scholarly journals SINGLE CENTRE, OPEN-LABEL & NON RANDOMIZED CLINICAL TRIAL TESTING LMWH EFFICACY ON PERINATAL OUTCOME INLATE SECOND TRIMESTER OLIGOHYDRAMNIOS CASES

2021 ◽  
Vol 71 (3) ◽  
pp. 952-56
Author(s):  
Bushra Iftikhar ◽  
Aysha Shahid ◽  
Nuzhat Aisha Akram ◽  
Afeera Afsheen ◽  
Rabia Mushtaq ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Second Trimester ◽  
Amniotic Fluid Index ◽  
Average Birth Weight

Objective: To find out low molecular weight heparin (LMWH) efficacy inlate second trimester oligohydramnios cases. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Malir, from Jan to Jun 2017. Methodology: A total of 30 patients having amniotic fluid index (AFI) <8 on ultrasound scan during their late second trimester phase were enrolled in the study after informed consent. Exclusion criteria included congenital anomalies on U/S, PPROM, and drug-induced oligohydramnios. Personal, medical and obstetric history was obtained for age, parity and co-morbids like hypertension, antiphospholipid syndrome, and previous oligohydramnios. Low molecular weight heparin was started at dose of 0.5mg/kg of body weight subcutaneously for 8-12 weeks and stopped 24 hours prior to delivery. Rescan for amniotic fluid index and fetal bio-metry assessment done every 2 weeks till date of delivery. Fetal outcome in terms of maturity, mode of delivery, birth weight, APGAR score and need for NICU admission were measured. Results: There were 28 live births and two intrauterine deaths. Twelve patients were delivered normally and 18 had elective LSCS. Of twenty eight cases, eight were premature low birth weight (LBW) babies. Twenty six patients showed significant improvement in amniotic fluid index. Average birth weight was 2.5kg. Neonates showed an average APGAR score of 7. Eight neonates admitted in NICU (for prematurity and/or low birth weight) and discharged within a week. Conclusion: Low molecular weight heparin plays significant role in treating oligohydramnios in cases with or without risk factors. However further studies with large sample............

scholarly journals Perinatal outcome in pregnant females at term having low amniotic fluid index.

2021 ◽  
Vol 28 (09) ◽  
pp. 1358-1364
Author(s):  
Nadia Sharif ◽  
Ayesha Qasim
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Multiple Pregnancy ◽  
Amniotic Fluid Index ◽  
Pregnant Females ◽  
Case Series Study ◽  
Nicu Admission

Objectives: To determine the frequency of perinatal outcome in pregnant females at term having low amniotic fluid index. Study Design: Descriptive, Case Series study. Setting: Department of Obstetrics & Gynecology, Independent University Hospital, Faisalabad. Period: 1st October 2019 to 31st March 2020. Materials & Methods: A total of 90 women having singleton pregnancy with cephalic presentation having 37-40 weeks of gestation with AFI <8cm, 20 to 35 years of age were included. Patients with multiple pregnancy, ruptured membrane, fetal anomaly, gestational diabetes and Rh Incompatibility were excluded. Cesarean delivery, meconium stained liquor, low birth weight, NICU admission and APGAR score <7 at 5 min were assessed by consultant gynecologist. Results: Age range in this study was from 20 to 35 years with mean age of 28.92 + 4.45 years. Majority of the patients 43 (47.77%) were between 31 to 35 years of age. Mean gestational age was 38.31 + 1.20 weeks. Mean parity was 2.72 + 1.02. In this study, frequency of perinatal outcome in pregnant females at term having low amniotic fluid index was as follows; cesarean section was performed in 60 (66.67%), low birth weight was observed in 58 (64.44%) patients, APGAR score <7 at 5 minutes in 56 (62.22%), meconium stained liquor in 24 (26.67%) and NICU admission in 17 (18.89%) patients. Conclusion: This study concluded that proper antenatal monitoring and management should be done in these high risk patients in order to reduce the morbidity and mortality of the fetus.

scholarly journals Perinatal outcome of term pregnancies with borderline amniotic fluid index: a prospective case control study

2020 ◽  
Vol 9 (5) ◽  
pp. 2047
Author(s):  
Devika V. Desai ◽  
Nigamananda Mishra ◽  
Gayatri V. Savani
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Research Centre ◽  
P Value ◽  
Amniotic Fluid Index ◽  
Chi Square ◽  
Test Analysis ◽  
Chi Square Test

Background: It has been since antiquity that the importance of amniotic fluid and fetal growth with perinatal outcome is being documented. But the lacunae lies in studying the relationship between borderline amniotic fluid and perinatal outcome. The following study was undertaken to provide recent data that would help predict perinatal outcome in borderline AFI pregnancies.Methods: About 144 patients were considered in the study OPD/IPD patients in obstetrics and gynecology department in Bhabha Atomic Research Centre and Hospital, with about 72 cases with borderline amniotic fluid index (5-8 cm) and controls with amniotic fluid index ≥9-25 cm. Patients were selected and subjected to history taking, examination, ultrasound test with doppler studies and perinatal outcome documented over a period of one year.Results: The incidence of borderline AFI in my study was 16%. 58% were primigravidas. Meconium stained liquor was found in 18% cases compared to 7% controls. Low birth weight was found in 12.5% cases and 2.7% in controls. On applying statistical test analysis chi square test, it was found that borderline amniotic fluid index in relation to presence of meconium stained amniotic fluid and low birth weight, p value was found to be statistically significant (<0.05).Conclusions: Borderline amniotic fluid and perinatal outcome had significant relationship in terms of meconium stained liquor and birth weight while rest had no significance. Thus, borderline amniotic fluid patients require vigilant fetal surveillance.

scholarly journals Relationship between Amniotic Fluid Index and Perinatal Outcome

2015 ◽  
Vol 10 (1) ◽  
pp. 48-51
Author(s):  
S Pradhan ◽  
A Adhikary ◽  
P Pradhan ◽  
S Pradhan
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Fetal Distress ◽  
Amniotic Fluid Index ◽  
Significant Difference ◽  
Low Birth Weight Babies ◽  
Meconium Staining

Aims:  This study was done to evaluate the predictive value of low amniotic fluid index (AFI) of < 5 cm for adverse perinatal outcome in term of caesarean section for fetal distress, birth weight, meconium stained liquor and APGAR scores. Methods: This was a prospective study of 200 antenatal women booked at Nepal Medical College Teaching Hospital during the year 2013-2014 with gestational age between 34 and 41 weeks. Patients history and clinical examination were recorded and AFI was measured and the perinatal outcome was compared between two groups i.e AFI <5 cm and >5 cm. Results: The caesarean section (C/S) rate for fetal distress and low birth weight babies (<2.5 kg) was higher in patients with low AFI (p=0.048, 0.001 respectively). There was no significant difference in meconium staining, APGAR score at 5 minutes between the two groups (p=0.881, 0.884 respectively). Conclusions: Caesarean section for fetal distress and low birth weight babies was significantly associated with low amniotic fluid index. There was no significant difference in meconium staining liquor, APGAR score at 5 minutes between the two groups.  

Low Molecular Weight Heparin Novo (LHN-1) Does Not Cross the Placenta During the Second Trimester of Pregnancy

1989 ◽  
Vol 61 (01) ◽  
pp. 055-056 ◽  
Author(s):  
A Omri ◽  
J F Delaloye ◽  
H Andersen ◽  
F Bachmann
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Control Group ◽  
Blood Collection ◽  
Low Molecular Weight ◽  
Time Interval ◽  
Second Trimester ◽  
Thromboembolic Complications ◽  
Safe Alternative ◽  
Drug Of Choice

SummaryUnfractionated heparin (UF-H) has been the drug of choice for the treatment of thromboembolic disorders during pregnancy. Low molecular weight heparin (LMW-H) preparations may present some advantages over UF-H. They have longer half-lives and a better bioavailability after subcutaneous (s. c.) injection and may cause less bleeding. It has not yet been established whether LMW-H Novo (LHN-1) crosses the placenta. 17 women admitted for abortion during the second trimester of pregnancy (induced by application of prostaglandine PGE2 gel at a concentration of 0.25 mg/ml into the cervix) were given s. c. 35 anti-Xa units per kg of body weight of LHN-1 (Novo). 10 patients not receiving LHN- 1 and their fetuses served as a control group. 7 women in whom the time interval between injection of LHN-1 and expulsion of the fetus was less than 3 h or more than 7 h were excluded from further study. In one fetus blood collection failed. Anti-Xa and anti-IIa levels increased approximately ten-fold in women receiving LHN-1 [anti-Xa units/ml from 0.02 ± 0.01 (mean ± SD) to 0.17 ± 0.01, p <0.001; anti-IIa units/ml from less than 0.01 ± 0.01 to 0.07 ± 0.03], but remained below the detection limit in their fetuses as well as in the women and fetuses of the control group.We conclude that LHN-1 at these doses does not cross the placenta during the second trimester of pregnancy to suggest that LHN-1 may be a safe alternative to heparin in the management of the thromboembolic complications during pregnancy.

scholarly journals Tubular Dysfunction Mimicking Dent’s Disease in 2 Infants Born with Extremely Low Birth Weight

2017 ◽  
Vol 7 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Midori Awazu ◽  
Mie Arai ◽  
Shoko Ohashi ◽  
Hirotaka Takahashi ◽  
Takashi Sekine ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Low Molecular Weight ◽  
Tubular Dysfunction ◽  
Low Molecular Weight Proteinuria ◽  
Proximal Tubular Dysfunction ◽  
Dent's Disease ◽  
Proximal Tubular

Two preterm infants, with extremely low birth weight born at gestational weeks 24 and 25, showed generalized proximal tubular dysfunction during their stay in the neonatal intensive care unit, including glucosuria, low molecular weight proteinuria, phosphaturia, uricosuria, enzymuria (elevated urine N-acetyl-β-D-glucosaminidase), panaminoaciduria, and hypercalciuria, associated with renal calcification. Renal tubular acidosis was not present in either patient. DNA mutation analysis for Dent’s disease, performed in patient 1, was negative. Although both patients had rickets of prematurity, tubular dysfunction persisted after its resolution. Patient 2, who had severe chronic lung disease, also had elevated serum creatinine, proteinuria, and hypertension, suggesting glomerular damage. In patient 1, low molecular weight proteinuria, enzymuria, panaminoaciduria, hypercalciuria, and renal calcification were still present at the age of 8 years. In patient 2, tubular dysfunction resolved except for β2 microglobulinuria at the age of 5 years. While a reduced nephron number resulting in focal segmental glomerulosclerosis is well-known, generalized proximal tubular dysfunction can also occur in infants born preterm and/or with extremely low birth weight.

scholarly journals COMPARISON OF PERINATAL OUTCOME IN TWIN PREGNANCY WITH AND WITHOUT CERVICAL CERCLAGE

2020 ◽  
pp. 48-52
Author(s):  
Kalpana Damor ◽  
Sandhaya Choudhary ◽  
Himanshi Gangwal
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Twin Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
The Mean

Background: The incidence of multifetal pregnancies has registered increase globally. Babies born from multiplebirth pregnancies are much more likely to result in premature birth than those from single pregnancies. Knowledge of role of cervical cerclage in preventing preterm birth especially in twin pregnancy can be helpful to prevent complication related to preterm birth and ultimately of low birth weight babies. Methods: Depending upon who opt for the procedure 100 patients were divided equally into two groups: 1)Twin pregnancy with cervical cerclage; 2)Twin pregnancy without cervical cerclage. We measured maternal outcomes which include time for which patient required to be hospitalized, maternal pyrexia, cervical or bladder injury and other maternal morbidity and perinatal outcomes which include preterm delivery (delivery before 37 completed weeks), low birth weight (birth weight ≤2000 g), IUGR, perinatal mortality, indicators of perinatal morbidity (APGAR scores and neonatal unit admission), stillbirth, second trimester loss and presence of congenital malformations. Results: In Study group 22% delivered before 34 weeks of gestation, 46% delivered between 34 and 37 weeks of gestation, 32% delivered after 37 weeks of gestation compared to 44%, 48% and 8% respectively in Control group. The mean gestational age at delivery was 35.3 weeks in Study group and was 33.2 weeks in Control group. In study group 47% neonates had birth weight less than 2Kg and in Control group 69% neonates had birth weight less than 2Kg. In Study group 95% had Apgar score more than 6 whereas in Control group 86% had APGAR score more than 6. The mean APGAR for Study group was 8.5 and for Control group was 7.5. 45% neonates had complications in Study group whereas 67% neonates in Control group. Overall Low birth weight was most common complications in both the groups. Respiratory distress was more common in Control group. Conclusions: In spite of close vigilance, preterm birth in twin gestation is common and unpredictable. It is difficult to predict those who may require cervical cerclage although all multiple pregnancies are at high risk. Cerclage should be considered an option for patients with twin pregnancies in the second trimester to prolong the duration of gestation as close to term as possible.

Low-molecular-weight heparin in the prevention and treatment of thromboembolic disorders

1998 ◽  
Vol 1 (5) ◽  
pp. 166-174 ◽  
Author(s):  
Evelyn R Hermes De Santis ◽  
Betsy S Laumeister ◽  
Vidhu Bansal ◽  
Vandana Kataria ◽  
Preeti Loomba ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Prevention And Treatment
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