Maternal and Fetal Outcome of Preterm Prelabor Rupture of the Membranes in a Tertiary Care Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 1-9
Author(s):  
Mst Rokeya Khatun ◽  
Nasrin Akter ◽  
Md Nowshad Ali

Objective: To describe the clinical presentation and feto-maternal outcome of preterm prelabor rupture of the membrane of patients admitted in a tertiary care hospital of Bangladesh. Methods and Material: This is a cross-sectional observational type study carried out in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the year 2019 in the Department of Obstetrics and Gynecology. Sixty pregnant women with preterm prelabor rupture of the membrane (gestational age 28 to 37 weeks) were included in this study. Results: The mean age of the women was 27.03±6.13 years. Forty (66.7%) of them were from rural area. Majority were studied up to primary school (33.30%). Sixty five percent were house wife. Thirty seven (61.7%) women were multi gravid. Mean gestational age of the patient was 34.43±2.75 weeks. Antenatal care of the women was low. Most of the women have associated one or more diseases like anemia (35%), Urinary tract infection (28.33%), Pregnancy induced hypertension (20%), Lower genital infection (13.33 %,), gestational diabetes mellitus (10%) and heart disease (3.33%). The mean time interval between membrane rupture and delivery was 29±9 hours. Thirty one patients (51.7%) were delivered by caesarian section. Twenty eight (46.7%) women did not experience any complication and other suffered from wound infection (20%), PPH (10%), puerperal sepsis (8.33%) and chorioamnionitis (11.7%). Mean birth weight of the newborns was 2.16±0.42 Kg. Thirty eight (63.33%) newborn suffered from complications like neonatal asphyxia (30%), respiratory distress syndrome (13.3%), neonatal jaundice (11.7%) and neonatal sepsis (3.3%). Neonatal death was noticed in three (5%) cases. Fetal outcome was found significantly (p< 0.001) associated with low gestational age. Conclusion: Women with low education, associated co-morbidity, long latency and neonate with low birth weight have unfavorable outcome. Antenatal care is an important tool to prevent preterm prelabor rupture of the membrane by identifying the risk factors and its management. Optimum obstetric and medical care is essential for the reduction of these devastating complications. TAJ 2020; 33(2): 1-9

2008 ◽  
Vol 47 (169) ◽  
Author(s):  
Srijana Adhikari ◽  
B P Badhu ◽  
N K Bhatta ◽  
R S Rajbhandari ◽  
B K Kalakheti

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening


Author(s):  
Isha Chopra ◽  
Sunil K. Juneja ◽  
Sarit Sharma

Background: Antenatal Care (ANC) utilization facility is available but poorly utilized because of many factors which play indirect role in inadequate utilization of antenatal care facility: low social status of women in the society, less opportunity for basic education, less ability to make decisions. Therefore, the present study is an attempt to study the effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital.Methods: A prospective study was carried out on 525 cases delivered during period of one year at Dayanand Medical College and Hospital, Ludhiana, Punjab, India; a tertiary care hospital catering both urban and rural population. All cases were categorized into two groups: booked and unbooked. The age, parity and education of each patient in booked and unbooked cases was noted. Further, its impact on antenatal care utilization, maternal and perinatal outcome was studied.Results: On studying education pattern, among illiterate subjects 50% were booked and 50% were unbooked; For graduate and above were 80.6% and 19.4%respectively. Among mothers who were illiterate 90.9% had low birth weight babies and 13.6% had stillborn. Among those graduates and above 38.7% had low birth weight babies,1.5 % stillborn and 1.2% neonatal deaths.Conclusions: The educational status of the women came out as a significantly important variable and predictor of perinatal outcome. Hence, whole hearted efforts should be directed in educating women population and also improving health care facilities in rural areas to provide early referral to higher centers.


2017 ◽  
Vol 4 (6) ◽  
pp. 2065 ◽  
Author(s):  
Arshiya Rehman Sheikh ◽  
Sushama Subhash Thakre ◽  
Subhash Thakre ◽  
Chaitanya Rangangouda Patil ◽  
Prithvi B. Petkar

Background: In spite of the interventions being taken, low birth weight still persists as a public health problem in low and middle-income countries. World Health Organization defines low birth weight as birth weight less than 2500 gm. There is a constant search to find newer methods to detect low birth weight babies so that early methods can be instituted. This study was conducted to evaluate calf circumference as procedure to screen low birth weight babies in tertiary care hospital in Nagpur. Methods: A cross sectional study was conducted in tertiary care hospital of Nagpur, Maharashtra for a period of 4 months. The study subjects were babies delivered at the hospital. Birth weight was recorded using a digital weighing scale within 24 hours of the delivery. Length, calf circumference, head and chest circumference were measured according to standard guidelines. Results: Majority of mothers were in the age group of 20 to 24 years of age group, were educated up to primary school and belonged to Hindu religion. The mean calf circumference of low birth weight babies was 9.64±1.13 cm and was 10.96±1.01 cm in normal weight babies. The mean values of calf circumference were significantly lower in low birth weight babies (p <0.001). The sensitivity and specificity for the best cut off of calf circumference was found to be 89.97% and 42.86% respectively.Conclusions: Measuring calf circumference was found to be a good test with higher sensitivity but lower specificity. Hence, calf circumference can be used as an alternative method to screen babies born in remote areas, where the facility of weighing the baby at birth is not available.


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Raju Kafle ◽  
Kabiraj Nibedita ◽  
Binod Kumar Gupta

Introduction: Placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, provide thermo-regulation to the fetus, waste elimination, and gas exchange. The present study was undertaken to look for mean birth weight and placental weight among deliveries in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in a tertiary hospital of Nepal. Ethical clearance was taken from institutional review comittee of hospital. Mothers with term and preterm gestation, their infants and the placentas were the subjects for the study. The study was conducted on 158 term and preterm deliveries. Placental weight, birth weight, gestational age, neonates’ gender, weight, length and head circumference were recorded. Results: The mean of weight of total 158 placentas was 449.24±82.07 g and the mean of birth weights was 2872.84±478.88 g. Out of 158 deliveries, 138 (87.4%) babies were of term gestation and 20 (12.6%) babies were preterm. Conclusions: Mean birth weight and placental weights are similar to that found on similar studies done on other hospitals. Knowing the mean placental weight and birth weight which relates to different functional dimensions of placenta and baby growth helps for further evaluation of placenta and baby.


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