scholarly journals Predictors of foeto-maternal outcome of patients with abruptio placenta at Bugando Medical Centre, Tanzania

2015 ◽  
Vol 18 (1) ◽  
Author(s):  
Dismas Matovelo ◽  
Kelvin Nandonde ◽  
Anthony Massinde ◽  
Richard Rumanyika

Background: Abruptio placenta (AP) is one of the life-threatening obstetric complications for both the foetus and mother. We conducted this study to determine the incidence and predictors of adverse outcomes of abruptio placenta at Bugando Medical Centre (BMC) in northwest Tanzania.Methods: This descriptive cross-sectional study was conducted from October 2012 to April 2013. Women with clinical features of abruptio placenta attending BMC were recruited. Data were collected using a structured checklist and analysed with STATA 11.Results: A total of 3,800 deliveries occurred during study period. The incidence of AP was 2.5% (95/3800). Among patients with AP, 49 (51.6%) delivered by Caesarean section. Three (3.2%) maternal deaths occurred. These deaths were strongly associated with the presence of maternal anaemia (p<0.05), and postpartum haemorrhage (p<0.05). The foetal adverse outcomes were prematurity 78 (82.1%), foetal distress 65 (68.4%), low birth weight 46 (48.4%) and intrauterine foetal deaths 30 (31.6%). Perinatal deaths occurred in 52 (54.7 %) of the cases, and were predicted by low birth weight (p<0.001), vaginal delivery (p=0.001), birth asphyxia (p<0.001), and retroplacental clot (>700ml) (p<0.001).Conclusion: The incidence of AP at BMC is high and characterised by poor maternal and foetal outcomes. Patients with AP should be delivered promptly to improve their survival.

2018 ◽  
Vol 5 (1) ◽  
pp. 40-46
Author(s):  
Sarada Duwal Shrestha ◽  
Padma Gurung ◽  
Reena Shrestha ◽  
Prashant Shrestha ◽  
Renee Pradhan ◽  
...  

Introductions: Stillbirth (SB) is one of the most common adverse outcomes of pregnancy. The aim of this study was to determine the SB rate and to identify the likely causes contributing to SB. Methods: This cross-sectional study was conducted at Patan Hospital from 15th June 2014 to 14th June 2017 for all the cases of SBs, at or after 22 weeks, birth weight of 500 gm or more. The perinatal outcome, demographic profile, fetal characteristics, causes and contributing factors were analyzed. Results: There were 262 SB out of total 23069 deliveries, (11.24 per 1000) and 119 (46.12%) had antenatal check-up (ANC) at Patan Hospital. The 214 (82.95%) SB were among 20-34 years mothers, 133 (51.55%) being multigravida. Antepartum SB were 234 (89.31%), macerated 213 (81.30%), birth weight <1000gm 86 (32.82%) and male 156 (59.54%). The intrauterine growth restriction (IUGR) was present in 60 (22.90%), unexplained casue in 43 (16.41%), prematurity 28 (10.69%), congenital anomalies 26 (9.92%), pre-eclampsia 19 (7.25%), gestational diabetes, and abruptio placenta each 13 (4.96%). Delay in seeking care in 202 (78.30%) was a potential contributing factor. Conclusions: The SB was 11.24/1000 births. The causes in descending order were IUGR, unexplained, prematurity, congenital anomalies, pre-eclampsia, gestational diabetes and abruptio placenta. Delay in seeking care was found as a potential contributing factor.


2015 ◽  
Vol 18 (1) ◽  
Author(s):  
Phillipo L Chalya ◽  
Fidelis Mbunda ◽  
Joseph B Mabula ◽  
Anthony N Massinde ◽  
Albert Kihunrwa ◽  
...  

 Background: Preoperative over-ordering of blood for surgical intervention, in excess of the actual and anticipated needs is a common practice in many developing countries. This can be decreased by simple means of changing the blood cross matching and ordering schedule depending upon the type of surgery performed. The aim of this study was to assess the blood transfusion practice in surgery at Bugando Medical Centre in northwestern Tanzania.Methods and Patients: This was a prospective cross sectional study among patients undergoing major operations at Bugando Medical Centre. We evaluated blood ordering and transfusion practices in emergency and elective surgical procedures at our centre and calculated different indices such as cross-match to transfusion ratio (C/T ratio), transfusion probability (% T) and transfusion index (TI). Next Maximal Surgical Blood Ordering System (MSBOS) was estimated for each procedure.Results: The overall blood utilization was only 28.2% at our centre, consisting of 17.1% in the elective operations and 26.9% in the emergency operations. Significant blood utilization was nil in most of the routine elective cases suggesting cross-matching of blood to be a culture than necessity. Generally, the overall blood transfusion of the requested blood as indicated by indices of C/T ratio, %T, TI and MSBOS were 3.5, 28.7%, 0.33 and 0.45, respectively. The overall CT ratio, %T, Ti and MSBOS in the elective operations were 5.8, 15.9%, 0.2 and 0.3, respectively. In the emergency operations, the overall CT ratio, %T, Ti and MSBOS were 3.7, 22%, 0.32 and 0.48, respectively.Conclusion: This study demonstrated that over-ordering of blood in excess of the actual needs is a common practice in our setting.  Blood ordering pattern needs to be revised and over-ordering of blood should be minimized. This can be possible by the estimation of MSBOS for each procedure and requisition as calculated.


Author(s):  
K. Famra ◽  
P. Barta ◽  
A. Aggarwal ◽  
B.D. Banerjee

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.


2021 ◽  
Vol 8 ◽  
pp. 2333794X2110196
Author(s):  
Sitotaw Molla Mekonnen ◽  
Daniel Mengistu Bekele ◽  
Fikrtemariam Abebe Fenta ◽  
Addisu Dabi Wake

Necrotizing enterocolitis (NEC) remains to be the most critical and frequent gastrointestinal disorder understood in neonatal intensive care units (NICU). The presented study was intended to assess the prevalence of NEC and associated factors among enteral Fed preterm and low birth weight neonates. Institution based retrospective cross-sectional study was conducted on 350 enteral Fed preterm and low birth weight neonates who were admitted at selected public hospitals of Addis Ababa from March 25/2020 to May 10/2020. The data were collected through neonates’ medical record chart review. A total of 350 participants were enrolled in to the study with the response rate of 99.43%. One hundred eighty-four (52.6%) of them were male. The majority 123 (35.1%) of them were (32 + 1 to 34) weeks gestational age. The prevalence of NEC was (25.4%) (n = 89, [95% CI; 21.1, 30.0]). Being ≤28 weeks gestational age (AOR = 3.94, 95% CI [2.67, 9.97]), being (28 + 1 to 32 weeks) gestational age (AOR = 3.65, 95% CI [2.21, 8.31]), birth weight of 1000 to 1499 g (AOR = 2.29, 95% CI [1.22, 4.33]), APGAR score ≤3 (AOR = 2.34, 95% CI [1.32, 4.16]), prolonged labor (AOR = 2.21, 95% CI [1.35, 6.38]), maternal chronic disease particularly hypertension (AOR = 3.2, 95% CI [1.70, 5.90]), chorioamnionitis (AOR = 4.8, 95% CI [3.9, 13]), failure to breath/resuscitated (AOR = 2.1, 95% CI [1.7, 4.4]), CPAP ventilation (AOR = 3.7, 95% CI [1.50, 12.70]), mixed milk (AOR = 3.58, 95% CI [2.16, 9.32]) were factors significantly associated with NEC. Finally, the prevalence of NEC in the study area was high. So that, initiating the programs that could minimize this problem is required to avoid the substantial morbidity and mortality associated with NEC.


BMJ Open ◽  
2012 ◽  
Vol 2 (1) ◽  
pp. e000327 ◽  
Author(s):  
Ryosuke Sato ◽  
Hiroshi Watanabe ◽  
Kenji Shirai ◽  
Shigeru Ohki ◽  
Rieko Genma ◽  
...  

2017 ◽  
Vol 15 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Kamal Prasad Kandel ◽  
Sindhu Kafle

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as Low Birth Weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million low birth-weight (LBW) babies are born every year throughout the world. Though, the health situation of Nepal has improved substantially over the years, the low birth-weight (LBW) rate is still high. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a live born infant among the institutionally delivered newborns. Methods: A hospital based cross sectional study was conducted in Obstetrics and Gynaecology ward of Bharatpur hospital, Bharatpur, from 17th September to 4th October , 2012. Altogether 480 respondents were taken and respondents were mothers who had delivered newborns in Bharatpur hospital.Results: A total of 480 births occurred during the study period, of which 480 met the study criteria. Among which 9.4% were low birth weight and 90.6% were normal birth weight .Overall mean birth weight was found to be 2.96 kg. Out of total 9.4% newborns were weighing less than 2.50 kg and mean birth weight 2.96kg. Conclusions: This study suggests that there were several factors interplaying which lead to LBW babies; which are age of mother at delivery,weight gain by mother during pregnancy, short, low body mass index and hyperemesis gravidarum was the strongest predictor in this study.


2020 ◽  
Vol 11 (2) ◽  
pp. 37-42
Author(s):  
Firdausi Ramadhani ◽  
Yanti Hz. Hano

Penelitian ini bertujuan untuk mengetahui beberapa faktor yang berhubungan dengan kejadian bayi Bayi Berat Badan Lahir Rendah (BBLR) di Wilayah Kerja Puskesmas Limboto Kabupaten Gorontalo. Metode yang digunakan adalah  Observasional Analitik dengan pendekatan cross sectional study. Populasi adalah seluruh ibu yang melahirkan berjumlah 853 responden, dengan Sampel yaitu sebanyak 202 responden. Teknik pengambilan sampel menggunakan tekhnik Purposive Sampling. Analisis data menggunakan uji Chi Square. Hasil penelitian menunjukkan proporsi bayi Berat Badan Lahir Rendah (BBLR) 34 responden (16,8%) dan bayi Berat Badan Lahir Normal (BBLN) 168 responden (83,2%). Hasil bivariat didapatkan bahwa ada hubungan pengetahuan (p-value 0,044), pendapatan keluarga (p-value 0,029) dengan kejadian bayi Berat Badan Lahir Rendah (BBLR). Sedangkan, jumlah paritas (p value 0,523),  jarak kehamilan (p-value 0,659), dan Kekurangan Energi Kronik (KEK) (p-value 0,637) tidak memiliki hubungan yang bermakna secara statisti dengan kejadian bayi Berat Badan Lahir Rendah (BBLR).    This study aims to determine several factors associated with the incidence of low birth weight babies (LBW) in the Limboto Health Center, Gorontalo District. The method used is analytic observational with a cross sectional study approach. The population was all mothers who gave birth totaling 853 respondents, with a sample of 202 respondents. The sampling technique used purposive sampling technique. The results showed that the proportion of Low Birth Weight (LBW) babies was 34 respondents (16.8%) and Normal Birth Weight (BBLN) babies were 168 respondents (83.2%). The bivariate results showed that there was a relationship between knowledge (p value 0.044), family income (p value 0.029) with the incidence of low birth weight babies (LBW). Meanwhile, the parity (p value 0.523), pregnancy distance (p-value 0.659), and Chronic Energy Deficiency (P-value 0.637) did not have a statistically significant relationship with the incidence of Low Birth Weight (LBW).


2017 ◽  
Vol 24 (08) ◽  
pp. 1176-1180
Author(s):  
Brig® Khalid Mehmood ◽  
Ijaz Ali ◽  
Syed Hyder Raza

Objectives: To determine the proportion of LBW Babies among those deliveredat DHQ Hospital Mirpur. Study design: Descriptive cross sectional study. Setting: DHQ hospitalMirpur AJK. Duration of study: January 2013-May 2013. Sample size: 459 deliveries. Studypopulation: women reporting in Peads OPD of DHQ hospital Mirpur AJ&K with their babiesduring study period. Sampling technique: Convenience method. Data collection tool: Datacollection Performa. Data analysis: SPSS version 14.0.Results: Out of 459 deliveriesconducted at Divisional Head Quarter hospital Mirpur, 149 cases of low birth weight babies(<2500gms) whereas the rest 310 had normal birth weight. Frequency of Low Birth Weight inmale new born babies was high, i.e ratio of male babies were 55% (82) out of 149 individualswhile females were 45% (67). Less than 37 weeks of gestational age, 37% (55) were pretermbabies and 37 – 42 weeks of gestational age, 63% (94) were full term babies.


Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.


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