Third Trimester Placental Grading by Ultrasonography and its Relationship with Fetal Outcome

2020 ◽  
Vol 33 (2) ◽  
pp. 94-99
Author(s):  
Farzana Begum ◽  
Shahela Jesmin ◽  
Rokeya Khatun ◽  
Somerose Parvin ◽  
Anisur Rahman
Keyword(s):  
High Risk ◽  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Medical College Hospital ◽  
High Risk Pregnancy ◽  
College Hospital ◽  
Early Maturation ◽  
Medical College ◽  
Risk Pregnancy ◽  
Grade Iii

Background: Antenatal ultrasound assessment of placental morphology plays an important role in evaluating fetal health, revealing abnormalities, such as infract & calcification.  Abnormal placental maturity is associated with poor pregnancy outcome. In some high risk pregnancy placental maturity is accelerated as in pregancy –induced hypertension (PIH), intrauterine growth retardation (IUGR), whether in other high risk cases like diabetes and Rh-isoimmunization there is delayed placental maturation. Objectives: This was a cross sectional type of descriptive study. The study was carried out to assess placental grading by USG in high risk and normal pregnancy for predicting neonatal outcome. Material and method: The study was carried out in the Department of Obstetrics & Gynaecology in collaboration with the Department of Radiology & Imaging of Rajshahi Medical College Hospital from January 2012 to December 2013. : A total 200 pregnant mother, attending the inpatient department constituted study population who delivered their babies at Rajshahi Medical College Hospital were selected in antenatal period for USG examination to detect placental grade. Result: Ultrasonography showed, 35% had Grade-II placental maturity, 33.5%- Grade-III, 25% Grade - I and 6.5% had Grade-0 maturity. Majority of the mother (75%) were normal and had healthy baby. The relationship of placental maturity with gestational age of mother in normal pregnancy and in high risk pregnancy was found to be statistically significant. Placental maturity and fetal outcome in normal pregnancy was found significantly associated (p<0.001) but in high risk pregnancy it was not associated significantly (p>0.5). Early maturation of placenta in hypertensive women and delayed maturation in diabetic women were observed. Conclusion: Sonographic diagnosis of grade-III placenta has been reported to be as excellent predictor of fetal lung maturity than difficult and hazardous invasive procedure like amniocentesis. TAJ 2020; 33(2): 94-99

scholarly journals Neonatal Out Come in High Risk Pregnancy

1970 ◽  
Vol 22 (1) ◽  
pp. 26-29 ◽  
Author(s):  
H Akthar ◽  
S Sultana ◽  
AH Siddique
Keyword(s):  
High Risk ◽  
Early Diagnosis ◽  
Rural Area ◽  
Educational Status ◽  
High Risk Pregnancy ◽  
College Hospital ◽  
High Risk Patients ◽  
Medical College ◽  
Risk Pregnancy ◽  
Risk Patients

A 12 months study was carried out on 226 pregnant high risk patients attending in Rajshahi Medical College Hospital from January 2008 to December 2008. The aim of the study was to identify various type of high risk pregnancies and to determine social and educational status as well as new born conditions of birth. Among the 226 recruited patients 69.5% came from rural area. Among the 69.5% rural high risk patients 63.69% were illiterate. Live born baby in this study was 95.13%. In our study neonatal out come was excellent. Excellent out come was attributed to early diagnosis of high risk pregnancy and suitable intervention both by Obstetrician and Paediatrician. DOI: 10.3329/taj.v22i1.5016 TAJ 2009; 22(1): 26-29

scholarly journals COAGULATION PROFILE IN DIFFERENT TRIMESTERS OF PREGNANCY TO IDENTIFY HIGH RISK PREGNANCY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Bharat Sejoo ◽  
Rajendra Bhati ◽  
Ajay Mathur ◽  
Prakash Keswani ◽  
Shrikant Sharma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
First Trimester ◽  
Antenatal Clinic ◽  
High Risk Pregnancy ◽  
Coagulation Profile ◽  
Medical College ◽  
General Physical Examination ◽  
Risk Pregnancy ◽  
D Dimer

Background: The physiological changes in pregnancy may serve to protect the mother from the hazard of bleeding imposed by placentation and delivery, but they also carry the risk of an exaggerated response, localized or generalized, to coagulant stimuli. After correlating the trends of coagulation profile in all three trimesters of pregnancy with parameters [Body Mass Index (BMI), Glycemic status, Blood Pressure Status];  We can find out high risk pregnancies so that special attention can be given during pregnancy, labour and postpartum period. Material & Methods: A observational prospective analytic study done on 100 Pregnant ladies who were visited to routine antenatal clinic in the department of Obstetrics & Gynecological SMS Medical College and attached group of hospitals, on outdoor basis were selected in their first trimester (after 8 week gestation) in SMS medical college & attached group of hospitals during April 2017 to March 2018. The study protocol was approved by the Institutional Ethics Committee. All participants submitted informed consent before enrolment. After taking proper history, all the subjects underwent clinical examination comprising of general physical examination, assessment of vital parameters and systemic examination. Results: Our study that the mean age of study subjects was 26.46 ± 3.34 years. There was significant but weak positive correlation of D Dimer with BMI and Blood sugar in all trimesters of pregnancy. Significant correlation was found between APLA with DBP and MAP in 1st trimester of pregnancy. No correlation was found between APLA and other parameters in any trimester of pregnancy. Conclusion: We concluded that there were increased in FDP, D-Dimer, INR, APLA while platelets count, PT and aPTT were decreased.  Further prospective study will be required to measure the outcome of pregnancy so we can define a high-risk pregnancy and those will get special attention in peripartum period. Keywords: Trimester, Pregnancy, D Dimer, BMI, Blood pressure, Correlation

scholarly journals COMPARISON OF INTRAPARTUM CARDIOTOCOGRAPHY & OBSTETRIC DOPPLER IN PREDICTING PERINATAL OUTCOME IN HIGH RISK PREGNANCY

2020 ◽  
pp. 1-3
Author(s):  
Karishma Gandhi ◽  
Ishit Shah ◽  
Ram Kumar Patidar
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Normal Delivery ◽  
Risk Pregnancy ◽  
Fetal Wellbeing ◽  
Adverse Fetal Outcome

Background: High risk pregnancy needs special antepartum as well as intrapartum care and investigations. CTG is aadmissionscreening test to monitor fetal wellbeing by use of cardiotocograph. It monitors fetal heart rate and uterine contractions. Color Doppler is ultrasound dependent test which uses vascular flow velocities and Doppler waveform to predict fetal outcome. Objective: Comparison of efficiency of CTG & Color Doppler ultrasound for intrapartum fetal surveillance in high risk pregnancy. Methods: Retrospective study of 100 high risk pregnancies of ≥ 34 weeks POG in labor with CTG and color Doppler findings were done on admission at Gujarat Adani Institute of Medical Sciences, Bhuj. Subjects were classified into 4 groups based on CTG and color Doppler findings. Maternal and fetal outcome were recorded and correlated with CTGand color Dopplerfindings. Results: Most common cause of high-risk pregnancy was preeclampsia(n=60/100,60%).In our study, rate of normal delivery was 40% and c-section was 60% (31% elective & 29% emergency). Out of 100 fetuses, 76 were healthy, 22 were admitted in NICU (6 NICU deaths) and 2 were still birth. Perinatal outcome was most favorable with normal CTG and Color doppler and was least favorable with both of them abnormal. Outcome was intermittent in other two groups. CTG found to have sensitivity 62.5% and specificity 82.5% in detection of adverse fetal outcome. Similarly,sensitivity and specificity of color doppler was 48.8% and 98.6% respectively. Conclusions: In our study it was found that CTG is more sensitive and color Doppler is more specific in detection of adverse fetal outcome.

scholarly journals Management and Outcome of Postdated Pregnancy at Rajshahi Medical College Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 50-53
Author(s):  
Most Merina Akhter ◽  
Mst Shaheen Nawrozy ◽  
Abu Hena Mostafa Kamal ◽  
Sahela Jesmin
Keyword(s):  
Perinatal Mortality ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Medical College Hospital ◽  
Maternal Complications ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College

Background: Postdated pregnancy complicates about 10% of all gestation and is associated with an increase in perinatal mortality and morbidity. This study was designed to observe fetal as well as maternal outcome in the management of postdated pregnancies admitted into Rajshahi Medical College Hospital. Methods: The study was carried out from July 2008 to June 2010. 100 cases of postdated pregnancies were included. Patients’ age, occupation, parity, mode of delivery, the indication of LUCS, fetal & maternal outcomes were recorded in a predesigned questionnaire. Results were expressed as Mean± SD, actual number and percentage of total where applicable. Results: Mean age (±SD) was 21.3 (±5.32) years. 90% were housewives, 5% were in service and 5% were in other occupations. 53% were nullipara, 21% para-2, 18% were para-3, 8% were para-4.57% of the study patients underwent caesarean section and 43% underwent vaginal delivery. Fetal distress (n=34), non-progression of labour (n=19), cord prolapse (n=1) & CPD (n=3) were the causes of LUCS. Regarding fetal outcome, healthy babies were 76%, meconium aspiration 13%, birth asphyxia 11%. Among birth asphyxia, neonatal death was 1% & still born was 2%. Maternal complications at delivery were tear in the genital tract 8%, PPH 5% & wound infection in 4% cases. Conclusion: Here, still-birth rate was 2% (normally about 1 in 3000 deliveries) and perinatal mortality rate is 3% (normally about 2-3 in 1000 deliveries). So, patients should be encouraged to attend regular antenatal check up to prevent postdated pregnancy and its complications. TAJ 2018; 31(2): 50-53

scholarly journals Role of Modified Biophysical Profile in High Risk Pregnancy in Predicting Fetal Outcome

2020 ◽  
Vol 18 (3) ◽  
pp. 401-405
Author(s):  
Santosh Jha ◽  
Ganesh Dangal
Keyword(s):  
High Risk ◽  
Amniotic Fluid ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
Biophysical Profile

Background: High risk pregnant women have increased risk of maternal and neonatal morbidity and mortality. Antepartum surveillance is important and should be effective in such conditions. Modified biophysical profile is the method of antepartum surveillance which comprises of cardiotocography and amniotic fluid index. Methods: A cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital from February 2019 to January 2020 to determine the effectiveness of modified biophysical profile. Cardiotocography was interpreted as reactive, equivocal and non-reactive. AFI was considered normal if it was 5 to 24 cm. In the study 172 high risk cases at term and not in labor were included. Each case was subjected to cardiotocography then amniotic fluid index was obtained using real time sonography where it was measured from all four quadrants. Modified biophysical results were obtained and then were divided into 2 arms as normal modified biophysical profile and abnormal modified biophysical profile then analysis was done. Results: Of 172 cases, there were 97 (56.4%) cases in normal modified biophysical profile and remaining 75 (43.6%) in abnormal modified biophysical profile group. The rate of cesarean section increased when there was abnormal modified biophysical profile.  Neonatal resuscitation and admission was increased in abnormal modified biophysical profile. Conclusions: Normal modified biophysical profile in high risk pregnancy had more cases of vaginal delivery and less adverse fetal outcome like low APGAR score, neonatal resuscitation and neonatal intensive care admission. Keywords: Amniotic fluid index; cardiotocography; fetal surveillance; modified biophysical profile

Role of Fetal Biophysical Profile in High Risk Pregnancy and Fetal Outcome

2017 ◽  
Vol 5 (2) ◽  
pp. 113-118
Author(s):  
Shivakumar H.C. ◽  
◽  
Chandrasheker . ◽  
Ramaraju H.E. ◽  
◽  
...  
Keyword(s):  
High Risk ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Risk Pregnancy ◽  
Biophysical Profile

High-risk Pregnancy and Perinatal Outcome: An Observational Study

2020 ◽  
Vol 16 (4) ◽  
pp. 318-326
Author(s):  
Naina Kumar ◽  
Ashu Yadav
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Low Birth Weight ◽  
Observational Study ◽  
Perinatal Outcome ◽  
Normal Pregnancy ◽  
High Risk Pregnancy ◽  
Neonatal Deaths ◽  
Risk Pregnancy ◽  
Tertiary Center

Background: High-risk pregnancies are associated with adverse perinatal and maternal outcomes. Aim: To know the overall perinatal outcome in high-risk pregnancies. Methods: Present observational study was conducted in the Obstetrics and Gynecology department of a rural tertiary center of Northern India over eight months (February-October 2018) on 3,085 antenatal women at gestation ≥ 28 weeks with 1,309 high-risk cases and 1,776 normal pregnancy cases after Institutional ethical committee approval and informed written consent from the participants. The demographic features including age, gravidity, parity, gestation, high-risk factors, the onset of labor, mode of delivery of all the selected antenatal women at gestation ≥ 28 weeks were recorded on a preformed datasheet by trained staff. All the participants were observed till delivery and the perinatal outcome was recorded. Statistical analysis was done using software SPSS 22.0 version and a p-value <0.05 was considered statistically significant. Results: Of total 1,309 high-risk pregnancies, 365(27.9%) were preterm, 936(71.5%) term and eight (0.6%) post-term cases. Of 1,309 neonates delivered, 66(5.04%) were intra-uterine dead fetuses, 1,243 live fetuses, of which nine (0.7%) had intrapartum still-birth, 278(22.4%) required neonatal intensive care unit admission, 70(5.6%) intubated, 238(19.1%) needed oxygen support, 343(27.6%) developed complications, while 11(0.9%) had early neonatal deaths. The average birth weight of neonates delivered to high-risk mothers was 2.47±0.571 Kg with 271(20.7%) neonates having low birth weight (<2.5 Kg). Of all high-risk factor Hypertensive disorders of pregnancy, Antepartum hemorrhage, Anemia, Gestational diabetes mellitus, Intra-uterine growth restriction, oligohydramnios was significantly associated with adverse perinatal outcomes (p<0.05). High-risk pregnancy was associated with preterm births, low birth weight, NICU admission, intubation, complications, neonatal deaths, still-births as compared to normal pregnancy. Most common neonatal complication was the low birth weight (20.7%) followed by Respiratory distress syndrome (17.6%), prematurity (13.1%). Conclusion: High-risk pregnancy was associated with an adverse overall perinatal outcome with increased risk of perinatal morbidities and mortalities.

scholarly journals Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy

2018 ◽  
Vol 7 (2) ◽  
pp. 628
Author(s):  
Rashmi L. ◽  
Ashish Bhattacharjee
Keyword(s):  
High Risk ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
High Risk Pregnancy ◽  
Doppler Velocimetry ◽  
Average Birth Weight ◽  
Risk Pregnancy ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome. 

Inflammatory and Procoagulant Cytokine Levels During Pregnancy As Predictors of Adverse Complications

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2296-2296
Author(s):  
Shannon Dibble ◽  
John Gianopolous ◽  
Ronald Potkul ◽  
Josephine Cunanan ◽  
Debra Hoppensteadt ◽  
...  
Keyword(s):  
High Risk ◽  
Preterm Delivery ◽  
Pregnancy Complications ◽  
Normal Pregnancy ◽  
Maternal Plasma ◽  
High Risk Pregnancy ◽  
Protein Z ◽  
Risk Pregnancy ◽  
Tnf Α ◽  
Cytokine Levels

Abstract Abstract 2296 Introduction: Adverse complications of pregnancy include preterm delivery resulting from preterm labor, preeclampsia, and postpartum hemorrhage. Plasma cytokine levels and immunoregulatory proteins that are produced by gestational tissues and involved in inflammatory processes of pregnancy, have shown that perturbation of cytokine signaling networks is associated with preterm labor and preeclampsia. The purpose of this study was to identify the levels of various cytokines and other analytes associated with tissue damage, inflammation, and ischemia in maternal plasma samples taken throughout pregnancy and to determine whether these levels correlate with adverse conditions. Methods: This study examined plasma samples collected from populations of women (Hilleroed Hospital, Copenhagen, Denmark) with high-risk pregnancy complications such as postpartum hemorrhage, preeclampsia, and multiple gestations (n=16), preterm delivery (n=20), and normal pregnancy (n=20). Citrated plasma samples were analyzed at different time points during pregnancy (< 21 weeks, 21–32 weeks, 33+ weeks). Maternal cytokine levels — IL-1β, IL-6, IL-8, IL-10, and TNF-α— were measured by ELISA (R&D Systems Quantikine®, Minneapolis, MN). The Hyphen Biomed (Paris, France) ZYMUTEST Anti-Protein Z, IgG ELISA assay was used to determine maternal levels of auto-antibodies to Protein Z. Results: IL-6 levels were elevated over the course of pregnancy in the preterm delivery group compared to the normal pregnancy, high-risk pregnancy, and normal control groups. Statistical differences were found between the preterm delivery group and the other groups at 21–32 weeks (P < 0.01) and 33+ weeks (P < 0.001). IL-10 was elevated in normal pregnancy and was statistically different compared to other patient groups at all time points (P < 0.05). TNF-α levels were elevated in the high-risk pregnancy group versus normal controls (P < 0.001 at < 21 weeks and P < 0.05 at 21–32 weeks). Statistical differences for TNF-α levels were also found between high-risk pregnancy and preterm delivery patients at < 21 weeks (P < 0.01). No statistical differences between patient groups were found for maternal plasma levels of IL-1β, IL-8, and auto-antibodies to Protein Z, IgG. Conclusion: Our results suggest that analysis of maternal plasma for IL-6 and IL-10 may be of value in the early prediction of pregnancy complications such as preterm delivery and other high-risk conditions. Elevated IL-6 levels can be measured in preterm delivery pregnancy patients as early as 21–32 weeks; thus, examining plasma IL-6 levels over the course of pregnancy may be beneficial for identifying pregnancies at risk for preterm delivery. Detecting reduced maternal plasma IL-10 levels compared to normal pregnancy may identify patients at risk for preterm delivery and high-risk pregnancy complications such as postpartum hemorrhage, preeclampsia and related vascular complications. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Uterine Rupture - Experience of 30 Cases at Faridpur Medical College Hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Dr Mahbuba ◽  
Irin Parveen Alam
Keyword(s):  
Uterine Rupture ◽  
Skilled Birth Attendant ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Medical College Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Ruptured Uterus

Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study  of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it  in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from  the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and  surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (including 1809 caesarian sections) over a one year time period, with a prevalence of 0.83%. The most common age group was 21-30 years. A majority of patients 16(53.3%) were cases of unscarred uterus presenting with rupture; the common cause of rupture in scarred uterus was injudicious use of oxytocin (13,43.33%). Proper antenatal care, appropriate counseling of patients with history of previous caesarian section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity due to rupture uterus. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13504 Faridpur Med. Coll. J. 2012;7(2):79-81

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