scholarly journals Umbilical Cord Abnormalities and Maternal and Perinatal Outcome: A Prospective Observational Study

2021 ◽  
Author(s):  
Kalpna Kulshrestha ◽  
Debbarma Sukla ◽  
Kalpana Verma
Keyword(s):  
Observational Study ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Insertion Site ◽  
Circulatory System ◽  
P Value ◽  
Maternal Complications

Introduction: The umbilical cord is the vital extension of the fetal circulatory system which regulates blood flow in both directions, thus allowing mother-child communications viz., immunological, oxygenation, fetal nutrition, cardiac function. Umbilical cord abnormalities are associated with the adverse maternal and perinatal outcome.. Aim: To assess prevalence of various umbilical cord abnormalities and its association with maternal complications and perinatal outcome. Materials and Methods: This prospective observational study was conducted at Saraswathi Institute of Medical Sciences Pilkhuwa, Hapur, Uttar Pradesh, India from June 2019 till March 2020. The approval for the study was taken from the Institutional Ethical Committee. Total number of deliveries during this period were 1284. After satisfying exclusion criteria, total 600 deliveries of more than 37 weeks of gestation were included in the study at random. Examination of cord was done during delivery for presence of loops of cord around the neck or body, any knots, true or false. After the delivery, the cord was clamped 5 cm from the fetal end and the total length was measured from the cut end till the placental insertion site, and 5 cm added therein. Umbilical cord was examined for any abnormalities and numbers of coils recorded and Umbilical Coiling Index (UCI) measured. Apgar score and NICU admissions noted. Results: Out of 600 patients, umbilical cord abnormalities were seen in 194 (32.33%) patients, while in 406 (67.67%) no abnormality was detected. The mode of delivery was vaginal in 441 cases (73.5%) while 159 (26.5%) had Lower Segment Cesarian Section (LSCS). Out of 194 cases with umbilical cord abnormality, 89 (45.87%) had LSCS and out of 406 cases with no cord abnormality, only 70 cases (17.24%) had LSCS (p-value<0.0001). Mean UCI was 0.25±0.09. Total 269(44.83%) had maternal complications and 143 cases (53.16%) had umbilical cord abnormalities. While 126 (46.84%) cases with maternal complications did not show any cord abnormality. Apgar score of <7 at one minute was seen in 43 cases (22.16%) and 23 (11.86%) were admitted in Neonatal Intensive Care Unit (NICU) with umbilical cord abnormality. Conclusion: The umbilical cord abnormalities were associated with the adverse maternal and perinatal outcome and increased rate of LSCS (p-value <0.0001). The study shows the importance of knowledge of cord abnormalities. The cord abnormality should be looked for after each delivery, with the aim to reduce perinatal morbidity.

scholarly journals Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre

2017 ◽  
Vol 6 (8) ◽  
pp. 3409
Author(s):  
Rashmi Kumar Karning ◽  
Bhanu B. T. ◽  
. Sarojini
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Fetal Outcome ◽  
Short Term ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery

Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician.

scholarly journals Perinatal outcome in pregnancies with nuchal cord: prospective cross-sectional study at tertiary care institute

2021 ◽  
Vol 10 (6) ◽  
pp. 2368
Author(s):  
Zaneta Dias ◽  
Shailesh Kore
Keyword(s):  
Umbilical Cord ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Common Finding ◽  
Control Group ◽  
Nuchal Cord

Background: The umbilical cord around the neck of fetus at the time of birth is nuchal cord (NC). NC is blamed as a major cause of fetal distress and perinatal mortality. The present study was undertaken to found out the incidence of nuchal cord at delivery and its perinatal outcomes in babies born with NC.Methods: Total 500 low risk women delivered either vaginally or abdominally after 34 completed weeks of gestation were included in the study. Cases with NC at the time of delivery were taken as study group and the cases which did not have NC served as control group. Various obstetric characteristics and perinatal outcome were studied.Results: The frequency of NC found was 35.6% of all the deliveries. Women with age between 21-25 years showed the maximum presence of NC (11.4%) and NC mostly seen between 38-40 weeks of gestation (24.8%). Presence of NC had no statistical significance on the maternal age, parity, period of gestation, mode of delivery, presence of meconium stained amniotic fluid and fetal distress. Prolonged duration of labour was seen in the presence of NC. The presence of NC was directly proportional to the length of cord and umbilical cord coiling. Perinatal outcome of babies in terms of Apgar score and seen as NICU admissions rate were not statistically significant. Tight NC had a poor Apgar score needed more intensive care.Conclusions: NC is a common finding at the time of delivery. The present study suggests that NC is not associated with significant perinatal outcome.

scholarly journals Comparison of Maternal and Perinatal Outcome in Elective and Emergency Cesarean Section in a Tertiary Care Centre

2019 ◽  
Vol 4 (1) ◽  
pp. 616-620
Author(s):  
Anjali Subedi ◽  
Junu Shrestha ◽  
Krishna Murari Adhikari ◽  
Aashika Shrestha ◽  
Sangeeta Gurung
Keyword(s):  
Cesarean Section ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
P Value ◽  
Antenatal Visit ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Elective Group

Introduction: Cesarean delivery is the birth of a fetus via laparotomy and then hysterotomy. There are increased maternal and fetal morbidities and mortalities associated with such delivery, more in emergency cesarean section. Various studies have shown increasing trend of this mode of delivery worldwide leading to an increase in its associated risks and cost to the patients. Objective: The objective of the study was to compare the maternal and perinatal outcome in elective and emergency cesarean section. Methodology: It was a prospective comparative study conducted in the department of obstetrics and gynecology, Manipal Teaching Hospital from March, 2018 to September, 2018. All the patients undergoing cesarean section either elective or emergency were enrolled in the study after their consent. After collecting data from patients, maternal and perinatal outcomes were analyzed by using SPSS software. Results: There were total 1254 deliveries in the study duration, out of which 461(36.76%) were cesarean section (cs). The incidence of emergency cs was 86.5% and elective cs was 13.5%. Majority of women (75.7%) undergoing cs had no any antenatal visit. Around 81% of cases undergoing emergency cs were unbooked whereas only 48.4% of unbooked cases underwent elective cs (P-value 0.000). The most common indication for cs in both elective and emergency category was previous cs. There was no maternal complication in elective cs group but there were 8 cases (2%) in emergency cs (P value-0.293). In emergency cs group, 7 babies had poor Apgar score whereas all babies had good Apgar score in elective group (P-value-0.057). There was increased rate of NICU admission in emergency group than in elective group (3% vs 0%, P value-0.166). Conclusion The study showed that the incidence of cesarean section was high in our centre. The maternal and fetal risks were higher in emergency cs than in elective cs, but these were not statistically significant.

scholarly journals Maternal and perinatal outcome in trial of labour after caesarean at tertiary care hospital: a prospective observational study

2020 ◽  
Vol 10 (1) ◽  
pp. 315
Author(s):  
Ingle Sharad Prabhakarrao ◽  
Shalaka Bansode ◽  
Sumathi Balakuduru
Keyword(s):  
Observational Study ◽  
Hospital Stay ◽  
Success Rate ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Bishop Score ◽  
Minute Apgar Score

Background: To compare maternal and perinatal outcomes in trial of labor after cesarean (TOLAC) and Emergency repeat cesarean delivery (ERCD).Methods: Prospective observational study at tertiary care center for one year. Selection of candidates for Vaginal Birth after caesarean section (VBAC) was based on the 2010 American College of Obstetricians and Gynecologists’ (ACOG) recommendation. The maternal outcome was observed in the form of VBAC success rate, maternal complications, number of days in a hospital stay, The perinatal outcome was observed as 5 minute Apgar score and need for neonatal intensive care unit (NICU) admission.Results: 250 patients were given trial for vaginal delivery. VBAC success rate was 169/249 (67.9%). 80/249(32.1%) patients required repeat CS. Cases with Bishop score >6 had more rate of vaginal delivery (89.6%) as compared to Bishop score ≤6 (17.4%) (p=<0.01). Spontaneous labour had better VBAC success rate (91.8%) than induced labour (55.5%) (p=<0.01). 8/12 (66.6%) subjects with history of previous vaginal deliveries delivered vaginally. 5/169 of VBAC babies had low 5-minute Apgar score as compared to 3/80 from repeat CS.Conclusions: VBAC has the benefits of short hospital stay, decreased morbidity and less expenditure. Considering the fact that fetal morbidity and mortality due to TOL is comparable with the women labouring without a scar, TOL may be encouraged. Women can be given TOL with careful monitoring and taken for emergency LSCS on minimal indication and can be the best answer to management of previous one CS in labour.

scholarly journals A clinical study of mode of delivery and perinatal outcome in iligohydramnios

2017 ◽  
Vol 6 (6) ◽  
pp. 2212
Author(s):  
U. S. Hangarga ◽  
V. G. Kulkarni ◽  
. Nikitha
Keyword(s):  
Perinatal Outcome ◽  
Maternal Age ◽  
Prospective Observational Study ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Research Centre ◽  
Maternal Complications ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: To evaluate intrapartum sequale of sonographically diagnosed Oligohydrominos such as rate of caesarean section, fetal distress and condition of the new born.Methods: This Prospective observational study was conducted in the department of obstetrics and Gynecology, Navodaya Medical College Hospital and Research Centre between June 2015 to December 2016. The antenatal women with gestational age more than 34 weeks and above, attending our OPD or labor room were included in this study.Results: A total of 140 cases of Oligohydromnias were selected for present study and outcome were assessed. The mean maternal age is 24.42 years. 32.14% cases have delivered vaginally, 67.82% patients went for caesarean sections, 10.7% of babies needed NICU care and 1 was still birth. No adverse maternal complications were observed during the study.Conclusions: Oligohydromnia is one of the frequent complications during labor. The risk of muconium staining of liquor, intrapartum fetal distress, operative delivery and NICU admissions are more in Oligohydromnia cases.

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

scholarly journals Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

2019 ◽  
Vol 7 ◽  
pp. 205031211983209 ◽  
Author(s):  
Seung-Joo Nam ◽  
Sung Chul Park ◽  
Sang Hoon Lee ◽  
Dong Wook Choi ◽  
Sung Joon Lee ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Eradication Rate ◽  
Laboratory Data ◽  
P Value ◽  
Diabetic Patients ◽  
Multicenter Prospective Observational Study ◽  
H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

scholarly journals Perinatal Outcome of the Second Twin

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
Second Twin

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 

scholarly journals A prospective observational study conducted in tertiary teaching hospital of Uttar Pradesh to compare safety and efficacy of PPIUCD and interval IUCD (380A)

2018 ◽  
Vol 8 (1) ◽  
pp. 295
Author(s):  
Nidhi Gupta ◽  
Akanksha .
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Uttar Pradesh ◽  
P Value ◽  
Efficacy And Safety ◽  
Puerperal Sepsis ◽  
Medical College ◽  
Tertiary Teaching ◽  
Reversible Method ◽  
Tertiary Teaching Hospital

Background: The objective of this study was to compare the efficacy and safety of PPIUCD and interval IUCD.Methods: This was a prospective observational study conducted on women attending the OPD and indoor services of S.N. Medical college, Agra. 800 women willing for PPIUCD insertion were included in the study after informed consent excluding chorioamnionitis, PROM>18 hours, unresolved PPH and puerperal sepsis. Another 200 willing women were inserted interval IUCD according to MEC criteria of WHO. All were followed up for 1 year.Results: It was found that rate of expulsion was more in PPIUCD group compared to interval IUCD group (6%vs 1.5% p value <.05),rate of removal was almost similar in both groups (11.5%inPPIUCD and 14%in interval IUCD group), cause of removal was mainly social in PPIUCD group while bleeding was more in interval IUCD group compared to PPIUCD (85.7%vs26%).Conclusions: Postpartum insertion of IUCD is a safe effective, feasible and reversible method of contraception.

scholarly journals Maternal and perinatal outcome in patients with severe pre eclampsia/ eclampsia with and without HELLP syndrome

2014 ◽  
Vol 1 (4) ◽  
pp. 7-12
Author(s):  
T Gupta ◽  
N Gupta ◽  
J Jain ◽  
S Gupta ◽  
P Bhatia ◽  
...  
Keyword(s):  
Birth Weight ◽  
Hellp Syndrome ◽  
Perinatal Outcome ◽  
P Value ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Prospective Longitudinal Study ◽  
Entire Study ◽  
Group 3 ◽  
Prospective Longitudinal

OBJECTIVE: To evaluate the occurrence of HELLP syndrome inpatients with severe pre eclampsia & eclampsia and to compare the maternal & perinatal outcome in patients with and without HELLP syndrome (partial and true). METHOD: This was a prospective longitudinal study conducted in the Department of Obstetrics & Gynaecology, E.S.I. PGIMSR,NewDelhi from August 2011-April 2013. 50 pregnant women with singleton pregnancy with severe pre eclampsia detected at 28 or more weeks of gestation were enrolled. Patients were divided into three groups: group 1 with severe pre eclampsia, group 2 with severe pre eclampsia with partial HELLP syndrome and group 3 with severe pre eclampsia with true HELLP syndrome. Patients in three groups were compared in regard to maternal complications, gestational age atdelivery, mode ofdelivery, hospital stay andperinatal outcome. RESULTS: Prevalence of HELLP syndrome in severe pre eclampsia was 40% (partial HELLP= 28% and true= 12%). Antenatal and maternal complications were more in true HELLP syndrome patients as compared to other groups. PPH was observed in 40% of entire study group. DIC was found more in true HELLP syndrome patient with high statistically significant p value<0.001 Blood and its product transfusion was more in true HELLP syndrome. There was 100% ICU admission in group 3. In severe pre eclampsia, 11 neonates had birth weight >2.5kg. Where as in partial and true HELLP syndrome, no neonate had birth weight more than 2.5kg.This difference was statistically significant. There was 100% NICU admission in HELLP syndrome, 91.66% in partial HELLP syndrome and 42.3% in severe preeclampsia. The perinatal morbidity and mortality was higher in HELLP syndrome patients than in patient with severe pre eclampsia without HELLP syndrome. CONCLUSION: The study concludes that both maternal and perinatal outcome were adverse in HELLP syndrome than in severe pre eclampsia without HELLP syndrome. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9564 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 7-12

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