scholarly journals Evaluation of Feto-maternal Outcome with Prelabour Rupture of Membranes in Term Pregnancy

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Dr. Samay Singh Meena ◽  
Dr. Badrilal Patidar ◽  
Dr. Girdhar Gopal Nagar ◽  
Dr. Sanjana Jourwal
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Maternal Morbidity ◽  
Early Recognition ◽  
Birth Asphyxia ◽  
Perinatal Morbidity ◽  
Genital Tract Infection ◽  
Major Morbidity ◽  
Medical College ◽  
Failed Induction

Premature rupture of membrane (PROM) is defined as the disruption of fetal membranes before the beginning of labor, resulting in spontaneous leakage of amniotic fluid. The present study is undertaken to study the labor outcome, maternal morbidity and perinatal morbidity and mortality in term PROM. This is a Prospective Observational and Descriptive type Study conducted at Government Medical college, Kota for a period of eighteen month from January 2019 to June 2020. 200 cases of Spontaneous rupture of membrane with term gestation and confirmed by per speculum examination were selected. PROM was common in primigravida (62.50%), majority of belonged to age group of 20-29 years (89.0%). Need of induction required in 88% of cases, induction by cerviprime-gel done in 84.5% cases, Cesarean sections were more among primigravida. Failed induction was the common indication (44.11%). Maternal morbidity was significant (20.0%). Febrile morbidity was the major morbidity noticed with 14.50% followed by PPH 1.5%. No maternal mortality in the study. Perinatal morbidity was seen in 21% of cases. Birth asphyxia was the commonest cause for perinatal morbidity (14.0%). No Perinatal mortality was seen in this study. Escherichia coli (16.50%) was common organism found in culture of amniotic fluid. Majority of babies had APGAR score 6 &7 at 1 minute of birth and APGAR score 9 and 10 at 5 min. of birth. PROM is associated with many complications which can be reduced, by educating the women to have regular antenatal care, and early recognition of genital tract infection, and treat appropriately and to report at the earliest.

scholarly journals Study of amniotic fluid index and its pregnancy outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4727
Author(s):  
Manisha M. Parmar ◽  
Sandeep M. Parmar
Keyword(s):  
Amniotic Fluid ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Well Being ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Neonatal Deaths ◽  
Still Births ◽  
Tertiary Teaching ◽  
Nicu Admission

Background: Amniotic fluid is vital to the well-being of the fetus. Severe oligohydramnios and polyhydramnios are associated with increased maternal morbidity and perinatal morbidity and mortality.Methods: This was prospective observational study conducted at tertiary teaching institute from July 2012 to July 2013. Total 200 patients were included in the study. On the basis of amniotic fluid index (AFI), patients were categorized in 3 groups, Normal AFI (8-24 cm), oligohydramnios (AFI <5cm) and polyhydramnios (AFI > = 25 cm). Results were analysed in the form of incidence, mode of delivery and perinatal outcome which includes preterm, low birth weight, still births, NICU admissions and neonatal deaths in all the 3 groups.Results: Out of 200 patients, there was 150 cases of normal AFI, 39 cases of oligohydramnios and 11 cases of polyhydramnios. Incidence of oligohydramnios was 4.1% and polyhydramnios was 1.1%. PIH was the most common etiological factor found in oligohydramnios (30.7%) and in polyhydramnios congenital anomalies (36.3%) followed by idiopathic cause (27.2%) was most common. Incidence of caesarean section was 58.9% in oligohydarmnios and 17.3% in normal AFI group. Incidence of NICU admission was 25.6% in oligohydramnios and 50% in polyhydramnios group in comparison to 9.3% in normal AFI group.Conclusions: Amniotic fluid index is an important part of antepartum fetal surveillance. Abnormalities of AFI are associated with high perinatal morbidity and mortality and maternal morbidity.

scholarly journals Study of perinatal asphyxia and its outcome concerning nucleated RBC count in venous blood of term neonates

2021 ◽  
Vol 8 (1) ◽  
pp. 54-63
Author(s):  
Dr. Pradeep Kumar Jena ◽  
◽  
Dr. Himansu Parida ◽  
Dr. Banashree Swain ◽  
Dr. Mangal Charan Murmu ◽  
...  
Keyword(s):  
Apgar Score ◽  
Perinatal Asphyxia ◽  
Venous Blood ◽  
Surrogate Marker ◽  
Birth Asphyxia ◽  
Neurological Impairment ◽  
Adverse Outcomes ◽  
P Value ◽  
Medical College ◽  
Nucleated Red Blood Cells

Introduction: Perinatal asphyxia is a serious problem globally and is one of the common causes ofneonatal mortality. Worldwide each year four million infants suffer from birth asphyxia. Of these onemillion die and an equal number develop serious sequelae. Perinatal asphyxia ranks as the secondmost important cause of neonatal death after infections accounting for about 23% of mortalityworldwide. Aim & objective: To establish the level of nucleated red blood cells as an indicator ofpoor immediate outcome in perinatal asphyxia. Method: It was a case-control study done in thedepartment of pediatrics, S C B Medical College & S V P PG I P, Cuttack. Observation: The NRBCcount was significantly higher in neonates with adverse outcomes than in those with favourableoutcomes (p-value <0.001). NRBC count cut-off of >27/100 WBC had a sensitivity of 75% andspecificity of 95.2% in predicting adverse outcome defined as death, hemiplegia, hypertonia orsignificant hypotonia, unreliable sucking and seizures resistant to Phenobarbital. Conclusion:Nucleated red blood cell count can be used as a surrogate marker for birth asphyxia. It has asignificant negative correlation with Apgar score at one minute and Apgar score at 5minutes &significant positive correlation with severity of hypoxic ischemic-encephalopathy, time is taken forrecovery of neurological impairment following birth asphyxia and duration of NICU stay.

scholarly journals Neonatal Outcome in Meconium Stained Amniotic Fluid (MSAF): A Study in a Neonatal High Dependency Unit (NHDU) of a Medical College Hospital

Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 65-71
Author(s):  
MB Ali ◽  
AA Maruf ◽  
N Naher ◽  
S Islam
Keyword(s):  
Amniotic Fluid ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Maternal Risk Factors ◽  
College Hospital ◽  
Maternal Risk ◽  
Medical College ◽  
High Dependency ◽  
Meconium Stained Amniotic Fluid ◽  
Ischemic Encephalopathy

Background: Meconium-stained amniotic fluid (MSAF) is a potential sign of fetal hypoxia as well as a potential toxin if the fetus aspirates with a gasping breath in utero or when it takes its first breaths following birth. Objective: To evaluate the outcome of neonates with meconium-stained amniotic fluid (MSAF). Material and Methods: This prospective observational study was carried out in the department of pediatrics of Gazi medical college Hospital, Khulna during one calendar year from 01 July 2016 to 30 June 2017. Maternal risk factors for MSAF, modes of delivery of neonates were recorded. All neonates born with MSAF were included in this study: they were shifted to neonatal high dependency unit for observation and monitoring as per the pediatrician’s advice. Neonatal outcomes like birth asphyxia, neonatal jaundice, aspiration pneumonia, septicemia, meconium aspiration syndrome (MAS), hypoxic-ischemic encephalopathy (HIE) and death were observed and recorded. Result: A total of 157 babies were included during the study period. Modes of delivery of babies were: normal delivery 86(54.78%), caesarean section 48(30.57%) and instrumental delivery 23(14.65%). Maternal risk factors were postdated pregnancy 51(32.48%), previous caesarian section 20(12.74%), pregnancy-induced hypertension (PIH) 20(12.74%), premature rupture of membranes 18(11.46%), gestational diabetes mellitus (GDM) 17(10.83%), intrauterine growth retardation (IUGR) 14 (8.92%), cephalopelvic disproportion 9(5.73%) and anemia 8(5.10%). Outcome of babies were: 118(75.16%) babies were discharged without any complications, 10(6.37%) developed neonatal jaundice, 10(6.37%) meconium aspiration syndrome (MAS), 8(5.10%) birth asphyxia, 4(2.55%), aspiration pneumonia, 3(1.91%) hypoxic-ischemic encephalopathy (HIE), 2(1.27%) septicemia and 2(1.27%) baby died in early neonatal period. Mediscope Vol. 6, No. 2: Jul 2019, Page 65-71

scholarly journals Obstructe d Labour: A Life Threatening Complication

2017 ◽  
Vol 29 (1) ◽  
pp. 12-14
Author(s):  
Jamila Khatun ◽  
Khudeja Khanom
Keyword(s):  
Maternal Death ◽  
Rural Areas ◽  
Maternal Morbidity ◽  
Perinatal Death ◽  
Medical College Hospital ◽  
Perinatal Morbidity ◽  
College Hospital ◽  
Cross Sectional ◽  
Obstructed Labour ◽  
Medical College

Obstructed labour is an important cause of maternal death in developing countries. Obstructed labour also causes significant maternal morbidity mainly due to infection and hemorrhage and foetal death from asphyxia is also common. Objectives are to reduce maternal and newborn complications by early detection and rapid interventions and to reduce maternal and perinatal morbidity and mortality. This Hospital-based prospective cross-sectional study was conducted from June 2013 to June 2014 in Sylhet, MAG Osmani Medical College Hospital. 100 obstructed labour cases were selected those who were admitted in Inpatient department of Obstetrics and Gynaecology, SOMCH. 100 obstructed labour cases were recorded. The majority (80%) were residents of rural areas in which transportation were difficult, the occupation of the women were housewives mostly (90%) and remaining (10%) were tea-garden worker.75% of the obstructed labour cases did not have any ante-natal follow-up. Most of the cases (70%) were visited Osmani Medical College Hospital by their attendant. 70% Visited at 12-24 hours of labour, (80%) came from a distance of 10-50 kilometers. Cepholo-pelvic disproportion was the major cause of obstructed labour (78%) and cesarean section was the main way of delivery (95%). PPH (4%), puerperal sepsis (4%), rupture uterus (2%), VVF (2%), rupture uterus with shock (1%), were the main complications and maternal death (1%). Obstructed labour was the major causes of poor perinatal outcome and perinatal death (7%). This study revealed high incidence of maternal morbidity and perinatal morbidity and mortality.Medicine Today 2017 Vol.29(1): 12-14

scholarly journals Neonatal Outcome of Antenatal Mothers with Pregnancy Induced Hypertension in Antenatal Ward of Kathmandu Medical College and Teaching Hospital

2018 ◽  
Vol 2 (3) ◽  
pp. 255-259
Author(s):  
Santoshi Shrestha Pradhan ◽  
Sabitra Paudel ◽  
Puspa Parajuli ◽  
Bina Rana Khagi
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Neonatal Death ◽  
Neonatal Outcome ◽  
Pregnancy Induced Hypertension ◽  
Perinatal Morbidity ◽  
Medical College ◽  
Induced Hypertension ◽  
Perinatal Management

Introduction: Hypertensive disorders seem to complicated in approximately 5-15% of pregnancies. Pregnancy induced hypertension (PIH) increases the risk of maternal and perinatal morbidity and mortality.Objective: To assess the neonatal outcome and to identify the association between the demographic variables and outcome of Pregnancy Induced Hypertension in antenatal ward of Kathmandu Medical College and Teaching Hospital.Methodology: Prospective study design was conducted for the study in Obstetrics ward of Kathmandu Medical College Teaching Hospital. The population was the 100 antenatal mothers with pregnancy induced hypertension admitted in antenatal ward and purposive convenient sampling technique was used to collect the data. The structured questionnaire was designed and the data was collected through interview technique from 1st February 2014 to 10 March 2016. The collected data was analyzed using SPSS programme.Results: Regarding neonatal outcome the findings of the study showed that most of the babies 83% had normal weight. The most of the babies 82% had adequate for gestational age. Regarding Apgar score half of the babies 50% scored mild asphyxia at the first minute whereas most of the babies 93% scored no asphyxia at five minutes after delivery. Regarding perinatal outcome 13% babies were delivered premature, 7% had birth asphyxia, 5% were born with low birth weight and stillbirth whereas only 1% had early neonatal death. The present study revealed that there was significant association between gestational age of delivery and Apgar score at 5 minutes and there was significant association between age and perinatal management outcome, gestational age of delivery and perinatal morbidity management, grading of proteinuria and perinatal morbidity management, grading of oedema and perinatal management outcome regarding neonatal outcome of pregnancy induced hypertension.Conclusion: Pregnancy induced hypertension during pregnancy were associated with a higher risk of adverse neonatal outcomes. Women with pregnancy induced hypertension during pregnancy had a higher risk of emergency caesarean section, pre-term birth, neonatal death, low birth weight children and neonates with low Apgar score. Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 255-259

scholarly journals A study on maternal and perinatal outcome in premature rupture of membranes at term

2017 ◽  
Vol 6 (12) ◽  
pp. 5368 ◽  
Author(s):  
Sailaja Surayapalem ◽  
Vijayalakshmi Cooly ◽  
Bhuvaneswari Salicheemala
Keyword(s):  
Gestational Age ◽  
Maternal Morbidity ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Well Being ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture

Background: Premature rupture of membranes is defined as rupture of foetal membranes before the onset of labour. Management of cases of PROM still remains as one of the most difficult and controversial problems in obstetrics. PROM can cause maternal complications like chorioamnionitis, increased operative procedures, puerperal sepsis and neonatal morbidity and mortality. The present study is undertaken to study the labour outcome, maternal morbidity and perinatal morbidity and mortality in term PROM.Methods: 200 Cases of spontaneous rupture of membranes with gestational age >37 weeks with confirmed PROM by a speculum examination were selected. A detailed history was taken, and gestational age confirmed, general, systemic and obstetric examinations were done. Parameters of maternal and foetal well being were recorded. All study groups received prophylactic antibiotics. Single pelvic examination done, and maternal vitals recorded fourth hourly. All the data was analyzed and statistical significance was calculated using Chi-square test.Results: PROM was common in age group of 20-24 years (35%) with mean age of 22.6 years and SD of 2.8 years, and common in primigravida. Majority of women were admitted within six hours of PROM (41.5%) and Mean duration of induction to delivery interval was 12.9 hours. The mean duration between PROM to delivery was 20.2 hours which was statistically significant. Cesarean sections were more among primigravidas. Failure to progress was the common indication. Maternal morbidity was significant (17.5%). No maternal mortality in the study. Perinatal mortality was 1.5%. Birth asphyxia was the commonest cause. Perinatal morbidity was seen in 26%. Escherichia coli was common organism found in cervical swab culture.Conclusions: In present study, majority was primigravidas and the most common age group was 20-24 years belonging to low socioeconomic status. Maternal morbidity and neonatal morbidity was associated with increased duration of PROM to delivery and infection of the female genital tract with pathogens. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy.

scholarly journals Comparative analysis of maternal and fetal outcome in meconium stained amniotic fluid and clear liquor in primigravida

2020 ◽  
Vol 9 (2) ◽  
pp. 482
Author(s):  
Deepali S. Kapote ◽  
Apeksha M. Mohite ◽  
Anam Syed
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Meconium Staining

Background: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients.Methods: A total of 121 pregnant women who had completed more than 37 weeks of gestation with live singleton pregnancy, spontaneous onset of labor and at term with adequate pelvis were included in the study. All (121) low risk primigravida with MSAF were studied to identify maternal and fetal outcome and compared with equal number of cases with clear amniotic fluid. Meconium stained cases were clinically classified into two groups- thin (54 cases) and thick (67 cases). MSAF on spontaneous or artificial rupture of membranes were monitored with fetal heart rate abnormality, 1- and 5-minutes Apgar score, NICU admissions and neonatal complications as outcome variables.Results: Overall incidence of meconium staining of AF during labour was 7.71%. The common fetal heart rate abnormalities i.e. bradycardia was seen in 36% in MSG. Apgar score of less than 7 was observed in MSG at 5 minutes in 5% of cases, in thick group. Major neonatal complication was birth asphyxia in MSG (18.18%) that was more in thick MSG (14.87%). MAS were observed in 6 cases in thick and 4 cases in thin meconium stained cases. NICU care was required in 18% cases in MSG and in control group it was required in 7% cases. Neonatal morbidity was more in newborn with thick meconium group (52%) compared to thin meconium group (20%).Conclusions: The present study confirmed that meconium staining of amniotic fluid adversely influences the fetal outcome.

scholarly journals Biochemical abnormalities in neonatal seizures in term and preterm neonates

2018 ◽  
Vol 6 (1) ◽  
pp. 40
Author(s):  
Manoj D. ◽  
Rajesh Reddy K. ◽  
S. S. Prakash
Keyword(s):  
Early Recognition ◽  
Birth Asphyxia ◽  
Detailed Examination ◽  
Preterm Neonates ◽  
Neonatal Seizures ◽  
Metabolic Disturbances ◽  
Medical College ◽  
Preterm Babies ◽  
Work Up ◽  
Biochemical Abnormalities

Background: Neonatal seizures may arise as a result of diverse etiologies and can have varied presentations. Biochemical abnormalities are commonly observed in neonates which can be either primary or secondary. Early recognition and treatment of biochemical disturbances is essential for optimal management and satisfactory long-term outcome.Methods: A total of 100 neonates presenting with seizures admitted to NICU of JJM Medical College, Davanagere, from November 2015 to April 2017 were enrolled in the study. Detailed antenatal, natal, postnatal history along with detailed examination was done along with baseline characteristics of convulsing were recorded at admission along with relevant biochemical investigations before instituting any specific treatment.Results: In the present study, out of 100 neonates studied, 64 were full term of which 49(76.5%) were AGA and 15(23.5%) were SGA, whereas 36 cases were preterm. Most neonatal seizures occurred in first 3 days of life, i.e. 59% of which majority occurred on first day of life (34%). Birth asphyxia and septicemia are common cause of neonatal seizures in present study (38 cases each), followed by pure metabolic disturbances 19%. In pure metabolic seizures, hypoglycemia (47.8%) is most common more in preterm babies (55%) followed by hypocalcemia.Conclusions: Biochemical abnormalities are common in neonatal seizures and often go unrecognized and may significantly contribute to seizure activity. Hence, a biochemical work up is necessary for all cases of neonatal seizures.

scholarly journals Clinical study of babies born through meconium stained amniotic fluid

2019 ◽  
Vol 6 (2) ◽  
pp. 491 ◽  
Author(s):  
Shilpasri Y. M. ◽  
Madhurya B.
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Medical College ◽  
Meconium Stained Amniotic Fluid

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.

scholarly journals Study of maternal and fetal outcomes in premature rupture of membrane in central rural India

2017 ◽  
Vol 6 (4) ◽  
pp. 1409
Author(s):  
Arpita A. Jaiswal ◽  
C. Hariharan ◽  
Deepika K. C. Dewani
Keyword(s):  
Early Onset ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Central India ◽  
Neonatal Infection ◽  
Care Hospital ◽  
Perinatal Morbidity ◽  
Premature Rupture ◽  
Fetal Outcomes

Background: Premature rupture of membrane is linked to significant maternal prenatal mortalities and morbidity. The maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes in patients with PLROM at tertiary care hospital in central rural India.Methods: This prospective study was conducted in Department of obstetrics & Gynecology, in a tertiary care institute located in central India, over a period of 18 months. 210 patients were diagnosed with PLROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books.Results: The rate of maternal morbidity was 26%, commonest cause was clinical chorioamnionitis (11.9%) followed by febrile illness seen in 10.5%. No maternal mortality was seen in the study. Perinatal morbidity was seen in 30% of cases. Clinical early onset neonatal infection was the commonest cause for perinatal morbidity noticed in 23.8% of cases (50 out of 210). Perinatal mortality observed was 1.43% (3 out of 210). Birth asphyxia being the commonest cases of mortality.Conclusions: Major maternal morbidity is chorioamnionitis (11.9%). Major perinatal morbidity observed is early onset neonatal infection (24%).

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