scholarly journals A STUDY OF MATERNAL AND PERINATAL OUTCOME IN POST DATED PREGNANCY

2020 ◽  
pp. 1-3
Author(s):  
Puja verma ◽  
Vinita Kumari ◽  
Dipti Roy

When pregnancy goes beyond 40 weeks it is called post dated pregnancy. The incidence of post term pregnancy varies from 3-12%1,2. Post term or post dated pregnancies are associated with various maternal and fetal complications. A total of 80 women attending labour room emergency with post dated pregnancy (<40 weeks) were recruited for the study. This study was done to observe the maternal and fetal outcome in post dated pregnancies. The mean age was 23.14±2.2 years. Maximum women were in the age group of 20-30 years (67.5%). More than 50% had meconium stained liquor whereas 42.5% had clear liquor. A birth weight more than 3 kg was observed in 21 babies which was 26.25 % and maximum of 53 babies (66.25%) had birth weight between 2.5 kg and 3 kg. Only 6 babies had birth weight less than 2.5 kg. Ten babies were admitted to NICU. Thus, post dated pregnancies require strict vigilance during antepartum, intrapartum and post partum period due to increased incidence of complications.

Author(s):  
Pragati Aggarwal ◽  
Sharda Patra

Background: Oligohydramnios is related to serious maternal and fetal complications. In case of isolated oligohydramnios in third trimester maternal oral hydration has shown promising results in improving maternal and perinatal outcome.Methods: This study was conducted on 50 pregnant women complicated by idiopathic oligohydramnios (AFI<5) in third trimester. Their pre hydration daily fluid intake was noted and they were advised to take oral fluids more than their usual intake (according to their convenience). The daily fluid intake and AFI was measured on day1, day2, day3 then weekly till delivery. At delivery maternal and fetal outcome were measured.Results: The mean AFI of the study population at the time of enrolment was 4.25±1.01 and daily mean fluid intake was 1.46±0.41. The post hydration fluid intake per day was significantly high as compared to pre hydration fluid intake (4.40±0.51 litres vs 1.46±0.41 litres, p<0.001). A significant difference in the amniotic fluid index was seen post hydration. The mean AFI on day 1, day 2, day 3 was 6.19±0.93, 7.33±1.13, 8.0±1.07 as compared to pre hydration AFI 4.25±1.01 (p<0.001). The amniotic fluid index post hydration normalized (AFI>8) in 6%, 30%, 61% and 100% of women on day1, day2, day3 and after a week. The perinatal outcome was favourable in all the women with 100% live births and a mean birth weight of 2.77±0.29 kg.Conclusions: A simple correction of maternal dehydration by an adequate and sustained daily oral fluid intake in pregnancies complicated by isolated third oligohydramnios in third trimester significantly improves amniotic fluid index, maternal outcome and perinatal outcome. 


2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.


2014 ◽  
Vol 2 (2) ◽  
pp. 21-27
Author(s):  
P Basnet ◽  
N Aggrawal ◽  
V Suri ◽  
P Dutta ◽  
K Mukhopadhyay

BACKGROUND: Thyroid disorder is one of commonest endocrine disorder in women and hence constitutes a common endocrine disorder complicating pregnancy. Diagnosing and treating hypothyroidism preconceptionally and during early pregnancy appears to be a useful strategy to improve maternal and fetal outcome. OBJECTIVE: To compare the maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed preconceptionally with hypothyroidism diagnosed during pregnancy. METHODS: A prospective study. One hundred pregnant women with hypothyroidism at less than 20 weeks Period of Gestation (POG) were recruited for the study and grouped into two groups: Group A-hypothyroidism diagnosed and on treatment before conception, Group B-hypothyroidism diagnosed and started on treatment during pregnancy. Both groups were intensively monitored during pregnancy with serial Thyroid Function Test (TFT) and thyroxine replacement doses were adjusted accordingly. Various maternal, perinatal and fetal outcome measures were studied in both groups prospectively till delivery. RESULTS: The maternal and fetal complications were comparable in the two groups, however the fetal birth weight was significantly higher in Group A versus Group B (2.89±0.485kg vs. 2.70±0.453kg; p=0.039). All the new born babies had normal thyroid function. CONCLUSION: Hypothyroidism diagnosed preconceptionally or during early pregnancy and treated appropriately has beneficial effect on fetal birth weight, and hence the total pregnancy outcome. Screening for thyroid dysfunction should be judiciously performed in all high risk women prior to a planned conception or during their first antenatal visit. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11170   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 21-27


Author(s):  
Dhiviya Narbhavi T. ◽  
Cicily T. J. ◽  
Kala B. S.

Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.


2014 ◽  
Vol 3 (3) ◽  
Author(s):  
Oktalia Sabrida ◽  
Hariadi Hariadi ◽  
Eny Yantri

AbstrakAda anyak penelitian yang membuktikan transfer kolesterol dari ibu ke janin melalui lapisan trofoblas yang membawa partikel LDL (Low Density Lipoprotein) dan HDL (High Density Lipoprotein). Pengambilan dan pemanfaatan LDL oleh plasenta merupakan mekanisme alternatif oleh janin untuk memperoleh asam lemak dan asam amino esensial. Tujuan penelitian ini untuk mengetahui hubungan kadar LDL dan HDL serum ibu hamil aterm dengan berat lahir bayi. Penelitian ini merupakan studi observasional dengan rancangan cross sectional. Dilakukan pemeriksaan kadar LDL dan HDL serum terhadap 31 sampel ibu hamil aterm yang dipilih secara consecutive sampling, kemudiaan saat bayi dari sampel lahir dilakukan penimbangan berat lahir bayi dalam 1 jam setelah lahir dengan keadaan tanpa pakaian. Data dianalisis menggunakan uji korelasi Pearson dilanjutkan dengan uji regresi linier sederhana, nilai p<0.05 dianggap bermakna secara statistik. Rerata kadar LDL serum ibu hamil aterm 138,52±37,86 mg/dl dengan 7 sampel (22,60%) kadar LDL <101 mg/dl. Rerata kadar HDL serum ibu hamil aterm 53,32±17,39 mg/dl dengan 13 sampel (41,90%) kadar HDL <48 mg/dl. Rerata berat lahir bayi 3150,00±489,89 gram dengan 2 sampel (6,50%) memiliki bayi dengan berat<2500 gram. Terdapat hubungan positif antara kadar LDL serum ibu hamil aterm dengan berat lahir bayi, kekuatan hubungan lemah (r=0,258), secara statistik tidak bermakna (p=0,161). Terdapat hubungan positif antara kadar HDL serum ibu hamil aterm, kekuatan hubungan sangat lemah (r=0,035), secara statistik tidak bermakna (p=0,850). Kesimpulan penelitian tidak terdapat hubungan kadar LDL dan HDL serum ibu hamil dengan berat lahir bayi.Kata kunci: kadar LDL serum, kadar HDL serum, ibu hamil aterm, berat lahir bayiAbstractMany studies proved that the transferring of cholesterol from mother to fetus through the trophoblastic layer carried LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein) particles. Uptake and usage of LDL by placenta to the fetus is an alternative mechanism to obtain fatty acids and essential amino acids. The objective of this study was to determine whether there is a relationship between LDL and HDL serum level of pregnant women at term with infant birth weight. This study was an observational study with cross sectional design. Examination of LDL and HDL serum level to 31 term pregnancy sample choose by consecutive sampling, and then infant’s birth weight was counted within 1 hour after birth without clothes. The data analyzed with Pearson correlation statistical test followed by simple linier regression statistical test. The mean of LDL serum level term pregnancy was 138,52±37,86mg/dlwith7 samples(22.60%) in LDL levels<101 mg/dl. The mean of HDL serum level at term pregnancy was 53,32±17,39 mg/dlwith 13 samples (41,90%) in HDL levels<48 mg/dl. The mean of infant birth weight was 3150,00±489,89 grams with 2 samples (6,50%) had infants weighing < 2500 grams. There is a positive relationship between LDL serum levels term pregnancy with birth weight infants, the strength of the relationship is weak (r =0,258), were not significant statistically (p=0,161). There is a positive relationship between HDL serum levels at term pregnancy with birth weight infants, the strength ofthe relationshipis veryweak(r =0,035), were not significant statistically (p=0,850). In conclusion there was no correlation of serum levels of LDL and HDL at term pregnant with birth weight.


Author(s):  
Aarthi Rajendran ◽  
Rajni Parikh

Background: Postdated pregnancy is gestation longer than 40 weeks or 280 day. Prolonged pregnancy is defined as any pregnancy that last 294 days or more. Reported frequency of post term pregnancy range from 3 - 1 4 percent with an average of about 10 percent. Several studies have concluded that these pregnancies are accompanied by a rise in perinatal morbidity and mortality. The presumed etiology for this rise is placental insufficiency. Abnormalities such as congenital anomalies, oligohydramnios, meconium aspiration, fetal asphyxia, fetal dysmaturity, macrosomia and shoulder dystocia are commonly observed in these pregnancies Materials and Methods: This study was conducted in the Department of Obstetrics and Gynecology, after approval from the Ethics Committee, from January 2019 to September2020 on 150 patients in the department of Obstetrics and Gynaecology, willing to participate and fulfilling the inclusion and excliusion criteria in the study period. Results: Of the total 150 women, 122 (81.34%) were in 40 weeks group; 28 (18.66%) in 41 weeks group and 0 (0%) were in > 42 weeks group. Most women (89.3%) were between 20-35 years of age. Among 150 women, 40 (26.6%) went into spontaneous labor, 87(8.0%) were induced andn23 (15.34%) was taken for caesarian section. Misoprostol, Dinoprostone gel and oxytocin were the different modes of induction (Table 7). Misoprostol was used in the majority of inductions followed by Dinoprostone gel. The success rate between these two is almost similar (92.45% & 95.1%).Lscs rate was 15.33%.Most of the newborn had weight between 2.5-3.5kg in 68.25% of women in gestational age >40 weeks. Conclusions: The present study, we conclude that postdated pregnancy can be considered as a high risk factor from the point of fetal outcome as there is more fetal morbidity. Keywords: High risk pregnancies, maternal mortality, Outcomes, Perinatal mortality, postdated pregnancy.


2020 ◽  
Vol 37 (1) ◽  
pp. 41-45
Author(s):  
Benjamin E. Udoh ◽  
Akwa Erim ◽  
Ekanem Anthony

Objective: To determine whether the assessment of umbilical cord diameter (UCD) is a viable indicator of fetal growth and perinatal outcome. Material and Methods: A total of 652 singleton pregnancies between 10 and 40 weeks of gestation were reviewed for this study. The UCD was measured vertically in the longitudinal section, adjacent to its insertion at the fetal abdomen. Other fetal biometrics were measured according to standard measurement protocols. The perinatal outcome of each patient case was also recorded. Result: The UCD ranged between 0.73 and 1.68 cm, and correlated positively with gestational age, estimated fetal weight ( r = 0.779, r = 0.639, P < .05), and other fetal biometrics. The UCD of 50 subjects was 2 standard deviations below the mean and correlated significantly ( r = 0.712, P < .05) with poor fetal outcome in the first and second trimester. Observational studies of 50 subjects, whose UCD was 2 standard deviations below the mean, resulted in 21 cases of intrauterine fetal death, 10 cases of preeclampsia, 8 cases of oligohydramnios, and 11 cases of intrauterine growth restriction. Conclusion: The UCD has the potential to serve as an important indicator of fetal growth, well-being, and perinatal outcome.


Author(s):  
Vandana Verma ◽  
Vaibhav Kanti ◽  
Pragya Shree

Background: The term delivery is defined as that occurring between 259 and 294 days of pregnancy from the last menstrual period. If the pregnancy exceeds this period, it is called as post term pregnancy. Our center is in rural area where most of the patients are unbooked or even booked patients are also loss of follow up. So, this study was done to know the incidence of prolonged pregnancy and maternal and fetal outcome in case of prolonged pregnancy in our rural population.Methods: This study was a retrospective observational study for 1 year, to analyze the maternal and fetal outcome of post term pregnancies. Data was collected from hospital record and analysed.Results: Out of 5210 total deliveries 1.49 % were beyond 42 wks. 57.69 % patients delivered vaginally whereas 42.3 % patients needed cesarean section.  6.41 % neonates developed meconium aspiration syndrome and 15.38 % of neonates needed NICU admission for different indications.Conclusions: This study concluded that prolonged pregnancy is associated with adverse outcomes like fetal distress, meconium aspiration syndrome and more neonatal ICU admissions. The outcome of prolonged pregnancy can be improved by proper counselling for follow up during pregnancy and proper monitoring and appropriate management during labour.


Author(s):  
Jaya Choudhary ◽  
Swati Singh ◽  
Kalpana Tiwari

Background: Maternal nutrition plays an important role in maternal and fetal outcome. The low maternal BMI or Obesity is associated with adverse outcome.Methods: A total 148 primigravida included. BMI was calculated on first visit and in each trimester, all booked patient was followed throughout pregnancy and delivery for any maternal and fetal complications.Results: (66.2%) of patients were with normal BMI, (17.56%) were underweight, (10.13%) were overweight and (6.08%) patients were obese. APH was seen in (11.1%) and (6.7%) cases in BMI grades ‘IV and III’ respectively. PIH was present in total 10 cases, (33.3%) cases belonged to BMI grades IV. Anemia was present in total 51 cases (53.8%) belonged to BMI grade I. Preterm delivery was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. GDM was present in 11 cases and out of them (26.7%) and (44.4%) cases belonged to BMI grade III and IV respectively. PPH was present in total 5 cases and out of them (7.7%), (2%) and (11.1%) belonged to BMI grades I, II and IV respectively. In BMI grade I group, (96.2%) babies had birth weight <2.5, while in BMI grade IV, (88.9%) babies had birth weight >2.5 (22.2%) cases of fetal macrosomia belonged to BMI grade IV.Conclusions: There is importance of pr-pregnancy counseling in maintaining weight of women during pregnancy to avoid pregnancy maternal and fetal outcomes. 


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