Maternal and neonatal outcome in pregnancy bbeyond 41 Weeks of Gestation: Observational study

2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Labour Induction ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Perineal Tear ◽  
Meconium Stained Amniotic Fluid

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.

scholarly journals Maternal and perinatal outcome of oligohydramnios in term pregnancy in rural tertiary care centre

2019 ◽  
Vol 8 (2) ◽  
pp. 389
Author(s):  
Swati Kagne ◽  
Sambhaji Chate
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Term Pregnancy ◽  
Tertiary Care Centre ◽  
Study Population ◽  
Nicu Admission

Background: Disorders of amniotic volume is one of the commonest obstetric problem. Amniotic fluid acts as cushion to the foetus allowing musculoskeletal development and also helps in the differentiation of lungs and gastrointestinal tract. Decreased amniotic fluid, known as oligohydramnios, is known to be associated with adverse perinatal outcome. The objective is to study the maternal and perinatal complications of oligohydramnios in term pregnancy.Methods: The present study was carried out in the Department of Obstetrics at rural tertiary care hospital in Maharashtra from February 2018 through October 2018. women with Oligohyamnios were studied for obstetrical and neonatal complications.Results: The incidence of oligohyamnios was 7.6% in present study. The mean age of the study population was 22.6±3.6 years. Induction of labour was required in 44 (61.11%) patients out of which 23 patients underwent emergency LSCS. Low birth weight (birth weight<2.5kg) was found in 14 (19.44%) babies with 11 babies having intrauterine growth restriction. 5-minute APGAR (appearance, pulse, grimace, activity, respiration) score was <7 in 13.88% babies. 16 babied needed NICU admission out of which 1 neonate died.Conclusions: Detection of oligohydramnios increases obstetrical interventions in term pregnancy.

scholarly journals Fetomaternal outcome following labour induction in oligohydramnios and borderline liquor: a retrospective study in a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 4615
Author(s):  
Jyothi Susan Thomas ◽  
Mary Daniel ◽  
Sangeetha Selvaraj
Keyword(s):  
Retrospective Study ◽  
Amniotic Fluid ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Labour Induction ◽  
P Value ◽  
Care Hospital ◽  
Parametric Data

Background: Amniotic fluid provides a protective milieu for the growing fetus in pregnancy and labour. A decrease in the amniotic fluid volume has been associated with increased maternal morbidity and fetal morbidity and mortality. The purpose was to compare the effect of labour induction on the fetomaternal outcome in women with oligohydramnios, borderline liquor and normal liquor at term.Methods: A retrospective study of all the labour induction in women with oligohydramnios, borderline liquor and normal liquor volume at 37-42 weeks gestation in a tertiary care teaching hospital. The demographic characteristics, maternal outcomes like mode of delivery, indication for operative delivery, meconium stained liquor and perinatal outcomes were compared in between the three groups. Parametric data was compared by chi-square test and non-parametric data by students’-test. A p-value less than 0.05 was taken as significant.Results: Among the 2338 deliveries during the study period, labour was induced in 266 women (11.3%). Out of which, 109 cases (40.9%) in oligohydramnios group, 111cases (41.7%) in borderline liquor group and 46 cases in normal liquor group. The incidence of meconium stained liquor, the number of operative deliveries and fetal distress was significantly higher and significantly lower birth weight (<2.5 kg) in the group with oligohydramnios and borderline liquor (p <0.05). Low Apgar score and admission to neonatal intensive care unit was higher in the oligohydramnios group (p<0.05).Conclusions: Induction of labour on detecting borderline liquor at term may help in reduction of maternal and fetal morbidity and mortality.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

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.

scholarly journals Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

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)

scholarly journals Maternal and Perinatal Outcome of Multiple Pregnancy in a Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 18 (2) ◽  
pp. 54-58
Author(s):  
Most Sabina Yeasmin ◽  
Md Jalal Uddin ◽  
Shireen Akter Khanam
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Multiple Pregnancies ◽  
Medical College ◽  
Tertiary Teaching ◽  
Gestational Age At Delivery ◽  
Tertiary Teaching Hospital

Background: Multiple pregnancies are prone to be associated with adverse maternal and perinatal outcome. The incidence of multiple pregnancies has shown a significant increase over the last decades. This study aimed to determine the maternal and perinatal outcome in a tertiary teaching hospital. Materials and methods: This prospective observational study was conducted in Chattogram-Maa-O-Shishu-Hospital Medical College, from July 2014 to June 2016. A total of 173 multiple pregnant women having 28 weeks completed gestation admitted for delivery were consecutively included in the study. Maternal and perinatal outcome were investigated. Results: The results show that the number of multiple pregnancies delivered during study periods was 173 with the incidence of 1.7% among total deliveries. There were 5 triplets pregnancies among these cases. The women with multiple pregnany were relatively older. There were no maternal mortality. Pregnancy complications were remarkabely higher. The main maternal adverse outcome were preterm delivery (84.97%), anaemia (39.88%), pregnancy induced hypertension (28.97%), premature rupture rupture of membrane (28.32%), postpartum haemorrhage (16.76%), antepartum haemorrhage (11.9%). The mean gestational age at delivery was 35.39 weeks for twins and 33.3 weeks for triplets. The commonest mode of delivery was by ceasarean section. The most common neonatal complications was low birth weight and most common cause of neonatal death was prematurity and neonatal sepsis. Conclusion: Majority of the multiple pregnancy is high risk one. So, all multiple pregnancies need early diagnosis, adequate antenatal, intra-natal and postpartum care to improve the outcome and should have mandatory hospital delivery. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 54-58

scholarly journals Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

2018 ◽  
Vol 7 (6) ◽  
pp. 2455
Author(s):  
Shivali Bhalla ◽  
Seema Grover Bhatti ◽  
Shalini Devgan
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Twin Pregnancy ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
North India ◽  
Care Hospital ◽  
Perinatal Morbidity

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians.

scholarly journals The association between isolated oligohydramnios at term and pregnancy outcome and perinatal outcome in case of isolated oligohydramnosis: a retrospective analysis

2021 ◽  
Vol 11 (1) ◽  
pp. 136
Author(s):  
Vijay M. Kansara ◽  
Kunal D. Kadakar ◽  
Akash S. Chikani ◽  
Pinal A. Pateliya
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Labour Induction ◽  
Control Group ◽  
Amniotic Fluid Index ◽  
Observational Cohort ◽  
Adverse Perinatal Outcomes ◽  
The Impact

Background: Current study was carried out to assess the impact of isolated oligohydramnios on perinatal outcomes and mode of delivery.Methods: A retrospective observational cohort study was conducted at term pregnancy with sonographic finding of isolated oligohydramnios (AFI <5 cm) were recruited for the study. Uterine anomaly and high risk pregnancies were excluded from the study. The mode of delivery and perinatal outcome were compared with control group of pregnancy with normal amniotic fluid (AFI >5-25 cm).Results: When compared to the normal AFI, women with oligohydramnios had significantly lower birth weight babies and were delivered at a significantly earlier gestational age. However there was no difference in the APGAR scores at birth and NICU admissions between the two groups. Reactive NST had more chances of good APGAR score at 1 and 5 minute and that lower the AFI more the probability of nonreactive NST and abnormal Doppler. The number of inductions and caesareans done for foetal reasons were significantly higher in the exposed group.Conclusions: Obstetric and perinatal outcome remains similar in both isolated oligohydramnios with reactive NST as well as in patients with normal amniotic fluid index. Isolated oligohydramnios is not associated with adverse perinatal outcomes. However, it increases the risk for labour induction and caesarean section.

scholarly journals Study of perinatal outcome of labour complicated with meconium stained liquor

2018 ◽  
Vol 7 (9) ◽  
pp. 3582
Author(s):  
Asmita N. Patil ◽  
Misbah M. Inamdar ◽  
Jaynarayan B. Senapati
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Demographic Data ◽  
Tertiary Care ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference

Background: Meconium stained amniotic fluid occurs in 9 to 20% of deliveries. It has long been implicated as a factor influencing foetal wellbeing during the intrapartum and postpartum period. Many authors have suggested that the type and the time of passage of meconium are most significant factors affecting foetal outcome. This study was carried out to find out the effect of meconium stained liquor during labour and its perinatal outcome.Methods: This prospective cross sectional and comparative study was carried out in a tertiary care hospital over a period of 1 year. The study group comprised of 118 women having MSAF during labour and the comparative group of 118 women with clear amniotic fluid which were randomly selected. The demographic data, obstetrical history, intrapartum findings and Apgar score were documented on predesigned proforma. Data collected was analysed using student t-test, chi square test, Z test for comparison of proportions and coefficient of variation for comparison of consistency of distributions.Results: Out of 1192 cases studied 118 cases showed presence of meconium stained liquor (9.89%). Caesarean section was performed in 41.52% cases with meconium stained liquor versus 31.35% in clear liquor group. Apgar score at 1 minute was significantly lower in meconium stained liquor (p<0.01). In meconium stained liquor group 42.37% foetuses had normal, 36.44% had suspicious and 21.18% had abnormal heart rate patterns respectively. There was no significant difference in the number of cases requiring NICU admission in meconium stained liquor (14.4%) and clear liquor groups (9.3%) (Z=1.214, P>0.05).Conclusions: Meconium staining is a commonly observed phenomenon. labour complicated with thick meconium stained liquor should ideally be categorised in to high risk obstetrics and managed in tertiary care with consultant obstetrician, consultant neonatologist and NICU in order to improve the perinatal outcome.

Duration of Exposure to General Endotracheal Anesthesia during Cesarean Deliveries at Term and Perinatal Complications

2021 ◽  
Author(s):  
Kate Swanson ◽  
Luzhou Liang ◽  
William A. Grobman ◽  
Nicole Higgins ◽  
Archana Roy ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Care Center ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Bladder Injury ◽  
Time Interval ◽  
Perinatal Complications ◽  
Cesarean Deliveries ◽  
Endotracheal Anesthesia

Objective To examine whether the duration of time from initiation of general endotracheal anesthesia (GETA) to delivery for cesarean deliveries (CDs) performed is related to perinatal outcomes. Study Design This is a retrospective study of patients with singleton nonanomalous gestations undergoing CD ≥37 weeks of gestation under GETA with reassuring fetal status at a single tertiary care center from 2000 to 2016. Duration from GETA initiation until delivery was calculated as the time interval from GETA induction to delivery (I-D), categorized into tertiles. Outcomes for those in the tertile with the shortest I-D were compared with those in the other two tertiles. The primary perinatal outcome was a composite of complications (continuous positive airway pressure or high-flow nasal cannula for ≥2 consecutive hours, inspired oxygen ≥30% for ≥4 consecutive hours, mechanical ventilation, stillbirth, or neonatal death ≤72 hours after birth). Secondary outcomes were 5-minute Apgar score <7 and a composite of maternal morbidity (bladder injury, bowel injury, and extension of hysterotomy). Bivariable and multivariable analyses were used to compare outcomes. Results Two hundred eighteen maternal–perinatal dyads were analyzed. They were dichotomized based on I-D ≤4 minutes (those in the tertile with the shortest duration) or >4 minutes. Women with I-D >4 minutes were more likely to have prior abdominal surgery and less likely to have labored prior to CD. I-D >4 minutes was associated with significantly increased frequency of the primary perinatal outcome. This persisted after multivariable adjustment. In bivariable analysis, 5-minute Apgar <7 was more common in the group with I-D >4 minutes, but this did not persist in multivariable analysis. Frequency of maternal morbidity did not differ. Conclusion When CD is performed at term using GETA without evidence of nonreassuring fetal status prior to delivery, I-D interval >4 minutes is associated with increased frequency of perinatal complications. Key Points

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