scholarly journals Neonatal and Maternal Outcomes in Spontaneously-Conceived Twin Pregnancies According to Mode of Delivery

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 468-476
Author(s):  
Samantha Mc Kenzie Stancu ◽  
Manuela Cristina Russu
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Statistical Correlation ◽  
P Value ◽  
Maternal Outcomes ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Twin Pregnancies

Introduction: Appropriate intrapartum conduct in a twin delivery remains a challenging aspect of obstetric practice. The objective of this study was to compare neonatal and maternal outcomes in twin pregnancies according to mode of delivery.&nbsp; Materials and methods: This is a single centre retrospective cohort study of all consecutive spontaneously-conceived twin deliver-ies (&ge; 24 weeks, estimated fetal weight &ge; 500 grams) over a nine-year period between 01/01/2007 - 31/12/2016 at a tertiary-level centre. Neonatal outcomes included survival, APGAR score, prematurity-associated pathology (PAP), admission to the neonatal intensive care unit (NICU) and length of stay (LOS). Maternal outcomes included postpartum complications and LOS. Statistical analysis comprised Chi-square test with subsequent p-value and odds-ratio with 95% confidence interval. Statistical significance was set at p<0.05. Results: A total of 173 consecutive women with spontaneously-conceived twin deliveries were enrolled in this study, 129 (74.6%) women delivered by caesarean section (CS). The success rate of vaginal delivery (VD) was 93.6% (44/47). A strong statistical correlation was identified between CS and NICU admission; 53.2% vs. 1.5% (p=0.0001). Neonatal LOS in the NICU was significantly longer in the CS group. Prematurity-associated pathology (PAP) was noted in 75 pairs of twins (75/173); 61 pairs were delivered by CS, bearing strong statistical significance (p<0.0001). Postpartum complications occurred in 14.7% of CS compared to 13.6% of VDs.&nbsp; Conclusion: Neonates delivered by CS had a higher rate of PAP, NICU admission, lower birth weight and longer LOS. This study showed that VD is safe, especially when the first twin is in cephalic presentation

scholarly journals Foetomaternal outcome in multifoetal pregnancy in a tertiary rural teaching hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 614
Author(s):  
Sneha Gond ◽  
Partha Pratim Sharma ◽  
Narra Madhuri ◽  
Kasturi Barman
Keyword(s):  
Prospective Observational Study ◽  
Statistical Significance ◽  
P Value ◽  
Statistical Association ◽  
Maternal Complications ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Nicu Admission ◽  
Rural Teaching

Background: Aim of the study was to find out foeto-maternal outcome of multifoetal pregnancy in relation to chorionicity and to analyse the associated risk factors.Methods: This study was a prospective observational study on multifoetal pregnancy conducted at Midnapore medical college and hospital. Statistical analysis was done by chi-square test and statistical significance was set at p-value<0.05.Results: Incidence of multifoetal pregnancy was 1.7%. Modal age group was 20-24 years age and 82% conceived spontaneously. Among chorionicity, Dichorionic diamniotic (DCDA) were 60% followed by 34% Monochorionic diamniotic (MCDA), 4% Monochorionic monoamniotic (MCMA) and 2% Trichorionic triamniotic (TCTA). Among maternal complications preterm labour were present in both twins and triplets followed by anemia. LSCS was required in 60.8 % of twins and common indication was malpresentation. Majority of MC and TC were delivered at gestational age of 31-33 weeks (47.1% MCDA, 50% MCMA and 60% TCTA) and dichorionic delivered at 34-36 week (48.7%). Statistical association between neonatal outcomes and chorionicity were significant in IUGR (p=<0.0001), stillbirth (p=0.0356), congenital anomalies (p=0.0017), discordant growth (p<0.0001), Apgar score <7 (p<0.0001), low birth weight (p=0.014), live birth (p≤0.0001) and NICU admission (p<0.0001).Conclusions: Maternal and perinatal outcome was significant in monochorionic and trichorionic pregnancies compared to dichorionic pregnancies with increased NICU admissions required in monochorionic and trichorionic gestations.

scholarly journals Gloves Perforations in Minor Oral Surgical Procedures: A Comparison of Latex and Nitrile Gloves

2021 ◽  
Vol 30 (02) ◽  
pp. 103-106
Author(s):  
Ajeet Kumar ◽  
◽  
Naveed Iqbal ◽  
Javaria Farooq ◽  
Saad Uddin Siddiqui
Keyword(s):  
Local Anesthesia ◽  
Surgical Procedures ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
P Value ◽  
Dominant Hand ◽  
Chi Square ◽  
Oral Surgical Procedures ◽  
Latex Gloves ◽  
Chi Square Test

OBJECTIVE: This study was performed to compare incidence of perforations in Latex and Nitrile examination gloves during Minor Oral surgical procedures performed under local anesthesia. METHODOLOGY: 100 pairs of latex and 100 pairs of Nitrile examination gloves where used to perform 200 minor oral surgical procedures under local anesthesia. After completion of every minor oral surgical procedure each gloves was examined by Water Inflation method to observe presence or absence of Perforations. A data sheet was used to collect data including type of Gloves used (Latex or Nitrile) presence of perforations, sites of perforations and nature of minor oral surgical procedures. Data was entered and analyzed using SPSS version 20. Descriptive analysis was conducted to calculate frequency and percentages of Number and sites of perforations for both Nitrile and latex examination gloves. Chi Square test was used to find out statistical significance of difference of perforations rate between Nitrile and Latex gloves. P value of < 0.05 was considered significant. RESULTS: Out of 200 latex gloves 23 (11.5) had 29 perforations whereas out of total 200 Nitrile gloves 28 (14%) had 22 perforations. Nitrile gloves had a statistically significant higher rate of perforations as compared to Latex gloves. (P value 0.043). For both Nitrile and Latex gloves left non dominant hand had highest frequency of perforations Latex 18 (81.81%) perforations and Nitrile 18(62.06%). Index finger and thumb were most frequent sites of perforations in both Latex and Nitrile gloves. CONCLUSION: Gloves perforations were more common in Nitrile examination gloves however total number of perforations was more in Latex examination gloves.

scholarly journals ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Uterine Scar ◽  
Age Range ◽  
The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

scholarly journals Incidences of Root Microcracks Caused by Hand and Rotary File System at Different Lengths

2019 ◽  
Vol 3 (9) ◽  
pp. 283-289
Author(s):  
Shuchi Sukul ◽  
Goldy Rathee ◽  
Parimal Anand ◽  
Sakshi Kataria ◽  
Pratibha Taneja
Keyword(s):  
File System ◽  
Statistical Significance ◽  
File Systems ◽  
In Vitro Study ◽  
Root Surface ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Group B

OBJECTIVES: The present research was conducted to assess incidences of root microcracks caused by hand and rotary file system at different lengths MATERIAL AND METHODS: This in-vitro study was undertaken to assess incidence of root microcracks caused by hand and rotary file system at different lengths In total, 100 the mandibular premolar with straight roots determined with intact, fully formed apices were taken. Samples were randomly distributed into 5 groups based on the file system used: a) Group A: Control, b) Group B: Reciproc, c) Group C: WaveOne, d) Group D: One Shape and e) Group E: ProTaper. Pearson Chi-square test was used to determine the differences between groups. The dentinal defects were expressed as percentage of samples with microcracks in each group. Level of statistical significance was set at p-value less than 0.05. RESULTS: The chi square test was used to compare the Distribution of the number of teeth in which cracks were observed on the horizontal sections. It was found to be significant with group ProTaper showing maximum cracks at 3,6,9 mm level as compared to other file systemCONCLUSION: Nickel-titanium instruments causes cracks on the apical root surface or in the root canal wall. ProTaper causes maximum dentinal cracks as compared to other file systems

scholarly journals Effect of maternal underweight on fetal outcome

Biomedicine ◽  
2020 ◽  
Vol 39 (3) ◽  
pp. 480-483
Author(s):  
Monteiro Geraldin ◽  
N Anupama ◽  
Rekha D. Kini ◽  
Nayanatara A. K. ◽  
Sneha Shetty ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Weight Gain ◽  
Body Mass ◽  
Neonatal Intensive Care ◽  
Fetal Outcome ◽  
Chi Square ◽  
Chi Square Test ◽  
Nicu Admission

Introduction and Aim: Nutritional state of the mother before and during pregnancy is one of the important determinants along with factors like pre-pregnancy BMI, weight gain during pregnancy and gestational age which determines pregnancy outcome. Adequate gestational weight gain contributes for better pregnancy outcomes in both mother and infants for short- and long-term health. Materials and Methods: This is an observational study conducted retrospectively over a year comprised 300 pregnant subjects in their second trimester. Incidence of anemia, preterm labour, intrauterine growth retardation (IUGR) and neonatal intensive care unit (NICU) admission were compared in women with various Body Mass index (BMI). Analysis of the data was done using SPSS version 13 using chi square test and p ? 0.05 was considered statistically significant. Results: Out of 300 subjects, 79 developed anemia, among these 64(81%) were in the underweight category. 49 cases had a preterm delivery, out of these 49 cases, about 37(75.5%) belonged to the underweight BMI category. 39 cases delivered an intra-uterine growth retarded baby. Out of these 39 cases, about 25 (64.1%) belonged to the underweight BMI category. 56 neonates required intensive care unit (NICU) admission, of which 41 (73.2%) neonates born for underweight BMI mothers. Conclusion: The high proportions of underweight pregnancies in this study reflects the poor nutritional status. Adverse effects of maternal low body mass index target the fetus. Adequate weight gain of pregnant woman is an extremely important factor for the fetal outcome.  

scholarly journals Small dose of ephedrine for prevention of hypotension following propofol and fentanyl administration during induction of general anesthesia

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Gamal Ejaimi ◽  
Abla Saab ◽  
Sittelnissa Ahmed ◽  
Areeg Ahmed ◽  
Hussain Abujamilah ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Statistical Significance ◽  
Control Group ◽  
P Value ◽  
Chi Square ◽  
Arterial Blood ◽  
Chi Square Test ◽  
Study Participants

Induction of general anesthesia with propofol and fentanyl could result in hypotension and bradycardia. Various methods are being used to prevent these adverse effects. The aim of our study was to assess the efficacy and safety of a small dose of ephedrine in prevention of hypotension following administration of propofol and fentanyl. This prospective, randomized, comparative study was conducted among a total of 50 patients, both genders, age 18 years up to 60 years with ASA grade Ι and ΙΙ and some of class ΙΙΙ, presented for elective surgery under general anesthesia. Patients were randomly allocated into one of two groups (25 patients in each): CG (the control group), which received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL normal saline: and EphG (Ephedrine group), while received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL of ephedrine (10 mg). The Mean Arterial Blood Pressure (MAP) and Heart Rate (HR) were recorded before induction and then every 1 min up to 6 min after induction. The categorical data are presented as a number and percentage and were subjected to Fisher’s exact or Chi-square test for analysis. The statistical significance was p≤0.05. The significant differences in HR were observed in the 3rd,4th, and 5th minutes with P-value, 0.018, 0.000, 0.000, respectively. However, no patient in the study participants had bradycardia. The significant differences in MAP were observed in the 2nd, 3rd,4th, and 5th minutes with P-value, 0.035, 0.000, 0.000, and 0.000, respectively. The percentage of patient in CG who developed hypotension in the 3rd and 4th is 44% and 32% compared to 8% and 0% in EphG, with significant differences (P-value 0.004 and 0.002, respectively). Administration of small dose of ephedrine with propofol could attenuate propofol/fentanyl hypotensive and bradycardic effects.

Vanishing congenital lung malformations: What is the incidence of true regression?

2021 ◽  
pp. 1-7
Author(s):  
C. Griggs ◽  
M. Schmaedick ◽  
C. Gerall ◽  
W. Fan ◽  
C. Orlas ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Retrospective Chart Review ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Congenital Lung Malformation ◽  
Nicu Admission

BACKGROUND: A congenital lung malformation (CLM) that is diagnosed on prenatal ultrasound exam may subsequently become undetectable on later scans, a “vanishing” CLM. OBJECTIVE: The purpose of our study is to characterize the prenatal natural history and postnatal outcomes of “vanishing” lesions treated at our institution. METHODS: We performed a retrospective chart review of 107 patients diagnosed prenatally with CLM at our institution. Comparisons were made using Kruskal-Wallis or t-test for continuous variables and Fisher’s exact test or Chi-Square test for categorical variables. Multivariable analysis using logistic regression was performed. RESULTS: Of the 104 patients, 59 (56.7%) had lesions that became sonographically undetectable on serial ultrasound scans. Patients with lesions that vanished prenatally tended to need less Neonatal Intensive Care Unit (NICU) admission at birth (persistent CLM: 54.8%vs vanished CLM: 28.8%), decreased need for supplemental O2 at birth (persistent CLM: 31.0%vs vanished CLM: 11.9%), and decreased delay in feeds (persistent CLM: 26.2%vs vanished CLM: 8.5%) compared to those with persistent CLM. After multivariate analysis controlling for maternal steroid administration and sex, admission to NICU maintained a slight statistical significance, with patients in the vanishing CLM group 2.5 times less likely to be admitted to the NICU. None of our patients whose lesions vanished prenatally required mechanical ventilation. Eighty-six patients underwent postnatal computed tomography (CT) chest. Only 2 patients had lesions that regressed on postnatal CT. CONCLUSION: Lesions that vanish on prenatal imaging may be associated with improved clinical outcomes. The rate of true regression at our institution was as low as 2.3%.

scholarly journals Fetomaternal Outcome in Twin Pregnancies: A Retrospective Analysis from a Tertiary Care Centre

2020 ◽  
Author(s):  
Kamlesh Kumari ◽  
Minakshi Misra ◽  
Ambika Jhanwar ◽  
Asha Kumari
Keyword(s):  
Twin Pregnancy ◽  
Preterm Labour ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Maternal Risk ◽  
Antenatal Period ◽  
The Mean ◽  
Twin Pregnancies

Introduction: Twin pregnancies are among the major challenges faced by obstetricians globally. Increased maternal and foetal morbidity is observed with an increase in the incidence of twin pregnancies. Due to elevated rates of complications, a larger number of caesarean sections are performed in twin pregnancies in comparison to singleton gestation. Aim: The study aimed to find out the incidence of twin pregnancy with associated maternal risk factors and foetal outcome in the study population. Materials and Methods: This retrospective observational study was carried out at JNU Hospital and Medical College, Jaipur for a period of 4 years from December 2015 to December 2019. A total of 70 mothers, who presented with twin pregnancy, were included in this study. Data were collected from hospital records regarding maternal age, parity, whether spontaneous or assisted conception, gestational age, pregestational Body Mass Index (BMI) and family history. Details of maternal and foetal complications that occurred during the antenatal period and labour as well as the mode of delivery were collected and analysed. Statistical significance was considered if the p-value was ≤0.05. Qualitative data were represented as rate and proportions, while quantitative data were represented as mean and standard deviation. Results: A total of 70 mothers with twin births, resulting in 140 babies during the 4 years study period were included. A total of 4240 deliveries overall during the study period, gave a twin pregnancy incidence rate of 16.5 in 1000 deliveries. Preterm labour (25.4%), anaemia (26.8%) and hypertension (22.5%) were common problems. The most common indication for caesarean delivery was foetal malpresentation (37.8%) The mean weight of the first twin was 2.12±0.35 kg while the mean weight of the second twin was 1.97±0.30 kg. Among foetal complications, Intrauterine Growth Restriction (IUGR) was seen in 11.4% and birth weight discordance in 21.4% of children. A low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was noted in 21.4% of babies, while 12.9% of babies died in the early neonatal period. Conclusion: Maternal complications during twin pregnancy were mainly preterm labour, diabetes, hypertension and anaemia. Caesarean section was the main mode of delivery in this study with significant association with hypertension and preterm labour. Foetal complications were in the majority related to IUGR. More vigilance during the antenatal period and labour is needed for proper selection of mode of delivery. Active foetal surveillance and intervention with appropriate neonatal care can improve fetomaternal outcome.

scholarly journals The Level of Awareness and Utilization of Computer Shields among Computer users in a Nigerian Community

2011 ◽  
Vol 1 (2) ◽  
pp. 49-52
Author(s):  
Chidi Oliver Ihemedu ◽  
Charles Oluwole Omolase
Keyword(s):  
Statistical Significance ◽  
Simple Random Sampling ◽  
Computer Users ◽  
Hard Copy ◽  
P Value ◽  
Chi Square ◽  
Ocular Symptoms ◽  
Chi Square Test ◽  
History Of ◽  
On Line

Objective: This study was designed to determine the level of awareness and extent of use of computer shields among computer users in Owo, in South-West Nigeria. Material & Methods: The subjects were selected by a simple random sampling method. Data collection was through a combination of e-mail based on-line questionnaire using the survey monkey website, and the self administered semi structured hard copy questionnaire. The information obtained from the respondents with the questionnaire included their bio-data, extent of computer use, history of ocular symptoms, awareness and utilization of computer shields. The data obtained with the study instrument was collated and analyzed using the SPSS 15.0.1 statistical software, cross tabulation of attendants results were done with chi-square test and statistical significance was set at p ≤ 0.05. Results: 108 of 124 selected subjects filled their questionnaire to acceptable level. There were a large number of respondents who were aware of the various types of computer shields (70.5%) (p-value 0.002). However, the utilization level was not commensurate as only 39.8% (N= 43) utilized any of these shields, 49.1% (N= 53) were none users while 11.1% (N= 12) did not respond (p-value 0.062). Conclusion: Majority of the respondents were aware of computer shield. However, less than half of the respondents utilized computer shields. There is need to encourage all computer users on the use of computer shields to ensure better computer working time. Key Words: Awareness; Computer shields; Nigeria DOI: 10.3126/ajms.v1i2.2826Asian Journal of Medical Sciences 1 (2010) 49-52

scholarly journals Twin pregnancy-maternal and fetal complications its association with mode of delivery: a study in a tertiary center

2017 ◽  
Vol 6 (11) ◽  
pp. 5089
Author(s):  
Jupirika E. Pyrbot ◽  
Manika Agarwal
Keyword(s):  
Vaginal Delivery ◽  
Statistical Significance ◽  
Mode Of Delivery ◽  
Tertiary Hospital ◽  
North East India ◽  
North East ◽  
Tertiary Center ◽  
Foetal Outcome ◽  
Nicu Admission ◽  
Twin Pregnancies

Background: Twin pregnancies are associated with many complications. Hence the mode of delivery and its effect on the maternal and foetal outcome is important.Methods: A retrospective study of twin pregnancies carried out from April 2015 to March 2017 in a tertiary hospital in north east, India. The maternal, foetal outcome and the mode of delivery data collected and analysed.Results: A total of 50 twin pregnancies studied. The prevalence of twin was 20/1000 deliveries. Most common age group was 20-29 years with a mean age of 28±5.7 years. A total of 24 (48%) had vaginal delivery and 26 (52%) had LSCS, 2 (4%) had the first twin as vaginal delivery and second twin LSCS. A statistical significance was seen in the mode of delivery of twin pregnancies conceived after ovulation induction, (p<0.05). The most common indication for LSCS was foetal malpresentation (14.58%) followed by foetal distress (12.5%) and elective LSCS (10.42%) on patient’s request. The most common complication was anaemia (28.08%) and PIH (27.08%). In the neonate prematurity was the most common morbidity. There was no association between the mode of delivery and the foetal outcome in the form of Apgar at 5 minutes, NICU admission and perinatal mortality.Conclusions: There is a rise of caesarean delivery in twin pregnancies, maternal request becoming one of the causes. Regular antenatal check-ups of pregnant women with counselling regarding the mode of delivery should be carried out.

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