scholarly journals Adverse Maternal and Fetal Outcome in Patients with Eclampsia

2019 ◽  
Vol 16 (41) ◽  
pp. 425-427
Author(s):  
Tarun Pradhan ◽  
Pappu Rijal ◽  
Rubina Rai ◽  
Rabindra Dev Bhatta ◽  
Baburam Dixit Thapa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Magnesium Sulphate ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Adverse Outcomes ◽  
Time Interval ◽  
Maternal Condition ◽  
Emergency Cesarean

Background: Eclampsia is a multisystem disorder that may lead to deterioration of maternal condition, hypoxia and acidosis of fetus. Objective was to evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia. Methods: All patients with eclampsia were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to the patients and attendants about antenatal visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate, then the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition and mortality were then noted. Results: Fifty-two patients with eclampsia were admitted in the study period. Thirty-one patients required mechanical ventilator support. Twenty-five (48.07%) patients were delivered by emergency cesarean section and 30(57.6%) babies were low birth weight and there were 11(21.1%) stillbirths. There was one maternal mortality and 45(86.5%) patients were discharged with improvement but 6(11.5%) patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusions: Early detection of hypertension and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes. Keywords: Eclampsia; maternal mortality; risk factors.

scholarly journals Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

2016 ◽  
Author(s):  
Denny Khusen
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Gestational Age ◽  
Post Partum ◽  
Severe Preeclampsia ◽  
Maternal Complications ◽  
History Of ◽  
Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/μl, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

scholarly journals Fetal outcome of pre-labor rupture of membranes

1970 ◽  
Vol 1 (2) ◽  
pp. 19-24 ◽  
Author(s):  
Sita Ram Shrestha ◽  
Paban Sharma
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Neonatal Morbidity ◽  
Neonatal Infection ◽  
Fetal Outcome ◽  
Time Interval ◽  
Normal Delivery ◽  
Study Results ◽  
Prelabor Rupture Of Membranes ◽  
Control Study

Objective: To study the determinants and outcome of prelabour rupture of membrane at term pregnancy in Patan Hospital. Method: A prospective, hospital based case control study done in maternity ward of Patan Hospital over the period of three months (Poush 2059-Phalgun 2059). A total no of 100 pregnant women with prelabor rupture of membrane and 100 pregnant women without prelabor rupture of membrane were included in this study. Results: The incidence of pre labor rupture of membrane in this study was 6.06%. Major risk factors for prelabor rupture of membranes were antecedent coitus, hydramnious, smoking, cephalo-pelvic disproportion, and previous abortion. Normal delivery occurred in 70% in prelabor rupture of membrane group and in 93 % in non-prelabor rupture of membrane group. Forty-nine pregnant women with pre-labour rupture of membrane received antibiotics and twenty-four babies (48.98%) developed neonatal infection in pre-labour rupture of membrane group and only one developed infection in non-prelabour rupture. Four cases of neonatal infection was seen in neonates born from mothers with prelabor rupture of membranes < 24 hours and 20 cases of neonatal infection were seen in those neonates born from mother with pre-labor rupture of membrane >24 hours (p < 0.05). Conclusion: Neonatal morbidity increases with the increase of time interval between the rupture of membrane and delivery and antibiotics given to mother of PROM does not totally protect neonates from infection. Keywords: Pre labor rupture of membrane, major risk factors for pre-labor rupture of membranes, neonatal infection   doi:10.3126/njog.v1i2.1489 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 19 -24 Nov-Dec 2006

scholarly journals REVIVAL OF VAGINAL BREECH DELIVERY

1969 ◽  
Vol 5 (1) ◽  
pp. 597-602
Author(s):  
NASIM AKHTAR
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

BACKGROUND: Since the publication of term breech trail there had been a dramatic changeworldwide from selective to planned Cesarean Section for all women with breech presentation at term.This high cesarean section rate led to adverse consequences in subsequent pregnancy &on futurefertility. Choice of safest mode of delivery has always been a dilemma.OBJECTIVE: Prospective interventional study. This study was done to determine the safety of vaginalbreech birth in terms of neonatal & maternal complications, so that to encourage the trend of breechdelivery in carefully selected cases & to discourage the trend of routinely recommending cesareansection for all gravidas with fetus in breech presentation at term. The study was conducted atDepartment of Obstetrics & Gynae Mardan Medical Complex from January 2010 to December 2015.PATIENTS & METHOD: About 809 patients with singleton pregnancy with breech presentation wereincluded. Decision about mode of delivery was taken on the basis of clinical judgment and ultrasoundwhich was further reviewed in the light of rate of progress during labour .Delivery was conducted byexperienced obstetrician. Mother & infants were followed up to 6 wks post partum. The primaryoutcome was neonatal mortality, infant mortality & serious infant morbidity.RESULTS: out of 809 total patients with breech presentation, 714 were planned for vaginal delivery674 delivered (83%) while 40 pts (5%) had emergency Cesarean Sections.95 patients (12%) hadElective cesarean section. In the delivery group two (0.29%) neonates had serious neonatal morbidity. Inthe cesarean group there was no serious neonatal morbidity. Infection & blood loss was greater in thecesarean group. There were no serious maternal complications in the vaginal delivery group. Thedifference between neonatal morbidity, perinatal mortality &neonatal mortality between the two groupswas not significant.CONCLUSION: Vaginal breech delivery is still a safe option which better suits the clinical situation&problems of our patients .In our set up, Cesarean section should not be routinely advised to patientswith breech presentation no matter it may be the best management option in developed countries.Careful case selection & vigilant monitoring of progress of labour will save many patients fromunnecessary section without costing extra morbidity & mortality.KEY WORDS: Breech presentation, Breech Delivery, Cesarean section, Apgar score.

scholarly journals Post-partum Hemorrhage and Anemia as its Modifiable Risk Factor: A Literature Review

2019 ◽  
Vol 14 (3) ◽  
Author(s):  
Mekar Dwi Anggraeni ◽  
Rahmi Setiyani ◽  
Nina Setiawati
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Multiple Pregnancy ◽  
Modifiable Risk Factor ◽  
Post Partum Hemorrhage ◽  
History Of ◽  
Develop Strategy

<p>Maternal mortality is an indicator of a country’s health status. Postpartum hemorrhage is the main cause of maternal mortality. Understanding the postpartum hemorrhage risk factors useful to develop strategy in order to reduce maternal mortality. The aim of this study was to find modifiable postpartum hemorrhage's risk factors. This study used 6 steps which include formulating the research questions and objectives, searching the extant literature, screening for inclusion, assessing the quality of primary studies, extracting data, and analyzing data. The article was searched from Google Scholar and NCBI databases using bilingual keywords: "faktor-faktor, perdarahan postpartum, risk factors, and postpartum hemorrhage". There were 1736 papers founded and only 14 articles met the inclusion criteria and included in the analysis. The review revealed that anemia, age, parity, birth passage laceration, obstetric history, multiple pregnancy, placental retention, prolonged labor, atonia uteri, pre-eclampsia, pregnancy induced hypertension, section caesarian, placental complication, history of post-partum hemorrhage, episiotomy, high neonatal birth weight. Anemia is the only modifiable risk factor which may be prevented by nurses. </p>

scholarly journals Maternal mortality following thromboembolism; incidences and prophylaxis strategies

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mahboobeh Shirazi ◽  
Behrokh Sahebdel ◽  
Mahnoosh Torkzaban ◽  
Elham Feizabad ◽  
Marjan Ghaemi
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Maternal Mortality ◽  
Post Partum ◽  
Standard Form ◽  
Clinical Manifestations ◽  
Case Series ◽  
Average Score ◽  
Control Group ◽  
Case Series Study

Abstract Background Thromboembolism is one of the main causes of maternal mortality, which can be prevented in many cases. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism in postnatal. Methods In this case series study, the data of the mortality cases were extracted according to the ethical and security standards of the Ministry of Health of the country and compared with a healthy control group. The thromboembolism risk factors measured and scored using a questionnaire entitled “the evaluation of risk factors for maternal mortality following thromboembolism during pregnancy, labor, or post-partum”. Results The maternal mortality rate was 16 per 100,000 live births. Among 297 mortality cases, 27 (9%) death were due to thromboembolism. The mean gestational age was 32.5 weeks. Dyspnea (88.8%) and tachycardia (18.5%) were found as common clinical manifestations in these patients. Sixteen cases (59.3%) did not get heparin, 6 (22.2%) received single dose and 5 (18.5%) received two doses and more. In these 11 cases, 5 (45%) patients received heparin before surgery, 1 after surgery, and 5 before and after surgery. Twenty cases deceased in the first hours after delivery and the rest after 2 to 12 days. The average score of risk for thromboembolism based on Royal College of Obstetricians & Gynecologist (RCOG) guideline was 4.6. Conclusion It seems that one of the most important cause of maternal mortality in this study was the lack of recognition of high-risk patients and the lack of prescription for prophylaxis with heparin and this clearly explains the need for accurate screening of high-risk mothers, designing a standard form and the care and treatment of these patients.

scholarly journals Maternal and Fetal Outcome of Eclamptic Patients in a Tertiary Hospital

2013 ◽  
Vol 26 (2) ◽  
pp. 77-80 ◽  
Author(s):  
Rowshan Akhtar ◽  
Afroza Ferdous ◽  
Syeda Nurjahan Bhuiyan
Keyword(s):  
Antenatal Care ◽  
Mode Of Delivery ◽  
Age Distribution ◽  
Tertiary Hospital ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Time Interval ◽  
Cross Sectional ◽  
Socioeconomic Condition ◽  
Medical College

Objective: To study on clinical profile & maternal - fetal outcome of eclamptic patient.Methods: A prospective cross sectional study was done in the department of Obstetrics & Gynaecology in Chittagong Medical College and Hospital from January to December 2010. All patients with eclampsia were included in the study, it was 416. Patients came with convulsion  other than eclampsia e.g. epilepsy, malaria, septicemia, meningitis, encephalitis, cerebral haemorrage, high fever, hepatic coma were excluded.Main outcome measures: Incidence of eclampsia, sociodemographic status, ante natal  care, time interval between attack and admission, level of consciousness was assessed by AVPU(Alert, response to voice, response to pain stimuli, Unconsciousness) score, types of eclampsia patients (antepartum,intrapartum,postpartum), number of convulsion, gestational age distribution of the patients, mode of delivery , maternal and fetal outcome.Results: Total number of deliveries during this period was 13,635. The incidence of eclampsia in this study was 3.05 %. Among 416 patients with eclampsia most of the patients were between 20-25 years (77%), a large number were primi para (72.5%), most of them comes from rural area (76%), most of them belongs to poor socioeconomic condition (72%), 49% patients were illiterate, 60 % patients had no antenatal check up, 52 % patients came after 6 hours of beginning of convulsion, 18 patients (4%) were unconscious, most of the patients had antepartum eclampsia (64%) , number of convulsion was between 5-9 in about 58% case , 63% were delivered by LSCS, 23% mother showed complications of eclampsia, of them pulmonary oedema (7.45%)  and renal failure(6.49%) were common, 35 (8%) mothers were died. Among perinatal mortality 18% baby were stillbirth and 9% were early neonatal death.Conclusion: Eclampsia is still a major killer disease in Bangladesh. It is a preventable  disease if preeclampsia is diagnosed by antenatal care. By giving quality antenatal care, mass awareness regarding the importance of antenatal care, emergency obstetric service in  the upazilla health complex we can prevent eclampsia. Female education, employment,  empowerment is urgently needed to reduce the incidence of this killer diseases. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13784 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 77-80  

scholarly journals POSTPARTUM HAEMORRHAGE

2011 ◽  
Vol 18 (04) ◽  
pp. 604-610
Author(s):  
TEHNIYAT ISHAQ ◽  
SAID AMIN ◽  
ISHAQ KHATTAK
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Postpartum Hemorrhage ◽  
Past History ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Uterine Atony ◽  
Cross Sectional ◽  
High Dependency ◽  
History Of

Objective: To determine the frequency, risk factors and existing practice for the management of massive primary postpartum hemorrhage (PPH). Study design: Retrospective cross-sectional study. Setting: Department of Obstetrics & Gynaecology at Kuwait Teaching Hospital, Peshawar. Materials and methods: this study was performed from June 2008 to June 2010. Women who developed massive primary PPH after admission or were admitted with it, were included in the study. Medical record files of these women were reviewed for maternal mortality and morbidities which included mode of delivery, possible cause of postpartum hemorrhage, supportive medical and surgical intervention. Data was entered in the pre-structured proforma. Estimates of blood loss were made on history, visual parameters and patient’s condition. All the data was analyzed by using statistical computer soft ware SPSS 6. Results: During the study period total number of obstetrical admissions were 2944. Forty nine out of 2769 (1.76%) deliveries, developed massive primary PPH. The highest frequency of massive primary PPH was observed in grand multiparous patients. Uterine atony was the most common cause of the complication. Birth attendants other than doctor and delivery outside the study unit were significantly associated with the adverse outcome in these patients. Seventy five percent patients,(36/49) who had massive PPH, delivered vaginally. High dependency unit (HDU) was required in 12% (6/49) of women. Only one caesarian hysterectomy was done. There was one maternal mortality. Blood transfusions were required in 82% (40/49) of the patients. Conclusions: Postpartum hemorrhage can be a preventable condition if early identification and timely management of this complication and its risk factors is observed. Uterine atony is the leading cause of immediate PPH. The main risk factors for PPH due to uterine atony are high parity, a large fetus, multiple fetuses, hydramnios, or past history of PPH. Determining the frequency, risk factors and management of primary postpartum hemorrhage will help design stepwise protocols for prevention and management of primary PPH in our setup. 

scholarly journals Study on prevalence of prelabour rupture of membranes and its maternal and fetal outcomes

2021 ◽  
Vol 10 (11) ◽  
pp. 4163
Author(s):  
Mamatha Poondru ◽  
R. Kala ◽  
A. Kumar
Keyword(s):  
Risk Factors ◽  
Tamil Nadu ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Previous History ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
Maternal Complications ◽  
Cross Sectional ◽  
History Of

Background: The aim is to study the prevalence of prelabour rupture of the membranes (PROM), to identify risk factors, mode of delivery, and its maternal and fetal effects.Methods: This was a cross-sectional study conducted in the department of obstetrics and gynaecology at Government Head Quarters Hospital, Cuddalore, Tamil Nadu, with a duration of 6months (January 2020 – June 2020). The study was conducted on 800 pregnant women between 28-42 weeks of gestational age consecutively and those who met the inclusion and exclusion criteria were taken into study.Results: The prevalence of PROM was 27.9% (tPROM 24.6% and PPROM 3.2%). Most of the cases were primigravida (74%). Risk factors associated with PROM were low socioeconomic state (63.2%), urinary tract infection (UTI) (7.2%), vaginal infections (5.8%), and previous history of PROM (3.1%). Most of the patients were delivered by lower segment caesarean section (LSCS) (55.2%), normal vaginal delivery (39.9%) and forceps delivery (4.9%). The most common indication for LSCS was fetal distress (43.9%). Misoprostol induction was associated with more failed induction (2 times) than syntocinon. Maternal complications were post-partum haemorrhage (PPH) (8%), fever (6.7%), wound infection (6.2%), manual removal of placenta (4.4%), and puerperal sepsis (0.9%). Neonatal complications were neonatal intensive care unit (NICU) admissions (14%), respiratory distress syndrome (RDS) (11%), neonatal sepsis (2.6%). Maternal (54.5%) and neonatal (90%) morbidity were more in prolonged PROM >24 hours.Conclusions: Antenatal screening for genitourinary infections especially in cases of the previous history of abortions and PROM should be done. Oxytocin is the preferred method of induction over misoprostol in this study. Active management in term PROM cases can reduce the cesarean section rate.

scholarly journals Maternal mortality following thromboembolism; Incidences and prophylaxis strategies

2020 ◽  
Author(s):  
Mahboobeh Shirazi ◽  
Behrokh Sahebdel ◽  
Mahnoosh Torkzaban ◽  
Elham Feyzabad ◽  
marjan ghaemi
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Maternal Mortality ◽  
Post Partum ◽  
Standard Form ◽  
Clinical Manifestations ◽  
Case Series ◽  
Average Score ◽  
Case Series Study ◽  
Security Standards

Abstract Background: Thromboembolism is one of the main causes of maternal mortality, which can be prevented in many cases. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism.Methods: In this case series study, the data of the mortality cases were extracted according to the ethical and security standards of the Ministry of Health of the country. The thromboembolism risk factors measured and scored using a questionnaire entitled "the evaluation of risk factors for maternal mortality following thromboembolism during pregnancy, labor, or post-partum".Results: The maternal mortality rate was 16 per 100,000 live births. Among 297 mortality cases, 27 (9%) death were due to thromboembolism. The mean gestational age was 32.5 weeks. Dyspnea (88.8%) and tachycardia (18.5%) were found as common clinical manifestations in these patients. Sixteen cases (59.3%) did not get heparin, 6 (22.2%) received single dose and 5 (18.5%) received two doses and more. In these 11 cases, 5 (45%) patients received heparin before surgery, 1 after surgery, and 5 before and after surgery. Twenty cases deceased in the first hours after delivery and the rest after 2 to 12 days. The average score of risk for thromboembolism based on Royal College of Obstetricians & Gynecologist (RCOG) guideline was 4.6.Conclusion: It seems that one of the most important cause of maternal mortality in this study was the lack of recognition of high-risk patients and the lack of prescription for prophylaxis with heparin and this clearly explains the need for accurate screening of high-risk mothers, designing a standard form and the care and treatment of these patients.

scholarly journals A cross sectional study to assess the prevalence and risk factors of post-partum depression in urban area of Indore district

2021 ◽  
Vol 9 (10) ◽  
pp. 3028
Author(s):  
Priyanka Bhaskar ◽  
Veena Yesikar ◽  
S. B. Bansal ◽  
Bhagwan Waskel
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Urban Area ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Depression Scale ◽  
Normal Vaginal Delivery ◽  
Cross Sectional ◽  
Post Partum Depression ◽  
Post Natal Depression

Background: Pregnancy and childbirth are important events in the life of a woman. Life with the new born can be very rewarding but it can be very tough for some women. This phase of life brings about many hormonals, physical and emotional changes in the women during childbirth. Aims and objectives were to find out the prevalence and risk factors of post-partum depression (PPD) in urban area of Indore district and to assess the socio demographic profile of study populationMethods: The study was a cross sectional community-based study, conducted on women who had delivered within a period of 6 weeks to 3 months. 100 women from urban area were selected from Indore district through simple random sampling. Informed consent in written was taken from the mothers. The study tool was pre designed semi structured questionnaire and Edinburgh post-natal depression scale (EPDS) scale, data were entered in excel sheet and analyzed using SPSS software, appropriate statistical test were applied wherever necessary.Results: In our study it was found that prevalence of PPD in urban Indore was 23%. We found that age at the time of marriage below 18 years, mode of delivery (LSCS), initiation of breast feeding (after 1 hour) and birth weight of baby less than 2.5 kg had a strong association with PPD. In our study 58% had normal vaginal delivery and 42% had LSCS in urban area. In urban areas 36% gave a history of birth weight of babies <2.5 kg.Conclusions: Symptoms of PPD were significantly high in urban Indore mothers and they were strongly associated with risk factors.

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