scholarly journals Maternal and perinatal mortality, morbidity and risk factor evaluation in ante partum hemorrhage associated with Placenta Praevia

2013 ◽  
Vol 1 (2) ◽  
pp. 65-70
Author(s):  
Farhana Kalam ◽  
Mohammad Omar Faruq ◽  
Saleha Begum Chowdhury

Objective: To determine the maternal & perinatal morbidity and mortality associated with Placenta Praevia in Bangladesh. To assess the risk factors of antepartum hemorrhage associated with Placenta Praevia. Design: A cross sectional observational hospital based descriptive study. Setting: Obstetric inpatient units of two tertiary care teaching hospitals of Dhaka. Participants: One hundred pregnant mothers with diagnosis or Placenta Praevia proven by pelvic ultra sonography presenting with ante partum hemorrhage . Outcome: Incidence of maternal and fetal morbidity and mortality and risk factors of ante partum hemorrhage in Placenta Praevia. Results: 38% study mothers had no ante natal care. There was no maternal death. 96% of mothers were delivered by Caesarean Section. Incidence of primary post partum hemorrhage was 38%. There were 21% still birth and 16% neonatal death. 47% mothers had no complication after delivery. 22% mothers presented with hemorrhagic shock. 59% delivered babies had birth weight below 2.5 kg and 55% delivered babies had no complication. 57% mothers belonged to low socio economic group. Conclusion: The study reflects status of mothers presenting with Placenta Praevia with perinatal morbidity and mortality in a small urban population of Bangladesh treated at two tertiary care hospitals of Dhaka. It is recommended that mothers with Placenta Praevia need to have access to prenatal care and at the same time need to be educated about the benefit of prenatal care. Emergency management of ante partum hemorrhage with hemorrhagic shock should be widely available to improve the outcome of Placenta Praevia in our population. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17197 Bangladesh Crit Care J September 2013; 1 (2): 65-70

2016 ◽  
Vol 14 (3) ◽  
pp. 317-323 ◽  
Author(s):  
Marina Parca Cavelagna Teixeira ◽  
Tatiana Peloso Reis Queiroga ◽  
Maria dos Anjos Mesquita

ABSTRACT Objective: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. Methods: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio. The significance level used was 0.050. Results: There was a 17.9% frequency of small-for-gestational-age newborns. The statistically significant factors associated with the birth of these babies were female sex (p=0.012); positive history of another small-for-gestational-age child (p=0.006); inadequate prenatal care (p=0.019); smoking (p=0.003); hypertensive disorders of pregnancy (p=0.007); placental bleeding (p=0.009) and infarction (p=0.001). Conclusion: In the population studied, the frequency of small-for-gestational-age newborns was high and associated with sex, inappropriate prenatal care, presence of maternal diseases and addictions, and placental abnormalities.


Author(s):  
Vasant Kabbur ◽  
Lakshmi K. S. ◽  
M. M. Umadi

Background: Worldwide there has been an increase in the rate of caesarean delivery due to multiple factors. The main objective of this study is to analyze the various indications of caesarean delivery over a period of 4 years and to evaluate the maternal and fetal outcomes between elective and emergency caesarean section.Methods: Retrospective study conducted at the Department of Obstetrics and Gynecology, Belgaum Institute of Medical Sciences, Belagavi, India. The study period was from January 2016 - December 2017. The details were taken from case sheets, operation and parturition records and newborn records of 325 patients who underwent caesarean section. The data was analyzed with special reference to the indication of caesarean section, maternal and fetal outcomes among elective and emergency cases.Results: The incidence of cesarean section was 28%. The commonest indication for C-delivery was repeat cesarean (43%) followed by CPD (15%). Failed induction and Fetal distress were the next common indication (10%) and (7%) respectively. Maternal morbidity was 20% with 1 maternal death (0.1%). The commonest complications were primary hemorrhage and wound infection, intra OP and post OP respectively. The perinatal morbidity and mortality were 10% and 2.26% respectively.Conclusions: The incidence of ceaserean section is 12.5% in our hospital falling well within the WHO guidelines. Among the indications, previous LSCS is contributing to a greater percentage, which should be reduced by promoting more VBAC. It also emphasizes the need for reducing primary sections. Post-partum haemorrhage has been brought well under control, sepsis still accounts for greater postop morbidity and meconium aspiration is the commonest cause for perinatal morbidity and mortality.


2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.


Author(s):  
Danica Loralyn Taylor ◽  
Janice F. Bell ◽  
Susan L. Adams ◽  
Christiana Drake

Abstract Introduction Passage of cannabis laws may impact cannabis use and the use of other substances. The suggested association is of particular concern in pregnant women where exposure to substances can cause harm to both the pregnant woman and fetus. The present study contributes to the minimal literature on factors associated with cannabis use during the preconception, prenatal, and postpartum periods including state legalization status, concurrent use of tobacco and e-cigarettes and adequacy of prenatal care. Methods We conducted a cross-sectional analysis using combined survey data from the 2016–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) collected from 36,391 women. Logistic regression was used to estimate the impact of state-legalization, adequacy of prenatal care, and other substance use on cannabis use during the preconception, prenatal, and post-partum periods. Results In the preconception model, residence in a recreationally legal state (OR: 2.37; 95% CI, 2.04–2.75) or medically legal state (OR:3.32; 95% CI, 2.90–3.80) compared to a non-legal state was associated with higher odds of cannabis use. In the prenatal model, residence in a recreationally legal state was associated with higher odds of cannabis use (OR: 1.51; 95% CI, 1.29–1.79) whereas there was no association with residence in a medically legal state. Tobacco use including e-cigarettes and moderate prenatal alcohol use were also significantly associated with cannabis use. Conclusion Recreational cannabis legalization is associated with the use of cannabis prior to, during, and after pregnancy. Renewed clinical and policy efforts may be warranted to update prenatal substance use prevention programs, educational campaigns, and provider education as cannabis legalization evolves.


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.


2021 ◽  
Vol 70 (5) ◽  
pp. 105-116
Author(s):  
Maria Yu. Abramova ◽  
Mikhail I. Churnosov

Preeclampsia is a serious complication of pregnancy and complicates its course in 2-8% of all cases. According to the literature, the disease is associated with an increase in maternal and perinatal morbidity and mortality, and is a predictor of the development of chronic diseases in the distant future, which is an important medical and social issue. Of particular interest is the study of the molecular mechanisms of etiopathogenesis and risk factors for preeclampsia, which, unfortunately, are currently poorly studied and understood, thus dictating the need for further study of this complication of pregnancy. This article discusses the current understanding of the etiology, pathogenesis and risk factors for preeclampsia.


2021 ◽  
pp. 1-4
Author(s):  
Biju Azariah ◽  
◽  
Geethu Babu ◽  

Work related musculoskeletal disorders (WRMSDs) have not only shown to impact the physical and pschycological comfort of the employee but also deteriorate the prospects of any production or service sector. The prevalence of WRMSDs, though studied extensively in various sectors, has been understudied in health sector, especially among doctors. This study which evaluated the prevalence and risk factors of these disorders among fifty cancer treating Radiation Oncologist at a Tertiary Care Cancer Centre in India had exposed out an alarming 68% prevalence of these disorders in the study population, with neck pain being the commonest site of these Muscloskeletal Disorders (MSDs). Several factors which could impact the development of MSDs were analysed. This higher incidence of MSDs is presumed to be because of extreme physical and mental stress of working in a high volume cancer care centre, persistent unhealthy postures during work, inadequate micropauses between works and uncomfortable working atmosphere. Adequate physician patient ratio, restricting the patient load, providing good physician friendly working environment and adequate mandatory breaks might significantly reduce the incidence of these disorders and can prevent the sagging of health care delivery.


2021 ◽  
Vol 10 (27) ◽  
pp. 2001-2006
Author(s):  
John Britto Augustin ◽  
Sureshbaboo Variamkandi

BACKGROUND Corneal ulcer is the leading cause of ocular morbidity and monocular blindness worldwide. To effectively prevent blindness in patients with corneal ulcer, a proper understanding of the risk factors predisposing to ulceration, its clinical and microbiological characteristics are essential. Timely identification of aetiological agents causing corneal ulcers and their prompt treatment helps to save the vision. We wanted to detect aetiological agents of corneal ulcer with special references to fungal causes and characterize the fungal aetiological agents to species level. METHODS This is a cross sectional study, conducted in Government Medical college, Kozhikode, between January 2016 and June 2017. All patients who were clinically diagnosed as cases of infectious corneal ulcer in the Ophthalmology department, Government Medical College, Kozhikode were included in the study. Corneal scrapings collected from the infected eye were subjected to microbiological examination and culture. A total of 120 cases were analysed. Each patient was examined with the slit lamp bio microscope after staining with fluorescein. Scrapings from cornea at the site of corneal ulcer were collected by ophthalmologist after a detailed clinical history and examination of the affected eye. The laboratory procedures used in the diagnosis of infectious keratitis were based on direct visualization of organisms by subjecting corneal scrapings to Gram stain and KOH wet mount and inoculation of material on to blood agar and Sabouraud dextrose agar. RESULTS Among the 120 cases, a total of 49 cases were culture positive. Twenty-one [17.5 %] were bacterial, twenty-two [18.34 %] were fungal and six [5.0 %] were poly microbial [bacteria and fungus]. Among the fungal aetiology, fusarium species was most common [32.14 %], followed by aspergillus species - 25.0 %. Trauma was the major risk factor. Diabetes mellitus, exposure keratitis were the other comorbidities / risk factors. CONCLUSIONS This study shows majority of infected corneal ulcers are associated with risk factors and the aetiology are mainly fungi. Microscopy, culture, and clinical correlation helped in adequate management. Thus, prognosis and outcome of corneal ulcers rely on timely identification of their aetiology and prompt treatment. KEY WORDS Corneal ulcer, Fungal Keratitis


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