scholarly journals IMPACT OF HIGH MATERNAL BMI ON FETAL AND MATERNAL OUTCOME: A PROSPECTIVE OBSERVATIONAL STUDY.

Author(s):  
Pammy Pravina ◽  
Rita Sinha

Aim: to study the impact of increased BMI on fetal and maternal outcome. Materials and methods:  The present descriptive observational study was conducted in the Department of Obstetrics and Gynecology, Nalanda Medical College and Hospital, Patna, Bihar, India over the period of 1 year. The study includes total 100 subjects who have taken antenatal care at the hospital. Descriptive statistics included computation of percentages, means and standard deviations were calculated using SPSS version 20. Results: mean maternal age at birth was 28.11 years and mean BMI (kg/m2) was 27.12. The mean birth weight of babies was 3.12 kgsand mean NICU stay was 5.21 days. Still birth (11%) and Neonatal death (8%) were reported as the major fetal outcome. Under maternal outcome Caesarean section followed by Pre-eclampsia, PIH and GDM were reported as the major morbidities. Conclusion: Present study confirmed that maternal obesity is now becoming one of the most common risk factors in pregnancy, leading to complications that impact on the health of both the woman and her offspring. Keywords: BMI, Obesity, Maternal, Fetal, Outcome

Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.


Author(s):  
Esther Kamalarani A. ◽  
Ramyajothi . ◽  
Ramalakshmi S.

Background: Obesity continues to be a global health concern. Although the increasing obesity rates in developed countries has slowed down in the past 10 years, obesity rates in developing countries continue to increase, as much as three times in some developing countries over the past 30 years. The aim of the study was to determine the adverse effects of obesity in pregnancy and maternal and fetal outcome.Methods: In all patients, a detailed history was taken and examinations and investigations were carried out.  Based on BMI (body mass index), patients were divided into 2 groups. Group 1 = patients with BMI >30 kg/m2 and Group 2 = patients with BMI <30 kg /m2.Results: In our study, comparing pregnant mothers with BMI >30 kg/m2 and normal BMI, authors found that the prevalence of maternal and fetal complications was higher in the obese group. Prevalence of antenatal complications like gestational hypertension, preeclampsia, imminent eclampsia and gestational diabetes mellitus requiring control with insulin was higher in obese women.Conclusions: Obesity is associated with increased adverse effects on pregnancy and its outcome.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Sonia Silinsky Krupnikova ◽  
Timothy Brady ◽  
Michael Sheppard ◽  
N. Andrew LaCombe ◽  
Derek Jones ◽  
...  

Objectives. This observational study was designed to evaluate the impact of a student-led Rheumatology Interest Group on medical student interest in rheumatology. Methods. The mean numbers of student-rheumatology interactions per six months were assessed for elective enrollment, abstract submissions, and manuscripts, in the pre- and postinterest group period. Results. Enrollment in the rheumatology elective increased from 2.0 ± 0.36 per six months in the preintervention period to 6.2 ± 1.24 per six months in the postintervention period (p=0.0064). Abstract submissions increased from 0.5 ± 0.34 to 5.86 ± 1.49 (p=0.0077), and manuscript submissions from 0.16 ± 0.16 to 1.57 ± 0.37 (p=0.074). Conclusion. The Rheumatology Interest Group significantly increased medical student engagement in rheumatology.


2020 ◽  
Vol 6 (1) ◽  
pp. 07-10
Author(s):  
Khalil-Ur -Rehman ◽  
Rizwan Faisal ◽  
Rizwan Qaisar ◽  
Mian Mujahid Shah

Introduction: A rigorous characterization of the impact of residential status of medical students (hostelites vs. day scholars) on the particulars of their academic performance has been lacking in Pakistan. Objective: To determine the relation of residential status of third year MBBS students to their academic performance in Forensic Medicine based on comparison of their pre-professional and professional examinations results during 2019. Materials & Methods: A comparative study was conducted from August to October 2019 on the examination performance of third year MBBS students of Rehman Medical College, Peshawar in the subject of Forensic Medicine. The results of theory and viva pre-professional and professional examinations were compared and categorized by residential status of students (Hostelites or Day Scholars). Students were categorized into groups according to their academic performance. Descriptive and Comparative data analysis was performed by SPSS 22.0, keeping p≤0.05 as significant. Results: No significant difference was found in the mean marks of hostelites and day scholars in pre-professional and professional examinations. The trend of significant improvement from pre-professional to professional examinations was similar in both groups, and it applied to both the theory and viva examinations. A significant correlation existed between the performance in two examinations among all students with no difference between the hostelites and day scholars. Conclusion: Residential status of MBBS students had no effect on their academic performance in the subject of Forensic Medicine. Keywords: Academic performance, Forensic Medicine, hostelites, day scholars


2021 ◽  
Vol 33 (2) ◽  
pp. 102-107
Author(s):  
Muhammad Zahangir

Introduction: The study carried out among the pregnant women who had anemia during pregnancy with the objectives to determine their maternal outcome at private hospitals in Dhaka city. Materials and Methods: The total sample size was 110. Data was collected by interviewing the respondents with a structured pre-tested questionnaire. The study was conducted in pregnant women with anemia at or after 28 weeks of gestation and had delivered at Obstetrics Department of Ad-Din Barrister Rafique ul-Huq Hospital, Jurain and Bashundhara Ad-Din Medical College Hospital South Keranigonj. Results: Most of the respondents (38.2%) belonged to the age group between 16-20 years. The mean age was 23.74±5.127 years. Almost (49.1%) up to primary & (38.2%) were up to secondary/higher secondary level. Most of the respondents were homemaker (87.3%); Monthly income means was 19340.91±12459.647. Most (90.9%) of the respondents had received ANC and 79.1% respondent’s hemoglobin level was below 10 gm. /dl. Among them 90.9% of the respondent’s fetal outcome were healthy & alive baby. More than half (51.8%) of the respondent’s baby were _ 2.5 kg birth weight. Study also shows that 55.5% respondents had anemia after delivery, 28.2% had sickness and 22.7% were sulfured with complications after delivery. There was a significant relationship with low birth weights (LBW) to less high education. Conclusion: All women should be given advice regarding diet in pregnancy with details of foods rich in iron. Dietary changes alone are not sufficient to correct an existing iron deficiency in pregnancy and iron supplements are necessary. Medicine Today 2021 Vol.33(2): 102-107


Author(s):  
S. Shruthi ◽  
A. Anisha Apollo

Background: The most common presentation of the fetus is malpresentation. These include breech, face, brow, shoulder and compound presentations. Malpresentations of fetus complicate labor in about 5% of pregnancies. To find out the incidence of malpresentation, to analyze etiological factors of malpresentation, to evaluate the maternal outcome in cases with a malpresentation.Methods: This prospective observational study was done in, Chengalpattu Government medical college and hospital. Study period from October 2018 to September 2019. Pregnancies with malpresentation presenting to the department of obstetrics and gynecology at CMCH were included in the study.Results: A total of 680 malpresentation were admitted in this period were included in this study. The incidence of malpresentation during the study period was 7.72%. The incidence of the breech was 4.38%, transverse lie 1.11%, face 0.28%, brow 0.05% and compound presentation 0.13%. The common causes were prematurity, multiple gestations, grand multiparty, IUGR, oligohydramnios, anomalies of uterus, polyhydramnios, contracted pelvis, placenta previa, hydrocephalus, prematurity was reported as the commonest cause of breech presentation and multiparty for transverse lie, face and brow presentations. The most common complication was obstructed labor 6.9% followed by post-partum hemorrhage 3.65%. There was no maternal death due to malpresentation during the period of study.Conclusions: Early diagnosis and timely management can prevent the complications of labor associated with a malpresentation. Delivery should be planned at centers which have expertise in conducting vaginal delivery in malpresentation with good intrapartum monitoring and with facilities for cesarean section for the better feto-maternal outcome.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Brodowski ◽  
Niels Rochow ◽  
Efrah I. Yousuf ◽  
Fabian Kohls ◽  
Constantin S. von Kaisenberg ◽  
...  

Abstract Objectives Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany. Methods This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity. Results Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores. Conclusions Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.


2021 ◽  
Vol 8 (20) ◽  
pp. 1489-1494
Author(s):  
Jayas Siby ◽  
Preetha S ◽  
Sindhu R.S

BACKGROUND Acute pancreatitis is a very common disease and severe acute pancreatitis is life threatening and needs early identification. Current severity predicting indices in acute pancreatitis are cumbersome. There have been previous reports of low HDL cholesterol in life threatening acute pancreatitis. Previous studies in this regard were done in a single ethnicity population and needed to be validated in other ethnic groups. We wanted to estimate the proportion of pancreatic necrosis among the patients with acute pancreatitis attending Government Medical College, Thiruvananthapuram. We also wanted to compare the mean HDL values in those who developed pancreatic necrosis and those who didn’t develop pancreatic necrosis and evaluate the association between HDL value measured 48 – 72 hours of onset of symptoms and pancreatic necrosis. METHODS This was a prospective observational study conducted among 271 patients diagnosed with acute pancreatitis in Government Medical College Hospital, Thiruvananthapuram. Consecutive sampling method was used. RESULTS There were 42 cases of pancreatic necrosis out of 271 cases. The mean HDL of those patients with pancreatic necrosis was found to be less than those without necrosis (P < 0.001). Mean HDL value among those having pancreatic necrosis was 17.7 whereas those without necrosis was 34.9. CONCLUSIONS Proportion of pancreatic necrosis was 15.5 %. The mean HDL measured at 48 hours of symptom onset among the necrotising pancreatitis patients was significantly low when compared to the non-necrotic group (17.7 vs 34.9). All the patients with pancreatic necrosis had their HDL less than 40. Thus, an inference that low HDL at 48 hours of symptom onset was associated with higher incidence of pancreatic necrosis and severe pancreatitis could be made. KEYWORDS Pancreatitis, HDL, Pancreatic Necrosis


2020 ◽  
Vol 7 (4) ◽  
pp. 1218
Author(s):  
Sudhir Singh Pal ◽  
Ashay Rathore

Background: Glasgow coma scale (GCS) and the Glasgow outcome scale help us with confident predictions after 24 h following the injury, but not on admission. The IMPACT and CRASH studies provided new methods for performing prognostic studies of traumatic brain injury. And this prognostic scoring system has been studied in our study.Methods: This is an observational prospective cohort study performed at the department of surgery, Gandhi medical college and Hamidia hospital, Bhopal on 87 patients during a period of 2 years. A preformed pro-forma was filled for each patient after 6 hours of resuscitation which included all the details of the patients like name, age, sex, CR no., and GCS after resuscitation, mode of injury, the clinical evaluation score used by IMPACT trial and neurological finding, management details, CT scan was done as soon as possible for all patients and findings were included in the pro-forma. The final outcome was recorded at the time of discharge.Results: Among Patients with mean total prognostic score of 0-4, 97% patients discharged without deficit, 3% discharged with deficit with no mortality. Among score of 15-20, only 7 % can be discharged without deficit and 7% could be discharged without deficit, while 86 % patient died.Conclusions: The mean total prognostic score of discharged groups was significantly lower than the patients in discharged group. We concluded that this prognostic model helps us to individually identify patients who will succumb to death and early need for surgical intervention.


Author(s):  
Shreedevi Kori ◽  
Dayanand Biradar ◽  
Aruna Biradar ◽  
Rajasri Yaliwal ◽  
Subhashchandra R. Mudanur ◽  
...  

Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.


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