scholarly journals Perinatal Outcomes in Premature Placental Calcification and the Association of a Color Doppler Study: Report from a Tertiary Care Hospital in Eastern India

2021 ◽  
Vol 11 (4) ◽  
pp. 841-849
Author(s):  
Sudarshan Dash ◽  
Banya Das ◽  
Soumya Ranjan Panda ◽  
Monalisa Rajguru ◽  
Pramila Jena ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Color Doppler ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Primary Objective ◽  
Care Hospital ◽  
Doppler Study ◽  
Low Birth Weight Babies ◽  
Grade Iii

Introduction: Placental calcification, identified before the 36th week of gestational age, is known as premature placental calcification (PPC). PPC could be a clue for the poor fetal outcome. However, its association with adverse perinatal outcomes is yet to be confirmed. Objective: The primary objective was to determine and compare the perinatal outcomes in pregnancies with and without documented premature placental calcification. Methodology: The present study was a prospective cohort study performed from October 2017 to September 2019. We consecutively enrolled 494 antenatal women who presented to our antenatal OPD after taking consent to participate in our study. Transabdominal sonographies were conducted between 28–36 weeks of gestation to document placental maturity. We compared maternal and fetal outcomes between those who were identified with grade III placental calcification (n = 140) and those without grade III placental calcification (n = 354). Results: The incidence of preeclampsia, at least one abnormal Doppler index, obstetrics cholestasis, placental abruption, and FGR (fetal growth restriction) pregnancies were significantly higher in the group premature placental calcification. We also found a significantly increased incidence of Low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores, NICU (Neonatal Intensive Care Unit) Admission, Abnormal CTG (cardiotocography), meconium-stained liquor, and low birth weight babies in those with grade III placental calcification. Conclusion: Clinicians should be aware of documenting placental grading while performing ultrasonography during 28 to 36 weeks. Ultrasonographically, the absence of PPC can define a subcategory of low-risk pregnant populations which probably need no referral to specialized centers and can be managed in these settings.

scholarly journals A study on maternal and perinatal outcome in pregnancy with oligohydramnios: study from a tertiary care hospital, Karnataka, India

2020 ◽  
Vol 9 (4) ◽  
pp. 1676
Author(s):  
Shilpa Nabapure ◽  
Rashmi P. S. ◽  
Prema Prabhudeva
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Clinical History ◽  
Care Hospital ◽  
Ultrasound Technique ◽  
Doppler Study ◽  
Detailed Clinical History ◽  
Four Quadrant

Background: Oligohydramnios is described as a condition with decreased amniotic fluid volume relative to gestational age. It is a severe and common complication of pregnancy which is associated with increased maternal morbidity and adverse perinatal outcomes. This study was conducted to find out the significance of oligohydramnios in determining the maternal and perinatal outcome in pregnant women with oligohydramnios.Methods: The present study is a hospital-based study conducted in the department of obstetrics and gynecology, of SSIMS and RC Davanagere, during the period between August 2018 to April 2019. Detailed clinical history was taken, AFI was measured using Phelan’s four quadrant ultrasound technique. All the information was entered in the proforma and analyzed.Results: The mean age group of the study participants was 26.36±4.46 years. Majority (51.9%) of them were primigravida. Gestational age, birth weight and abnormal Doppler study were found to have an association with the perinatal outcome. Perinatal mortality in the present study was 4%.Conclusions: Oligohydramnios is a frequent occurrence in obstetrics and this condition requires intensive surveillance and proper antenatal care.

scholarly journals Maternal and fetal outcome in oligohydramnios: study from a tertiary care hospital, Ahmedabad, India

2018 ◽  
Vol 7 (3) ◽  
pp. 907
Author(s):  
Runoo Ghosh ◽  
Heena Oza ◽  
Bhakti Padhiyar
Keyword(s):  
Gestational Age ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Vaginal Route ◽  
Still Birth ◽  
Medical College ◽  
Gestation Age ◽  
Post Natal Care

Background: Most severe and frequent complication of pregnancy is Oligohydramnios and the incidence of this is observed to be about 1-5 % of total pregnancies. Objective of present study was to find the maternal and perinatal outcome, etiology associated with oligohydramnios at tertiary care hospital.Methods: This prospective study was done among 55 patients with gestational age from 30-40wks with Oligohydramnios AFI<5cms with intact membranes were analysed for perinatal outcomes admitted at department of obstetrics and Gynecology in B.J. Medical college, Ahmedabad during July 2008 to July 2010.Results: 65.5% participants were belonged to 20 to 25 age group and 35.5% participants were Primigravida. Mean age was 23.9±3.3 years and mean gestation age was 36.9 week. Almost 72.2% were in 34 to 37 weeks of gestational age. Study found FMC <10 in 56.4% of participants. Forty percent participants have AFI 4 and 27.3% have AFI 5.  47.3% delivery was done by vaginal route. 5.5% baby was still birth and prematurity were the most common cause of still birth. Around 71% babies were low birth weight and congenital anomalies were present in 7.3% babies. APGAR score measured <7 at 1 minute was in 65.4% and <7 at 5 minutes was in 43.6% babies.Conclusions: Oligohydramnios in obstetrics is a frequent occurrence and it points towards intensive surveillance and proper ante-natal and post-natal care. Due to high perinatal morbidity and mortality, the incidence of LSCS increases. However, vaginal delivery has similar outcome, but strict vigilance in labor is mandatory.

scholarly journals The Effect of Pregnancy-Induced Hypertension on Uteroplacental Vasculature Hemodynamic Changes and Pregnancy Outcome

2021 ◽  
pp. 211-215
Author(s):  
Fahmida Gul ◽  
Sameena Gul Memon ◽  
Maria Javaid ◽  
Suresh Kumar ◽  
Yaswant Rai ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Color Doppler ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Uterine Arteries ◽  
Induced Hypertension

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. Pregnancy induced hypertension can cause growth retardation of fetus. Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome. Materials and Methods: The study was carried out at tertiary care hospital of nawab shah for the period of 06 months at Department of Radiology in association with Department of Gyne and Obs. Total 106 participants were selected for the study and all females were pregnant with 1st or 2nd trimester gestational record and medical history was taken from all participants and co-morbidities was also evaluated. Blood pressure was checked from all participants from their right arm in lying position and Ultrasound test was repeated as per requirement through color Doppler ultrasound machine and Data was analyzed by using statistical software SPSS. 24.00 version. Results: After collection of research data from all participants, the entire data was assembled for the analysis. Participants were divided into various age groups as 26 were in 18-21yeras, 34 in 22-25years, 21 in 26-29years and only 07 were from 34-37years. 26 participants were belongs to 1st trimester, 34 among 2nd trimester and 21 in third trimester. PI was also noted with three different readings 32 in Umbilical artery, 21 in middle cerebral artery and 37 in uterine artery. RI was also noted among different arteries 41 in umbilical, 36 in middle cerebral and 39 in uterine arteries. S/D was also noted, 33 in umbilical artery, 49 in middle cerebral artery and 30 in uterine arteries. Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

2019 ◽  
Vol 2 ◽  
pp. 1
Author(s):  
Bhushita Lakhkar ◽  
M. M. Patil ◽  
Bhavana Lakhkar ◽  
Bhushan Lakhkar
Keyword(s):  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Color Doppler ◽  
Periventricular Leukomalacia ◽  
Birth Asphyxia ◽  
Common Finding ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Study

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventricular leukomalacia was the most common and earliest finding followed by thalamic hyperechogenicity and intracranial hemorrhage. Intraventricular hemorrhage was more common in preterm babies. Other common finding in NICU was meningitis which was more common in pretrms. Among congenital anomalies, corpus callosal agenesis was more common. Conclusions Point of care ultrasonography along with Doppler study is very useful and safe to use in NICUs. It helps in diagnosis, patient management as well as prediction of many short- and long-term outcomes.

Selective IUGR in dichorionic twins: what can Doppler assessment and growth discordancy say about neonatal outcomes?

2018 ◽  
Vol 46 (9) ◽  
pp. 1028-1034 ◽  
Author(s):  
Paola Algeri ◽  
Matteo Frigerio ◽  
Maria Lamanna ◽  
Petya Vitanova Petrova ◽  
Sabrina Cozzolino ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Neonatal Intensive Care ◽  
Neonatal Resuscitation ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Abdominal Circumference ◽  
Doppler Study ◽  
Umbilical Artery Doppler ◽  
Nicu Admission ◽  
Twin Pregnancies

Abstract Objective: The aim of the present study was to assess, in a population of dichorionic twin pregnancies with selective growth restriction, the effect of inter-twin differences by use of Doppler velocimetry and fetal growth discordancy on perinatal outcomes. Methods: This was a retrospective study including dichorionic twin pregnancies from January 2008 to December 2015 at the Department of Obstetrics and Gynecology of Fondazione MBBM. Only dichorionic twin pregnancies affected by selective intrauterine growth restriction (IUGR) delivering at ≥24 weeks were included in the study. Results: We found that twin pregnancies with inter-twin estimated fetal weight (EFW) discordance ≥15% were significantly associated with a higher risk of preterm delivery before 32 (P=0.004) and 34 weeks (P=0.04). Similarly, twin pregnancies with inter-twin abdominal circumference (AC) discordance ≥30° centiles were associated with a higher rate of neonatal intensive care unit (NICU) admission (P=0.02), neonatal resuscitation (P=0.02) and adverse neonatal composite outcome (P=0.04). Of interest, when comparing twin pregnancies according to Doppler study, growth restricted twins had a higher rate of composite neonatal outcome and in multivariate analysis, an abnormal Doppler was an independent risk factor for this outcome. Conclusions: Our study associated growth discrepancy with specific pregnancy outcomes, according to defined cut-offs. In addition, we demonstrated that an abnormal umbilical artery Doppler is independently associated with a composite neonatal adverse outcome in growth restricted fetuses.

scholarly journals Adverse perinatal outcome in diabetic mother treated with oral hypoglycemic agents vs. insulin

2017 ◽  
Vol 6 (6) ◽  
pp. 2252
Author(s):  
Leena Das ◽  
Bijay Kumar Meher ◽  
Sagar Parida ◽  
Deepti Damayanty Pradhan ◽  
Lucy Das ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Perinatal Outcomes ◽  
Educational Background ◽  
Diabetic Mother ◽  
Hypoglycemic Agents ◽  
Care Hospital ◽  
Oral Hypoglycemic Agents ◽  
Significant Difference

Background: Insulin has been the primary mode of therapy in diabetic mother for glycemic control as oral hypoglycemic agents (OHA) were initially thought to have teratogenic effect. Recent data supports the use of certain OHA; this study was designed to compare the perinatal outcomes in infants born to diabetic mother treated with insulin vs. oral hypoglycemic agents and to find out the relation of adverse perinatal events to glycemic control in both groups.Methods: This prospective observational study was conducted in a tertiary care hospital. 108 neonates born to diabetic mother between October 2014 to September 2016 were taken for study immediately after delivery after excluding the mothers who were treated with lifestyle modification and/or dietary modification alone only. 60 mothers had received insulin and 48 OHA for glycaemic control. Glycemic control was assessed by HbA1C estimation on the day of delivery. The infants were followed up in neonatal care unit for perinatal complications. Main outcome measure(s): birth weight, gestational age, respiratory problems, birth injury, birth asphyxia, congenital anomalies, hypoglycemia, hypocalcaemia, hyperbillirubinemia.Results: Out of 108 infants, 27 were born to pregestational and 81 to gestational diabetic mothers. 60(55.5%) were treated with insulin and rest with OHA, 53(49.1%) had optimal glycemic control. Both the groups had similar glycemic control in the third trimester. None of the perinatal outcomes showed significant difference between insulin and OHA group except neonatal hyperbillirubinemia. (p=0.013, RR=8 and OR=0.106). Within the optimal glycemic control (HbA1C <8), LGA has significant association with the insulin group than OHA (p=0.012, RR=2.217 and OR=4.2018).Conclusions: As compared to insulin, oral hypoglycemic agents have similar glycemic control and no adverse perinatal outcomes and can be used in pregnant mothers with diabetes mellitus from poor socioeconomic and educational background for its low cost and better patient compliance. Within the glycemic control, maternal treatment with insulin showed significant difference in LGA compared to OHA which needs further studies for validation.

Sign in / Sign up

Export Citation Format

Share Document