scholarly journals КОМПЛЕКС ПРОФІЛАКТИЧНИХ ЗАХОДІВ ДЛЯ ВАГІТНИХ ПІСЛЯ ДРТ З ВИСОКИМ РИЗИКОМ ПРЕЕКЛАМПСІЇ

World Science ◽  
2020 ◽  
pp. 1-6
Author(s):  
Камінський В’ячеслав Володимирович ◽  
Коломійченко Тетяна Василівна ◽  
Жданович Олексій Ігоревич ◽  
Рогава Ірина Володимирівна
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Pregnancy And Childbirth ◽  
System Reduction ◽  
Vascular Regulation ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Gynecological Care

The purpose of the study: to evaluate the effectiveness of the proposed set of preventive measures for pregnant women after ART with a high risk of preeclampsia. Material and methods. To test the effectiveness of the proposed set of prophylactic measures, 60 pregnant women after ART were selected, which were randomly divided into 2 groups: 30 women who received the recommended complex (main group) and 30 women (comparison group), whose preeclampsia was prevented by order of the Ministry of Health. № 417 "Guidelines for the provision of outpatient obstetric and gynecological care." Results. The use of the recommended measures improves lipid metabolism (significant reduction of triglycerides and low density cholesterol), eliminates vitamin D deficiency, balances the cytokine profile (reduction of proinflammatory focus), reduces the prothrombotic potential of the hemostasis system (reduction of D-dimer and background marker damage). Improving the general condition and the use of psychotherapy can reduce the manifestations of vegetative-vascular dystonia, anxiety and improve quality of life. Such changes provide a more favorable background for the development of gestation. The incidence of preeclampsia decreased by 43.8% (from 26.7 to 15.0%), and mainly due to early preeclampsia, the incidence of which decreased by 78%, no cases of severe preeclampsia were reported. The frequency of placental insufficiency, fetal distress and growth retardation is reduced. The frequency of birth of children in a state of asphyxia is reduced by 2 times (up to 20.0 vs. 46.7%), severe asphyxia is not observed. Significantly lower and the frequency of violations of the period of neonatal adaptation (30.0 vs. 53.3%). Conclusions. The use of treatment and prophylactic complex to prevent preeclampsia in pregnant women after ART can improve a woman's homeostasis, balance vegetative-vascular regulation, reduce the incidence of preeclampsia by 43.8% (from 26.7 to 15.0%) and other complications of pregnancy and childbirth, improve perinatal outcomes. Proven medical, social and economic efficiency of the developed complex allows to recommend it for implementation in medical practice.

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Test System ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Wide Range ◽  
Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

scholarly journals Prevention of complications of pregnancy and childbirth of patients with a burdensome gynecological anamnesis

2021 ◽  
Vol 6 ◽  
pp. 56-60
Author(s):  
T. P. Andriichuk
Keyword(s):  
Pregnant Women ◽  
Fetal Distress ◽  
The Body ◽  
Prevention Measures ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Treatment And Prevention ◽  
Prophylactic Measures ◽  
The Mean

The objective: determination of the effectiveness of prevention and medicinal correction of placental dysfunction in pregnant women with chronic salpingo-oophoritis.Materials and methods. The study included 100 pregnant women (basic group) with chronic salpingo-oophoritis, of these, I group (50 women) included patients who received proposed treatment and prevention approach, II group (50 women) received a common set of treatment and prevention measures. The proposed treatment-and-prophylactic approach included prophylactic administration to pregnant women with chronic salpingo-oophoritis from the 8th to the 10th and from the 16th to the 18th week inclusive of natural micronized progesterone at a dose of 100 mg intravaginally twice a day for two weeks. Venotonik and angioprotector were prescribed prophylactically at dose 600 mg from 18 weeks to 37-38 weeks of pregnancy. For therapeutic purposes (blood flow disorders in the uterine arteries and vessels of the umbilical cord that are determined by Doppler), the drug was prescribed at dose 600 mg twice a day for 3–4 weeks.Results. A lower frequency of obstetric and perinatal complications was found in the women in I group than in the patients in the II group. Thus, the rate of placental dysfunction was 6.0±3.36% vs. 34.0±6.7%, respectively, oligohydramnios – 6.0±3.36% and 12.0±4.59%, polyhydramnios – 10.0±4.24% and 22.0±5.86%, fetal distress during childbirth – 6.0±3.36% and 14.0±4.91%, cesarean section – 12.0±4.6% and 24.0±4.27%. In the group of patients with treatment-and-prophylactic approach, the mean of the body weight of newborns was 3486.7±312.71 g, and in women who received a common set of treatment-and-prophylactic measures – 3099.8±295.69 g. The mean of the assessment of the condition of newborns by the Apgar scale at the 1st minute – 7.92±1.54 and 6.81±1.16 points, respectively.Conclusions. The use of micronized natural progesterone and the drug diosmin 600 mg in pregnant women with a history of chronic salpingo-oophoritis reduces the rate of obstetric and perinatal complications during pregnancy.

Великі акушерські синдроми – сучасні можливості профілактики

2018 ◽  
pp. 67-72
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Statistical Analysis ◽  
High Risk ◽  
Pregnant Women ◽  
Fetal Distress ◽  
Placental Insufficiency ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Prophylactic Measures ◽  
Pathological Pregnancy ◽  
Micronized Progesterone

The objective: was to reduce the incidence and severity of the development of «Great Obstetrical Syndromes»: miscarriage of pregnancy, placental insufficiency, fetal growth retardation and / or fetal distress, preeclampsia, premature detachment of a normally located placenta, premature delivery, by developing an algorithm for prophylaxis during pregnancy in women at high risk for their development. Materials and methods. Clinical and statistical analysis of pregnancy in 88 pregnant women with high risk of decompensation of placental insufficiency was conducted. Depending on the method of preventing complications, 2 groups were formed. The I group included 58 pregnant women who were offered the following algorithm: micronized progesterone 200 mg PV from 6 to 20 weeks of gestation; from 21 to 26 weeks of gestation and from 31 to 36 weeks; phleboprotector with ultra-micronized fractions of bioflavonoids (Flego) 15 ml per os; with subsequent appointment from 21 to 26 weeks of gestation; and from 31 to 36 weeks. Group II included 30 pregnant women who had abandoned any proposed prophylactic measures. The control group consisted of 30 healthy pregnant women. Clinical and statistical analysis of pregnancy in the study groups was conducted. During statistical processing, personal computer and software Microsoft Excel XP and Statistica 6.0 Windows, methods of descriptive statistics, correlation analysis were used. The reliability of the difference between the indicators is estimated by the Student-Fisher criterion. Results. The method of prophylaxis of «Great Obstetrical Syndromes» by sequential administration from the early stages of pregnancy of micronized progesterone with the following appointment – from the second trimester of pregnancy – showed a high efficacy of the phleboprotector, which is manifested in a significantly lower number of cases of preeclampsia in the main group of 3.5% (2) versus 50% (15) in the control group, placental insufficiency was 13.8% (8) versus 100% (30); fetal growth retardation was 5.2% (3) versus 56.7% (17); fetal distress was 3.5% (2) versus 43 , 3% (13), preterm labor 1.7% (1) versus 13.3% (4) and in the absence of premature detachment normal but located on the placenta, severe forms of preeclampsia and placental insufficiency. Conclusions. Pregnant of «Great Obstetrical Syndromes» risk groups need timely prophylactic measures to reduce the likelihood of a pathological pregnancy and improve perinatal outcomes. The proposed prophylaxis scheme significantly lowered the incidence of large obstetric syndromes and improved neonatal outcomes. Key words: great obstetrical syndromes, pathological pregnancy, placental dysfunction, phleboprotector.

MATERNALAND PERINATAL OUTCOMES WITH COVID-19: A TERTIARY CARE CENTRE STUDY

2021 ◽  
pp. 31-32
Author(s):  
Sweety Sinha ◽  
Anjana Sinha ◽  
Ankita Ankita
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Neonatal Infection ◽  
Fetal Distress ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Polymerase Chain ◽  
Poor Outcomes

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy. Methods:Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR). Results: Atotal of 40 pregnant women positive for COVID-19 as conrmed by RT-PCR, were included in the study. 5% cases had preterm deliveries and LSCS was the preferred mode of delivery in 28 of 40 i.e., 70% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD only in this study. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy. Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.

scholarly journals Use of Noninvasive Cerclage in Combination of Micronized Progesterone in Miscarriage Of Multifetal Pregnancy

2017 ◽  
Vol 24 (4) ◽  
Author(s):  
Iryna Nikitina ◽  
Alla Boychuk ◽  
Valentina Kondratiuk ◽  
Tatyana Babar
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The State ◽  
Control Group ◽  
Group I ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Group Ii ◽  
Multifetal Pregnancy ◽  
Micronized Progesterone

We represent the results of the combined method of treatment and prevention of miscarriage in women with a multiple pregnancy and a high risk of the threat of termination the pregnancy because of using the obstetric unloading pessaries, combined with micronized progesterone. The efficiency of this method of treatment is evidenced by the rapid elimination of clinical symptoms of threatened abortion, accelerating the regression of ultrasound markers, reducing the number of complications in of pregnant women and reducing the time of their stay in hospital.Goal: To evaluate the effectiveness of the handling the obstetric pessary in combination with micronized progesterone at women with multifetal pregnancy and a high risk of miscarriage.Materials and methods. We analyzed 120 cases of multifetal pregnancies with signs of miscarriage within the terms from 16 to 28 weeks. The first group of the examined women was: 40 pregnant women with twins and signs of miscarriage, who in the scheme of treatment and prophylactic measures were offered to use the unloading obstetric pessaries in combination with continuous therapy by natural micronized progesterone until 36 weeks of pregnancy. The second group included 40 pregnant women with twins, who were laid seam on the cervix because of istmicocervical insufficiency and were applied short-term courses of therapy by gestagens. The control group comprised 40 pregnant women with twins at the age of 16-28 weeks of pregnancy who were conducted the therapy about the threat of miscarriage according to the current clinical protocols (Order of the Ministry of Health of Ukraine No. 624). It was carried out the analysis of the course of pregnancy, childbirth, the postpartum period and the state of neonatal adaptation in the surveyed groups.Results of the research and their discussion. In the first group, urgent childbirth occurred in 34 (85%) cases, in group II in 29 (72.5%) cases, in control group – in 25 (62.5%) cases. Cesarean delivery was performed in 7 (17.5%) patients of group I pregnant women, in 9 (22.5%) of group II patients and in 11 (27.5%) in the pregnant group. When studying the state of neonatal adaptation of newborns in the examined groups, the following results were obtained. The average weight of the newborns in group I was 3245 ±280 g, in group II 2865 ±365 g, in the control group - 2975 ±325 g (p>0.05). The evaluation of the state of newborns on the Apgar scale, respectively at the 1st and 5th minutes, was respectively: in newborns of the I group, 7.5 ± 1.4 and 8.4 ± 1.3 points, in group II - 7.3 ± 1.6 and 8.2 ± 1.1 points, in the control group – 7.2 ± 1.6 and 8.6 ± 1.2 (р 1-р 2> 0.05).Conclusions. Comprehensive prophylaxis of non-pregnancy in multiple pregnancies, combining the use of a traumatic cardiac cervix with the help of unloading obstetric pussies with progesterone preparations, allows prolonging pregnancy, preventing the development of prematurity, contributes to the improvement of perinatal indicators.

scholarly journals ВНУТРІШНЬОПЕЧІНКОВИЙ ХОЛЕСТАЗ ВАГІТНИХ ПІСЛЯ ЗАСТОСУВАННЯ ДОПОМІЖНИХ РЕПРОДУКТИВНИХ ТЕХНОЛОГІЙ: КЛІНІЧНІ ОСОБЛИВОСТІ

World Science ◽  
2021 ◽  
Author(s):  
Boychuk O. G. ◽  
Ebae N. E. N. ◽  
Kolomiichenko T. V. ◽  
Zhdanovich O. I. ◽  
Savchenko A. S.
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Polycystic Ovary ◽  
Fold Increase ◽  
Fetal Distress ◽  
Main Group ◽  
Short Term ◽  
Art Programs ◽  
History Of ◽  
Neonatal Adaptation

80 pregnant women were examined after assisted reproductive technology (ART) programs: 40 women with manifestations of intrahepatic cholestasis of pregnant women (IHP) - the main group and 40 women without manifestations of IHP (comparison group).In the majority (62.5%) of patients after ART, the diagnosis of IHP established after 30 weeks of pregnancy. Some patients (27.5%) reported short-term episodes of IHP up to 24 weeks of gestation. In 17.5% of women, IHP had a severe course. Almost a third (27.5%) of women are over 35 years old. Women with IHP have a significantly higher frequency of allergies in the anamnesis (35.0%), liver pathology (20.0%) and diseases of the gastrointestinal tract (25.0%). In one third of women, IHP developed repeatedly, 42.5% of the main patients indicated a family history burdened with IHP. Almost a third of women (27.5% vs. 12.5%, p<0.05) had a history of polycystic ovary syndrome.The current pregnancy characterized by a high frequency of complications. A quarter of patients (25.0%) had early preeclampsia. In the second half of pregnancy, the threat of preterm birth noted in most women during the manifestation of IHP (60.0%). The incidence of fetal distress in women with IHP was almost 2 times higher than in patients without this complication (47.5% vs. 25.0%, respectively, p <0.05). The frequency of preeclampsia is also higher (40.0%).The vast majority of women in the main group were born by cesarean section (70.0%). Almost half of patients with IHP were premature (45.0%). A third of women (35.0%) had fetal distress in childbirth. In 27.5%, childbirth complicated by bleeding of more than 5% of body weight. The postpartum period was characterized by a 4-fold increase in the frequency of late bleeding (20.0% vs. 5.0%, p <0.05).One case of antenatal mortality noted in pregnant women after ART with IHP. Almost half of the children were born with asphyxia of varying severity (48.7%), with 10.3% diagnosed with severe asphyxia. One third of children were born with a body weight below 2500 g (30.8%). In 74.4% of newborns from mothers of the main group, various disorders of the period of early neonatal adaptation were noted, among which the most prominent were: RDS (35.9%), jaundice (43.6%) and gastrointestinal syndrome (30.8%). The 2-fold increased incidence of hemorrhagic syndrome (17.9%) is noteworthy.

scholarly journals ECLAMPTIC PATIENTS

2015 ◽  
Vol 22 (11) ◽  
pp. 1464-1470
Author(s):  
Sadia Zahoor ◽  
Tahira Malik ◽  
Sonia Zulfiqar
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Basic Care ◽  
Induced Hypertension ◽  
Qualitative Variables ◽  
Unfavorable Cervix ◽  
Hospital Study ◽  
Very High

Background: Hypertensive disorders are the second most common cause ofmaternal death worldwide. Eclampsia is the extension of pregnancy induced hypertension tothe point of conclusions, coma or both. Objectives: To find out the incidence of eclampsiaamong pregnant women and to identify the maternal and perinatal outcomes of eclampticpatients treated in a tertiary care referral hospital. Study Design: Discretional cross sectionalstudy. Setting: Department of Obstetrics & Gynecology, Sheikh Zayed Hospital, Rahim YarKhan. Period: January 2014 to December 2014. Methods: A total number of 96 patients out of10513 who were diagnosed as being eclamptic during the study period were included in thisstudy. While normal pregnant women and Patient’s with uncertain diagnosis was excluded. Allpatient variables were entered and analyzed using SPSS v20. Frequency and percentages wereused to express qualitative variables. Results: There were total ninety six patients (0.913%) outof 10,513 who presented with eclampsia. Most of eclamptic patients were of having age >21years. Among patients who developed eclampsia 52 (54.16%) were in Ante partum period and40 (41.66%) were in postpartum period. Out of 96, five patients died before delivery and thirteenafter delivery, seventy eight patients developed one or more complications during delivery.Out of total 91 deliveries, 54 (59.30%) were delivered by cesarean section (C/S). Main reasonfor C/S was unfavorable cervix. Out of total ninety one deliveries two were twins and eightynine singletons. Fifty eight (62.36%) babies were born at a gestational age <37 weeks. Birthasphyxia occurred in sixty one (65.60%) newborns. There were twenty two (23.65%) perinataldeaths, fourteen (63.64%) were stillbirths and eight (36.36%) were early neonatal deaths.Conclusion: Eclampsia is found to be associated with very high rates of maternal mortality andmorbidity as well as perinatal mortality. Early diagnosis of eclampsia and its timely managementcan reduce the risk of this mortality. This can be made possible by provision of basic facilitiesand improvements in the quality of basic care provided by our antenatal clinics.

scholarly journals Profile of infected pregnant women and children exposed to HIV at a specialized service in the South of Brazil

2018 ◽  
Vol 18 (4) ◽  
pp. 791-801
Author(s):  
Marília Alessandra Bick ◽  
Tamiris Ferreira ◽  
Clécia de Oliveira Sampaio ◽  
Stela Maris de Mello Padoin ◽  
Cristiane Cardoso de Paula
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Prophylactic Measures ◽  
The Social ◽  
Specialized Service ◽  
Women And Children ◽  
South Of Brazil ◽  
Clinical Records

Abstract Objectives: to characterize the social and clinical profile of pregnant women infected with HIV, the factors associated to the prevention of vertical transmission, and to analyze the quality of the information available in the SINAN notification forms and clinical records of infected pregnant women and children exposed to HIV in a specialized service in the countryside of Rio Grande do Sul. Methods: retrospective documentary study conducted from medical records of 110 HIV mothers and their children born between June/2014 and March/2017. For the analysis, the absolute frequency and the data percentage were taken under consideration. Results: the characterization of infected women represents a Brazilian scenario among young adults, low schooling level and the occurrence of unpaid employment situation. Most mothers underwent treatment during pregnancy and had prenatal care with the intention of applying the prophylactic measures recommended by the national protocols. A greater occurrence of incompleteness of data in the factors of prevention of vertical transmission was identified. Conclusions: the compromise is identified regarding the quality of assistance addressed to the population, which is largely exposed to unfavorable social conditions. The occurrence of data incompleteness shows that there is still not a culture among health professionals that ensures that the information is adequately filled out and favors the exchange of the information among the services.

Frequency and weight of complications of pregnancy and childbirth at women with tuberculosis of various localization in Krasnoyarskiy kraY

2014 ◽  
Vol 63 (3) ◽  
pp. 58-65
Author(s):  
Svetlana Anatolyevna Vetushenko ◽  
Tatyana Grigoryevna Zakharova
Keyword(s):  
Pregnant Women ◽  
Premature Birth ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Maternity Hospital ◽  
Obstetric Complications ◽  
Medical Monitoring ◽  
Pregnancy And Childbirth ◽  
Prevention And Treatment

The purpose of researches - to reveal clinical manifestations of obstetric complications at pregnant women with tuberculosis of various localization on the basis of results of medical monitoring, and also to establish the complications of fetoplatsentarny insufficiency taking place in the studied period, at pregnant women with tuberculosis according to localizations of tubercular process. During medical monitoring stories of families of 210 women with tuberculosis of various localization and a condition of their newborns during 2006-2013 on the basis of interdistrict maternity hospital N 4 of Krasnoyarsk, profiled on this pathology are analysed. As a result of the analysis of structure of obstetric complications at women with tuberculosis in the territory of Krasnoyarsk Kray it is established: from 210 pregnant women at 76 there were no complications; at 133 pregnant women with FPN clinical manifestations are noted it are 43 cases of a hypoxia of a fruit, 31 cases of SZRP, 14 cases of SZRP with a hypoxia, thus clinical manifestations were accompanied by lack of water and abundance of water at the level of 22 and 4 cases respectively; in the same group the increase in number of complications of pregnancy by a preeklampsiya, anomalies of patrimonial activity, premature birth at the level of 51, 16 and 28 cases respectively is looked through. From only 133 pregnant women with placentary insufficiency 11 cases of childbirth without clinical manifestations of FPN are noted. The revealed number of clinical manifestations of placentary insufficiency and other complications of pregnancy says that at pregnant women with a disease of tuberculosis these indicators many times is more, than at pregnant women without disease of tuberculosis. The established structure of obstetric complications at pregnant women with tuberculosis of various localization highlighted prevalence of FPN proceeding with heavy clinical manifestations, such as SZRP, the fruit hypoxia, and also revealed most often meeting complications of pregnancy, such as a preeklampsiya, abnormal patrimonial activity, premature birth. It is the indication for development of effective measures of prevention and treatment of these complications, their forecasting from early terms of pregnancy for improvement of perinatal outcomes.

scholarly journals Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study

2014 ◽  
Vol 5 (1) ◽  
pp. 22-26
Author(s):  
Sailaja Devi Kallur ◽  
Nuzhat Aziz
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Negative Likelihood Ratio ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Likelihood Ratios ◽  
Amniotic Fluid Index ◽  
Diastolic Flow ◽  
Adverse Perinatal Outcomes

Abstract Aim To determine the ability of fetal monitoring tests to predict adverse perinatal outcomes in absent end diastolic flow (AEDF) babies. Materials and methods A retrospective cohort study of pregnant women with AEDF during the period 2001 to 2009. Fetal monitoring tests of interest included amniotic fluid index (AFI), nonstress tests (NST), and Doppler flow studies. Adverse perinatal outcomes included perinatal/neonatal mortality, necrotizing enterocolitis, respiratory distress syndrome, and grades III/IV intraventricular hemorrhage. Sensitivity, specificity, likelihood ratios, adjusted odds ratios, area under the receiver operator characteristic curves (AUROC) and the 95% confidence intervals were determined. Study included 142 women with AEDF who delivered before 34 weeks. Indications for delivery included abnormal AFI in 6 (4.23%), worsening Doppler in 31 (21.83%), and abnormal NST in 48 (33.80%). An adverse fetal event was noted in 107 [75.35%, 95% confidence interial (CI) 68.18%, 82.53%]. Birth weight adjusted odds for an adverse perinatal outcome decreased (Odds ratio: 0.79, 95% CI: 0.56, 1.10, p = 0.16) with an increase in each week of gestation. Fetal monitoring tests did not have clinically meaningful positive/negative likelihood ratio or significant AUROC. Conclusion Current fetal monitoring tests are more useful to identify noncompromised fetuses than to identify fetal distress. Delaying delivery till 34 weeks might improve outcomes. How to cite this article Kallur SD, Aziz N. Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study. Int J Infertil Fetal Med 2014;5(1):22-26.

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