was not needed. The two groups did not differ as regards complications experienced during labour and delivery significantly. In overall out come 2 failed induction in misoprostol only group but not in combinedgroup.Conclusion: In Induction of IUFD mifepriston plus misoprostol is an effective combined group. It is safe, non invasive, easily tolerable, highly cost effective, had less induction to delivery interval, required less dose of misoprostol and no need of augmentation with oxytocin. So,the combined group is more effective than conventional regimen of misoprostol alone.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 50-54

scholarly journals Study of risk factors among stroke patients in a tertiary hospital of Northern India

2017 ◽  
Vol 4 (2) ◽  
pp. 446
Author(s):  
Amit Kumar ◽  
Onkar Nath Rai
Keyword(s):  
Risk Factors ◽  
Tertiary Hospital ◽  
Stroke Incidence ◽  
Medical College ◽  
Northern India ◽  
Different Types ◽  
History Of ◽  
Chest X Ray ◽  
Associated Risk Factors

Background: Stroke is one of the leading causes of death and disability worldwide. The aim of the study was to find out the incidence of different types of strokes and the associated risk factors and to establish the role of different investigations in patients of stroke.Methods: The study dealt with 100 patients of stroke who were admitted to B. R. D. Medical College, Gorakhpur, India. Each patient was analyzed in detail about clinical presentation and the investigations were aimed to establish the pathologic type of stroke and estimation of risk factors.Results: Stroke incidence was more in males (Male: Female= 1.43:1). Maximum incidence of stroke was in 6th decade (32%) followed by 7th decade (30%). Among modifiable risk factors, history of hypertension was the commonest (51%) followed by smoking (36% patients) exclusively, found in males. Hemiparesis was the most common presentation (95%) followed by altered sensorium (55%). Chest X-ray was abnormal in 16% patients, abnormal ECG was found in 27% patients and abnormal lipid values were found in 54 patients.Conclusions: Apart from control of hypertension and diabetes, abnormal lipid profile remains an important modifiable risk factor for stroke.

scholarly journals Prevalence of hyperemesis gravidarum and associated risk factors among pregnant women in a tertiary health facility in Northeast, Nigeria

2020 ◽  
Vol 9 (9) ◽  
pp. 3557
Author(s):  
Muhammad B. Aminu ◽  
Mohammed Alkali ◽  
Bala M. Audu ◽  
Toyin Abdulrazak ◽  
Dauda Bathna
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Hyperemesis Gravidarum ◽  
Past History ◽  
Tertiary Hospital ◽  
Grand Multiparity ◽  
History Of ◽  
Associated Risk Factors ◽  
Age Range ◽  
Northeast Nigeria

Background: One of the commonest symptoms observed in pregnant women before the 20th week of gestation is nausea and vomiting, an exaggeration of these symptoms hyperemesis gravidarum (HEG) could result in maternal and fetal catastrophes and even death. The objective of this study was to determine the prevalence and associated risk factors for hyperemesis gravidarum among pregnant women at booking.Methods: A prospective institutional based study design was done among 452 pregnant women seen at booking in a tertiary hospital in Northeast Nigeria from the 1st February 2019 to 30th June 2019. Data was summarized using descriptive statistics. OR was used to measure significant risk.Results: The observed prevalence of hyperemesis gravidarum among pregnant women in the study is 44.9%. The Majority (81.4%) of these women were between the age range of 21 and 35 years. Mean age of 27 years. Multiparity (33.4%), previous (44.9%) and family history of HEG (31.6%) were identified as important risk factors for developing HEG. Grand multiparity (11.5%) and gestational age less than 13 weeks (6.64%) were however less likely observed to be risks for HEG.Conclusions: HEG is a common problem in pregnancy with almost half of the number of pregnant women at booking affected. Multiparity and past history of HEG are pointers to developing the condition and it should be looked out for among at risk group of pregnant women, so that early intervention can be instituted to avoid any possible adverse outcome.

scholarly journals Evaluation of Sonographic Measurement of Umbilical Cord Coiling Index in the Second Trimester and Its Correlation to Perinatal Outcome

2021 ◽  
Vol 5 (05) ◽  
pp. 01-07
Author(s):  
Naglaa Ali M. Hussein ◽  
Mohammed H. El Refaey
Keyword(s):  
Antenatal Care ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Apgar Score ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Intrauterine Fetal Death ◽  
Ultrasound Scan ◽  
Umbilical Cords

The umbilical cord represents a unique lifeline between the fetus and mother and contains two arteries and one vein wrapped up in Wharton’s jelly with moderate twists. Umbilical coiling abnormalities can result in fetal growth restriction, fetal distress, or intrauterine fetal death. Hypocoiled umbilical cords are associated with intrauterine fetal death (IUFD), fetal growth restriction, fetal distress, low Apgar scores, fetal congenital anomalies, and abnormal insertion of the umbilical cord. Hypercoiled umbilical cords are associated with IUFD, fetal distress, asphyxia, fetal congenital anomalies, and the presence of a single umbilical artery. The aim of this work is to determine if the umbilical Cord coiling index measurement during second trimester ultrasound scan can predict perinatal outcome. Seventy eight healthy uncomplicated pregnant women who regularly attended the antenatal care clinic for antenatal care and to do anomaly ultrasound scan on her baby in 2nd trimester. All participants were informed about the aims and the procedures of the study and signed an informed consent form prior to beginning. Regular antenatal cThe umbilical cord represents a unique lifeline between the fetus andmother and contains two arteries and one vein wrapped up in Wharton’s jelly with moderate twists. Umbilical coiling abnormalities canresult in fetal growth restriction, fetal distress, or intrauterine fetal death. Hypocoiled umbilical cords are associated with intrauterine fetal death (IUFD), fetal growth restriction, fetal distress, low Apgar scores, fetal congenital anomalies, and abnormal insertion of the umbilical cord. Hypercoiled umbilical cords are associated with IUFD, fetal distress, asphyxia, fetal congenital anomalies, and the presence of a single umbilical artery. The aim of this work is to determine if the umbilical Cord coiling index measurement during second trimester ultrasound scan can predict perinatal outcome. Seventy eight healthy uncomplicated pregnant women who regularly attended the antenatal care clinic for antenatal care and to do anomaly ultrasound scan on her baby in 2nd trimester. All participants were informed about the aims and the procedures of the study and signed an informed consent form prior to beginning. Regular antenatal care visit was done every two weeks till delivery with assessment of perinatal outcomes regarding: gestational age at delivery, fetal monitoring by CTG, method of delivery, meconium staining amniotic fluid or not, examination by apgar score at 1stand 5th minute, birth weight, admission to NICU or not and perinatal death. According to umbilical cord index, of total 78 pregnant women who completed the study 62 (79.2%) were having normal UC coiling, 10 of cases (12.8%) were having hypocoiling and 6 (7.7%) were having hypercoiling. Our results showed that hypo- and hyper-coiling were associated with increased incidence of preterm labor (32-36 weeks) “22.2%and 40% respectively” while normo-coiling was associated with lesser incidence “2%”. Both hypocoiling “10%” and hypercoiling “16.7%”groups showed higher incidence of IUGR when compared with the normocoiling group “1.6%”. APGAR score at minute one was significantly lower in the both hypocoiling and hypercoiling groups than the normocoiling group with p- value: 0.005. While at minute five, there was no significant difference between the three groups of the study. Conclusion: The abnormal umbilical coiling index “< 10th percentile or > 90th percentile” is associated with adverse perinatal outcomes. Therefore, early evaluation on Umbilical cord Index in the 2nd trimester can identify fetuses who are at risk and thus help in further management.are visit was done every two weeks till delivery with assessment of perinatal outcomes regarding: gestational age at delivery, fetal monitoring by CTG, method of delivery, meconium staining amniotic fluid or not, examination by apgar score at 1stand 5th minute, birth weight, admission to NICU or not and perinatal death. According to umbilical cord index, of total 78 pregnant women who completed the study 62 (79.2%) were having normal UC coiling, 10 of cases (12.8%) were having hypocoiling and 6 (7.7%) were having hypercoiling. Our results showed that hypo- and hyper-coiling were associated with increased incidence of preterm labor (32-36 weeks) “22.2%and 40% respectively” while normo-coiling was associated with lesser incidence “2%”. Both hypocoiling “10%” and hypercoiling “16.7%”groups showed higher incidence of IUGR when compared with the normocoiling group “1.6%”. APGAR score at minute one was significantly lower in the both hypocoiling and hypercoiling groups than the normocoiling group with p- value: 0.005. While at minute five, there was no significant difference between the three groups of the study. Conclusion: The abnormal umbilical coiling index “< 10th percentile or > 90th percentile” is associated with adverse perinatal outcomes. Therefore, early evaluation on Umbilical cord Index in the 2nd trimester can identify fetuses who are at risk and thus help in further management.

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