scholarly journals The use of dinoprostone at third trimester in pregnant women with oligohydramnios

2021 ◽  
Vol 38 (4) ◽  
pp. 604-607
Author(s):  
Mehmet GÜÇLÜ ◽  
Nur DOKUZEYLÜL GÜNGÖR ◽  
Tuğba GÜRBÜZ ◽  
Arzu YURCİ

The aim of this study was comparing the efficacy of dinoprostone administration for labour induction in pregnant women with oligohydramnios and in pregnant women with normal amniotic fluid volume at third trimester. This retrospective study included 187 pregnant women between January 2015-December 2020. Four quadrant technique was used to determine amniotic fluid index. The cases in the study were divided into two groups as Group:1(the ones with oligohydramnios) and Group:2 (the ones with normal amniotic volume) Age ,gravida, parity ,gestational week according to the last date of menstruation, Bishop score ,dilatation ,hours elapsed after the first contraction, hours elapsed after active contraction, labour entry time (hour) , time elapsed until delivery (hour) , birth weight, Apgar score 0th minute and 5th minute and their distribution between the groups showed similarity (p> 0.05). The values of amniotic fluid index (AFI) (p <0.001) and effacement (p = 0.012) were found to be significantly higher in Group 2 compared to the values of the cases in the Group 1 (p <0.05). It was found in the analysis that the findings of premature rupture of membrane (PROM), oxytocin augmentation need, tachysystole, vaginal delivery rate, caesarean delivery rate, meconium stained amnion rate, neonatal intensive care unit (NICU) need, postpartum hemorrhage, and transfusion need (p = 0.394) were similar between two groups (p> 0.05). We can state that dinoprostone can be used safely and effectively to induce labor in third trimester pregnancies both with normal AFI and oligohydramnios.

2018 ◽  
Vol 5 (2) ◽  
pp. 58-61
Author(s):  
Yogita Dwa ◽  
Shreejana Shrestha ◽  
Pooja Jaiswal

Introductions: Sonographic assessment of four quadrant measurement of amniotic fluid index (AFI) is an integral part of antenatal evaluation of pregnancies, especially in the third trimester. Decreased (oligohydramnios, AFI 0-9.9 cm) or increased (polyhydramnios >25 cm) increases the risk of intrauterine growth retardation, birth asphyxia and induction or operative interference. The aim of this study was to analyse abnormal liquor volume and mode of delivery. Methods: This retrospective cross-sectional study analysed the cases of abnormal liquor volume in term pregnancies during 2013-2016 at Patan Hospital. Patient's files were traced from medical record section. We analysed the abnormal liquor volume based on amniotic fluid index (AFI) and the mode of deliveries. Results: Among 15,272 term pregnancies scanned, 130 had abnormal AFI, 128 oligohydramnios and 2 polyhydramnios. Out of 128 oligohydramnios, 40 (30.8%) were severe, 54 (41.5%) moderate and 34 (26.2%) mild. Two cases had polyhydramnios. The emergency lower uterine segment caesarean sections (emLSCS) were performed in 99 (76.1%) oligohydramnios. Conclusions: This study suggests that oligohydramnios measured by AFI at term pregnancy required more emLSCS.


Author(s):  
Vidyasagara M. ◽  
Chandrashekhar T. ◽  
Sunil S. Raikar

Background: Amniotic fluid acts like a protective cover around the baby. Advances in ultrasound have increased early detection of abnormal amniotic fluid volumes. Any variation in the amniotic fluid volume warrants antenatal foetal surveillance.Methods: 300 pregnant women between 37 to 40 weeks of gestation were included in the study. A detailed history, examination and ultrasound was done. Pregnant women were divided into 3 groups’ i.e. normal liquor, oligohydramios and polyhydramnios. All the women were closely monitored during labour and puerperium. Follow-up was done till 7 days post-delivery. Maternal and neonatal data were collected.Results: 300 pregnant women were included in the study, out of which 221 had normal amniotic fluid index (AFI), 64 had oligohydramnios and 15 had polyhydramnios. All baseline characteristics were comparable between the groups except body mass index (BMI). Incidence of meconium stained liquor was significantly higher in oligohydramnios compared to normal AFI and polyhydramnios groups (34.4% versus 10.5% versus 13.3%; p=0.0001). Caesarean section rates were significantly higher in polyhydramnios and oligohydramnios compared to normal AFI group (73.3% versus 70.3% versus 19.9%; p=0.0001). Higher cases of low birth weight were recorded in oligohydramnios group compared to normal AFI and polyhydramnios group group (32.8% versus 18.6% versus 13.3%; p=0.011). Neonatal intensive care unit (NICU) admissions were higher in oligohydramnios (35.9%) and polyhydramnios (33.3%) compared to normal AFI group (35.9% versus 33.3% versus 12.7%; p=0.0001).Conclusions: Abnormal liquor volumes are associated with increased caesarean section rates, NICU admissions and neonatal mortality. Careful assessment of pregnant women is imperative for proper counselling and management.


2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.


2020 ◽  
Vol 2 (3) ◽  
pp. 19-22
Author(s):  
Dilek Kartal ◽  
Azra Arıcı Yurtkul ◽  
Ayşe Rabia Şenkaya

Objective: We aimed to investigate the effectiveness of uterine artery Doppler index and nuchal translucency (NT) measurement in determining perinatal problems in patients diagnosed with hyperemesis gravidarum (HEG). Material and methods: We included 80 pregnant women between the ages of 19–40 years with a singleton, noncomplicated pregnancy, no systemic disease, and no structural and chromosomal disorders in the fetus, who were admitted to our hospital which is a tertiary center with a large patient population in the region, between October 2015 and October 2016 in this study. Further, two group were formed as 40 pregnant women with the diagnosis of HEG (group 1) and 40 pregnant women for control group (group 2). Age, body mass index (BMI), educational status,pregnancy history (live birth, miscarriages), smoking, alcohol consumption, substance use, last menstrual period, serum pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotropin, (free ß-hCG), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) levels, nuchal translucency (NT), and uterine artery Doppler measurement values were recorded. The data between two groups were compared. Results: The education level of the group 1 was found higher (p = 0.001). The frequency of smoking in group 1 (n = 18; 45%) was found significantly higher than group 2 (n = 3; 7.5%) (p = 0.001). In group 1, uterine artery Doppler pulsatility index (PI) and resistance index (RI) values were found higher than group 2 (p = 0.026 and 0.024, respectively). Conclusion: The uterine artery Doppler PI, RI values measured at 20–24 weeks in patients with HEG were statistically significantly higher than those without HEG.


2021 ◽  
Vol 4 (2) ◽  
pp. 119-123
Author(s):  
N.A. Nashivochnikova ◽  
◽  
V.N. Krupin ◽  
V.E. Leanovich ◽  
◽  
...  

Aim: to assess the efficacy of biologically active additive Cystenium II as a component of combined antimicrobial treatment of acute cystitis or exacerbation of chronic cystitis and asymptomatic bacteriuria (ASB) in pregnant women. Patients and Methods: 65 pregnant women with urinary tract infections were enrolled. Group 1 included 22 women with acute cystitis or exacerbation of chronic cystitis and group 2 included 20 women with ASB. These women received standard antimicrobial therapy (fosfomycin trometamol 3 g) and Cystenium II (1 tablet twice daily with food for 14 days). The control group included 23 women with acute cystitis or exacerbation of chronic cystitis or ASB who received standard antimicrobial therapy only. Treatment results were evaluated after 14 days and 2 months. Results: complete resolution of cystitis occurred on days 2 and 3 in group 1 and days 4 and 5 in group 2. Eradication of causative agent as demonstrated by inoculation of urine samples after 14 days was reported in 77.3% of women in group 1, 70% of women in group 2, and 61% of women in group 3. Total treatment efficacy in group 1 was 81.9%, i.e., exacerbations of chronic cystitis were diagnosed in 3 women (13.6%), acute pyelonephritis in 1 woman (4.5%). Total treatment efficacy in group 2 was 90%, i.e., recurrence of ASB was diagnosed in 2 women (10%). Meanwhile, treatment efficacy in the control group was 56.5%, i.e., clinical exacerbation of chronic cystitis was diagnosed in 6 women (26%). Moreover, in 4 women (17.4%), the disease was complicated by acute pyelonephritis. Conclusions: Cystenium II for acute cystitis or exacerbation of chronic cystitis and ASB in pregnant women improves treatment success and also maintains the effect. KEYWORDS: cystitis, asymptomatic bacteriuria, pregnancy, treatment, cranberry, prevention of recurrences. FOR CITATION: Nashivochnikova N.A., Krupin V.N., Leanovich V.E. Prevention and treatment of non-complicated infections of the lower urinary tract in pregnant women. Russian Journal of Woman and Child Health. 2021;4(2):119–123. DOI: 10.32364/2618-8430- 2021-4-2-119-123.


2018 ◽  
Vol 99 (2) ◽  
pp. 291-296
Author(s):  
A E Samigullina ◽  
V A Vybornykh

Aim. Study of somatic and obstetric and gynecologic morbidity of women of the Kyrgyz Republic after Cesarean section. Methods. Retrospective cohort study was conducted in 2016 in Kyrgyz state medical institute of retraining and advanced training. Three regions of the Kyrgyz Republic were selected: Bishkek, Jalal-Abad and Issyk-Kul regions. 908 pregnant women after abdominal delivery were chosen as the subject of the study and divided into three groups: group 1 (Bishkek) - 305 pregnant women, group 2 (Jalal-Abad region) - 300 females, group 3 (Issyk-Kul region) - 303 females. The age was 15 to 49 years. The incidence of gynecologic and extragenital pathology and complications during previous pregnancies were studied. Results. Gynecologic pathology in past medical history was revealed in 15.8% of females, while women from group 1 are statistically significantly more likely to have gynecologic diseases than women from group 3. Females from group 2 had gynecologic pathology more rarely. In the structure of gynecologic incidence, sexually transmitted infections take the first place, cervical ectopy takes the second place and uterine fibroids - the third place. Extragenital pathology was detected in 38.2% of pregnant women. In its structure the first ranked place is taken by urinary tract diseases (12.3%), the second one - by infectious and parasitic diseases (11.6%), and the third place - by cardiovascular diseases (3.2%). Pathological course of pregnancy was also more frequent in group 1 than in group 2; there was no significant difference with group 3. Spontaneous abortion interrupted previous pregnancy in 19.8% of women, 5% had premature births, significantly more frequently in group 1, as well as preeclampsia. Conclusion. The most unfavorable region is the city of Bishkek, female residents of Jalal-Abad region are less susceptible to diseases; in general, gynecologic pathology was revealed in 15.8% of females, extragenital pathology - in 38.2% of pregnant women; pathological course of pregnancy was statistically more frequent in group 1 than in group 2, without significant difference with group 3.


Author(s):  
I. L. Okoroiwu ◽  
Jane Ugochi Chinedu-Madu ◽  
Emmanuel Ifeanyi Obeagu ◽  
C. C. N. Vincent ◽  
O. M. T. B. Ochiabuto ◽  
...  

The study was done to determine iron status, haemoglobin and protein levels of pregnant women in owerri metropolis. A total of 100 pregnant women were recruited for this study. The mean Hb levels in group 1, group 2, and group 3· were 12.00±1.68g/dl, 10.06±1.J4g/dl and 10.96±1.19g/dl respectively. The mean Serum ferritin level of group 1 was 67.00±88.38ng/ml, group 2, 52.48±52.47ng/ml and group 3, 51.26±48.70ng/ml. The mean Serum iron in group 1, 2 and 3 were 46.72±16.41 g/dl, 79.59±63.24 g/dl and 83.35±53.04 g/dl respectively. In group 1, 2 and 3 the mean results. ( g/dl) of TIBC were 295.58 ± 109.53, 324.06 ± 178.00 and 319.88 ± 92.95 and % T.S (%) were 18.78 ± 11.77,26.59 ± 19.40 and 17.97 ± 10.87 percent respectively. The mean total protein was group 1,6.83±l1.77g/dl, group 2,6.39±0.70g/dl and group 3, 6.39 ±0.98 g/dl while the mean albumin (g/dl) in group 1, 2 and 3 were 4.84±0.47, 4.13±0.28 and 4.14±0.29 respectively. The mean values of globulin (g/dl) were 1.98 ± 0.91, 2.29 ± 0.87 and 1.89 ± 0.90 in groups 1, 2 and 3 respectively. As gestational age increased; serum ferritin, total protein, and albumin levels decreased while serum" iron and TIBC increased. The differences in the mean results between the groups were statistically significant (p<0.05) while % T.S and globulin levels when compared showed no significant difference (p>0.05). Iron status showed no statistical difference with increasing parity (p>0.05). However, from this study iron deficiency anaemia was most prevalent in second trimester; hence iron status estimation should be an integral part of routine antenatal care test during second trimester of each pregnancy for proper assessment and management of iron deficiency anaemia in pregnancy.


2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Aneela Umber

Objective:To determine the effect of maternal (oral) hydration on amniotic fluid volume in patients with third trimester oligohydramnios. Design: Interventional study. Place and Duration of Study: Department of Obs & Gynae Unit III, Sir Ganga Ram Hospital, Lahore from May 2002 to October 2002. Patients and Methods: Twenty five women with third trimester oligohydramnios (AFI ?5.0cm) and twenty five controls with normal amniotic fluid volume (AFI 8-24 cm) were prospectively recruited for this study. Maternal urine specific gravity and amniotic fluid index were determined before and after maternal hydration by asking them to drink 2 L of water in 2-4 hours before repeat amniotic fluid index and recorded on printed proformas. Results: Hydration increased amniotic fluid volume in women with oligohydramnios (mean change in amniotic fluid index 4.3 cm, 95% confidence interval 4.02 to 5.06; P value <0.001); as well as in women with normal fluid volume (mean change in Amniotic fluid index 2.7 cm, 95% confidence interval 2.23 to 3.21; P value <0.01). However, percentage increase in mean AFI was 58.6% in the oligohydramnios group, which was significantly greater (P value <0.05) than the percentage increase of 28.4% in control group. Hydration was associated with decrease in urine specific gravity in both groups. Conclusion: Maternal (oral) hydration increases AFV in women with oligohydramnios as well as in women with normal AFV and may be beneficial in the management of oligohydramnios.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1895 ◽  
Author(s):  
Débora Cañizo Vázquez ◽  
Sandra Salas García ◽  
Montserrat Izquierdo Renau ◽  
Isabel Iglesias-Platas

Human milk contains non-nutritional factors that promote intestinal maturation and protect against infectious and inflammatory conditions. In the Neonatal Intensive Care Unit (NICU) setting, donor milk (DM) is recommended when availability of own mother’s milk (OMM) is not enough. Our aim was to compare the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in very preterm infants (VPI) after the introduction of DM. Growth and breastfeeding rates were examined as secondary outcomes. Single center, observational and retrospective cohort study comparing 227 VPI admitted to our neonatal unit before (Group 1, n = 99) and after (Group 2, n = 128) DM introduction. Enteral nutrition was started earlier after DM availability (2.6 ± 1.1 vs. 2.1 ± 1 days, p = 0.001). Incidence of NEC decreased in group 2 (9.1% vs. 3.4%, p = 0.055), especially in those born between 28 and 32 weeks (5.4 vs. 0.0%, p = 0.044). Surgical NEC was also less frequent. Suffering NEC was 4 times more likely in group 1 (multivariate analysis). Availability of DM did not impact breastfeeding rates or preterm growth. Our findings support the protective role of DM against NEC, particularly in non-extreme VPI, a group less frequently included in clinical guidelines and research studies on the use of DM.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.


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