Abnormal labor as a medical and social issue

Abnormal labor is a main cause of obstetric and perinatal complications. Impaired uterine contraction during childbirth is accompanied by an increase in the risk of fetal asphyxia, obstetric bleeding and postpartum inflammatory diseases. The frequency of diagnosed abnormal uterine contractile activity is 10-25%, which, along with the high need for operative delivery, allows for considering abnormal labor as one of the main medical and social issues of the present time. The aim of this study was to consider abnormal labor as a medical and social problem. This was achieved by using an analytical method including carrying out a detailed systematic analysis of modern domestic and foreign literature on abnormal labor. The study used databases such as eLIBRARY.RU, Scopus, PubMed, MEDLINE, ScienceDirect, and Cochrane Library from the creation until July 2021. Abnormal labor is an important medical and social issue that requires the active development of methods to predict and prevent not only violations of uterine contractility, but also their complications.

Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy is the most common liver disease during pregnancy. The main features are maternal pruritus, in the absence of a rash, and raised serum bile acids. Intrahepatic cholestasis of pregnancy is associated with an increased risk of adverse perinatal outcomes, including preterm birth, meconium-stained amniotic fluid, fetal asphyxia with neonatal unit admission or even stillbirth. The main treatment option is ursodeoxycholic acid. We review the etiology, diagnosis, adverse pregnancy outcomes, focusing especially on management of this intriguing condition.

Treatment of intrauterine fetal asphyxia

Frey (Zentr. F. Gyn., 1924, No. 18) proposes chloroforming to combat intrauterine fetal asphyxia.

A PROSPECTIVE AND OBSERVATIONAL STUDY ON FETOMATERNAL OUTCOME IN POSTDATED PREGNANCY

Background: Postdated pregnancy is gestation longer than 40 weeks or 280 day. Prolonged pregnancy is defined as any pregnancy that last 294 days or more. Reported frequency of post term pregnancy range from 3 - 1 4 percent with an average of about 10 percent. Several studies have concluded that these pregnancies are accompanied by a rise in perinatal morbidity and mortality. The presumed etiology for this rise is placental insufficiency. Abnormalities such as congenital anomalies, oligohydramnios, meconium aspiration, fetal asphyxia, fetal dysmaturity, macrosomia and shoulder dystocia are commonly observed in these pregnancies Materials and Methods: This study was conducted in the Department of Obstetrics and Gynecology, after approval from the Ethics Committee, from January 2019 to September2020 on 150 patients in the department of Obstetrics and Gynaecology, willing to participate and fulfilling the inclusion and excliusion criteria in the study period. Results: Of the total 150 women, 122 (81.34%) were in 40 weeks group; 28 (18.66%) in 41 weeks group and 0 (0%) were in > 42 weeks group. Most women (89.3%) were between 20-35 years of age. Among 150 women, 40 (26.6%) went into spontaneous labor, 87(8.0%) were induced andn23 (15.34%) was taken for caesarian section. Misoprostol, Dinoprostone gel and oxytocin were the different modes of induction (Table 7). Misoprostol was used in the majority of inductions followed by Dinoprostone gel. The success rate between these two is almost similar (92.45% & 95.1%).Lscs rate was 15.33%.Most of the newborn had weight between 2.5-3.5kg in 68.25% of women in gestational age >40 weeks. Conclusions: The present study, we conclude that postdated pregnancy can be considered as a high risk factor from the point of fetal outcome as there is more fetal morbidity. Keywords: High risk pregnancies, maternal mortality, Outcomes, Perinatal mortality, postdated pregnancy.

Do Increased Intra-alveolar Squamous Cells at Autopsy Correlate With Acute Fetal Asphyxia?

It is a generally held concept that finding increased aspirated amniotic fluid squames at autopsy supports a diagnosis of acute fetal asphyxia, the massive aspiration of squames being an indicator of terminal gasping. To evaluate this concept, we identified autopsies on 15 third-trimester stillborns with clinical acute placental abruption (acute asphyxia); 13 also had thymic petechiae and none had severe acute thymic involution, findings also supporting acute asphyxia. Thirty third-trimester stillborns with findings supporting a subacute or chronic mode of death, including severe thymic involution and absence of thymic petechiae, comprised the comparison group. Intra-alveolar squames were scored as 0, no squames; 1+, scattered squames singly or in small groups; and 2+, squames in many alveoli, at least focally in compacted clusters. In all cases, the squames were patchily distributed, and none received a score of 0. In the abruption group, the intra-alveolar squames were scored as 1+ in 12 (80%) and as 2+ in 3 (20%) cases, while in the comparison group, the squames were scored as 1+ in 20 (67%) and 2+ in 10 (33%) cases ( P = NS). There was also no difference in the quantification of intra-alveolar squames in term compared to preterm stillborns. In conclusion, quantification of intra-alveolar squames did not aid in separating an acute mode of death (acute asphyxia) from subacute or chronic modes of death.