scholarly journals Characteristics of PPROM in General Hospital Dr. Soetomo Surabaya Period September 2017 to September 2019

2021 ◽  
Vol 2 (2) ◽  
pp. 81-87
Author(s):  
Letizia Alessandrini ◽  
Budi Wicaksono
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Perinatal Care ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Lung Maturation ◽  
Exclusion Criteria ◽  
Type Of Delivery

Background: Preterm Prelabour Rupture of Membranes (PPROM) is one of the causes of perinatal morbidity and mortality. Objective: To find out the characteristic of PPROM in Dr. Soetomo Hospital in September 2018 to September 2019. Method: A Retrospective Descriptive Study. The data came from the medical records of patients with PPROM who were included in the inclusion criteria. The exclusion criteria is all PPROM cases at Gestational age > 34 weeks. Result: The incidence of PPROM during September 2017 to September 2019 was 6.8% (175 patients), of which 152 patients included NBC cases and 23 patients with BC cases. Primipara 76 patients and Multipara 99 patients. For gestational age <26 weeks it was 17.1%, 26-30 weeks 29.7% and 31-34 weeks 53.1%. In this study, PPROM was amused 23.6%, underweight 3.1%, HBsAg 7.5%, HIV 7%, anemia 10.3%, Obesity 5.2%, Pragestational Diabetes 7.4%, Gestational Diabetes. 2,6%, preeclampsia 7,9% and severe preeclampsia 2,2%. The distribution of PPROM patients who received lung maturation was 72%, while the remaining 28% did not get lung maturation. Type of delivery for PPROM cases was vaginal delivery as much as 60% while 40% for cesarean section. Indications for vaginal delivery include fetal distress 25%, abnormal NST 18%, gemeli 17%, BSC 12%, febris 10%, pulmonary edema 5% and breech presentation 5%. The outcome distribution of PPROM infants born with asphyxia at birth was 87%. Weight of babies born with PPROM> 2500 g 4%, 1000-2500 g 73% and <1000 g 23%. The condition of the babies at birth with spontaneous breathing was 36 babies, nasal O2 was 13 babies and CPAP was 70 babies. The causes of death for preterm KPP babies included RDS 9 babies, Sepsis 4 babies and severe asphyxia 19 babies. The length of NICU care for infants who died with KPP Preterm mothers was <24 hours for 15 babies, 1-3 days 13 babies, 4-7 days 3 babies,> 7 days 3 babies and 5 fetuses were IUFD. 12 patients with PPROM received amnioinfusion while 5 patients with amniopatch, Outcome of infants from conservative PPROM who were treated with amniopatch or amnioinfusion obtained 6 babies died at birth, 8 babies with CPAP breath support, 1 baby with PCV breath support, 1 baby with ventilator and 1 infant spontaneously breathed. A total of 3 babies were outpatient after treatment for a maximum of ± 25 days. Conclusion: Perinatal care is currently experiencing some rapid progress, but the case of PPROM is still one of the biggest contributors to perinatal morbidity and mortality.

scholarly journals Fetomaternal outcome in breech delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2480
Author(s):  
Bhavesh B. Airao ◽  
Vishal M. Sharma ◽  
Ravi A. Zala ◽  
Vimal Vasava
Keyword(s):  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Different Types

Background: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation.  Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section.Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014.Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%.Conclusions: The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.

scholarly journals A STUDY ON VERY LOW BIRTH WEIGHT BABIES ADMITTED IN NICU

2020 ◽  
pp. 1-3
Author(s):  
Janki Prajapati ◽  
Sucheta Munshi ◽  
Ankit Chauhan
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Perinatal Care ◽  
Morbidity And Mortality ◽  
Mortality Pattern ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Major Factors

Background: Very low birth weight (VLBW) neonates are at high risk for morbidity and mortality. Preterm birth is one of the major clinical problems in Obstetrics and Neonatology. Aim & Objective: To study morbidity and mortality pattern of VLBW neonates admitted to NICU at Department of Pediatrics, Civil hospital, Ahmedabad. Methodology: This cross-sectional prospective observational study was performed on all hospitalized VLBW neonates. Their course during hospitalization and relevant was documented in pre designed performa. Results: In the present study, out of 1748 neonates, 374 (21.39%) were VLBW with 69% males. Mean gestational age was 31.3±1.8 weeks; mean birth weight 1279±193 grams. Common morbidities in VLBW neonates are Neonatal jaundice, Probable sepsis, Apnea of prematurity and RDS. Mortality rate is improved with increasing gestational age and weight. Conclusion: Birth weight and mechanical ventilation are the 2 major factors responsible for mortality. A decline in the mortality and morbidity of these newborns (especially the ELBW neonates) can only be made possible through optimizing perinatal care including regionalization, CPR at birth, early NCPAP and quality improved collaborative (QIC) in our NICU.

Application of Customized Birth Weight Curves in the Assessment of Perinatal Outcomes in Infants of Diabetic Mothers

2014 ◽  
Vol 37 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Nieves L. González-González ◽  
Enrique González-Dávila ◽  
Francisco Cabrera ◽  
Begoña Vega ◽  
Erika Padron ◽  
...  
Keyword(s):  
Gestational Age ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Perinatal Morbidity ◽  
Infants Of Diabetic Mothers ◽  
Diabetic Mothers

Objective: To determine whether the use of customized curves (CC) allows better detection of large- (LGA) or small-for-gestational age (SGA) infants at risk of adverse perinatal morbidity than non-CC in women with diabetes mellitus (DM). Material and Methods: A model of CC was applied to all infants of diabetic mothers (IDM) who attended the Hospital Universitario Materno Infantil de Canarias between 2008 and 2011. We compared perinatal outcomes of IDM classified as LGA or SGA by non-CC versus CC. Results: One of 4 LGA was appropriate for gestational age (AGA) by CC (false-positive rate: 25%) and 30% of SGA by CC were not identified by non-CC (false-negative rate). False-positive LGA and SGA showed similar perinatal outcomes to AGA infants. The rates of cesarean section, cephalopelvic disproportion, total fetal distress and shoulder dystocia were significantly higher in false-negative LGA than in AGA by CC (p < 0.004, p < 0.02, p < 0.04 and p < 0.04, respectively). Fetal distress was higher in false-negative SGA than in AGA by CC (p < 0.03). Discussion: In pregnancies complicated by DM, the use of CC allowed more accurate identification of LGA and SGA infants at high risk of perinatal morbidity than non-CC.

scholarly journals Prelabour Rupture of Membrane : Maternal and Foetal Outcomes

2020 ◽  
Vol 19 (2) ◽  
pp. 23-27
Author(s):  
Monira Jamal ◽  
Rajat Kumar Biswas
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Care Service ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Income Group ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Cross Sectional ◽  
The Mean

Background: The leading cause of perinatal morbidity and mortality is prematurity in developed and underdeveloped countries. In one third of the patients with preterm labour, there is associated premature rupture of membranes. The study was conducted to evaluate the clinical presentation of Pre-labour Rupture of Membrane (PROM) in pregnancy and obstetric outcome. Materials and methods: This is a cross sectional study carried out in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, between September 2013 to February 2014. About 50 women having PROM with more than 32 weeks gestational age who admitted in the above department for delivery were enrolled in this study. Results: The mean age was found 27.4 ± 4.42 years with range from 17 to 41 years. Forty eight percent of PROM patient were primi and 52.0 percent of patients were multigravida. Six percent patients were illiterate. Almost two third patients were housewives. More than half (54.0%) of the patients were came from poor class income group family. Majority (64.0%) patients had term PROM (>37 weeks) gestational age and the mean gestational age was 38.1 ± 2.7 weeks with range from 32- 40 weeks. More than half (54.0%) didn't received any antenatal checkup. A total of (56.0%) patients had associated disease, out of which anaemia was more common. Twelve percent had diabetes mellitus and 8.0% had UTI infection. Almost two third (64.0%) was vaginal delivery and 18(36.0%) were caesarean section and common indication for caesarean section was fetal distress (38.9%). Two third patients were healthy and 17 patients had morbidities, wound infection is highest (29.4%). The mean birth weight was found 2.74 ± 0.7 kg. APGAR score >7 at 1 minute was found (92.0%) and (94.0%) at 5 minutes of birth of baby after birth. Fetal outcome take home alive (98.0%) and neonatal death 2.0%. Among 50 foetus morbidity develop in 26 cases. Among them respiratory insufficiency is highest (38.5%). Conclusion: Motivation of the patients, health education, improvement of nutritional status of mother, neonatal care service, early diagnosis, treatment, overall institutional delivery is needed for reduction of neonatal morbidity and mortality, as well as maternal morbidity. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 23-27

scholarly journals A study on maternal and perinatal outcome in premature rupture of membranes at term

2017 ◽  
Vol 6 (12) ◽  
pp. 5368 ◽  
Author(s):  
Sailaja Surayapalem ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Salicheemala
Keyword(s):  
Gestational Age ◽  
Maternal Morbidity ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Well Being ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture

Background: Premature rupture of membranes is defined as rupture of foetal membranes before the onset of labour. Management of cases of PROM still remains as one of the most difficult and controversial problems in obstetrics. PROM can cause maternal complications like chorioamnionitis, increased operative procedures, puerperal sepsis and neonatal morbidity and mortality. The present study is undertaken to study the labour outcome, maternal morbidity and perinatal morbidity and mortality in term PROM.Methods: 200 Cases of spontaneous rupture of membranes with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. Parameters of maternal and foetal well being were recorded. All study groups received prophylactic antibiotics. Single pelvic examination done, and maternal vitals recorded fourth hourly. All the data was analyzed and statistical significance was calculated using Chi-square test.Results: PROM was common in age group of 20-24 years (35%) with mean age of 22.6 years and SD of 2.8 years, and common in primigravida. Majority of women were admitted within six hours of PROM (41.5%) and Mean duration of induction to delivery interval was 12.9 hours. The mean duration between PROM to delivery was 20.2 hours which was statistically significant. Cesarean sections were more among primigravidas. Failure to progress was the common indication. Maternal morbidity was significant (17.5%). No maternal mortality in the study. Perinatal mortality was 1.5%. Birth asphyxia was the commonest cause. Perinatal morbidity was seen in 26%. Escherichia coli was common organism found in cervical swab culture.Conclusions: In present study, majority was primigravidas and the most common age group was 20-24 years belonging to low socioeconomic status. Maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery and infection of the female genital tract with pathogens. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy.

scholarly journals Role of Ultrasound in Detection of Abruptio Placentae and its Clinical Correlation

2018 ◽  
Vol 8 (2) ◽  
pp. 35-39
Author(s):  
Sangeeta Devi Gurung ◽  
Junu Shrestha ◽  
Prakash Sharma
Keyword(s):  
Gestational Age ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Abruptio Placentae ◽  
Ultrasound Findings ◽  
Recorded Data ◽  
A Prospective Study ◽  
Singleton Pregnancies

Introduction: Abruptio placentae is one of the major complications in second half of pregnancy. It accounts for 0.4-1 % of all deliveries. With the advent of ultrasonography, though abruptio placentae has been diagnosed however the sensitivity is less. Those patients clinically suspicious of abruption placenta with negative ultrasound findings can have positive intrapartum findings suggestive of abruptio. Fetal outcome is associated with the gestational age. Preterm deliveries with abruption have higher incidence of perinatal morbidity and mortality as compared to term pregnancies.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara from July 2017 to July 2018. All the cases of more than twenty eight weeks gestation, singleton pregnancies without preexisting maternal medical diseases suspicious of abruption placentae were included in the study. Ultrasonological and intrapartum findings were recorded. Data was analyzed using SPSS (VERSION16).Results: Out of forty patients presented with per vaginal bleeding, sixteen were diagnosed as placental abruption either clinically or ultrasonographically. Only ten patients had positive ultrasound findings of retroplacental clot or subchorionic hemorrhage. Out of six patients with negative ultrasound findings, only four had positive Intrapartum findings suggestive of abruption placenta. The specificity (100%) of ultrasound in diagnosing abruption was more than the sensitivity (71.43%) and the accuracy was 75%.Conclusion: Ultrasound is less sensitive in diagnosing abruption placenta and the lesser the gestational age, the more in the increase in perinatal morbidity and mortality.

scholarly journals Twin-Twin transfusion syndrome: a case report

2020 ◽  
Vol 9 (3) ◽  
pp. 1282
Author(s):  
Romi Bansal ◽  
Jasleen Kaur ◽  
Priyanka .
Keyword(s):  
Case Report ◽  
Gestational Age ◽  
Twin Pregnancy ◽  
The Other ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Monochorionic Twin

Twin to twin transfusion syndrome is a rare but serious complication of monochorionic twin pregnancy. It is characterized by the development of abnormal placental vascular communication from one foetus (donor) to the other foetus (recipient). If left untreated it led to high rates of perinatal morbidity and mortality due to its poorly understood etiology and difficulty in diagnosing and treatment. Authors report a case of twin to twin transfusion syndrome in 24 years old primigravida with gestational age of 18 weeks 5 days diagnosed on ultrasound.

scholarly journals Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 4 ◽  
Author(s):  
Buddhi Kumar Shrestha ◽  
Subha Shrestha
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
College Teaching ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Vaginal Deliveries ◽  
Significant Difference

Introduction: Many times, parturient opt for labour and vaginal breech delivery even after informing increased perinatal risks. Vaginal breech deliveries are undertaken with the reasons like avoidance of cesarean section in next pregnancy, null risk of operative and anesthetic hazards, ability to resume early all household works after vaginal birth, etc. The purpose of this study is to compare the perinatal outcome of breech deliveries in singleton breech presentation between vaginal breech delivery and cesarean section.   Methods: A retrospective study was done in Lumbini Medical College Teaching Hospital for the duration of one year (December 2014 to November 2015). Data of perinatal outcome of breech deliveries were collected from the hospital records. The records of neonatal examination were also collected. The primary outcomes included were neonatal morbidity and mortality.   Results: Out of 80 selected women with breech presentation, 42 of them had vaginal deliveries and 38 women had undergone caesarean section. The perinatal mortality was 4.8% and morbidity was 2% in vaginal breech deliveries. There was no significant difference of APGAR score in the two groups at any time. Similarly, there was no significant difference in perinatal morbidity and mortality in the two groups. Nulliparous women were more likely to deliver by Cesarean section.   Conclusion:  In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal breech delivery of singleton fetus in breech presentation remains a safe option that can be offered to women.

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