scholarly journals A Retrospective Review of 25 cases of Lethal Fetal Anomalies

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Dalia FA ◽  
Hamizah I ◽  
Zalina N ◽  
Yong SL ◽  
Mokhtar A
Keyword(s):  
Gestational Age ◽  
Retrospective Review ◽  
Post Partum ◽  
Case Series ◽  
Tertiary Hospital ◽  
Prenatal Ultrasound ◽  
Age At Diagnosis ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Failed Induction

Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.

scholarly journals Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

2016 ◽  
Author(s):  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Gestational Age ◽  
Post Partum ◽  
Severe Preeclampsia ◽  
Maternal Complications ◽  
History Of ◽  
Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/μl, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

scholarly journals REVIVAL OF VAGINAL BREECH DELIVERY

1969 ◽  
Vol 5 (1) ◽  
pp. 597-602
Author(s):  
NASIM AKHTAR
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

BACKGROUND: Since the publication of term breech trail there had been a dramatic changeworldwide from selective to planned Cesarean Section for all women with breech presentation at term.This high cesarean section rate led to adverse consequences in subsequent pregnancy &on futurefertility. Choice of safest mode of delivery has always been a dilemma.OBJECTIVE: Prospective interventional study. This study was done to determine the safety of vaginalbreech birth in terms of neonatal & maternal complications, so that to encourage the trend of breechdelivery in carefully selected cases & to discourage the trend of routinely recommending cesareansection for all gravidas with fetus in breech presentation at term. The study was conducted atDepartment of Obstetrics & Gynae Mardan Medical Complex from January 2010 to December 2015.PATIENTS & METHOD: About 809 patients with singleton pregnancy with breech presentation wereincluded. Decision about mode of delivery was taken on the basis of clinical judgment and ultrasoundwhich was further reviewed in the light of rate of progress during labour .Delivery was conducted byexperienced obstetrician. Mother & infants were followed up to 6 wks post partum. The primaryoutcome was neonatal mortality, infant mortality & serious infant morbidity.RESULTS: out of 809 total patients with breech presentation, 714 were planned for vaginal delivery674 delivered (83%) while 40 pts (5%) had emergency Cesarean Sections.95 patients (12%) hadElective cesarean section. In the delivery group two (0.29%) neonates had serious neonatal morbidity. Inthe cesarean group there was no serious neonatal morbidity. Infection & blood loss was greater in thecesarean group. There were no serious maternal complications in the vaginal delivery group. Thedifference between neonatal morbidity, perinatal mortality &neonatal mortality between the two groupswas not significant.CONCLUSION: Vaginal breech delivery is still a safe option which better suits the clinical situation&problems of our patients .In our set up, Cesarean section should not be routinely advised to patientswith breech presentation no matter it may be the best management option in developed countries.Careful case selection & vigilant monitoring of progress of labour will save many patients fromunnecessary section without costing extra morbidity & mortality.KEY WORDS: Breech presentation, Breech Delivery, Cesarean section, Apgar score.

Hodgkin lymphoma in United Arab Emirates UAE, epidemeology, histological types and treatments outcome: Case series of 47 cases from Mafraq Hospital, Abu Dhabi, UAE.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e19016-e19016
Author(s):  
Aladdin Maarraoui ◽  
Ahmed AlMessabi ◽  
Omar Al Teneji ◽  
Yasmeen Maarraoui
Keyword(s):  
Overall Survival ◽  
United Arab Emirates ◽  
Case Series ◽  
Stage Iv ◽  
Tertiary Hospital ◽  
Age At Diagnosis ◽  
Abu Dhabi ◽  
Data Collection Tool ◽  
Mixed Cellularity ◽  
Oncology Unit

e19016 Background: Approximately 9,050 Americans gets diagnosed annually with Hodgkin's Lymphoma HL and approximately 1,150 dies each year from HL(1).Nodular Lymphocyte-predominant LP (NLPHL) represents 5% of HL (2). Mafraq Hospital is a tertiary hospital in Abu Dhabi, UAE, We suspected that we are seeing more than expected cases of NLPHL.Therefore, we carried a retrospective study to review all cases of HL seen at our oncology unit for the period from 01/01/2016 till 30/06/ 2018. Methods: We developed Excel data collection tool. After Ethics approval, Electronic Medical Records of all cases seen with the diagnosis of HL between 01/2016 and 06/2018 at Mafraq Hospital were reviewed. Results: Total of 47 case were collected. 8 cases (17%) were found to have NLPHL, The rest of cohort were 39 cases, 22 (57%) of them had nodular sclerosis HL, 4 cases (10%) mixed cellularity HL, 2 (5%) lymphocyte rich HL, no cases of lymphocyte depleted HL. 9 (23%) of cases were classical HL with no type as diagnosis was made from core biopsies. 2 cases (5%) unlisted type.The stage for the 42 case were as follows Stage I: 1 case = 2.3%, Stage II: 24 case = 57.1%Stage III: 11 case = 26.1%Stage IV: 6 cases = 14.2%. Conclusions: We saw 23 (49%) females and 24 (51%) males. Our hypothesis that NLPHL is more frequently seen in UAE seems to be correct as 17% of all HL cases seen were from this subtype. Mean age at diagnosis of all HL cases is 33 years. In the NLPHL there were 2 (25%) females and 6 (75%) males. Mean age at diagnosis for NLPHL is 31.8 years. Most HL patients received ABVD as first line regimen. This is documented in 38 out of 47 case. Mean overall survival registered at the closure of the study is 45 months. It is important that this overall survival is premature as no patient has relapsed or died.

scholarly journals Hypoparathyroidism and Pseudohypoparathyroidism in Pregnancy: An Italian Retrospective Observational Study

2020 ◽  
Author(s):  
Gemma Marcucci ◽  
Paola Altieri ◽  
Salvatore Benvenga ◽  
Marta Bondanelli ◽  
Valentina Camozzi ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Serum Albumin ◽  
Case Reports ◽  
Post Partum ◽  
Case Series ◽  
Urinary Calcium ◽  
Total Calcium ◽  
Maternal Complications ◽  
Pharmacological Management ◽  
The Mean

Abstract Background: Hypoparathyroidism (HypoPT) or pseudo-hypoparathyroidism (pseudo-HypoPT) during pregnancy may cause maternal and fetal/neonatal complications. In this regard, only a few case reports or case series of pregnant or lactating women have been published. The purpose of this study was to describe clinical and biochemical course, pharmacological management, and potential adverse events during pregnancy and post-partum in pregnant women with HypoPT or pseudo-HypoPT. This was a retrospective, observational, multicenter, study involving nine Italian referral centers for endocrine diseases affiliated with the Italian Society of Endocrinology and involved in “Hypoparathyroidism Working Group”.Results: This study identified a cohort of 28 women (between 2005 and 2018) with HypoPT (n=25, 80% postsurgical) and pseudo-HypoPT (n=3). The mean calcium carbonate and calcitriol doses of both groups were increased during pregnancy compared to pre-pregnancy period. During the three trimesters of pregnancy the mean calcium carbonate and calcitriol doses were variable, remaining unchanged throughout gestation respectively in 40% and 60% of women with HypoPT, whilst tended to decrease from the third trimester to the post-partum six months. Most identified women (~70%) did not display maternal complications and (~90%) maintained mean serum albumin-corrected total calcium levels within the low-to-mid normal reference range (8.5±0.8 mg/dl) during pregnancy. The main complications related to pregnancy period included: preterm birth (n=3 HypoPT women), and history of miscarriages (n=6 HypoPT women and n=2 pseudo-HypoPT women). Conclusion: This study shows that mean serum albumin-corrected total calcium levels were carefully monitored during pregnancy and post-pregnancy, with limited evaluation of other biochemical parameters, such as serum phosphate, 24h urinary calcium, 25-OH vitamin D, and creatinine clearance. To avoid complications in mothers and offspring, intense biochemical, clinical and pharmacological monitoring during pregnancy and breastfeeding is highly recommended.

scholarly journals Case series of Foley’s induction in patients with previous caesarean

2017 ◽  
Vol 6 (4) ◽  
pp. 1635
Author(s):  
Hemalatha K. R. ◽  
Swetha D.
Keyword(s):  
Caesarean Section ◽  
Previous History ◽  
Case Series ◽  
Fetal Outcome ◽  
Labour Induction ◽  
Maternal Complications ◽  
History Of ◽  
Foley’S Catheter ◽  
Failed Induction ◽  
Meconium Stained Amniotic Fluid

Background: The objective of this study was to study the efficacy of intracervical Foley’s catheter induction in women with previous history of caesarean section and to evaluate the maternal and fetal outcome of these pregnancies.Methods: It is a prospective analysis of 30 patients whose labour was induced by intracervical Foley’s bulb for VBAC delivery. This study was conducted in KIMS, Hubli. Age, parity, indication of previous caesarean, inter-pregnancy interval and outcome of index pregnancy were studied in detail and analysed.Results: 30 women with previous history of caesarean were included into the study. Various indications of induction during index pregnancies were- post-datism, IUGR, intra-uterine foetal demise and severe pre-eclampsia and eclampsia. Out of 30 women, 18 (60%) had successful VBAC delivery, 12 (40%) underwent repeat LSCS. 19 cases needed augmentation of labour. Indications for caesarean section were failed induction in 5 (16.6%) women, threatened scar rupture in 3 (10%), non-progress of labour in 2 (6.6%) and meconium stained amniotic fluid in 2 (6.6%). No cases of uterine rupture or maternal mortality was noted in the study.Conclusions: In our study the rate of vaginal birth was 60% without major maternal complications. Hence intracervical Foley’s catheter is an effective, safe and acceptable for labour induction in women with previous caesarean.

scholarly journals Feto-maternal outcome of pregnancies diagnosed as hypothyroidism after 28 weeks of gestation, at a tertiary hospital

2021 ◽  
Vol 10 (11) ◽  
pp. 4136
Author(s):  
Asha Garg ◽  
Sham Sunder Goyal ◽  
Mini Bedi ◽  
Muskan .
Keyword(s):  
Post Partum ◽  
Neonatal Resuscitation ◽  
Tertiary Hospital ◽  
Maternal Outcome ◽  
Adverse Outcomes ◽  
Labour Induction ◽  
Overt Hypothyroidism ◽  
Maternal Complications ◽  
Increased Risk ◽  
Nicu Admission

Background: The most frequent thyroid alteration observed in pregnancy is hypothyroidism with subclinical hypothyroidism being more common than overt hypothyroidism. Women with thyroid dysfunction both overt and subclinical are at increased risk of pregnancy-related complications. In present study we assessed feto-maternal outcome of pregnancies in whom hypothyroidism was diagnosed after 28 weeks of gestation.Methods: This study was conducted in the department of obstetrics and gynaecology, Adesh institute of medical sciences and research Medical College, Bathinda. The present study was of prospective, observational design, conducted in pregnant women with more than 28 weeks pregnancy, first time diagnosed as hypothyroid (TSH>3.0 mIU/l).Results: In present study total 37 patients completed study protocol, 6 patients were delivered at other hospital. Most patients were less than 20 years (32%), nulliparous (68%). 19% patients delivered preterm either due to spontaneous labour or labour induction for obstetric reason. 62% patients delivered vaginally, 35% underwent LSCS. In present study maternal complications such as preterm labour (24%), hypertensive disorders of pregnancy (22%), oligohydramnios (16%), overt/gestational diabetes mellitus (8%) and post-partum haemorrhage (5%) were noted. 2.5-3.4 kg birth weight was most common group (65%). Total 16 % babies required neonatal resuscitation. Babies requiring neonatal resuscitation were admitted in NICU for observation and for any further management. Neonatal jaundice was noted in 30% babies. Total 22% babies needed NICU admission. We noted early neonatal death in one baby. No maternal mortality was noted.Conclusions: Treatment of maternal hypothyroidism is essential, because adverse outcomes for both mother and baby are greatly reduced, if not eliminated, when patients are treated.

scholarly journals Palivizumab reimbursement criteria and neonatal RSV hospitalisation: a regional retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e000985
Author(s):  
Valeria Belleudi ◽  
Federico Marchetti ◽  
Marco Finocchietti ◽  
Marina Davoli ◽  
Antonio Addis
Keyword(s):  
Respiratory Syncytial Virus ◽  
Gestational Age ◽  
Retrospective Review ◽  
Lower Prevalence ◽  
Different Seasons ◽  
Syncytial Virus

In Italy, reimbursement restrictions regarding palivizumab prophylaxis approved in 2016 have been revoked in 2017, restoring use in infants with Gestational Age (GA) >29 weeks. Respiratory Syncytial Virus (RSV) hospitalisations and prevalence of palivizumab use in infants aged <6 months during five seasons (2014–2019), were considered according to different GA. Although RSV hospitalisations rate showed no significant changes, during different seasons in all GA, lower prevalence of palivizumab use in 2016 (0.8% vs 0.3%), returned to a higher level following the revoke of restrictions. Changes in reimbursement criteria were not associated with neonatal RSV hospitalisations rate but with a significant impact on palivizumab use.

Causes of delayed exploration of the acute scrotum in a regional tertiary centre

2020 ◽  
pp. 205141582098119
Author(s):  
Benjamin Storey ◽  
Nathan Shugg ◽  
Alison Blatt
Keyword(s):  
Retrospective Review ◽  
Testicular Torsion ◽  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
Acute Scrotum ◽  
Tertiary Institution ◽  
Level Of Evidence ◽  
Scrotal Pain ◽  
Surgical Exploration ◽  
Significant Difference

Background: Testicular torsion is an organ-threatening surgical emergency with a limited timeframe for intervention. Objective: To identify the delays to surgical exploration of patients with an acute scrotum in a tertiary hospital to prevent adverse outcomes associated with this time critical emergency. Methods: A retrospective review of medical records for all patients who underwent scrotal exploration for acute scrotal pain in a tertiary hospital in regional New South Wales between January 2008 to December 2018 was performed. Results: Retrospective review identified 242 patients, of whom 161 had testicular torsion and 56 resultant orchidectomies. No statistically significant difference in pre-hospital delays between paediatric or adult populations was found. The average time from presentation to theatre was 4 h 36 min. Patients who were delayed > 6 h from presentation to surgical exploration had significantly increased rates of orchidectomy. Delays that significantly affected rates of orchidectomy were transfer from peripheral sites, late presentation, misdiagnosis and representation after discharge. Conclusion: The most common reason for delay was diagnostic error with the patient later re-presenting to hospital. Patient transfer from the primary hospital to a tertiary institution and subsequent delayed surgical exploration also contributed to significantly higher rates of orchidectomy. Level of Evidence: 3

scholarly journals Non‐immune fetal hydrops: etiology and outcome according to gestational age at diagnosis

2020 ◽  
Vol 56 (3) ◽  
pp. 416-421 ◽  
Author(s):  
F. G. Sileo ◽  
A. Kulkarni ◽  
I. Branescu ◽  
T. Homfray ◽  
E. Dempsey ◽  
...  
Keyword(s):  
Gestational Age ◽  
Age At Diagnosis ◽  
Fetal Hydrops
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