scholarly journals A CLINICAL STUDY OF MATERNALAND PERINATAL OUTCOME IN OLIGOHYDRAMNIOS AT DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 26-28
Author(s):  
Supriya Kumari ◽  
Surya Narayan ◽  
Kumudini Jha ◽  
Debarshi Jana

Background:Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. Our study was aimed to study the maternal and perinatal outcome in oligohydramnios and measures needed to reduce the incidence. Aims: To find out the incidence of oligohydramnios by ultrasonographic evaluation of AFI, obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery. The purpose of this study is also to assess congenital anomalies in fetus along with their apgar score at birth, NICU admission rates and still birth rates. Materials and Methods: After taking consent from the women, risk factors at the time of admission were recorded. Detailed clinical history including obstetric, menstrual, past and personal history were taken.AFI to be measured using Phelan’s four quadrant ultrasound technique. All the information was entered in the proforma and analyzed and observations were made and accordingly discussion and recommendations were made. Results: The incidence of oligohydramnios was 3%. In the present study 78.5% cases had associated obstetrical complications; acting singly or in combination for causing oligohydramnios. The incidence of congenital anomalies is 9%. The LSCS was done in 47% in present study.17.5% babies had low Apgar score (less than 7 at 5 min).In our study 36% of neonates were admitted in nursery. The perinatal mortality was 15% in present study. Conclusion: Hence it can be concluded that maternal evaluation of risk factors, AFI, regular antenatal and intranatal monitoring of fetus should be done to improve maternal and neonatal outcome in oligohydramnios.

Author(s):  
Shilpa Nabapure ◽  
Rashmi P. S. ◽  
Prema Prabhudeva

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.


Author(s):  
Rita Saxena ◽  
Brinda Patel ◽  
Anjana Verma

Background: Oligohydramnios is one of the major causes of perinatal morbidity and mortality. The sonographic diagnosis of oligohydramnios is usually based on an AFI≤5 cm or on a single deepest pocket of amniotic fluid≤2 cm3. Our study was aimed to study the perinatal outcome in oligohydramnios. Aim and objective were to study obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery, and to assess neonatal complications in terms of APGAR score at birth, NICU admission rates, meconium stained liquor and still birth rates.Methods: It was an Observational, Prospective, clinical study of 100 pregnant patients diagnosed with oligohydramnios by ultrasound, carried out in Geetanjali medical college and hospital, Udaipur for period of from January 2020-August 2020. The study was conducted after ethical clearance and with informed consent. Detailed history on demographic profile, medical illness, obstetric history and antenatal complication if any in the present pregnancy; general examination, obstetric examination and bimanual examination were performed meticulously.Results: In our study 53% cases of oligohydramnios were associated with some of the risk factors like PIH (29%), IUGR (22%), fetal anomaly (1%), systemic maternal disease (1%) and 47% of the cases were Idiopathic. LSCS was done in 85.71% cases with AFI<5 cm. Low birth weight was found in 51.43% cases with AFI<5 cm. NICU admission was required for 28.57% cases with AFI<5 cm.Conclusions: AFI is an important and convenient screening test for prediction of perinatal outcome. In presence of oligohydramnios, the risk of fetal distress, operative delivery, low Apgar score, low birth weight, perinatal morbidity and mortality are more. Hence early detection of oligohydramnios, associated antenatal risk factors and timely management can improve the maternal and fetal outcome.


2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 


2021 ◽  
pp. 4-6
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.


2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)


Author(s):  
H. Coenen ◽  
J. Braun ◽  
H. Köster ◽  
M. Möllers ◽  
R. Schmitz ◽  
...  

Abstract Purpose Aim of our study was to compare the prognostic value of the Umbilical-to-Cerebral ratio (UCR) directly to the Cerebroplacental ratio (CPR) in the prediction of poor perinatal outcomes in pregnancies complicated by Fetal Growth Restriction (FGR). Methods A retrospective study was carried out on pregnant women with either a small-for-gestational age (SGA) fetus or that were diagnosed with FGR. Doppler measurements of the two subgroups were assessed and the correlation between CPR, UCR and relevant outcome parameters was evaluated by performing linear regression analysis, binary logistic analysis and receiver operator characteristic (ROC) curves. Outcomes of interest were mode of delivery, acidosis, preterm delivery, gestational age at birth as well as birthweight and centiles. Results Boxplots and Scatterplots illustrated the different distribution of CPR and UCR leading to deviant correlational relationships with adverse outcome parameters. In almost all parameters examined, UCR showed a higher independent association with preterm delivery (OR: 5.85, CI 2.23–15.34), APGAR score < 7 (OR: 3.52; CI 1.58–7.85) as well as weight under 10th centile (OR: 2.04; CI 0.97–4.28) in binary logistic regression compared to CPR which was only associated with preterm delivery (OR: 0.38; CI 0.22–0.66) and APGAR score < 7 (OR: 0.27; CI 0.06–1.13). When combined with different ultrasound parameters in order to differentiate between SGA and FGR during pregnancy, odds ratios for UCR were highly significant compared to odds ratios for CPR (OR: 0.065, 0.168–0.901; p = 0.027; OR: 0.810, 0.369–1.781; p = 0.601). ROC curves plotted for CPR and UCR showed almost identical moderate prediction performance. Conclusion Since UCR is a better discriminator of Doppler values in abnormal range it presents a viable option to Doppler parameters and ratios that are used in clinical practice. UCR and CPR showed equal prognostic accuracy conserning sensitivity and specificity for adverse perinatal outcome, while adding UA PI and GA_scan increased prognostic accuracy regarding negative outcomes.


2015 ◽  
Vol 7 (1) ◽  
pp. 15-17
Author(s):  
K Shereen ◽  
K Patil

ABSTRACT Aims To establish the incidence of nuchal cord at the time of delivery and to assess its impact on the intrapartum and perinatal outcome. Materials and methods This was a cross-sectional study conducted at KLES Dr Prabhakar Kore Hospital and Medical Research Centre, Belgaum, India, from January 2011 to March 2011. A sample size of 429 was calculated. Informed consent was obtained and eligible women were enrolled. The babies born with a cord around the neck were compared to those without. The particulars noted were age, BMI, parity, loops of cord around the neck (single or multiple), type of loop, mode of delivery, weight of the baby and Apgar score at birth and 5 minutes. The parameters were then compared and statistically analyzed using Chi-square test. Results Incidence of nuchal cord at the time of delivery was 13.75%, of which single nuchal cord was highest (76.66%). The study revealed that age, BMI (in kg/m2), parity, gestational age and birth weight were not statistically significant to the presence of nuchal cord. Though instrumental deliveries were more in babies with nuchal cord, it was not statistically significant (p = 0.932). Apgar score < 7 at 1 minute was significantly low in nuchal cord group and Apgar score at 5 minutes and admission to neonatal unit was equivalent to those babies born without nuchal cord (p = 0.947). Conclusion Nuchal cord is not associated with adverse perinatal outcome. How to cite this article Shereen K, Patil K, Swamy MK. Nuchal Cord and Perinatal Outcome. J South Asian Feder Obst Gynae 2015;7(1):15-17.


2015 ◽  
Vol 3 (2) ◽  
pp. 25
Author(s):  
Ajay Adhikaree ◽  
Suresh Chandra Kohli ◽  
Daya Ram Pokhrel ◽  
Dharma Bhatta

Introduction: Urinary Tract Infection (UTI) is a well- known complication of Diabetes Mellitus (DM). Its spectrum ranges from Asymptomatic Bacteriuria (ABU) to acute pyelonephritis. Many studies have delineated an increased prevalence of ABU in DM whereas to the same degree other studies have come to naught showing insignificant association. Hence, this study was drafted to evaluate the presence of ABU among diabetics and assess various risk factors.   Methods: Total of 116 diabetic adults without symptoms of UTI attending medical out-patient department, Manipal Teaching Hospital were enrolled by detailed clinical history, examination and laboratorial examination as per standard set of questionnaire from February 2013 to May 2014. Data were analyzed by SPSS (17.0).   Results: The rate of ABU in diabetic adults was 10.3% and was significantly associated with duration of DM, fasting blood glucose level and poor glycaemic control. Escherichia coli was the most frequently isolated pathogen which was sensitive to Nitrofurantoin and Imipenem.   Conclusion: Being asymptomatic, diabetics fail to recognise ABU, however, ABU is preponderant in DM and is linked mainly with duration of DM and poor glycaemic control. Hence screening for ABU is imperative in diabetic adults if above mentioned risk factors are present.


Author(s):  
Kalpna Kulshrestha ◽  
Debbarma Sukla ◽  
Kalpana Verma

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.


KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 145-149
Author(s):  
Kazi Shaila Naznin ◽  
Sayeed Bin Sharif ◽  
Nadia Mirza ◽  
Farzana Hamid ◽  
Tanzia Akter

Background: Preterm labour is a major cause of maternal mortality in our country. Hypomagnesaemia during pregnancy could be an indirect cause of preterm labour. Magnesium has a role on uterine smooth muscle relaxation, which is the basis for the use of magnesium sulphate as a tocolytic agent. Objective: This study was done to see the effect of magnesium sulfate to prevent preterm labour and perinatal outcome. Materials and Methods: This study was carried out in Comilla Medical College & Hospital, from December 2011 to May 2012. Fifty pregnant women, both primi and multi with preterm labour were selected for the study. Results: Study showed labour delayed >24 hours in 86% cases. And the majority of newborn (96%) had Apgar score in 5 minute was 8-10, 4% had Apgar score 7-8. The mode of delivery was vaginal in 70% cases and by c/s in 16% cases; among subject whose labour delayed more than 24 hours. Conclusion: Intravenously administration of magnesium sulfate is safe, well tolerated and effective tocolytic agent for prolongation of pregnancy in preterm labour. It produces minimal harmful effects on mother and fetus. KYAMC Journal Vol. 11, No.-3, October 2020, Page 145-149


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