scholarly journals Study on Etiology and Maternal Complications of Intrauterine Fetal Death

2019 ◽  
Vol 18 (1) ◽  
pp. 23-26
Author(s):  
Adiba Malik ◽  
Tahera Begum ◽  
Serajun Noor

Background : Management of pregnancy with good fetal and maternal outcome is a challenge to the obstetrician which can be achieved by screening the risk factors of Intra Uterine Fetal Death (IUFD) and thereby prevent, control and treat them by quality preconceptional and antenatal care. Materials and methods: This cross-sectional study, done in a tertiary care hospital during a period of two years where 100 pregnant women with history of intrauterine fetal death were included after informed written consent. Intrauterine fetal death was confirmed by Ultrasonogram. Different risk factors and maternal complications were observed. Then data was analyzed with the help of SPSS-20. Results: Among 100 women, maximum patients were aggregated between age group 26-35 years (45%) and next to which was 16-25 years (35%) primipara was 32% and multipara was 31%. Regarding Antenatal care (ANC) 32% patients attended two antenatal visits and 28 % patients had no antenatal visits and 18% patients completed > 5 visits. Regarding causes of IUFD, 34% due to hypertension in pregnancy, 14% mother was severely anemic, 13% mother had Diabetes Mellitus (DM) abruptio placenta was found in 15% mother, maternal gastroenteritis 05%, maternal fever 09%, cord accident 3% and in 19% cases no causes were identified. Regarding maternal complications, blood transfusion needed in 28% patients, PPH occurred in 12% patients, Sepsis 08%, caesarean section needed in 07 % cases, ARF 4%, DIC in 03% cases and maternal mortality 01%. Mean ± SD of total hospital stay was 4 ± 1.5 days. Conclusion: There are different risk factors of IUFD which if identified earlier,then by treating the correctable etiologies, recurrence of IUFD and its related maternal complications can be prevented or reduced. Chatt Maa Shi Hosp Med Coll J; Vol.18 (1); Jan 2019; Page 23-26

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2376-2380
Author(s):  
Nanda J. Patil ◽  
Jyoti S. Tele ◽  
Rohit S. Kadam ◽  
Pawar S. J ◽  
Sujata M. Kumbar

Placenta is the most accessible and readily evaluable specimen which is mirror image of pregnancy. The objective here is to study the histomorphological changes in placenta in cases of intrauterine fetal deaths and to study correlation of placental findings with causes of fetal death which is significant to understand. The present cross sectional study was carried out in Department of Pathology of a tertiary care hospital from June 2015 to May 2017. Study of Placental Pathology in Intrauterine Fetal Death cases comprised of 99 placentas. The present study was undertaken to study the placental pathology in cases of intrauterine fetal death. IUFD was found to be more common in primigravida 50/99 (50.50%) mothers. Placental study gives useful morphological information regarding the abnormality of pregnancy. Gross and microscopic examination of the placenta plays an important role in identifying the underlying causes of fetal death and helps prevent further recurrence by making appropriate interventions during the next pregnancy. Study of placental pathology gives clues to events occurring throughout gestation and can potentially help to answer, questions concerning pregnancy management and risk assessment of future pregnancies. It will help the researchers who are doing the research in the field of placental pathology in the days to come.


Author(s):  
CH Karthik Reddy ◽  
Mahesh Krishnamurthy ◽  
Ashray Vasanthapuram ◽  
Girish Narayan ◽  
SS Narendra

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young has been increasing globally. Research in this population has been limited in developed countries or urban areas in developing countries. Identifying the various epidemiologic features in this age group is crucial to understand the disease. Aim: To describe the clinical characteristics of young adults presenting with ACS in a rural tertiary care hospital. Materials and Methods: This cross-sectional study included 50 patients diagnosed with ACS. Data were collected from consecutive patients between the ages of 18 to 45 years diagnosed with ACS between January 2014 to January 2015 in the Emergency Medicine Department of a tertiary care hospital in Davanagere, India. Data were collected on demographic characteristics, risk factors, laboratory tests, and angiographic findings. Range, mean and percentages were calculated for continuous and categorical variables, respectively. A 95% confidence intervals were calculated for all variables. Results: The mean age was 38.1±5.8 years with male preponderance 46 (92%). Risk factors were smoking 36 (72%), diabetes 17 (34%), hypertension 6 (12%) and Body Mass Index (BMI) >23 kg/m2, 36 (72%). Anterior Wall Myocardial Infarction (AWMI) was observed in 35 (70%) of subjects with angiography revealing Single Vessel Disease (SVD) 28 (56%), Double Vessel Disease (DVD) 5 (10%), Triple Vessel Disease (TVD) 3 (6%) and Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) 11 (22%). Three patients died during their course of treatment before initiating an interventional procedure. Conclusion: Smoking, diabetes mellitus and elevated BMI are associated with ACS among young patients. Interventions targeting these risk factors among younger individuals should be developed.


Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.


2021 ◽  
Vol 8 (01) ◽  
pp. 23-27
Author(s):  
Partha Chakma ◽  
Debal Kisor Pal ◽  
Amar Kanti Chakma

BACKGROUND Secondary glaucoma is an anatomically identifiable abnormality which in turn is an underlying cause of the events that lead to aqueous outflow obstruction and rise in the intraocular pressure. This prospective study mainly highlights the secondary glaucoma with special reference to its proportion, causes and its risk factors in a tertiary care hospital. METHODS This study was a cross sectional study. Patients, who attended the Department of Ophthalmology after fulfilling the inclusion and exclusion criteria diagnosed with secondary glaucoma, were included in the study. The study period was from February 2018 to June 2020. A standard form was filled up for each patient documenting parameters and findings of various examinations and was evaluated as per protocol. RESULTS Secondary glaucoma was seen in 0.2 % patients who visited during the study period. Out of 106 patients, males were 50, females were 56, with a male: female ratio of 1:1.1. The most common cause of secondary glaucoma was lens induced glaucoma seen in 44.34 % followed by uveitic glaucoma in 20.8 % cases, traumatic 17.9 %, neovascular 10.4 %, pseudoexfoliation glaucoma 2.8 %, pigmentary glaucoma 1.9 %, silicon oil induced 0.9 %, and uveitis-glaucomahyphema syndrome in 0.9 % cases. Around thirty five percent (34.9 %) cases presented with sudden onset of painful diminution of vision with nausea and vomiting. CONCLUSIONS Secondary glaucoma is still one of the prevalent diseases in this part of country. Lens induced glaucoma is still the most common cause of secondary glaucoma. Hypermature cataract, uveitis, trauma and neovascularisation are the different risk factors. KEYWORDS Secondary Glaucoma, Lens Induced Glaucoma, Phacomorphic Glaucoma, Uveitic Glaucoma


Author(s):  
Ajini K. K. ◽  
Radha K. R. ◽  
Reena R. P.

Background: Stillbirths account for a major proportion of   perinatal deaths. The cause for a large number of stillbirths, remain unexplained. The ReCoDe system (classification of stillbirths by relevant condition at death) has helped to improve our understanding of the causes of stillbirths. We evaluated stillbirths and classified them by the ReCoDe system. The objective was to identify factors associated with stillbirths and to classify the causes of stillbirths using the ReCoDe system.Methods: We recruited all women admitted to a tertiary care centre with a diagnosis of intrauterine fetal death after 22 weeks of gestation. Maternal sociodemographic characteristics and relevant antenatal and intrapartum investigations were studied. We examined the stillborn babies, placenta and umbilical cord and classified them according to the ReCoDe system.Results: There were177 women with intrauterine fetal death admitted during the 2 year study period. The stillbirth rate was 38.56 per 1000 live births. We could explain the cause of stillbirth in 87.58% of   cases by using the ReCoDe system.  Intra uterine growth restriction (41.8%) was the commonest cause followed by hypertensive disorders (27.68%), congenital anomalies (15.81%) and diabetes (14.68%) in present study.Conclusions: We found the ReCoDe system useful in classifying the cause of stillbirths in resource limited settings.


2020 ◽  
Vol 27 (09) ◽  
pp. 1966-1970
Author(s):  
Saima Yasmin Qadir ◽  
Hajira Sultana ◽  
Saima Ashraf ◽  
Shazia Siddiq ◽  
Asia Fayyaz

Objective: To determine the frequency of anemia and its causative risk factors in patients attending the gynecology outpatient department of Nishtar Medical University and Hospital. Study Design: Cross sectional study. Setting: Gynecology Outpatient Department attendees of Nishtar Medical University and Hospital. Period: 1st September to 31st December 2019. Material & Methods: Total 361 females between 19-49 years of age were enrolled and included those patients who consented to be tested for blood hemoglobin estimation. Their brief history was taken after proper consent according to predesigned proforma to rule out the risk factors. Patients with chronic kidney disease, chronic lung diseases and liver diseases were excluded. Blood test was done by obtaining the blood sample by finger prick method. Hemoglobin analysis was performed by portable Hemocueanalyser. Frequency of anemia, severity of anemia and their stratification was performed against the risk factors like age, educational status, socioeconomic status, status of pregnancy, parity and contraception were obtained to rule the causative factors. Anemia was defined per standard criteria as hemoglobin less than 11gm/dl. Results:  Majority of patients 65% were between 19-35 years of age and 34% were 36-49years of age. Frequency of pregnant patients and non-pregnant patients was 63.4% and 36.6%.  Frequency of anemia was 56.8%, mean hemoglobin 10.48±1.18 with mild, moderate and severe anemia were 36.8%, 17.2% and 2.8%. Majority of females 82.9%, never went to school and had primary education, 71.70% belong to very poor and poor socioeconomic status, 79.02% were multipara and 81.95% never and infrequently practiced the contraceptive methods. Conclusion:  Frequency of anemia is very high in females presenting to tertiary care hospital being more common in younger age group. Frequent pregnancies, poor socioeconomic status and low level of educational attainment were the major determinants of anemia in females.


2021 ◽  
Vol 12 (12) ◽  
pp. 68-72
Author(s):  
Mayank Gupta ◽  
Chanchal Kumar Dalai ◽  
Shah Newaz Ahmed ◽  
Deblina Sarkar ◽  
Rajath Rao UR ◽  
...  

Background: Self-medication in pregnancy is a common but unsafe practice. There is a possibility of surreptitious exposure of the developing fetus to the teratogenic and abortifacient effects of the drugs. Aims and Objectives: In this study, we assessed the prevalence and risk factors of self-medication in pregnant mothers visiting the antenatal clinic in our hospital. Materials and Methods: A standard questionnaire seeking information on the socio-demographic profile, clinical characteristics, laboratory data, and knowledge and habits was administered to the pregnant mothers (n=190). The risk factors of self-medication were determined using Fischer’s exact test. P<0.05 was deemed statistically significant. Results: The prevalence of self-medication in pregnancy was found to be 6.3%. Low education level (P<0.027), employed women (P<0.031), and history of miscarriage (P<0.036) in the previous pregnancy were the main determinants of self-medication in the present pregnancy. Conclusion: The prevalence of self-medication in the study sample was low as compared to contemporary studies. High literacy (94.2%) and easy availability of health facility (98%) may be the possible reasons. Further studies are warranted to confirm the prevalence and risk factors of self-medication in this part of the country.


Author(s):  
Venkat Sunil Bommishetty ◽  
Suresh Keshav Kumbhar

Background: Prevalence of hypertension is on rising trend with rise in life style and behavioral changes. It is also a major risk factor for most of the dreadful conditions like coronary artery disease, stroke, etc. Medication adherence would help in reducing the chance of occurrence of such complications. Thus objectives of study are 1) to evaluate the risk factors of hypertension among the diagnosed essential hypertensive patients; and 2) to assess the magnitude and the factors associated with non-adherence to the prescribed treatment.Methods: A hospital based cross-sectional study among 71 participants was conducted, using a pre-structured questionnaire and physical examination to assess risk factors of hypertension and CULIG’s 16 questionnaire medication adherence scale to assess the non-adherence. Data analysed with proportions and Chi square test.Results: Out of 71 participants, 60 (84.5%) were found to be non-adherent to their anti-hypertensive medication and factors like being male (p=0.0055), alcohol consumption (p=0.0485) and paid medication (p=0.0091) were found to be significantly affecting the medication non-adherence. Positive family history, sedentary life style, preference of extra salt and smoking/tobacco products usage were the most common risk factors of essential hypertension observed along with others.Conclusions: The participants who experienced the complications/ill effects of hypertension were more adherent as compared to others. Factors which are responsible for non -adherence need to be addressed and appropriate interventions required to improve adherence by educating the people about its importance in prevention of complications.


Author(s):  
Azeem Khan ◽  
Vikram Kumar ◽  
Erum Choudry ◽  
Sana Niaz ◽  
Mareena Ahmad ◽  
...  

Background: Birth weight is one of the significant determinants of perinatal survival and infant morbidity and illnesses during early childhood. The burden of LBW neonates in the developed world is around 7%, whereas it is more than double at around 16.5% in developing countries.Methods: The retrospective cross-sectional study was conducted at the Indus Hospital and Health Network, Karachi, Pakistan. Data was extracted through the electronic medical record (EMR) with specific coding related to LBW from 1st January 2019 to 31st December 2020.Results: Our study showed LBW disease burden of 7.61% equated to 7% in the developed world while, in contrast with LBW prevalence in the developing countries, 16.5%. Gestational diabetes, pregnancy-induced hypertension, and primigravida are the major risk factors associated with LBW.Conclusions: Our study concludes that antenatal care is one of the major aspects to decrease the incidence of LBW, especially in primigravida. By estimating LBW, we can plan early detection and prompt interventions against this problem, reducing the burden of morbidity and mortality in neonates.


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