scholarly journals Clinical Profile and Feto-Maternal Outcome of Preterm Prelabour Rupture of The Membrane in a Tertiary Level Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 166-171
Author(s):  
Sanjida Hossain ◽  
Syeda Sharmin Sultana ◽  
Joyti Rani Biswas ◽  
Mosammat Salma Noor ◽  
Sharmin Farzana

Background: The rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation. Incidence of Preterm prelabour rupture of membrane (PPROM) ranges from 3.0-10.0% of all deliveries and causes around 25-30% of all preterm deliveries. Objective: To see the clinical profile, maternal and fetal outcome of preterm prelabour rupture of the membrane. Materials and Methods: One hundred fifteen pregnant women with 28-37 weeks of gestation and diagnosed as PPROM admitted in different units selected by purposive sampling, fulfilled the inclusion and exclusion criteria were enrolled as study population in this study. Results: The mean age was 24.65(±3.68) years. Majority (75.65%) were primi para. The mean gestational age was 32.34(±2.86) weeks, 79.13% had gestational age between 30-36 weeks and 20.87% had up to 30 wks. The common risk factors of the study population were history of coitus, CPD, infection and history of abortion which were 42.61%, 9.57%, 5.22% and 4.35% respectively. Majority 55.65% women had vaginal delivery, 44.35% had caesarian section. Majority of the babies born to PPROM group were in the very low birth weight category (53 cases 62.3%), whereas only 32 cases (37.6%) were of normal birth weight. Infection and perinatal mortality was significantly associated with PPROM. Conclusion: PPROM can be prevented avoiding the certain risk factors by proper ante natal checkup, strict follow up, good obstetrical care and perinatal care , making mass awareness of the sequele. KYAMC Journal. 2021;12(3): 166-171

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.


2018 ◽  
Vol 21 (04) ◽  
pp. 745-749
Author(s):  
Sikandar Ali Bhand ◽  
Farzana Sheikh ◽  
Abdul Rehman Siyal ◽  
Muhammad Akber Nizamani ◽  
Muhammad Saeed

… Objective: To determine the presenting features and assessment of the neonateswith hypoglycemia along with maternal and neonatal risk factors for hypoglycemia. Subjects &methods: All consecutive neonates with hypoglycemia admitted were included in the study.Demographic characteristics of the mothers and their babies, past medical history and illnessesduring pregnancy especially that, of diabetes mellitus and duration, details of the management oflabour and place of delivery, birth asphyxia as well as history of feeding prior to admission. All therisk factors and clinical features were documented. Results: From presenting features neonateswere most common temperature instability 32% of the neonates. Maternal risk factors were asMaternal diabetic mellitus, Intrapartum administration of glucose , Maternal drug uses as: (Betablockers, Oral hypoglycemic agents, Valproate), family history of metabolic disorder and withoutany factors with the percentage 13%, 17%, (15%, 08%, 07%) , 27% and 13% respectively.Neonatal risk factors of the patients were found low birth weight 49%, small gestational age 26%,macrosomia 11%, respiratory distress 32%, sepsis 20%, hypothermia 25%, congenital cardiacabnormalities 4%, endocrine disorder 4%, family history of metabolic disorder 7%, inborn errorsof metabolism 4%, rhesus hemolytic disease 5%, erythroblastosis fetalis 1%, inadequate feeding35% and neonates without factors were 6%. Conclusions: The risk factors associate withneonatal hypoglycemia are, low birth weight, small gestational age, macrodome, respiratorydistress, sepsis, hypothermia and inadequate feeding , and maternal risk factors associate toneonatal hypoglycemia was Eclampsia, Maternal diabetic mellitus, and maternal drug uses


2017 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Mohammod Shahidullah ◽  
Arjun Chandra Dey ◽  
Firoz Ahmed ◽  
Ismat Jahan ◽  
Sanjoy Kumer Dey ◽  
...  

<p>Retinopathy of prematurity is considered as an important cause of blindness. This prospective study was undertaken to document the frequency and the associated factors of retinopathy of prematurity among 97 preterm newborn weighing &lt;2000 g and/or with a gestation of &lt;35 weeks. The first eye examination was performed by an ophthalmologist at 4 weeks of postnatal age for the infants born at ≥30 weeks of gestation or birth weight ≥1200 g and at 3 weeks of postnatal age for the infants &lt;30 weeks of gestation or birth weight &lt;1200 g. The overall incidence of retinopathy of prematurity was 23.7%. Premature newborn with retinopathy was having significant low mean birth weight (p=0.001) and the mean gestational age (p=&lt;0.001) when compared with newborns without retinopathy of prematurity. Newborns with retinopathy of prematurity were requiring a longer duration of oxygen (p=0.005) than that of non-retinopathy of prematurity newborns. Logistic regression shows the duration of oxygen in the hospital and lower gestational age were independent risk factors of retinopathy of prematurity. Prematurity and longer duration of oxygen administration were the risk factors for the development of retinopathy of prematurity.</p>


1970 ◽  
Vol 28 (1) ◽  
pp. 17-23 ◽  
Author(s):  
S Akter ◽  
R Akter ◽  
M Rashid

Objective: The aim of this study was to see the maternal and fetal outcome of preterm pre labor rupture membrane and to identify the risk factors for preterm pre labor rupture membrane. Methods and Material: This was a cross-sectional descriptive type study carried out in Dhaka Medical College Hospital, Dhaka, during April to September, 2005 (6months) in the Department of Obstetric and Gynecology. 50 pregnant women with preterm premature rupture of the membrane (gestational age 29-0 to 36-6 weeks) were included in this study. Results: The mean age of the women was 27.24±6.28years and 36% of them more than 30 years old. Sixty two percent women were multi gravid .Socio-economic condition, level of education and antenatal care of the women was low. Median gestational age of the patient was 35 weeks. Fifty six percent had previous history of PROM, preterm delivery, abortion, MR and dilatation and curettage. Sixty two percent women had history of sexual activity between 2 to 7days. Seventy two percent women had UTI, anaemia, and lower genital tract infection. Mean duration of the latent period was 18.87 ±16.17hours and time interval of rupture membrane and delivery was 27.60 ± 21.127 hours. Eighty four percent patient delivered by vaginal route and Fifty four percent delivered within 24 hours of ruptured membrane. Forty two percent newborn suffered from neonatal asphyxia, respiratory distress syndrome, neonatal jaundice and neonatal sepsis. Thirty two percent women suffered from chorioamnionitis, abruptio placent and endometritis.Conclusion: PPROM is malnutrition and poverty related disease. Antenatal care is an important tool to prevent PPROM by identifying the risk factors and its management. Steroid for fetal lung maturity, antibiotics to prevent fetal and maternal infection and induction and /or augmentation of labor will speeded delivery and reduce hospital stay and infection. Key words: Premature rupture of the membrane; maternal and neonatal outcome; risk factors. DOI: 10.3329/jbcps.v28i1.4639 J Bangladesh Coll Phys Surg 2010; 28: 17-23


2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.


2012 ◽  
Vol 2 (1) ◽  
pp. 19-22
Author(s):  
Md Abdul Baki ◽  
Afroza Haque ◽  
Fauzia Mohsin ◽  
Jebun Nahar ◽  
Shahida Akhter ◽  
...  

Background and objective: Neonates with birth weight <1500 gm constitute approximately 4-7% of all live births. Mortality in this group is very high, contributing to as much as 30% of early neonatal death. This study was done to evaluate the morbidities associated with preterm neonates with birth weight < 1500 gm and possible factors determining the death of these babies. Methods: This study was done at Special Care Baby Unit (SCABU), BIRDEM Hospital from January to October 2010. The medical records of neonates with birth weight <1500 gm admitted in SCABU during the study period were retrospectively reviewed. The outcome measure was in-hospital death. Univariate analysis was done to determine the risk factors of mortality. Results: Total 64 babies with birth weight <1500 gm were admitted during this study period. Mean gestational age was 30.76 (± 2.97) weeks, mean birth weight was 1182 (±283) gm. Jaundice (59.4%), Thrombocytopenia (57.8%), apnoea (53.15), sepsis (45.3%) feeding intolerance (43.8%), and RDS (23.4%) were common co-morbidities in these neonates. Among 64 babies more than one-third died (36%). Risk factors for mortality were gestational age less than 30 wks (OR: 7.73; 95% CI: 2.43-24.53), weight <1000 gm (OR: 4.93; 95% CI: 1.28-18.87), RDS (OR: 13.81; 95% CI: 13.81- 57.86) and baby who required mechanical ventilation (OR: 61.66; 95% CI: 12.54- 303.22). Conclusion: Extreme low birth weight (birth weight <1000 gm), prematurity (gestational age <30 wks) and RDS were the significant risk factors for mortality in this study population. Prevention of prematurity and appropriate management of RDS may reduce the mortality of these neonates. DOI: http://dx.doi.org/10.3329/birdem.v2i1.12356 Birdem Med J 2012; 2(1) 19-22


2021 ◽  
Vol 43 (2) ◽  
pp. 173-178
Author(s):  
Amir Eftekhari ◽  
Vahideh Manouchehri ◽  
Farideh Mosavi ◽  
Mohammad Ali Jahanbani

Background: Since Retinopathy of prematurity (ROP) is a leading cause of childhood blindness, the identification of contributed risk factors is crucial. In recent years, great attention has been paid to maternal factors. The reason is that maternal factors can directly affect fetus via intrauterine hypoxia. However, the results of this studies are conflicting. The purpose of this study was to evaluate the effect of maternal factors on the development of ROP. Methods: In a prospective study, 150 premature infants with the gestational age of less than 32 weeks and birth weight of less than 1500 grams were examined. They divided into two groups based on ophthalmologic examination; those with ROP and those without ROP. Variables of study including maternal age, injection of corticosteroid in the last week of pregnancy, history of maternal diabetes mellitus, preeclampsia, hypertension, anemia, thyroid, renal, cardiovascular and rheumatologic diseases were compared between groups. Results: Forty-seven infants (31.33 %) had ROP. The mean age of gestational age was 27.89 weeks in ROP group and 29.06 weeks in non-ROP group. The mean birth weight was 1180.53 grams in ROP group and 1079.44 grams in non-ROP group. There were no statistically important differences regarding to maternal factors between two groups. Conclusion: The above mentioned maternal factors have no effect on the development of ROP.


Author(s):  
Kishan A. Makvana ◽  
Apurva H. Suthar

Background and Aim: Despite considerable progress made in the treatment of Retinopathy of prematurity (ROP), it is still a common cause of reduced vision in children in developed countries, and its prevalence is increasing. This is a preventable disease and responds to treatments appropriately if diagnosed at early stages, but in case of delayed diagnosis and treatment, it may lead to blindness. The aim of the present study is to describe the incidence, severity, and risk factors of ROP in a tertiary healthcare center. Material and Methods: This was a prospective, observational, nonrandomized study conducted in a tertiary-level neonatal intensive care unit (NICU) of a teaching hospital in Gujarat. A total of 130 preterm neonates admitted in the NICU during the study period were screened for ROP as per the guidelines of NNF of India. Screening was done under topical anesthesia, and findings were documented according to the International Classification for Retinopathy of Prematurity recommendations. The data were analyzed for gestational age, birth weight, and systemic factors predisposing to ROP. Results: Of the 130 neonates, 37 neonates were found to have ROP, with the incidence of ROP being 28.4%. The mean birth weight (1388 ± 312 g) and the mean gestational age (32.21 ± 2.50 wk) Out of the 37 neonates with ROP, 14 had a gestational age of > 32 weeks and/or birth weight of > 1500 g. ROP was classified into type 1 and type 2 as per the ETROP study, 14 (39.39%) neonates had type 1 or treatable ROP; there were no cases of APROP in our study; ROP regressed without any intervention in 13 neonates; 7 neonates were defaulters; and 11 neonates were treated with laser. Conclusion: ROP is strongly associated with smaller, more immature, and sicker neonates. However, in our study, about 40% of neonates who developed ROP were of higher gestation (> 32 wk) and birth weight (> 1500 g). The analysis of risk factors for ROP development will help to understand and predict it in severe preterm infants.


2015 ◽  
Vol 53 (200) ◽  
pp. 250-255 ◽  
Author(s):  
Neebha Ojha

Introduction: Low birth weight and preterm birth are the major community health problems in developing countries. They are the major determinants of perinatal survival and infant morbidity and mortality.  The aim of this study was to determine the proportion and the maternal risk factors for low birth weight and preterm birth among hospital deliveries in Tribhuvan University Teaching Hospital. Methods: A cross sectional retrospective study was carried out in the Department of Obstetrics and Gynecology of TUTH. Maternal risk factors like age, parity, ethnicity, history of previous abortion, history of previous cesarean section, antepartum hemorrhage and medical disorders were studied. Information on all births that occurred was extracted from maternity case notes and delivery registers. Results: During the study period, there were 685 singleton live births.  Among these 78(11.4%) were low birth weight and 47(6.9%) were preterm birth. The mean birth weight was 2950 ± 488 gm. The mean weight of female was statistically less compared to male babies (p=0.032). The significant risk factors for LBW were primiparity (OR 2.12; 95%CI 1.25-3.58), Indo-Aryan ethnicity (OR 1.97; 95%CI 1.12-3.45) and history of medical disorder (OR 3.08; 95%CI 1.17-8.12). As for PTB antepartum hemorrhage (OR 8.63; 95%CI 1.99-37.30) and history of medical disorder (OR 3.20; 95%CI 1.04-9.89) were significant risk factors. Conclusions: Parity, ethnicity, and medical disorders were the main risk factors for low birth weight. Antepartum hemorrhage and medical disorders were significant risk factors for preterm birth. Keywords: low birth weight; preterm birth; risk factors.


Author(s):  
Muhammed Nebi Caliskan ◽  
Mehmet Tekin ◽  
Çapan KONCA

Background: The aim of this study was to determine the predictive risk factors for development of severe bronchiolitis in patients with acute bronchiolitis with no previous chronic disease. Methods: Four hundred forty children aged 1-24 months hospitalized with acute bronchiolitis, were examined between February 2018 and February 2019 in this prospective study. Results: Eighty-five cases were regarded as severe bronchiolitis and 355 as mild-moderate bronchiolitis. Statistically significant differences were observed between the severe and mild-moderate bronchiolitis groups in terms of weight-for-age z-scores, history of bronchiolitis, hemoglobin levels, and time elapsed between onset of symptoms and admission. Weight-for-age z-scores, the mean time interval between onset of symptoms and admission, and mean hemoglobin values were lower in the severe bronchiolitis group while the mean number of bronchiolitis attacks was higher than in the mild-moderate bronchiolitis group. Logistic regression analysis determined that a low weight-for-age z-score increased the risk of severe bronchiolitis development 0.56-fold (CI: 0.409 – 0.760), a short duration between the onset of symptoms and admission increased the risk 0.62-fold (CI: 0.519 – 0.735), a frequent history of bronchiolitis increased the risk 1.81-fold (CI: 1.135 – 2.968) and low hemoglobin levels increased the risk 0.72-fold (CI: 0.537 – 0.969). Conclusion: Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks, and low hemoglobin levels were identified as independent parameters of severe bronchiolitis development. Key words: Bronchiolitis, Infant, Risk factors, Severity degree


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