scholarly journals Stillbirths - Determining the associated factors and causes according to relevant condition at death: an experience from Pokhara, Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 58-65
Author(s):  
Junu Shrestha ◽  
Rami Shrestha ◽  
Sonam Gurung

Background: Stillbirth contributes significantly to perinatal mortality. This study was conducted with aim to determine various factors associated with it and to define the causes of stillbirth according to relevant condition at birth.Materials and Methods :This is prospective cross-sectional study conducted in the Department of Obstetrics and Gynaecology of Manipal Teaching Hospital from July 2015 to June 2017. All cases of stillbirth occurring during antenatal or intrapartum period after 28 weeks of gestation or fetus weighing 1000 grams or more were included. Detailed demographic parameters were noted. After delivery, fetus, placenta, umbilical cord and amniotic fluid were noted in detail. Data was entered in SPSS version 16 and analysis done.Results: The stillbirth rate was 22 per 1000 births. Low educational level of women, lack of antenatal care, multiparous status, gestational age less than 34 weeks, low birth weight and male gender of fetus were found to be significantly associated with stillbirths. The cause of fetal death could be identified according to relevant condition at death in 84% of cases. Only in 16%, the cause of stillbirth was not identified. Intrauterine growth restriction was the commonest cause of stillbirth (22%), followed by congenital anomalies (15%) and hypertensive disorders of pregnancy (14%). Other causes were abruptio (7%), intrapartum asphyxia (7%) and rupture uterus (5%). Other minor causes were anemia, diabetes, cord prolapse and amniotic fluid abnormalities.Conclusion :Low level of education, lack of quality antenatal care, multiparity, low gestational age and birth weight and male sex of fetus were factors associated with stillbirth. The cause of stillbirth was identified in most of the cases and largely was due to intrauterine growth restriction.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11, July-December 2017, 58-65

2021 ◽  
Vol 8 (7) ◽  
pp. 1168
Author(s):  
Gurunathan Gopal

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (>2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.


2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Sitotaw Molla Mekonnen ◽  
Daniel Mengistu Bekele ◽  
Fikrtemariam Abebe Fenta ◽  
Addisu Dabi Wake

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.


2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Raheli Misiko Mukhwana ◽  
Margaret N Keraka ◽  
Meshack Onyambu

Introduction/Aims Focused antenatal care provides individualised counselling, targeted assessment and safe, cost effective, evidence-based intervention. It has been implemented in developing countries as a strategy to improve maternal health. This study aimed to investigate sociodemographic factors associated with maternal complications in selected public county hospitals in Nairobi City County, Kenya. Methods This was a cross-sectional study using a sample of 397 postnatal women who were given a questionnaire, with sections on their sociodemographic and health characteristics. Data analysis was done using the Chi Square test to determine the association between study variables, with P<0.05 considered statistically significant. Results The study found that 30% of respondents reported a maternal complication during their current delivery outcome. Sociodemographic factors significantly associated with maternal complications were age (P=0.002), occupation (P=0.001) and income (P=0.011). The health factors associated with occurrence of maternal complications were number of deliveries (P=0.001) and mode of delivery (P=0.001). Conclusions A number of factors were found to be significantly associated with maternal outcomes, including age and occupation. Further studies to determine why young women do not use focused antenatal care are necessary, as this would help reduce the incidence of birth-associated complications.


2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.


2017 ◽  
Vol 56 (207) ◽  
pp. 325-330
Author(s):  
Santosh Pathak ◽  
Nagendra Chaudhary ◽  
Prativa Dhakal ◽  
Shyam Kumar Mahato ◽  
Sandeep Shrestha ◽  
...  

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods:  This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.


2017 ◽  
Vol 24 (08) ◽  
pp. 1176-1180
Author(s):  
Brig® Khalid Mehmood ◽  
Ijaz Ali ◽  
Syed Hyder Raza

Objectives: To determine the proportion of LBW Babies among those deliveredat DHQ Hospital Mirpur. Study design: Descriptive cross sectional study. Setting: DHQ hospitalMirpur AJK. Duration of study: January 2013-May 2013. Sample size: 459 deliveries. Studypopulation: women reporting in Peads OPD of DHQ hospital Mirpur AJ&K with their babiesduring study period. Sampling technique: Convenience method. Data collection tool: Datacollection Performa. Data analysis: SPSS version 14.0.Results: Out of 459 deliveriesconducted at Divisional Head Quarter hospital Mirpur, 149 cases of low birth weight babies(<2500gms) whereas the rest 310 had normal birth weight. Frequency of Low Birth Weight inmale new born babies was high, i.e ratio of male babies were 55% (82) out of 149 individualswhile females were 45% (67). Less than 37 weeks of gestational age, 37% (55) were pretermbabies and 37 – 42 weeks of gestational age, 63% (94) were full term babies.


2018 ◽  
Vol 18 (3) ◽  
pp. 539-547
Author(s):  
Micaely Cristina dos Santos Tenório ◽  
Marilene Brandão Tenório ◽  
Raphaela Costa Ferreira ◽  
Carolina Santos Mello ◽  
Alane Cabral Menezes de Oliveira

Abstract Objectives: to analyze the factors associated with the birth of small for gestational age (SGA)infants, in a Northeastern Brazilian capital. Methods: a cross-sectional study was carried out with 331 pregnant women and their newborns attending the public health network in the city of Maceió, in 2014. Maternal antenatal data were collected (socioeconomic, lifestyle, clinical and nutritional) as well as data of the newborns (gestational age, mode of delivery, sex, birth weight and length), after delivery. Birth weight was classified according to the INTERGROWTH-21st curves, being considered SGA those below the 10th percentile according to gestational age and gender. The results were analyzed by Poisson regression using a hierarchical model and were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI95%). Results: it was verified that 5.1% of the newborns were SGA. Regarding the associated factors, after adjustment of the hierarchical model, the variable working outside the home was associated with the endpoint studied [PR = 0.14; (CI95% = 0.02-0.75); p=0.022]. Conclusions: it was verified a low frequency of SGA infants in the evaluated population. The fact that the mother works outside the home proved to be a protective factor for this condition.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Maria Arroyas ◽  
Cristina Calvo ◽  
Santiago Rueda ◽  
Maria Esquivias ◽  
Cristina Gonzalez-Menchen ◽  
...  

AbstractOur main objective was to study respiratory evolution and pulmonary and cardiac function in adolescents born preterm in the post-surfactant era. Observational cross-sectional study, comparing very preterm (< 32 weeks) and moderately-late preterm adolescents (≥ 32 weeks) (74 each group). We recorded respiratory symptoms, spirometry and functional echocardiogram. Very preterm adolescents required more respiratory admissions (45.9% vs. 28.4%) (p = 0.03, OR 2.1, CI95% 1.1–4.2) and had more current asthma (21.6% vs. 9.5%, p = 0.04, OR 2.3, CI95% 1.1–5.2). Preterm subjects with intrauterine growth restriction (IUGR) presented lower FEV1 (88.7 ± 13.9 vs. 95.9 ± 13.3, p = 0.027) and lower FVC (88.2 ± 13.6 vs. 95.5 ± 13.3, p = 0.025). When assessing right ventricle, very preterm showed a greater E/E’ ratio (p = 0.02) and longer myocardial performance index (MPI) (p = 0.001). Adolescents with IUGR showed less shortening fraction (p = 0.016), worse E/E′ ratio (p = 0.029) and longer MPI (p = 0.06). Regarding left ventricle, very preterm showed less E′ wave velocity (p = 0.03), greater E/E′ ratio (p = 0.005) and longer MPI (p < 0.001). Gestational age < 32 weeks is independently associated with current asthma in adolescence. Children 13–14 years old born very preterm required more respiratory admissions and had poorer diastolic and global function of both ventricles. IUGR is a risk factor for poorer lung function in preterm adolescents, regardless gestational age.


2020 ◽  
Vol 7 (8) ◽  
pp. 414-419
Author(s):  
Dr. Abhinaya Arun Raj ◽  
◽  
Dr. K. Maheswari ◽  

Introduction: This study was done to assess the utility of foot length in determining theanthropometric parameters of a newborn in a tertiary care teaching hospital. Materials andMethods: This cross-sectional study among 270 newborns were done at Sri Venkateswaraa medicalcollege hospital and research centre, from Nov 2018 to May 2020. All the healthy live newbornswere taken into the study and newborns with congenital lower limb anomalies were excluded.Results: The mean birth weight of the neonate 2.948+0.344 kg which ranged from 2.050 kg to3.750kg. The mean foot length, head circumference and chest circumference of the foot length was8.113+0.468 cm, 48.989+1.093 cm, 34.437+0.659 cm and 32.372+0.734 cm respectively. The footlength had a maximum correlation with birth weight (r-value=0.905) followed by gestational age (r-value=0.809), length (r-value=0.786), head circumference (r-value=0.719) and chest circumference(r-value=0.603). Conclusion: Foot length had a significant correlation with birth weight andgestational age of the neonates. Foot length also correlated significantly with other anthropometricvariables like length, head circumference and chest circumference.


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