DIAGNOSTIC PERFORMANCE OF ULTRASONOGRAPHY FOR DETECTION OF ABRUPTION AND ITS CLINICAL CORRELATION AND MATERNAL AND FETAL OUTCOME

2021 ◽  
pp. 5-7
Author(s):  
Jeel Patel ◽  
Dhruvi Umarwadia ◽  
Ishit Shah ◽  
Narottam Patel
Keyword(s):  
Perinatal Mortality ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Placental Abruption ◽  
Fetal Outcome ◽  
Medical Sciences ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Obstetric Management ◽  
Nicu Admission

Placental abruption complicates about 1% of singleton pregnancies and is an important cause of perinatal mortality and morbidity. Though sensitivity and reliability of ultrasound are poor for detecting or excluding placental abruption, because of the advances in ultrasound resolution, imaging and interpretation, sensitivity of ultrasound is better than what was reported previously. To determine the diagnostic performance of Aim: Ultrasonography (USG) for the detection of placental abruption and whether sonographic results correlate with maternal and foetal management and outcome Sixty patients with clinical diagnosis of placental abruption we Materials and Methods: re studied in the Obstetrics and Gynaecology Department of Gujarat Adani Institute of Medical Sciences, Bhuj over a period of 6 months. These patients underwent ultrasonography for conrmation. Obstetric and neonatal outcome and sonographic results were compared and reviewed. Sonographic sensitivity and specicity and positive and negative predictive values were calculated. Incidence of abruption in present study was 3.05% (56 Results: patients out of 1834 total deliveries). Sensitivity of ultrasonography in the diagnosis of abruption was 57% while its specicity was 100% with a positive predictive value of 100% and a 14% negative predictive value. An 87.5% of patients(28 out of 32) with a positive USG nding of abruption had Intrauterine foetal Death (IUD)/still birth while 91.6% of patients (22 out of 24) with negative USG ndings of abruption gave birth to babies who required NICU admission. Sonography has a poor sensitivity for diagnosing placental abrupt Conclusion: ion, even though it has a high specicity and PPV. In a positive sonographic result, maternal morbidity and perinatal mortality are high which needs aggressive obstetric management as compared to the normal sonography. In case of a negative sonographic nding but a strong clinical suspicion of abruption if Obstetric intervention is made in due time, foetal as well as maternal outcome are better

scholarly journals A comparative study of low dose magnesium sulphate therapy with Pritchard’s regime in management of Eclampsia

2019 ◽  
Vol 8 (10) ◽  
pp. 3907
Author(s):  
Vijay M. Kansara ◽  
Payal Sureshkumar Patel ◽  
Ajesh N. Desai
Keyword(s):  
Perinatal Mortality ◽  
Magnesium Sulphate ◽  
Low Dose ◽  
Fetal Outcome ◽  
Control Group ◽  
Average Weight ◽  
Indian Women ◽  
Mortality And Morbidity ◽  
Labour Room ◽  
And Control

Background: Eclampsia is one of the most common causes of maternal and perinatal mortality and morbidity in India. Amongst the principles of management of eclampsia, the first is the control of convulsions. Magnesium sulphate is the main stay of treatment in eclampsia and imminent eclampsia. Average weight of Indian women is less than the western women due to which lower dose of magnesium sulphate can be used.  The aim of the study was to compare the efficacy of low dose magnesium sulphate regimen with standard Pritchard regimen in control of eclampsia.Methods: The study was carried out at emergency labour room, GMERS Sola Civil Hospital Ahmedabad. 120 patients of eclampsia were divided randomly into study group (n=60) receiving low dose MgSO4 and control group (n=60) receiving Pritchard regimen. The recurrence of convulsion, toxicity of MgSO4 and maternal and fetal outcome was studied.Results: It was observed that with low dose MgSO4 regime, convulsions were controlled in 91.7% of the cases. With standard Pritchard’s regime convulsions were controlled in 95% of patients. The maternal and perinatal mortality and morbidity were comparable in both groups.Conclusions: Low dose magnesium sulphate therapy is as effective as Pritchard’s regime for controlling convulsions in eclampsia and can be safely given in Indian women. 

scholarly journals Study of maternal and fetal outcome in twin pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2272 ◽  
Author(s):  
Lata Singh ◽  
Kiran Trivedi
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Twin Pregnancy ◽  
Fetal Outcome ◽  
Medical Sciences ◽  
Maternal Complications ◽  
Perinatal Mortality Rate ◽  
Increased Risk ◽  
Twin Pregnancies ◽  
Singleton Pregnancies

Background: Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries. The present study aims to understand the maternal and perinatal outcomes of multiple and singleton pregnancies delivering at Rajendra Institute of Medical Sciences, Ranchi, India. Aim of study was to investigate the maternal and fetal outcome in twin pregnancies in Rajendra Institute of Medical Sciences (RIMS), RanchiMethods: This comparative prospective study was conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi from the period of 1st April 2015 to 30th September 2016. Consecutive sampling was done till the sample size of 75 was reached for both twin and singleton pregnancies. It included all women admitted in antenatal ward and labor room with clinical or ultrasound diagnosis of twin pregnancy after 28 weeks of gestation.Results: The incidence of twins in this study was 1.85%. Mean maternal age was 25.25±4.5 years for twin pregnancies and 23.53 ± 3.3 for singleton pregnancies. Twins were seen more in multigravida (70.7%) as compared to primigravida (29.3%). Preterm labor (74.7%), anemia (44%) and hypertensive disorders (32%) and PPH (13.33%) were the most common complication in twin pregnancies. Significantly higher rate of LSCS were seen in twin pregnancies (32.67%) as compared to singletons 18.67%. Mean weight of first twin was 2.03±0.52kg and for second twin it was 1.98±0.51kg. There was higher incidence of moderate to severe asphyxia, IUGR and higher rate of NICU admissions in twins as compared to singletons. Perinatal mortality rate of monchrionic pregnancy was 30% and it was 10.2% for dichorionic pregnancy which shows a significant association of perinatal mortality rate and chorionicity.Conclusions: Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.

scholarly journals Analytical study to assess fetal and perinatal outcome in booked and unbooked obstetric cases

2016 ◽  
Vol 6 (1) ◽  
pp. 203
Author(s):  
Sapna Chourasia ◽  
Kamlesh Yadav
Keyword(s):  
Perinatal Mortality ◽  
Service Providers ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Control Group ◽  
Study Group ◽  
Neonatal Deaths ◽  
Nicu Admission ◽  
The Relationship ◽  
Antenatal Services

Background: The high perinatal mortality rates are indicators of the poor state of health services and it is pertinent to determine the relationship between the booking status of mother and fetal outcomes.Methods: In the present randomized prospective study of 400 unbooked (study group) obstetric cases were evaluated and compared with 400 booked (control group) obstetric cases over a period of one year.Results: Perinatal outcomes of women in study group were significantly poorer than women in control group due to high preterm delivery, LBW, with low Apgar score at five minutes, with more NICU admission due to RDS, with high perinatal mortality in term of IUD, early neonatal deaths in study group.Conclusions: Findings of the study will help the programmers and service providers in identifying areas where emphasis has to be given in the development of strategies that will promote the utilization of antenatal services, to reduce adverse perinatal and 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 A prospective study of maternal and fetal outcome in repeat LSCS mother

2019 ◽  
Vol 8 (4) ◽  
pp. 1327
Author(s):  
Pradeep Ganiga ◽  
Shanthala Rudrappa
Keyword(s):  
Fetal Outcome ◽  
Research Centre ◽  
Cesarean Sections ◽  
Medical Sciences ◽  
Singleton Pregnancy ◽  
Intraoperative Complication ◽  
Abdominal Operations ◽  
Nicu Admission ◽  
A Prospective Study ◽  
Febrile Morbidity

Background: Cesarean section is one of the most commonly performed abdominal operations on women in most countries. The incidence of primary LSCS is increasing all over the world, Consequently, there is a rise in multiple repeat LSCS with associated complications. Previous LSCS is a common indication for repeat LSCS. Primarily, authors aim at studying the influence of repeat LSCS on maternal and fetal outcome in a tertiary centre.Methods: All mothers with one previous LSCS admitted for emergency/elective LSCS at term gestation with singleton pregnancy in A.J. Institute of Medical Sciences and Research centre, Mangalore were recruited in the study from July to December 2018. Detailed history with antenatal risk factors were noted. Intraoperative and postoperative events were noted. Neonatal outcome was also noted correlated.Results: Majority of patients (58%) were in age group of 20-24years. Most of them were between 38 to 39 weeks of gestation. Most common intraoperative complication was bladder adhesion (18% of cases). In postoperative period febrile morbidity (7%) was common followed by urinary tract infection (2%). Most of the neonates (80%) weighed 2.5 to 3kg at birth. The incidence of poor APGAR respiratory distress, NICU admission was not significantly increased. There were 5 morbidly adherent placenta, 1 scar rupture, 4 scar dehiscence, no maternal or perinatal death.Conclusions: Previous caesarean is the most common cause of repeat caesarean and is associated with maternal morbidity. Measures should be taken to reduce primary caesarean sections which indirectly reduces the incidence of repeat cesarean sections.

scholarly journals Study of maternal and fetal outcome in eclampsia at Government Medical college, Aurangabad, Maharashtra, India

2019 ◽  
Vol 8 (3) ◽  
pp. 932
Author(s):  
Rahulkumar S. Mahale ◽  
Srinivas N. Gadappa
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Fetal Outcome ◽  
Private Hospitals ◽  
Maternal Deaths ◽  
Medical College ◽  
Life Threatening ◽  
Obstetric Intervention ◽  
Nicu Admission ◽  
Method Analysis

Background: Eclampsia is an obstetric enigma. Eclampsia as a clinical entity has been known from times immemorial. Even today it is one of the dreaded complications. Today also eclampsia is a life-threatening emergency that continues to be a major cause of serious maternal and perinatal morbidity and it’s still the leading cause of maternal mortality in our country.Methods: Method analysis of case records of all eclampsia cases from study period of October 2013 to September 2015, a observational study.Results: The incidence of eclampsia was found to be 1.06% in GMC, Aurangabad. The number of maternal deaths of eclampsia patients was 7 out of 335 eclampsia cases. Maternal mortality in eclampsia patients was 2.08% in 2-year study, however maternal mortality in hospital was 0.23% in 2 years study and the perinatal mortality rate in eclampsia was 361 per 1000 total births. while it is 84 per 1000 total birth for total deliveries in GMC Aurangabad during study. Majority of patients i.e. 87.75% were in the age group of 16-25 years, 55.82% of total eclampsia were primigravida 57% eclampsia cases were referred from government or private hospitals, 11% booked in GMC and 32% patients were self.  Antepartum eclampsia was the commonest type 82.11%. 80% patients of eclampsia were delivered vaginally and 18% underwent caesarean section ,2% instrumental deliveries. 12% of babies had birth weight 1000gm. 41% babies delivered with weight 2001 gm. Out of 264 live births 92 babies required NICU admission and 45 babies died in early neonatal period.Conclusions: With good antenatal, intranatal and postnatal care with judicious use of anti-hypertensive, anti-convulsant and battery of investigations and judicious obstetric intervention, maternal and perinatal mortality can be reduced.

The 5-Factor Modified Frailty Index in the Geriatric Surgical Population

2020 ◽  
pp. 000313482095243
Author(s):  
Sneha Subramaniam ◽  
Jeffrey J. Aalberg ◽  
Rainier P. Soriano ◽  
Celia M. Divino
Keyword(s):  
Predictive Value ◽  
Frailty Index ◽  
Correlation Coefficients ◽  
Predictive Ability ◽  
Improvement Program ◽  
Geriatric Population ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Modified Frailty Index ◽  
Factor Index

Background The modified frailty index (mFI-11) is a National Surgical Quality Improvement Program (NSQIP)–based 11-factor index that has been proven to adequately reflect frailty and predict mortality and morbidity. In the past years, certain NSQIP variables have been removed from the database; as of 2015, only 5 out of the original 11 factors remain. While the predictive power and usefulness of this 5-factor index (mFI-5) has been proven in previous work, it has yet to be studied in the geriatrics population. The goal of our study was to compare the mFI-5 to the mFI-11 in terms of value and predictive ability for mortality, postoperative infection, and unplanned 30-day readmission for patients aged 65 years and older. Methods Spearman’s Rho was calculated to compare the value, and unadjusted and adjusted logistic regressions were created for three outcomes in nine surgical subspecialties. Correlation coefficients were above .86 across all surgical specialties except for cardiac surgery. Adjusted and unadjusted models showed similar C-statistics for mFI-5 and 11. Results Overall predictive values of geriatric mFI-5 and mFI-11 were lower than those for the general population but still had effective predictive value for mortality and post-operative complications (C-Stat ≥ .7) and weak predictive value for 30-day readmission. Conclusions The mFI-5 is an equally effective predictor as the mFI-11 in all subspecialties and an effective predictor of mortality and postoperative complication in the geriatric population. This index has credibility for future use to study frailty within NSQIP, within other databases, and for clinical assessment and use.

scholarly journals Predictive value of hepatic transaminases during febrile phase as a predictor of a severe form of Dengue: analysis of adult Dengue patients from a tertiary care setting of Sri Lanka

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Dickowita Kankanamge Dilani Priyangika ◽  
Gayani Premawansa ◽  
Madura Adikari ◽  
Sharmila Thillainathan ◽  
Sunil Premawansa ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Predictive Value ◽  
Large Scale ◽  
Severe Disease ◽  
Tertiary Care ◽  
Roc Curves ◽  
Severe Form ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Significant Difference

Abstract Objectives Dengue viral infection is an ongoing epidemic in Sri Lanka, causing significant mortality and morbidity. A descriptive-analytical study was carried out using serologically confirmed Dengue patients during a 6 month period. The relationship between the elevation of hepatic enzymes and severity of Dengue was assessed after stratifying recorded maximum AST/ALT (SGOT/SGPT) values 2–15 times elevated and by the phases of the illness. Sensitivity, specificity, predictive values, and ROC curves were assessed using maximum values for AST and ALT. Results Out of 255 patients, 107(42%) were females. The majority (52.9%) were in the 20–39 year age group. Only 19.6% had DHF. No statistically significant difference was noticed in the values of maximum transaminases during the febrile phase among DF and DHF patients. Higher sensitivity and low specificity with the 1–5 times elevation range was noticed, and a higher cut-off level of more than 5 times elevation showed low sensitivity and higher specificity. The combination of both transaminases cut-offs with age and sex also does not show clinically significant predictability of severe disease. The AST and ALT elevations are not showing discriminatory predictive value on dengue severity. As different serotypes cause different epidemics, it is important to carry out large-scale specific studies considering the serotypes.

scholarly journals Intrapartum fetal monitoring by cardiotocography and its correlation with labour outcome

2020 ◽  
Vol 9 (12) ◽  
pp. 4937
Author(s):  
Kanupriya Singh ◽  
Mubassira Pathan ◽  
Mukul Shah
Keyword(s):  
High Risk ◽  
Vaginal Delivery ◽  
Predictive Value ◽  
Fetal Monitoring ◽  
Fetal Outcome ◽  
Low Risk ◽  
Fetal Surveillance ◽  
Intrapartum Fetal Monitoring ◽  
Nicu Admission ◽  
Adverse Fetal Outcome

Background: The intrapartum fetal surveillance has gained significant importance. Avoidance of adverse fetal outcome is the objective of intrapartum fetal monitoring. This study helps in forming the aims to provide simple and clear approach to intrapartum fetal surveillance in high risk population.Methods: In present study 80 laboring patients were analyzed retrospectively who were admitted in GCS Hospital from December 2017 to May 2018. Continuous fetal monitoring was done and results were correlated with maternal and fetal outcome.Results: Cases with high risk (23) had more non-reassuring pattern of 8.7% as compared to low risk which had 5%. With non-reassuring pattern, C-section was done in 38% whereas in reassuring pattern 85% had vaginal delivery. NICU admission in non-reassuring pattern were 7 (63.6%) whereas in reassuring were only 2 (2.89%). This makes false positivity as 36.4%.Conclusions: Predictive value of CTG of reassuring pattern is quite high. In spite of false positives, it is a very effective tool in labor room.

scholarly journals Fever in pregnancy and its maternal and fetal outcome at tertiary care level

2018 ◽  
Vol 7 (5) ◽  
pp. 1864
Author(s):  
M. Poovathi ◽  
N. Prasanna
Keyword(s):  
Maternal Mortality ◽  
Dengue Fever ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Pregnant Mother ◽  
Care Level ◽  
Common Cause ◽  
Mortality And Morbidity ◽  
Nicu Admission

Background: The fever during pregnancy is the omnious sign. Early detection and prompt management of fever prevents maternal mortality and morbidity. Any maternal hyperthermia (>38.9°C) potentially affect the fetus. Hence study was conducted to know the outcome of fever in pregnancy.Methods: To study the outcome of pregnant women admitted with fever in obstetrics ward at MGMGH, Trichy over the period of 6 months from July 2017 to December 2017.Results: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.Conclusions: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.

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