scholarly journals The Prenatal Diagnosis~ What should we do? What can we do?

2021 ◽  
pp. 1-7

Purpose: Prenatal diagnostic accuracy has improved; however, the pediatric surgeon’s role remains unclear. This paper aimed to determine the prenatal diagnoses made and the role of pediatric surgeons. Methods: A 6-year retrospective review of 904 pregnancies managed at our institute was conducted. They were classified as a normal pregnancy (NP, n=194), abnormal pregnancy maternal factor (MF, n=449), or abnormal pregnancy fetal factor (FF, n=261). Results: In the FF group, the identified conditions were twin pregnancies (n=75), intrauterine growth restriction (IUGR) (n=49), breech presentation (n=26), arrested development (n=19), hypoamnion (n=42), fetal distress (n=16), hydramnios (n=10), abnormal heart sounds (n=5), meconium staining (n=5), surface anomaly (n=4), calcification (n=2), fetal hydrops (n=2), fetal death (n=2), bowel dilatation (n=2), abdominal mass (n=1) and diaphragmatic hernia (n=1). Case of twin pregnancies, breech presentation, arrested development, IUGR, hypoamnion, abnormal heart sounds, meconium staining and fetal hydrops did not require surgery. Of the 16 cases of fetal distress, 1 had biliary atresia. Of the 10 cases of hydramnios, 1 had meconium peritonitis. Of the 4 with surface anomalies, 3 had gastroschisis. Of the 2 with calcification, 1 had meconium peritonitis. Of the two fetal deaths, 1 had anal atresia suggesting a chromosomal abnormality. Of the 2 cases of bowel dilatation, 1 had bowel atresia. The abnormal mass was caused by adrenal bleeding. These diagnoses were made at an average of 27.4 gestational weeks; however, 2 cases of gastroschisis, suggesting a body stalk anomaly; diaphragmatic hernia; and brain cysts were diagnosed before 20 weeks and were aborted. After delivery, the mortality rate was 0% in neonates treated by pediatric surgeons and neonatologists. Conclusion: Fetal abnormalities are rare; however, early aggressive management with the cooperation of obstetricians and parents is crucial for pediatric surgeons to minimize the effects of anomalies.

1985 ◽  
Vol 34 (3-4) ◽  
pp. 207-211 ◽  
Author(s):  
P. Buekens ◽  
R. Lagasse ◽  
F. Puissant ◽  
F. Leroy

AbstractWe have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.


Author(s):  
Kamlesh R. Chaudhari ◽  
Kushagra R. Chaudhari ◽  
Omkar M. Desai

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.


2018 ◽  
Vol 8 (2) ◽  
pp. 27-31
Author(s):  
Yam Prasad Dwa ◽  
Sunita Bhandari ◽  
Devendra Shrestha ◽  
Ajaya Kumar Dhakal

Introduction: Adolescent pregnancy is prevalent in Nepal and bears significant consequences to both mother and newborn. Methods: All pregnant women aged 19 years or less who were admitted for delivery at KIST Medical College during 14th April 2017 to 15th July 2018 were included in this study. Maternal and immediate neonatal outcomes were analyzed retrospectively from their medical records. Results: There were 135 pregnant adolescent women out of 1300 deliveries. Preeclampsia was observed in 2 pregnancies. Vaginal delivery (99; 73.3%) was the predominant mode of delivery. Emergency LS CS was performed in 35 (25.9%) deliveries and most frequent indications for LS CS were nonprogress of labor (8/35), breech presentation (8/35) and fetal distress (6/35). 10 (7.4%) babies were born preterm. 23 (17%) babies were born low birth weight. 37 (27.4%) neonates were symptomatic and required neonatal admission. Respiratory distress was the most frequent neonatal problem (29; 21.5%), followed by neonatal sepsis (18; 13.3%) and perinatal asphyxia (9; 6.7%). There were 3 (2.2%) still birth and 2 (1.5%) early neonatal deaths. Conclusion: Adolescent pregnancy was common and associated with increased early neonatal problems.


2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Banu Öndeş

Abstract Introduction Uterus didelphys is a rarely observed Müllerian duct fusion defect. Two separately developing Müllerian ducts create two hemi uteri with separate fallopian tube, ovary and cervix which may cause obstetric complications. This case report presents a case reaching term for the 8th time, with eight live births discussed in view of the literature. Presentation of case A 38-year-old, gravid 9 para 7 abortion 1, pregnant woman applied to the hospital with breech presentation after unsuccessful home birth attempt. As a result of the indications of acute fetal distress, meconium in amniotic fluid and breech presentation emergency cesarean section was performed. A 2800 g, 49 cm long with 33 cm head circumference female infant was born with 1st min Apgar score of 6 and 5th min Apgar score of 8. During the operation it was observed that the patient had uterus didelphys with each hemi uterus having its own fallopian tube and ovary. After the operation vaginal speculum examination identified two cervices. The patient’s other seven births were homebirth and seven children were healthy and alive. Discussion It is rare for pregnancies in uterus didelphys cases to reach term. Due to the frequency of obstetric complications and negative pregnancy results, close monitoring is required before and during pregnancy.


Author(s):  
Nkencho Osegi ◽  
Olakunle I. Makinde

Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.


Author(s):  
Samik Medda ◽  
Sibani Sengupta ◽  
Upasana Palo

Background: Obstetric cholestasis is one of the most common causes of liver disease in pregnancy. Present study was carried out to study the incidence of Obstetric Cholestasis and its feto-maternal outcome in a tertiary care hospital.Methods: It is a prospective epidemiologycal study during a period of one year (2014 to 2015) over 100 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as fetal-neonatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.9%. Majority of cases (43.0%) are diagnosed in late gestational age, mostly during 28 to 32 weeks period of gestation. Maternal morbidities are due to sleep disturbance (60/100), dyslipidemia, coagulation abnormality, PPH (10.0%) and increase chance of operative delivery (66.0%). Neonatal morbidities are mainly due to fetal distress, prematurity (22.0%), low birth weight (32/100) and meconium staining of amniotic fluid (42.0%). Maximum number of patients are delivered at 37 to 38 weeks, due to active and early intervention.Conclusions: Early diagnosis and active maternal and fetal surveillance is of utmost importance to avoid adverse outcomes.


1970 ◽  
Vol 9 (3) ◽  
pp. 179-183
Author(s):  
S Chhetri ◽  
U Singh

Background: There has been a sustained increase in the rate of caesarean section in the last few years around the world. Data regarding the current caesarean rate and the trends of its indications in eastern Nepal have not been estimated earlier. Aim: To assess the rate of caesarean sections and the varying indications for caesarean section in a tertiary referral center in eastern Nepal. Methods: All hospital deliveries that took place in BPKIHS between January 2006 and December 2007 were recorded to assess the caesarean section rate and its indications. Results: A total of 5330 deliveries were conducted in 2006. Likewise the total number of deliveries conducted in 2007 was 6634. In 2006 caesarean sections were performed in 28.6% (1524) of all patients. The rate of caesarean sections in 2007 increased and was 33.7% (2239). The most common indication for caesarean section was meconiumstained liquor, which constituted 23.4% (883). The next frequent indication was previous caesarean section, which accounted for 17.2% (650), followed by breech presentation in 11.1% (417), fetal distress in 9.6% (364), non-progress of labor in 7.2% (270), cephalopelvic disproportion in 6.2% (234, and placenta previa in 4.4% (165). Conclusions: There is a increasing trend of performing cesarean section in the tertiary referral center in east era Nepal. The most common indication for cesarean section is meconium-stained liquor. Keywords: Caesarean section; caesarean delivery rates; Nepal DOI: http://dx.doi.org/10.3126/hren.v9i3.5587   HR 2011; 9(3): 179-183


Open Medicine ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 491-494
Author(s):  
Aleksandra Doronjski ◽  
Taita Stojilković ◽  
Slobodan Spasojević ◽  
Borko Milanović ◽  
Vesna Stojanović

AbstractTRAP (Twin Reversed Arterial Perfusion) sequence is a rare malformation that occurs in monozygotic twin pregnancies. Twin weight ratio in our case was 76% (body weight of pump twin was 1800 g, acardiac twin 1370 g), but in spite of that the pump twin had a mild clinical picture with premature birth, fetal hydrops (mild pleural effusion; hypoproteinemia; on the 3rd day of life the baby was without edema and the level of his serum proteins were in referral ranges) and mild myocardial hypertrophy of left ventricle (echocardiography performed on the 28th day of life was normal).


2009 ◽  
Vol 16 (03) ◽  
pp. 454-45
Author(s):  
MADIHA RASHID ◽  
SHAMAILA HALEEM ◽  
SADIA CHEEMA

Objective: The study was designed to determine the fetomaternal morbidity and mortality in post date pregnancies and tocalculate various modes of delivery in post date pregnancies in our set up. Study design: Non interventional descriptive study. Setting: GyneaUnit- III Services Hospital, Lahore. Material and methods: The data was collected with the help of Proforma which was filled for every patientdelivered at 40 weeks of gestation or above. The proforma included all points relevant to study. Results: The rate of meconium staining of liquor,fetal distress and caesarean section (C-section) increased significantly after 40 weeks gestation. Conclusion: The study shows that morechances of meconium staining, fetal distress and macrosomia in Post date patients. The study further shows that the induction and operativedeliveries are more common mode of deliveries in post date patients.


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