scholarly journals DOPPLER ULTRASOUND, AS VITAL AID TO PREDICT FETAL OUTCOME IN HIGHRISK PREGNANCIES

2020 ◽  
pp. 1-3
Author(s):  
Lalit D. Kapadia ◽  
Brinda patel ◽  
Amrita Patel
Keyword(s):  
High Risk ◽  
Flow Velocity ◽  
Doppler Ultrasound ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Resistance Index ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Full Term ◽  
High Rate

Introduction:Pulsed Doppler ultrasound allows a clearer understanding of hemodynamic changes and has thus become one of the most effective clinical methods in highrisk pregnancies for fetomaternal surveillance.Fetuses with abnormal flow velocity waveform exhibit a high rate of perinatal asphyxia and death compared to those with normal flow properties.Doppler velocimetrydetermines not only the frequency of antenatal testing and the optimum delivery time, but also the mode of delivery. Objective: To evaluate fetal outcome in High Risk Pregnancies with Doppler changes. Material and methods: Fetal outcome of 100 high risk pregnancies with doppler changes showing abnormality were analysed over a period of 4 months from May 2020 to August 2020. Ultrasound was done followed by Doppler evaluation. Uterine, umbilical and middle cerebral artery flow velocity waveforms (FVW) were analyzed and the resistance index (RI), pulsatility index (PI) and the systolic/diastolic (S/D) ratios were measured. Fetal outcome was determined by APGAR score after 5minute. Results:Out of 100 cases, 43 patients underwent vaginal delivery, out of which 25 full term and 18 were preterm deliveries. 57 patients underwent caesarean section out of which 33 were full term and 24 were preterm. Out of 88 live births,22 babies had APGAR <6 at 5 minutes and 34 babies required NICU admission because of fetal distress, low birth weight, low APGAR, respiratory distress syndrome and IUGR. Conclusion: Doppler can be used as promising adjunct in management of high risk pregnancies. It helps in guiding early intervention and improving fetal outcome.

scholarly journals FETAL OUTCOME;

2017 ◽  
Vol 24 (03) ◽  
pp. 462-465
Author(s):  
Afsheen Memon ◽  
Aisha Abdullah Sheikh ◽  
Anisa Kamal
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
P Value ◽  
Study Group ◽  
Nuchal Cord ◽  
Nicu Admission

Objectives: To compare the effect of nuchal cord versus without cord aroundthe neck on mode of delivery and fetal outcome. Study design: Case control comparativestudy. Period: 1st August 2013 to 31st March 2014. Setting: Gyn /Obs Department at Sir SyedHospital Karachi. Material and Methods: A comparative study was carried out on 2 groupsof parturient ladies. The study group comprised of those ladies who at the time of delivery(vaginal delivery/caesarean-section) had clinically cord around the neck while the other group(control) did not have nuchal cord. Duration of labour, mode of delivery were noted. Perinataloutcome was measured in terms of Apgar score and NICU admission. High risk pregnancieswere excluded from the study. Result: Incidence of nuchal cord at the time of delivery was22.7%. A high rate of caesarean delivery observed in study group as compared to controlgroup (70 % vs 40%) (P value 0.00006). Fetal heart rate irregularities & meconium stainedliquor finding was not significantly different in two groups (p< 0.161) & (p<0.169) respectively.Similarly fetal outcome measured in terms of Apgar score at 1 & 5 min & NICU admissionwas also not significantly different between the two groups. Conclusion: A significant highrate of caesareans section rate was observed in the study group mainly due to fetal distress(FHR irregularities). This means cord around the neck is a risk factor & needs extra monitoringspecially through intermittent CTG monitoring during labour so that fetal distress can be pickedup early & emergency caesarean section can be performed to avoid fetal compromise.

scholarly journals Lifting the veil of secrecy: maternal and neonatal outcome of oocyte donation pregnancies in Germany

2021 ◽  
Author(s):  
J. Altmann ◽  
J. Kummer ◽  
F. Herse ◽  
L. Hellmeyer ◽  
D. Schlembach ◽  
...  
Keyword(s):  
High Risk ◽  
Treatment Options ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Oocyte Donation ◽  
University Hospital ◽  
Detailed Knowledge ◽  
Peripartum Hemorrhage ◽  
The Veil

Abstract Background In Germany, performing fertility procedures involving oocyte donation is illegal, as stated by the Embryo Protection Law. Nonetheless, in our clinical routine we attend to a steadily rising number of pregnant women, who have sought oocyte donation abroad. Due to the legal circumstances many women opt to keep the origin of their pregnancy a secret. However, studies have shown, that oocyte donation is an independent risk factor for the development of pregnancy complications, such as preeclampsia. Objective The aim of this study is to evaluate maternal and neonatal outcomes of oocyte donation pregnancies in three large obstetric care units in Berlin, Germany. Methods We retrospectively analyzed all available medical data on oocyte donation pregnancies at Charité University hospital, Vivantes Hospital Friedrichshain, and Neukoelln in the German capital. Results We included 115 oocyte donation (OD) pregnancies in the present study. Our data are based on 62 singleton, 44 twin, 7 triplet, and 2 quadruplet oocyte donation pregnancies. According to our data, oocyte donation pregnancies are associated with a high risk of adverse maternal and fetal outcome, i.e., hypertension in pregnancy, preterm delivery, Cesarean section as mode of delivery, and increased peripartum hemorrhage. Conclusion Although oocyte donation is prohibited by German law, many couples go abroad to seek reproductive measures using oocyte donation after former treatment options have failed. OD pregnancies are associated with a high risk of preeclampsia, C-section as mode of delivery, and peripartum hemorrhage. Detailed knowledge of the associated risks is of utmost importance to both the patient and the treating physician and midwife.

scholarly journals Perinatal outcome associated with oligohydramnios in third trimester

2016 ◽  
Vol 6 (1) ◽  
pp. 72 ◽  
Author(s):  
Kamlesh R. Chaudhari ◽  
Kushagra R. Chaudhari ◽  
Omkar M. Desai
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
Research Centre ◽  
Meconium Staining ◽  
Nicu Admission

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.

scholarly journals Perinatal outcomes in adolescent pregnancy

2018 ◽  
Vol 8 (2) ◽  
pp. 27-31
Author(s):  
Yam Prasad Dwa ◽  
Sunita Bhandari ◽  
Devendra Shrestha ◽  
Ajaya Kumar Dhakal
Keyword(s):  
Adolescent Pregnancy ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Neonatal Deaths ◽  
Medical College ◽  
Adolescent Women ◽  
Pregnant Adolescent

Introduction: Adolescent pregnancy is prevalent in Nepal and bears significant consequences to both mother and newborn. Methods: All pregnant women aged 19 years or less who were admitted for delivery at KIST Medical College during 14th April 2017 to 15th July 2018 were included in this study. Maternal and immediate neonatal outcomes were analyzed retrospectively from their medical records. Results: There were 135 pregnant adolescent women out of 1300 deliveries. Preeclampsia was observed in 2 pregnancies. Vaginal delivery (99; 73.3%) was the predominant mode of delivery. Emergency LS CS was performed in 35 (25.9%) deliveries and most frequent indications for LS CS were nonprogress of labor (8/35), breech presentation (8/35) and fetal distress (6/35). 10 (7.4%) babies were born preterm. 23 (17%) babies were born low birth weight. 37 (27.4%) neonates were symptomatic and required neonatal admission. Respiratory distress was the most frequent neonatal problem (29; 21.5%), followed by neonatal sepsis (18; 13.3%) and perinatal asphyxia (9; 6.7%). There were 3 (2.2%) still birth and 2 (1.5%) early neonatal deaths. Conclusion: Adolescent pregnancy was common and associated with increased early neonatal problems.

scholarly journals Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals CARDIOTOCOGRAPHY

2018 ◽  
Vol 25 (10) ◽  
pp. 1537-1545
Author(s):  
Muhammad Ikram ◽  
Amna Javed ◽  
Shafqat Mukhtar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Cross Sectional ◽  
Group A ◽  
Group B ◽  
Labour Room

Introduction: The cardiotocography (CTG) is more commonly knows aselectronic fetal monitoring (EFM). A cardiotocography measures the fetal heart and the frequencyof uterine contractions. Using two separate disc shaped transducers. Objectives: The objectiveof this study is to co-relate the intrapartum cardiotocography monitoring with fetomaternaloutcome. Study Design: Cross sectional analytical study. Setting: Department of Obstetricsand Gynaecology, Shaikh Zayed Hospital, Lahore, Pakistan. Period: From September 2012 toMarch 2013 (Six Months). Patient & Method: Total 60 patients (pregnant females) fulfilling theinclusion criteria were selected for this study, who were admitted in labour room in early andactive labour. In group A normal CTG monitoring and in Group B women with abnormal CTGmonitoring. Maternal outcomes in terms of mode of delivery and fetal outcome (APGAR Score,neonatal seizures, admission to nursery and time of neonatal discharge were seen). Result: Themean age in group A was 26.13+3.90 years and in group B was 26.53+4.17 years. The meangestational age in group A was 38.40+1.50 weeks and in group B was 36.60+1.59 weeks. Ingroup A, 25 (83.3%) woman were delivered through spontaneous vaginal birth and 4(13.4%)women, who were delivered by caesarean section (for all indication except fetal distress), 1(3.3%) woman by assisted vaginal birth (for all other indications). In group B there were 7(23.8%)women who delivered through spontaneous vaginal birth. 3(10%) women by assisted vaginalbirth (for abnormal CTG monitoring) and 20(66.7%) women by caesarean section (for abnormalCTG). In group A, there were 7(23.3%) neonates who were admitted in nursery, while in groupB, there were 19(63.3%) neonates, who were admitted in nursery. Conclusion: Intrapartumexternal fetal cardiotocography is not a single indicator of fetal distress. An increased caesareansection rate in babies with a pathological cardiotocography stresses on the need for additionaltests to differentiate hypoxic fetuses from non-hypoxic.

scholarly journals Evaluation of maternal and fetal outcome in corona positive pregnant women

2020 ◽  
Vol 9 (12) ◽  
pp. 5037
Author(s):  
Bharti Maheshwari ◽  
Preeti Sharma ◽  
Kamini Pawar ◽  
Kirti Goswami
Keyword(s):  
Pregnant Women ◽  
Viral Infections ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Normal Delivery ◽  
Medical College ◽  
Cell Immunity ◽  
Term Delivery ◽  
Fetal Complications

Background: COVID-19 has spread globally at an accelerated rate with rapid increases in cases and mortality. Viral pneumonia is one of the leading causes of pregnancy deaths worldwide. Physiological changes during pregnancy, such as reduced functional residual volumes, diaphragm elevation, and oedema of respiratory tract mucosa, as well as changes in cell immunity can lead to increased susceptibility to viral infections and can have worsened outcomes.Methods: The study was conducted after clearance from Board of Studies and Ethical committee in the Department of obstetrics and gynaecology, Muzaffarnagar medical college, Muzaffarnagar. It was a retrospective study. Out of total 1500 covid positive patients admitted in 3 months, 33 pregnant women were included which were covid positive.Results: The study population consisted of 16 (48.5%) women from 20-25 years, 12 (36.4%) women from 26-30 years and 5 (15.2%) women from above 30 years. There was history of exposure among all (100.0%) pregnant women with only 2 (6.1%) having symptoms of COVID-19.Out of 33, 8 patients were severelyanemic, 4 had preeclampsia, 2 cases had previous 2 LSCS, 5 previous 1 LSCS, 1 leaking pervaginum, 3 cases had fetal distress at admission. As per gestational age, 9 (27.3%) women had pre-term delivery, 21 (63.6%) had normal term delivery and 3 (9.1%) had post-term delivery. 13 women were primigravida and 20 were multigravida. The mode of delivery was LSCS among 24 (73%) and normal delivery among 1 (3.0%) women.Conclusions: In our study, there were no maternal and fetal complications among pregnant women with COVID-19.

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 Admission Cardiotocography in High Risk Pregnancies

2018 ◽  
Vol 12 (1) ◽  
pp. 50-54
Author(s):  
Jwala Thapa ◽  
Rajib Sah
Keyword(s):  
High Risk ◽  
Apgar Score ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
Invasive Technique ◽  
P Value ◽  
Vaginal Deliveries ◽  
Admission Test ◽  
The Relationship

Aims: The objective of the study was to evaluate the relationship between admission cardiotocography and fetal outcome among high risk obstetrics patients.Methods: The study was a hospital based observational study of 130 patients, conducted at Paropakar maternity and Women’s Hospital, Kathmandu from January 2014 to June 2014. A 20-minute cardiotocography reading was done in admission room and reading was categorized in 3 groups- reactive, equivocal and ominous. The results were compared to see the relationship between normal and abnormal admission test in terms of color of liquor, mode of delivery, Apgar score at 5 minutes, neonatal resuscitation needed and NICU admission.Results: Result of admission test (AT) was reactive in 95(73.1%), equivocal in 19(14.6%) and ominous in 16(12.3%) which has significant relationship with mode of delivery (p-value=0.003), color of liquor (p-value=0.000), Apgar score at 5 minutes (p-value=0.000) and perinatal outcome (p-value=0.00). Incidences of vaginal deliveries were more common when the test was reactive whereas operative deliveries were more common when the AT was ominous/equivocal.Conclusions: Admission test is simple, cost effective and non-invasive technique for detecting fetal hypoxia and predicting fetal outcome that can serve as a screening tool in triaging fetuses of high-risk patients in developing countries with a heavy workload and limited resources.

scholarly journals Maternal and fetal outcome in term labour with meconium stained amniotic fluid

2012 ◽  
Vol 10 (3) ◽  
pp. 198-202
Author(s):  
S Kumar ◽  
SN Gupta ◽  
IP Mahato ◽  
R Giri ◽  
A Yadav ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Delivery Methods ◽  
Normal Delivery ◽  
Term Labour ◽  
Meconium Stained Amniotic Fluid ◽  
Control Study ◽  
Additional Monitoring

Introduction: Passage of meconium in utero is a dangerous sign for fetal outcome which influence the decision to deliver as well as the mode of delivery. Methods: This descriptive case control study was carried out in the department of Obstetrics and Gynaecology, Koshi Zonal Hospital from March 2006 to July 2006. A total of 50 women with meconium stained amniotic fluid( MSAF) were studied to identify maternal and fetal outcome and was compared with women with clear amniotic fluid. Results: Normal delivery was significantly higher (58%) in clear liquor group as compared to MSAF group (22%). Cesarean section was more common in MSAF group (66%) where as it was (38%) in the clear liquor group (p=0.005). Low Apgar scores of < 5 at one minute was seen in 48% of MSAF and 6% of clear liquor born babies (p<0.2). But at 5 minutes low Apgar score persisted in same 48% of MSAF babies whereas it was seen in 12% of clear liquor group (p<0.000). Among the babies born with MSAF 34% were referred to higher center compared to 6% in clear liquor babies (p=0.000). Four babies with thick MSAF and one baby with clear liquor had neonatal death (p=0.005). Conclusion: Mode of delivery and fetal outcome were adversely affected by the presence of thick meconium stained liquor as compared to clear liquor. Additional monitoring facilities e.g. cardiotocography (CTG) if available would reduce fetal distress and allow timely intervention in such cases. DOI: http://dx.doi.org/10.3126/hren.v10i3.7135 Health Renaissance; September-December 2012; Vol 10 (No.3);198-202

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