scholarly journals The Association of Various Placental Lesions with Perinatal Outcome in Preterm Births

2021 ◽  
Vol 8 (5) ◽  
pp. 357-364
Author(s):  
Ashwini Sarode ◽  
Anil R Joshi ◽  
Anjali S Kulkarni
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Preterm Births ◽  
Neonatal Morbidity ◽  
Vascular Lesions ◽  
Placental Pathology ◽  
Tertiary Care Centre ◽  
Inflammatory Lesions ◽  
Clinical Records

Objective: Present study was designed to identify various lesions in placenta and investigate their impact on neonatal and perinatal outcome and also to determine the frequency of various inflammatory lesions in placenta. Materials and Methods: Placentae of 60 singleton nonanomalous preterm births were examined at Department of pathology at Tertiary care centre. Complete placental examination including both macroscopic and microscopic examination with the help of Haematoxylin and Eosin staining done. Thereafter placental lesions were classified according to Redline criteria for classification of placental pathology. Thereafter placental lesions were correlated with perinatal mortality and neonatal morbidity in early neonatal period. The relevant clinical details were collected from the obstetric clinical records and neonatal clinical records. Result: We found placental vascular processes as most frequent (73.33%) pathological lesion in our study. Most common inflammatory lesion in our study was chorioamnionitis (15%). Also among placentae of stillbirths, placental vascular lesions were predominant finding present in 85.7% of placentae of stillbirths. Other lesions found in placentae of stillbirths were Immune inflammatory lesions, maternal floor infarction and placenta accreta. Out of total placentae with vasculopathy, 19.2% cases developed neonatal sepsis, in chorioamnionitis group 66.6% live births were having sepsis. In present study we observed higher frequency of resuscitation in babies with placentae having chorioamnionitis. Discussion: This study revealed that the placental pathological findings appear to be correlated with perinatal mortality and early neonatal morbidity. So, examination of the preterm placentae gains importance in early determination of morbidity in infants. Placental findings can help neonatologist in routine diagnosis and management. Keywords: Placenta, Placental pathology, Preterm births, Perinatal outcome.

STUDY OF MATERNALAND PERINATAL OUTCOME IN CASES OF PRETERM PREMATURE RUPTURE OF MEMBRANES

2021 ◽  
pp. 11-14
Author(s):  
Madhuri Rani ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Preterm Births ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Preterm Premature Rupture

Background: Preterm premature rupture of membranes (PPROM) occurs in 3%to6% of pregnancies and is responsible for approximately one third of all preterm births. Aims & Objective: of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6days admitted in labour room of obs and gynae dept. of DMCH from January 2019 to April 2020. Material and Methods: It is hospital based prospective observational study of 100 patients of preterm premature rupture of membranes in between 28-36 weeks+6 days gestation with singleton pregnancy admitted in our tertiary care centre (Department of Obstetrics and Gynaecology, DMCH, Laheriasarai, Bihar). Results: In this study 42% patients went into spontaneous labour and 58% needed induction or augmentation. 68% patients had vaginal delivery and 23% required LSCS. The main indications for LSCS being malpresentation (26%) followed by foetal distress (22%). There was no maternal mortality; morbidity was found in 15% patients. Perinatal morbidity was seen in 40% and was mainly due to RDS, sepsis andhyperbilirubinaemia . Perinatal mortality was seen in 17% and was due to sepsis in 29.4%, RDS in 52.94% and birth asphyxia in 17.6%. Conclusion: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity & mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. Therefore management of PPROM requires accurate diagnosis and evaluation of the risks and benets of continued pregnancy or expeditious delivery. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benets of conservative management of preterm PROM at any gestation

scholarly journals Risk factor and perinatal outcome of preterm delivery in a tertiary care centre in rural Haryana

2020 ◽  
Vol 9 (10) ◽  
pp. 4187
Author(s):  
Sunaina Singla ◽  
Banashree Das
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Delivery ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Preterm Births ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
History Of

Background: Aim of the study was to identify risk factors and to assess neonatal mortality and morbidity associated with preterm delivery in patient attending a tertiary care centre in rural Haryana.Methods: This retrospective cohort study was conducted in Shree Guru Gobind Singh Tricentenary Medical College, over a period of one year (January to December). All pre-term deliveries were included in the study. They were followed up from admission till delivery and till discharge from hospital. Various, parameters like maternal age, associated medical disorder, obstetric complications, gestational age, neonatal mortality, need of neonatal intensive care and condition of baby at discharge were analyzed.Results: In the present study, incidence of preterm deliveries was 16.1%. The most common risk factor found to be history of previous abortion (23.6%), preterm premature rupture of membrane (17.1%), Intra-uterine growth restriction (IUGR) with oligohydramnios (10.5%), hypertensive disorder during pregnancy (5.9%), and antepartum hemorrhage (4.6%). But majority of the patient (56.5%) no cause could be identify. Out of total 160 preterm births 3 were still born and 157 live preterm births, and out of which total Neonatal intensive care (NICU) admission were 60. Mortality rate was 100% in neonate weighing less than 1000 gm and 18% in babies weighing less than 2000 gm.Conclusions: The commonest risk factor for preterm delivery is previous history of abortion and adverse perinatal outcome is inversely proportionate to the period of gestation at the time of delivery. All efforts should be made to prolong the pregnancy beyond 34 weeks by identifying and actively managing the risk factors for better neonatal outcome.

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.

scholarly journals Pregnancy outcome in women with previous preeclampsia versus women normotensive in previous pregnancy

2018 ◽  
Vol 7 (12) ◽  
pp. 5045
Author(s):  
Jayshree Mulik ◽  
Snehalata Suresh
Keyword(s):  
Pregnancy Outcome ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Subsequent Pregnancy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Previous Pregnancy ◽  
Index Pregnancy ◽  
History Of ◽  
Adverse Pregnancy

Background: Women with history of preeclampsia have reportedly higher risk of development of preeclampsia in subsequent pregnancies, along with other adverse pregnancy outcomes. Authors aimed to study the incidence of recurrent preeclampsia and compare the pregnancy outcome in women with history of preeclampsia in previous pregnancy with those who were normotensive in previous pregnancy and further compare outcomes in women with recurrent preeclampsia between their previous and index pregnancy.Methods: Pregnancy outcome was studied in women with preeclampsia in previous pregnancy (cases) and compared with women normotensive in previous pregnancy (controls). Further analysis of cases was done by dividing them into subgroups: those with recurrent preeclampsia in index pregnancy (A1) and those normotensive in index pregnancy despite being pre-eclamptic in previous pregnancy (A2). Total 100 cases and 100 controls were enrolled in the study, which was conducted at present tertiary care centre from January 2012 to June 2013.Results: Out of total 200 participants (100 cases, 100 controls) enrolled in the study; 58 out of 100 cases had recurrent preeclampsia and remaining 42 remained normo-tensive in index pregnancy. Among 100 controls, 93 were normotensive in index pregnancy.Conclusions: Women with history of preeclampsia in previous pregnancy had adverse maternal and perinatal outcome in subsequent pregnancy when compared to the women who were normotensive in the previous pregnancy. But when compared with their own previous preeclamptic pregnancy, they had better pregnancy outcome with good perinatal outcome in their index pregnancy. 

scholarly journals Maternal and perinatal outcome in pregnancy complicated by obstetric cholestasis: study from a tertiary care centre in North India

2021 ◽  
Vol 10 (7) ◽  
pp. 2830
Author(s):  
Deepika Jamwal ◽  
Gurpreet Kour ◽  
Anil Mehta
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Liver Disorder ◽  
North India ◽  
Tertiary Care Centre ◽  
Impaired Liver Function ◽  
Nicu Admission ◽  
Cholestasis Of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (IHCP) is the most common pregnancy related liver disorder. It typically presents with troublesome itching and can lead to complications for both mother and foetus. Present study was carried out to study the incidence of Obstetric Cholestasis and its fetomaternal outcome in a tertiary care hospital.Methods: It was a prospective epidemiological study during a period of one year (May 2020 to April 2021) over 120 pregnant ladies suffering from pruritus and detected as having Obstetric Cholestasis. They were followed up and maternal as well as perinatal outcome recorded. Appropriate statistical analysis done as applicable.Results: The incidence of Obstetric Cholestasis in our hospital was 9.3%. Majority of cases delivered at term (78.3%). 41.6% patients delivered vaginally, 43.3% had emergency caesarean section, and 2.5% patients had instrumental delivery. Maternal morbidities are due to sleep disturbance (60%), coagulation abnormality (13.3%), increase chance of operative delivery (55.8%) and postpartum haemorrhage (12.5%). Neonatal complications include meconium aspiration (46.6%), NICU admission (36.6%), prematurity (5%) and perinatal mortality (3.3%).Conclusions: Cholestasis of pregnancy causes maternal pruritus with impaired liver function tests. Maternal morbidity is increased in terms of increased caesarean section rates and discomfort due to pruritus. A timely intervention at 37-38 weeks will reduce the adverse perinatal outcome. 

scholarly journals Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 2210
Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Medical College ◽  
Abruptio Placenta

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.

scholarly journals Study of fetomaternal outcomes in antepartum haemorrhage at tertiary care centre

2021 ◽  
Vol 10 (4) ◽  
pp. 1509
Author(s):  
Faaizah Husain Ghanchibhai ◽  
Sharda Goyal ◽  
Nalini Sharma ◽  
Ankita Pargee
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Mortality And Morbidity ◽  
Antepartum Haemorrhage ◽  
Abruptio Placenta

Background: Antepartum haemorrhage (APH) is a challenge to obstetrician as it involves a question of life and death to mother and fetus. Antepartum hemorrhage is the 2nd most common cause of maternal mortality and morbidity as sepsis and obstructed labour has decreased now. The aim of the study is to find the prevalence of APH. And to study foeto-maternal outcomes in patients with antepartum haemorrhage, association of comorbidities and risk factors.Methods: This study was conducted at Geetanjali Medical College and Hospital, Udaipur after obtaining approval from institutional research ethical board and written informed consent during the period of February 2019 to July 2020. This was prospective observational study, sample size was 60 patients. All the APH patients who were admitted at GMCH Obstetrics and Gynaecology department after 28 weeks of gestation were included in study. Extrauterine or bleeding due to general pathology was excluded. Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%.Results: Total number of delivery were 1900 in above duration and number of APH patients were 60, so our incidence is 3.1%. According to maternal complications rate, It was 66.66 % in abruptio placenta, 37.03 % in placenta previa and jointly 53.33%. In placenta previa group 100% patients discharged with good GC, In abruptio placenta group 96.96% patients discharged with good GC and 3.04% patients discharged with poor GC. Perinatal mortality was zero in placenta previa group and in abruptio placenta, it was 27.27% (24.24% IUD, 3.03% neonatal death).Conclusions: The main cause of APH was abruption which was seen in 33 (55%) of patients and placenta previa was seen in 27 (45%) of patients. Maternal and neonatal complications, both were very high in abruption group as compared to placenta previa group. Overall maternal mortality rate was 53.33% and perinatal mortality rate was zero in placenta previa group while in abruption placenta group, it was 27.27%. There was no maternal complications in booked placenta previa cases only there were very few complications in emergency cases. In abruptio placenta group also complications were more in emergency cases, irregular booked and uncontrolled pregnancy pathology cases. 

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