scholarly journals The Effect of Pregnancy-Induced Hypertension on Uteroplacental Vasculature Hemodynamic Changes and Pregnancy Outcome

2021 ◽  
pp. 211-215
Author(s):  
Fahmida Gul ◽  
Sameena Gul Memon ◽  
Maria Javaid ◽  
Suresh Kumar ◽  
Yaswant Rai ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Color Doppler ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Uterine Arteries ◽  
Induced Hypertension

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. Pregnancy induced hypertension can cause growth retardation of fetus. Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome. Materials and Methods: The study was carried out at tertiary care hospital of nawab shah for the period of 06 months at Department of Radiology in association with Department of Gyne and Obs. Total 106 participants were selected for the study and all females were pregnant with 1st or 2nd trimester gestational record and medical history was taken from all participants and co-morbidities was also evaluated. Blood pressure was checked from all participants from their right arm in lying position and Ultrasound test was repeated as per requirement through color Doppler ultrasound machine and Data was analyzed by using statistical software SPSS. 24.00 version. Results: After collection of research data from all participants, the entire data was assembled for the analysis. Participants were divided into various age groups as 26 were in 18-21yeras, 34 in 22-25years, 21 in 26-29years and only 07 were from 34-37years. 26 participants were belongs to 1st trimester, 34 among 2nd trimester and 21 in third trimester. PI was also noted with three different readings 32 in Umbilical artery, 21 in middle cerebral artery and 37 in uterine artery. RI was also noted among different arteries 41 in umbilical, 36 in middle cerebral and 39 in uterine arteries. S/D was also noted, 33 in umbilical artery, 49 in middle cerebral artery and 30 in uterine arteries. Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

scholarly journals Role of Color Doppler in predicting perinatal outcome in preeclampsia

2018 ◽  
Vol 7 (2) ◽  
pp. 652
Author(s):  
Anjuri J. Roy ◽  
Archana A. Bhosale
Keyword(s):  
Birth Weight ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Perinatal Death ◽  
Color Doppler ◽  
Tertiary Care ◽  
Care Hospital ◽  
Doppler Examination

Background: Preeclampsia is one of the most common complications of pregnancy, which increases both fetal and maternal mortality and morbidity. Since preeclampsia is characterized by abnormal placenta formation leading to inadequate uteroplacental blood flow, Doppler ultrasonography can prove to be a useful tool to assess fetal outcome in PIH patients. Through this study, we sought to determine the perinatal outcome on the basis of Doppler changes seen in Umbilical and Middle Cerebral artery.Methods: This was a prospective study conducted from September 2014 to August 2017 in a tertiary care hospital where 150 singleton pregnant patients with preeclampsia were examined with Doppler ultrasound of the Umbilical artery and Middle cerebral Artery. Serial Doppler examination was performed and the results of the last Doppler examination within 10 days of delivery was considered. Perinatal outcome was studied in the form of perinatal death, mean APGAR at 1 and 5 minutes, birth weight and admission to Neonatal Intensive Care Unit (NICU).Results: Abnormal Doppler velocimetry of the umbilical artery (increased resistance, AEDV, REDV) were significantly associated with poor perinatal outcome in the form of low birth weight, APGAR of ≤7 at five minutes of birth and NICU admission. However, S/D ratio of the Middle cerebral artery could not positively predict poor perinatal outcome in this study.Conclusions: Doppler technology has provided the best opportunity for repetitive non-invasive hemodynamic monitoring in human pregnancy. Umbilical artery Doppler findings are slight better predictor of adverse perinatal outcome than an abnormal MCA.

FUNDUS CHANGES IN PATIENTS WITH PREGNANCY INDUCED HYPERTENSION AND ITS ASSOCIATION WITH FETAL OUTCOME IN WESTERN INDIA

2021 ◽  
pp. 15-18
Author(s):  
Saxena Devendra A ◽  
Makhija Sneha C
Keyword(s):  
Birth Weight ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Western India ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Neonatal Care Unit ◽  
Reliable Marker

Aim: To study the association between fundus changes in patients with pregnancy induced hypertension and the fetal outcome. A prospective cohort study was conducted on 50 patients with PIH at Methods: a tertiary care hospital in Gujarat, India. Retinal status was evaluated under mydriasis in the antepartum and postpartum period. Fetal outcome was recorded in the form of gestational age at birth, birth weight, live/stillborn, mode of delivery, need for induction of delivery and need for admission to neonatal care unit. In this study, PIH induced Results: fundus changes were seen in 48% of the patients. 17(34%) of the fetus were stillborn and 12 of the live born required hospital admission. Mothers of 13(44.82%) of these 29 fetuses with adverse outcome had PIH retinopathy. 14(50%) of the 28 mothers with fetus with low birth weight had abnormal fundi. Serous detachment occurred in 10% of the patients all of which had severe PIH or eclampsia, were primigravida and delivered preterm. Serous detachment resolved over 7-10 days postpartum. Presence of PIH Conclusion: retinopathy may be used as an indicator for predicting the fetal outcome in patients of PIH. It is a particularly reliable marker for preterm delivery when serous detachment occurs in primigravida women with severe PIH or eclampsia.

USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

2014 ◽  
pp. 9-18
Author(s):  
Thi Linh Giang Truong ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Functional Method ◽  
Invasive Technique ◽  
Routine Practice ◽  
Fetal Health ◽  
Uterine Arteries ◽  
Non Invasive ◽  
Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

scholarly journals Effect of maternal high body mass index on outcome of pregnancy in women with recurrent miscarriages

2021 ◽  
Vol 8 (4) ◽  
pp. 237-241
Author(s):  
Malangori Parande ◽  
Tanvi V Wagh ◽  
Anjali V Wagh ◽  
Nandkumar Salunke
Keyword(s):  
Gestational Diabetes ◽  
Preterm Delivery ◽  
Maternal Obesity ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Recurrent Miscarriages ◽  
Induced Hypertension ◽  
Maternal Overweight

The epidemic of obesity is spreading worldwide and subsequently, rate of obesity during pregnancy has also increased. Maternal overweight and obesity are widely associated with adverse pregnancy outcomes. Recurrent miscarriage is an important reproductive health issue, because it affects many couples. So the present study is planned to study the relationship between maternal obesity and pregnancy outcome in women with recurrent miscarriages. Observational Cross sectional study was conducted in a tertiary care hospital. 111 Postnatal women between 18 to 44 years of age with history of two or more miscarriages less than 20 weeks of gestation in previous pregnancy were included in the study. First trimester weight at the first visit (registration) was recorded, BMI was calculated & women were divided into obese and non obese groups. The outcome of present pregnancy was noted as Mode of delivery, Gestational diabetes mellitus, Pregnancy induced hypertension, Preterm delivery etc. Statistical tests were used to quantify the risk. Gestational diabetes (OR= 13.6) and pregnancy induced hypertension (OR=4.2) were significantly associated with obesity in women with recurrent miscarriages. [At 95% CI] The incidence of LSCS and preterm delivery was more in overweight and obese mothers, though not statistically significant. Maternal obesity significantly contributes to poor prognosis for the mother and the baby during delivery. Hence the women of this group should be regarded as ‘high risk’ and counselling and the risk assessment should be done during ANC visits.

scholarly journals Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

2019 ◽  
Vol 8 (1) ◽  
pp. 96
Author(s):  
Rihab A. Yousif ◽  
Awadia G. Suliman ◽  
Raga A. Aburaida ◽  
Ibrahim M. Daoud ◽  
Naglaa E. Mohammed
Keyword(s):  
Flow Velocity ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
Fetal Mortality ◽  
Pregnancy Induced Hypertension ◽  
Diastolic Flow ◽  
Induced Hypertension ◽  
The Mean ◽  
Doppler Indices ◽  
In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

scholarly journals The study of arterial and venous Doppler in high risk pregnancies and its role in perinatal outcome

2018 ◽  
Vol 7 (3) ◽  
pp. 1116
Author(s):  
S. Tabitha ◽  
Madishetti Rajini
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Delivery Mode ◽  
Care Hospital

Background: Antepartum foetal surveillance is the corner stone in the management of high risk pregnancies, aimed at reducing maternal and perinatal mortality and morbidity. This study was conducted to analyse the blood flow in umbilical artery, middle cerebral artery, umbilical vein and ductus venous using doppler ultrasound in high risk pregnancies.Methods: This was a prospective study conducted in pregnant patients with high risk factors after 28 weeks of gestation who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Hyderabad during the period from October 2013 to December 2014.Results: Patients were divided into two groups, first with normal Doppler and second with abnormal Doppler, containing 76 and 20 patients respectively. Group 2 is again 4 sub-groups according to the vessel affected. Group A included the cases with affected umbilical artery, Group B included the cases with affected middle cerebral artery, Group C included the cases with both affected umbilical artery and middle cerebral artery (UA+MCA), Group D included the Cases with the affected umbilical artery, middle cerebral artery and Ductus Venosus (UA+MCA+DV) containing 12, 2, 4 and 2 patients respectively. There were more number of emergency caesarean sections than vaginal deliveries which is statistically significant (p <0.034), there were more number of sick babies than healthy babies and there are more number of still births which is statistically significant (p <0.0001), there are more number of low birth weight babies in comparison to normal weight, which is statistically significant (p <0.0037). Distribution of cases with abnormal Doppler depending on vessel abnormality according to gestational age at the time of delivery, mode of delivery, perinatal outcome, birth weight, which was statistically significant. The sensitivity and specificity of abnormal Doppler in predicting perinatal outcome is 45% with (95% CI 26.9-64.0) and 89.5% with (95% CI 79.0-95.3) respectively. The positive predictive value is 65% with (95% CI 40.9-83.6) and negative predictive value is 78.9% with (95% CI 67.7-87.1).Conclusions: This study recommends that all high risk pregnant women should undergo serial foetal monitoring. When doppler abnormalities are detected, delivery should be conducted at a tertiary care centre where facilities for caesarean section and NICU are present.

scholarly journals Obstetrics critical care: a 2 years retrospective study in a medical college hospital of western India

2019 ◽  
Vol 8 (4) ◽  
pp. 1440
Author(s):  
Savita C. Pandit ◽  
Surendra D. Nikhate
Keyword(s):  
Critical Care ◽  
Tertiary Care ◽  
Multidisciplinary Care ◽  
Safe Motherhood ◽  
Western India ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Obstetric Hemorrhage ◽  
College Hospital ◽  
Induced Hypertension

Background: This study highlights the possibilities of new contribution to the management of high risk pregnancies and those pregnancies with unpredictable outcomes. The objective was to study the incidence and the clinical profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and final outcome.Methods: A retrospective cohort study of all obstetric critical care admissions during 2-year period from January 2016 to December 2017 was done at 1296 bedded tertiary care hospital. During the study total 349 obstetric patients were admitted to the ICU. The data were analysed by using percentage.Results: Primigravida (54.73%) were more as compared to multigravida (45.27%). Only 15.76% patients were in antepartum period while majority of patients (84.24%) were admitted during postpartum period. The main obstetric indications for ICU admission were pregnancy-induced hypertension (14.32%) followed by obstetric hemorrhage (9.16%) and community acquired pneumonia (7.44%). Other indications were valvular heart disease (5.44%), ANC with severe anemia (1.72%), monitoring (6.30%). In the present study maternal mortality among the women admitted to ICU was 18.05%. The leading cause of maternal death was obstetric hemorrhage (28.57%) followed by pregnancy induced hypertension (25.40%). An ICU intervention during the stay of the patients in terms of mechanical ventilation was used in 250 (71.63%) cases.Conclusions: A high quality multidisciplinary care is required in complicated pregnancies for safe motherhood. So, there is a need for dedicated ICU for obstetric patients.

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