scholarly journals Successful Management of Early Onset Rh-immunized Pregnancy

2015 ◽  
Vol 7 (3) ◽  
pp. 202-204
Author(s):  
Pushpalatha LNU ◽  
G Naga Vasanthalakshmi ◽  
Sirisha LNU
Keyword(s):  
Early Onset ◽  
Neonatal Intensive Care ◽  
Color Doppler ◽  
Good Health ◽  
Fetal Anemia ◽  
Successful Management ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Care Facilities ◽  
Fetal Wellbeing

ABSTRACT Rh-isoimmunization still remains an important preventable cause of perinatal mortality and morbidity. The improved perinatal outcome in sensitized patients is mainly attributed to application of color Doppler ultrasonography as a noninvasive method of detecting and monitoring fetal anemia and fetal wellbeing, improvement in ultrasonography machines and fetal interventional techniques and better neonatal intensive care facilities. Here, we present a case G3P2L1D, Rh negative with previous lower segment cesarean section (LSCS), diagnosed to be indirect Coomb's test (ICT) positive (1:64) at 9 weeks. She was followed up with serial ICT titers every 2 weeks along with ultrasonography (USG) and Doppler. Fetal anemia was detected with middle cerebral artery (MCA) Doppler at 27 weeks and same treated with intrauterine transfusions twice. She was diagnosed to have gestational diabetes mellitus and treated for the same. Patient then delivered at 36 weeks and 5 days by emergency LSCS in labor, a healthy girl baby, 3.07 Kg. Postnatally, baby developed jaundice and was treated with double light phototherapy. Baby also developed anemia subsequently 3 days after birth and was treated with one dose of intravenous (IV) immunoglobulin. Baby with mother were discharged on postoperative day 5 in good health. How to cite this article Vasanthalakshmi GN, Sirisha, Pushpalatha. Successful Management of Early Onset Rhimmunized Pregnancy. J South Asian Feder Obst Gynae 2015;7(3):202-204.

Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

2019 ◽  
Vol 2 ◽  
pp. 1
Author(s):  
Bhushita Lakhkar ◽  
M. M. Patil ◽  
Bhavana Lakhkar ◽  
Bhushan Lakhkar
Keyword(s):  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Color Doppler ◽  
Periventricular Leukomalacia ◽  
Birth Asphyxia ◽  
Common Finding ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Study

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventricular leukomalacia was the most common and earliest finding followed by thalamic hyperechogenicity and intracranial hemorrhage. Intraventricular hemorrhage was more common in preterm babies. Other common finding in NICU was meningitis which was more common in pretrms. Among congenital anomalies, corpus callosal agenesis was more common. Conclusions Point of care ultrasonography along with Doppler study is very useful and safe to use in NICUs. It helps in diagnosis, patient management as well as prediction of many short- and long-term outcomes.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

scholarly journals Incidence, Risk Factors, and Outcomes of Preterm and Early Term Births: A Population-Based Register Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5865
Author(s):  
Salma Younes ◽  
Muthanna Samara ◽  
Rana Al-Jurf ◽  
Gheyath Nasrallah ◽  
Sawsan Al-Obaidly ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Population Based ◽  
Incidence Rates ◽  
Large For Gestational Age ◽  
Mortality And Morbidity ◽  
Early Term ◽  
Incidence Risk

Preterm birth (PTB) and early term birth (ETB) are associated with high risks of perinatal mortality and morbidity. While extreme to very PTBs have been extensively studied, studies on infants born at later stages of pregnancy, particularly late PTBs and ETBs, are lacking. In this study, we aimed to assess the incidence, risk factors, and feto-maternal outcomes of PTB and ETB births in Qatar. We examined 15,865 singleton live births using 12-month retrospective registry data from the PEARL-Peristat Study. PTB and ETB incidence rates were 8.8% and 33.7%, respectively. PTB and ETB in-hospital mortality rates were 16.9% and 0.2%, respectively. Advanced maternal age, pre-gestational diabetes mellitus (PGDM), assisted pregnancies, and preterm history independently predicted both PTB and ETB, whereas chromosomal and congenital abnormalities were found to be independent predictors of PTB but not ETB. All groups of PTB and ETB were significantly associated with low birth weight (LBW), large for gestational age (LGA) births, caesarean delivery, and neonatal intensive care unit (NICU)/or death of neonate in labor room (LR)/operation theatre (OT). On the other hand, all or some groups of PTB were significantly associated with small for gestational age (SGA) births, Apgar <7 at 1 and 5 minutes and in-hospital mortality. The findings of this study may serve as a basis for taking better clinical decisions with accurate assessment of risk factors, complications, and predictions of PTB and ETB.

scholarly journals Increasing adherence to plotting e-partograph: a quality improvement project in a rural maternity hospital in India

2021 ◽  
Vol 10 (Suppl 1) ◽  
pp. e001404
Author(s):  
Shuchi Jain ◽  
Pramod Kumar ◽  
Manish Jain ◽  
Megha Bathla ◽  
Shiv Joshi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Control Charts ◽  
Neonatal Intensive Care ◽  
Data Entry ◽  
Birth Asphyxia ◽  
Maternity Hospital ◽  
Improvement Project ◽  
Mortality And Morbidity ◽  
Prolonged Labour ◽  
Labour Room

Abnormal prolonged labour and its effects are important contributors to maternal and perinatal mortality and morbidity worldwide. E-partograph is a modern tool for real-time computerised recording of labour data which improves maternal and neonatal outcome. The aim was to improve the rates of e-partograph plotting in all eligible women in the labour room from existing 30% to achieve 90% in 6 months through a quality improvement (QI) process.A team of nurses, obstetricians, postgraduates and a data entry operator did a root cause analysis to identify the possible reasons for the drop in e-partograph plotting to 30%. The team used process flow mapping and fish bone analysis. Various change ideas were tested through sequential Plan-Do-Study-Act (PDSA) cycles to address the issues identified.The interventions included training labour room staff, identification of eligible women and providing an additional computer and internet facility for plotting and assigning responsibility of plotting e-partographs. We implemented these interventions in five PDSA cycles and observed outcomes by using control charts. A set of process, output and outcome indicators were used to track if the changes made were leading to improvement.The rate of e-partograph plotting increased from 30% to 93% over the study period of 6 months from August 2018 to January 2019. The result has been sustained since the last PDSA cycle. The maternal outcome included a decrease in obstructed and prolonged labour with its associated complications from 6.2% to 2.4%. The neonatal outcomes included a decrease in admissions in the neonatal intensive care unit for birth asphyxia from 8% to 3.4%. It can thus be concluded that a QI approach can help in improving adherence to e-partography plotting resulting in improved maternal health services in a rural maternity hospital in India.

Personal attributes associated with successful management in the hospitality industry - a pilot study in licensed retail operations

2010 ◽  
Vol 16 (2) ◽  
pp. 151-164
Author(s):  
Elizabeth M. Ineson ◽  
Graham J. Stone
Keyword(s):  
Hospitality Industry ◽  
Good Health ◽  
Personal Attributes ◽  
Retail Operations ◽  
Successful Management ◽  
Success Indicators ◽  
Primary Success ◽  
Retail Managers ◽  
Depth Interviews ◽  
Attention To Detail

The research sought to identify key qualities associated with successful licensed retail managers, defined as effective, efficient and profitable operators. Through semi-structured in-depth interviews, managers’ views on success criteria, and problems associated with this type of employment, were elicited. The greatest assets were considered to be personal stability, mobility, good health and support from relatives/family. Physical and mental stamina, well-developed interpersonal skills, anticipation, vigilance and attention to detail were also cited. Prior academic attainment was not considered to be crucial to success; hard biodata from application forms did not allow successful managers to be identified.. The greatest problems in the job centred on people management. Reasons for choosing the job included variety, challenge, the need to be with, enjoyment from talking to, entertaining, pleasing and developing others and delivering a service. Elements of emotional intelligence, including commitment and hardiness, were identified as primary success indicators.

scholarly journals Healthy life expectancy in Brazil: applying the Sullivan method

2005 ◽  
Vol 21 (suppl 1) ◽  
pp. S7-S18 ◽  
Author(s):  
Dalia Elena Romero ◽  
Iúri da Costa Leite ◽  
Célia Landmann Szwarcwald
Keyword(s):  
Life Expectancy ◽  
Functional Limitation ◽  
Good Health ◽  
World Health ◽  
Healthy Life Expectancy ◽  
State Of Health ◽  
World Health Survey ◽  
Healthy Life ◽  
Mortality And Morbidity ◽  
Sullivan Method

The objective of this study is to present the method proposed by Sullivan and to estimate the healthy life expectancy using different measures of state of health, based on information from the World Health Survey carried out in Brazil in 2003. By combining information on mortality and morbidity into a unique indicator, simple to calculate and easy to interpret, the Sullivan method is currently the one most commonly used for estimating healthy life expectancy. The results show higher number of healthy years lost if there is a long-term disease or disability that limits daily activities, regardless of the difficulty in performing such activities or the severity of the functional limitations. The two measures of healthy life expectancy adjusted by the severity of functional limitation show results very similar to estimates based on the perception of state of health, especially in advanced age. It was also observed, for all measures used, that the proportion of healthy years lost increases significantly with age and that, although females have higher life expectancy than males, they live proportionally less years in good health.

scholarly journals Left ventricular noncompaction: Clinical-echocardiographic study

2012 ◽  
Vol 69 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Aleksandra Nikolic ◽  
Ljiljana Jovovic ◽  
Slobodan Tomic ◽  
Milan Vukovic
Keyword(s):  
Heart Failure ◽  
Clinical Presentation ◽  
Color Doppler ◽  
Neuromuscular Diseases ◽  
Left Ventricular ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Mortality And Morbidity ◽  
Echocardiographic Examination ◽  
Myocardial Fibers

Background/Aim. Left ventricular noncompaction (LVNC) is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies) or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System). Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ? 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit of NGMC

2017 ◽  
Vol 15 (1) ◽  
pp. 20-22
Author(s):  
Roma KM ◽  
Manita Pyakurel ◽  
Veena Gupta ◽  
Piush Kanodia
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Study Data ◽  
Clinical Profile ◽  
Mortality And Morbidity ◽  
Medical Practitioners ◽  
Common Causes ◽  
Causes Of Mortality ◽  
The Common

Background: Neonatal period is a period from birth to under 28 days of life. The common causes of mortality and morbidity in our region are preventable, among which neonatal sepsis is the commonest one. Most of the deaths occur within 7 days of life. Objectives: To study the clinical profile, pattern of diseases, causes of morbidity and mortality amongst newborns. Materials and methods: A hospital based descriptive study was done among total 967 newborns including both inborn and out born admitted in NICU, NGMC from January 2016 to December 2016. Age, sex, gestational age, diagnosis at admission, outcome of admitted th newborns were the main variables under study. Data was entered in Excel and analyzed using SPSS 20th version. Data were presented through pie, bar graph and table with frequency and percentage. Results: Male were predominant in the study (65%). One third of the admitted newborns were preterms. Half of the admitted newborns were admitted on their first day of life. Neonatal sepsis was the most common cause of admission. Deaths occured in 7.4%of total babies. Seventy-six percent got improved after treatment. Only 2.8% were referred to higher center. Conclusions: Most of the neonates got admitted in first day of life with commonest cause being neonatal sepsis. Recovery rate was satisfactory. To reduce the mortality and morbidity of neonates, we need to increase awareness level in general population and proper aseptic practices in medical practitioners.

scholarly journals Neonatal candidiasis: clinical spectrum and epidemiology in a tertiary care centre

2017 ◽  
Vol 4 (2) ◽  
pp. 438
Author(s):  
Bhavana Koppad ◽  
Kulkarni Poornima Prakash
Keyword(s):  
Candida Albicans ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Candida Guilliermondii ◽  
Clinical Spectrum ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Neonatal Candidiasis

Background: Candidial infections are a serious problem in neonatal intensive care units (NICU) which increases the mortality and morbidity in addition to increasing health care costs. Confirming the diagnosis by laboratory tests is difficult and a high index of suspicion is required. The objective of this study was to identify the clinical spectrum and epidemiology of neonatal candidiasis in a tertiary care NICU.Methods: The present study was carried out in the NICU of SDM medical college and hospital, Dharwad. All babies who were admitted to NICU and who had positive blood culture for Candida were included in the study. One year Data (1st December 2015 to 31st November 2016) was collected retrospectively from NICU case records. Statistical test used was chi square test.Results: Total admissions to the NICU during the study period were 2591. Blood cultures were positive in 132 babies. Among these, Candidial sepsis was noted in 39.39% (52) babies. Out of the 52 positive fungal cultures, 15 were Candida albicans, 35 were Candida non albicans and 2 were mixed cultures (Candida albicans and non albicans) showing an increasing incidence of non-albicans Candida infections. Among the non albicans Candida, Candida tropicalis and Candida guilliermondii were the predominant species (11 each) followed by Candida famata (6), Candida krusei (6) and Candida parapsilosis (3). Candidial sepsis was seen to be more common among preterm and low birth weight babies. Usage of antibiotics, Total parenteral nutrition (TPN) and mechanical ventilation were common risk factors noted in our study.Conclusions: Systemic Candidiasis is a disease of modern neonatal intensive care. It deserves urgent attention for its prevention as well as effective treatment in order to minimize neonatal morbidity and mortality.

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