scholarly journals CLINICAL ANALYSIS OF RISK FACTORS AND OUTCOME IN PLACENTA PREVIA

2021 ◽  
pp. 1-3
Author(s):  
H. Anitha Virgin Kumari ◽  
S. Nivedita ◽  
M. Monisha
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Gestational Age ◽  
Maternal Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
Expectant Management ◽  
Clinical Analysis ◽  
Delivery Mode

BACKGROUND Placenta previa describes a placenta that is implanted somewhere in the lower uterine segment,either over or near the internal cervical os. AIM OF THE STUDY To analyse the risk factors and outcomes associated with placenta previa METHODS A prospective study of all the placenta previa patients delivered at Govt RSRM Lying in Hospital,Chennai from June 2019 to November 2020 are included.Control of 533 patients without placenta previa were selected randomly during the same period.The differences between the groups with respect to age,parity ,mal presentation,pregnancy associated complications,gestational age at onset of bleeding,gestational age at delivery,mode of delivery,third stage complications,neonatal outcome,during of hospital stay are noted. RESULTS The risk of occurrence of placenta previa is increased with advancing maternal age,parity and previous uterine surgery.Incidence is 0.5%,69% of placenta previa cases delivered by cesarean section,10% developed PPH,2% managed surgically,25% preterm delivery. CONCLUSION Accurate diagnosis,judicious expectant management with blood transfusion as required and timely delivery may lead to the most favorable outcome. The current study also suggested that advancing maternal age,parity and cesarean section increase the risk of placenta previa.

EFFECT OF HBA1C LEVEL ON MODE OF DELIVERY

2018 ◽  
Vol 6 (2) ◽  
pp. 781-784
Author(s):  
SAIMA PERVEEN ◽  
PARVEEN NAVEED ◽  
NAZISH HAYAT ◽  
NADIA RASHID
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
Gestational Age ◽  
Maternal Age ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Dominant Mode ◽  
Normal Vaginal Delivery ◽  
Number Of Patients ◽  
Sugar Levels

BACKGROUND: Perinatal outcome is related to the onset and duration of glucose intolerance. Theobjective of the study is to determine the effect of HbAlc on mode of delivery in Obs/Gynea departmentof Saidu Teaching Hospital, Swat.MATERIAL AND METHODS: This observational & descriptive study was carried out in theDepartment of Obstetrics and Gynecology at Saidu Teaching Hospital, Swat, from 1st March 2015 to29th Feb 2016. Total 313 pregnant women were included in the study, who had Gestational Diabetes orEstablished Diabetes.Detail history was taken regarding maternal age in years, gestational age in weeks.Abdominal examination was done for lie and presenting part of the fetus, and vaginal examination wereperformed. These patients were followed till the end of labour and their mode of delivery i-e; normalvaginal delivery, instrumental delivery or cesarean section was recorded. Maternal HbAlc level wasdone at the time of delivery and was categorized as Mild (< 6.5), Moderate (6.5-9) and severe (>9).Maternal HbAlc was measured in hospital laboratory. The numerical variables of mean HbAlc,maternal age in years and gestational age in weeks were analyzed by mean ± SD (range). Categoricalvariables like; grades of severity of HbAlc levels and frequency of modes of delivery were analyzed byfrequency (number) and relative frequency (percentages). SPSS 20 (SPSS Inc. Chicago, Illnios, USA)was used to analyze the data.RESULTS:The total number of patients was 313. Mean age of the study population was 27.85 ± 6.37(43 - 15) (95% Cl 28.39 - 27.30). The mean age of gestational amenorrhea, at which most of thepatients presented was 38.31 ± 3.02, ranging from 41 to 29, (95%CI 38.57 - 38.5). The meanglycosylated Hemoglobin (HbAlc) was 6.9 ± 1.69 (95% Cl 6.17 - 5.88). Majority of the patients hadpoorly controlled diabetes, i-e: 64%. In different levels of HbAlc levels, normal vaginal delivery wasthe pre dominant mode of delivery.CONCLUSION:^ patients with uncontrolled diabetes the rate of complications increased and so doesthe rate of macrosomia and fetal distress, leading to higher rate of cesarean section and instrumentaldelivery, so by strict control of the blood sugar levels in a diabetic patient one can reduce the risk ofoperative deliveries and complications.KEY WORDS:Hbalc levels, Mode of delivery, cesarean section

scholarly journals Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhifen Hua ◽  
Fadwa El Oualja
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Fetal Membrane ◽  
Delivery Mode ◽  
Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

scholarly journals Birthweight Discordance, Risk Factors and its Impact on Perinatal Mortality Among Japanese Twins: Data From a National Project During 2001–2005

2010 ◽  
Vol 13 (5) ◽  
pp. 490-494 ◽  
Author(s):  
Ruoyan Gai Tobe ◽  
Rintaro Mori ◽  
Norio Shinozuka ◽  
Takahiko Kubo ◽  
Kazuo Itabashi
Keyword(s):  
Risk Factors ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Maternal Age ◽  
Delivery Mode ◽  
Clinical Practices ◽  
Sex Composition ◽  
Assisted Reproduction Technologies ◽  
Care Project ◽  
Perinatal Health Care

Our aims were to assess the incidence of birthweight discordance of twins, to explore risk factors and its impact on perinatal mortality, and to quantify the risks at different severity of birthweight discordance in Japan, by using a nationwide obstetric database. There were 10,828 pairs of twins, born from 2001 to 2005 recorded in the database of the national Perinatal Health Care Project, fully enrolled. The overall incidence of birthweight discordance was 47.34%. The incidence of mild, severe and extremely severe discordance was 19.26%, 10.21% and 17.87%, respectively. The incidence of birthweight discordance in Japan is much higher than that in other countries, particularly at higher severity level. By linear regression model, our study added independent factors of primiparity (p < .001), sex composition (p < .001), chorionicity (p < .001), gestational age (p < .001), and delivery mode (p < .001) in determining birthweight discordance percentage. Maternal age and application of assisted reproduction technologies (ART) didn't significantly influence the birthweight discordance. The birthweight discordance is closely associated with gestational age and affected discharge mortality. From 25% of birthweight discordance, risk to discharge mortality tended to significantly increase, suggesting it should be added as a reference for clinical practices.

scholarly journals Incidence and Risk Factors of Postpartum Hemorrhage in China: A Multicenter Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Cesarean Section ◽  
Subgroup Analysis ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Mode Of Delivery ◽  
Predictive Performance ◽  
Vaginal Deliveries ◽  
Twin Pregnancies

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide but the incidence and its risk factors in China is limited. The objective of this study is to investigate the incidence and the risk factors of PPH in Chinese women.Methods: A multi-center retrospective study of pregnant women at ≥28 weeks of gestation was conducted. Logistic regression was used to identify potential risk factors of PPH and receiver operating characteristic curve was used to evaluate the predictive performance of the identified risk factors. Subgroup analysis focusing on the number of fetus and the mode of delivery was conducted.Results: A total of 99,253 pregnant women were enrolled and 804 (0.81%) experienced PPH. The subgroup analysis revealed that the incidence of PPH was 0.75, 2.65, 1.40, and 0.31% in singletons, twin pregnancies, cesarean sections, and vaginal deliveries, respectively. Placenta previa and placenta accreta were the predominant risk factors of PPH in the overall population and all subgroups. A twin pregnancy was a risk factor for PPH regardless of the mode of delivery. Obesity, and multiparity were risk factors for PPH in both singletons and cesarean section cases, but the latter predicted a reduced probability of PPH in vaginal deliveries. Macrosomia was associated with increased risk of PPH in singletons or vaginal deliveries. In women who delivered vaginally, preeclampsia was associated with a higher risk of PPH. The areas under the curve for the overall cohort, singletons, twin pregnancies, cesarean section cases, and vaginal deliveries were 0.832 (95% confidence interval [CI] 0.813–0.851), 0.824 (95% CI 0.803–0.845), 0.686 (95% CI 0.617–0.755), 0.854 (95% CI 0.834–0.874), and 0.690 (95% CI 0.646–0.735), respectively.Conclusions: The risk factors of PPH varied slightly based on the number of fetuses and the mode of delivery, while placenta previa and placenta accreta were the two major risk factors. A combination of the identified risk factors yielded a satisfactory predictive performance in determining PPH in the overall cohort, singletons pregnancies, and women who delivered by cesarean section, whereas the performance was moderate in twin pregnancies and in women delivering vaginally.

scholarly journals Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen-ning Liu ◽  
Fu-bing Yu ◽  
Yun-zhe Xu ◽  
Jin-sheng Li ◽  
Zhi-hong Guan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Maternal Age ◽  
Placenta Previa ◽  
Previous Cesarean Section ◽  
Estimated Blood Loss ◽  
History Of ◽  
Prolonged Labor ◽  
Previous Cesarean

Abstract Background Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China. Methods In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH. Results SPPH was observed in 532 mothers (1.56%) among the total population of 34,178 mothers. Placenta-related problems (55.83%) were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%. The risk factors for SPPH were maternal age < 18 years (adjusted OR [aOR] = 11.52, 95% CI: 1.51–87.62), previous cesarean section (aOR = 2.57, 95% CI: 1.90–3.47), history of postpartum hemorrhage (aOR = 4.94, 95% CI: 2.63–9.29), conception through in vitro fertilization (aOR = 1.78, 95% CI: 1.31–2.43), pre-delivery anemia (aOR = 2.37, 95% CI: 1.88–3.00), stillbirth (aOR = 2.61, 95% CI: 1.02–6.69), prolonged labor (aOR = 5.24, 95% CI: 3.10–8.86), placenta previa (aOR = 9.75, 95% CI: 7.45–12.75), placenta abruption (aOR = 3.85, 95% CI: 1.91–7.76), placenta accrete spectrum (aOR = 8.00, 95% CI: 6.20–10.33), and macrosomia (aOR = 2.30, 95% CI: 1.38–3.83). Conclusion Maternal age < 18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia were risk factors for SPPH. Extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

scholarly journals Management of massive hemorrhage in pregnant women with placenta previa

2020 ◽  
Vol 15 (4) ◽  
pp. 409-416
Author(s):  
Hee-Sun Park ◽  
Hyun-Seok Cho
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Cesarean Section ◽  
Maternal Age ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Anesthetic Management ◽  
Advanced Maternal Age ◽  
Massive Hemorrhage ◽  
Increased Risk

Patients with placenta previa are at risk for intra- and postpartum massive blood loss as well as increased risk of placenta accreta, a type of abnormal placental implantation. This condition can lead to serious obstetric complications, including maternal mortality and morbidity. The risk factors for previa include prior cesarean section, multiparity, advanced maternal age, prior placenta previa history, prior uterine surgery, and smoking. The prevalence of previa parturients has increased due to the rising rates of cesarean section and advanced maternal age. For these reasons, we need to identify the risk factors for previa and identify adequate management strategies to respond to blood loss during surgery. This review evaluated the diagnosis of placenta previa and placenta accreta and assessed the risk factors for previa-associated bleeding prior to cesarean section. We then presented intraoperative anesthetic management and other interventions to control bleeding in patients with previa expected to experience massive hemorrhage and require transfusion.

scholarly journals DISTRIBUSI FREKUENSI FAKTOR PENYEBAB KEJADIAN ASFIKSIA PADA BAYI BARU LAHIR DI RS. FADHILLAH KOTA PRABUMULIH TAHUN 2017

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Maria Septiana Maria Septiana
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Maternal Age ◽  
Placenta Previa ◽  
Secondary Data ◽  
Maternal Factors ◽  
Premature Babies ◽  
Severe Infections ◽  
Abnormal Bleeding

Komplikasi yang menjadi penyebab kematian bayi baru lahir yang terbanyak yaitu asfiksia. penyebab terjadinya asfiksia ada 3 yaitu, faktor ibu (preeklamsi dan eklamsia, perdarahan abnormal yang disebabkan karena plasenta previa atau solusio plasenta, partus lama, demam selama persalinan, infeksi berat, kehamilan post matur, usia ibu kurang dari 20 tahun atau lebih dari 35 tahun), faktor bayi (bayi prematur, persalinan sulit, kelainan konginetal, air ketuban bercampur mekonium), faktor tali pusat (lilitan tali pusat, tali pusat pendek, simpul tali pusat dan prolapsus tali pusat) Metode penelitian : Pengambilan data dalam penelitian ini menggunakan data sekunder dengan pendekatan retrospektif. Hasil Penelitian : Faktor penyebab kejadian asfiksia pada bayi baru lahir berdasarkan faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun sebanyak 16 (51,6%), , paritas10 (32,3%), umur kehamilan 18 (58,1%) dan berdasarkan faktor dari bayi yaitu mayoritas terjadi pada berat lahir bayi >2500 gram sebanyak 12 (38,7%), dan jenis persalinan yang mengalami asfiksia pada persalinan normal sebanyak 10 (32,3%). Kesimpulan : Faktor penyebab kejadian asfiksia pada bayi baru lahir di RS Fadhilah Kota Prabumulih yaitu dari faktor ibu yaitu mayoritas terjadi pada usia ibu 20-35 tahun, paritas multipara, umur kehamilan 37-42 minggu dan dari faktor bayi yaitu bayi dengan berat lahir >2500 gram dan jenis persalinan normal.     ABSTRACT Asphyxia is one of the complications that become the largest cause of death. Therevare three cause of asphyxia, namely, maternal factors (preeclampsia and eclampsia, abnormal bleeding caused by placenta previa or placental abruption, prolonged labor, fever during labor, severe infections, pregnancy post mature, maternal age less than 20 years old or over 35 years ), factor infants (premature babies, difficult delivery, konginetal disorders, meconium-stained amniotic fluid mixes), factor umbilical cord (umbilical cord loops, short umbilical cord, knot the cord and umbilical cord prolapse). Athere are 31 cose of asphyxia in Fadhilah Hospital. Objective : Knowing the factors that cause asphyxia in newborns at RS Fadhilah Prabumulih City. Methods : Collecting data in this study using secondary data with retrospective approach Result: Factors that cause asphyxia in newborns by maternal factors that occur in the majority of maternal age 20-35 years as many as 16 (51.6%), parity 10 (32.3%), gestational age 18 (58.1%) and by factors of which the majority occur in infants birth weight> 2500 g were 12 (38.7%), and the type of delivery that asphyxiated the normal labor as much as 10 (32.3%). Conclusion : Factors that cause asphyxia in newborns at PKU Muhammadiyah Hospital in Bantul 2016 ie from the maternal factors that occur in the majority of maternal age 20-35 years, multiparas parity, gestational age of 37-42 weeks and infant factors that infants with birth weight> 2500 gram and type of normal deliveries.

Vaginal Delivery and Low Gestational Age are Key Risk Factors for Hypernatremia in Neonates < 32 Weeks

2021 ◽  
Author(s):  
Nadia S. Eugster ◽  
Florence Corminboeuf ◽  
Gilbert Koch ◽  
Julia E. Vogt ◽  
Thomas Sutter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Preterm Neonates ◽  
Multiple Birth ◽  
Plasma Sodium ◽  
Delivery Mode ◽  
Antenatal Corticosteroids ◽  
Clinical Complications

Abstract Background Preterm neonates frequently experience hypernatremia (plasma sodium concentrations >145 mmol/l), which is associated with clinical complications, such as intraventricular hemorrhage. Study design In this single center retrospective observational study, the following 7 risk factors for hypernatremia were analyzed in very low gestational age (VLGA, below 32 weeks) neonates: gestational age (GA), delivery mode (DM; vaginal or caesarian section), sex, birth weight, small for GA, multiple birth, and antenatal corticosteroids. Machine learning (ML) approaches were applied to obtain probabilities for hypernatremia. Results 824 VLGA neonates were included (median GA 29.4 weeks, median birth weight 1170 g, caesarean section 83%). 38% of neonates experienced hypernatremia. Maximal sodium concentration of 144 mmol/l (interquartile range 142–147) was observed 52 hours (41–65) after birth. ML identified vaginal delivery and GA as key risk factors for hypernatremia. The risk of hypernatremia increased with lower GA from 22% for GA ≥ 31–32 weeks to 46% for GA < 31 weeks and 60% for GA < 27 weeks. A linear relationship between maximal sodium concentrations and GA was found, showing decreases of 0.29 mmol/l per increasing week GA in neonates with vaginal delivery and 0.49 mmol/l/week after cesarean section. Sex, multiple birth and antenatal corticosteroids were not associated hypernatremia. Conclusion VLGA neonates with vaginal delivery and low GA have the highest risk for hypernatremia. Early identification of neonates at risk and early intervention may prevent extreme sodium excursions and associated clinical complications.

scholarly journals Study of maternal and perinatal outcome among twin pregnancies with one twin demise

2019 ◽  
Vol 8 (7) ◽  
pp. 2622
Author(s):  
Sunanda N. ◽  
Akhila M. V.
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Delivery Mode ◽  
Care Hospital ◽  
Monochorionic Twins ◽  
Medical College ◽  
Twin Pregnancies

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.

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