cord prolapse
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2021 ◽  
Vol 41 (4) ◽  
pp. 182-183
Author(s):  
L. Wong ◽  
W.T. Tse ◽  
C.Y. Lai ◽  
A.S.Y. Hui ◽  
P. Chaemsaithong ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khalid Hassan Swidan ◽  
Wessam Magdy Abuelghar ◽  
Mohamed Adel Ali ◽  
Mohamed Soliman Hussein Soliman

Abstract Background Amniotomy, also known as artificial rupture of membranes (AROMs) and by the lay description "breaking the water," is the intentional rupture of the amniotic sac by an obstetrical provider. This procedure is common during labor management and has been performed by obstetrical providers for at least a few hundred years. Amniotomy during labor induction is associated with a faster time to delivery, most notably in nulliparous women, without an increase in cesarean delivery or maternal and neonatal morbidity. Shortening time to delivery is associated with decreased hospital costs and increased patient satisfaction, and therefore, early amniotomy, given the safety profile, should be considered when a faster delivery is of importance to patients and providers. Objective To determine the efficacy of prophylactic antibiotics in patient during labor on reducing maternal and neonatal morbidities. Methods This prospective randomized study was performed from January 2020 to July 2020, at maternity hospital of Ain Shams University. Informed consent was obtained from all participants. Candidates for this study included all patients with singleton gestations between 37 weeks and 41 weeks of gestation underwent artificial rupture of the membranes during active phase of labor. Gestational age was confirmed by a reliable last menstrual period, early sonogram. Amniotomy was confirmed by visualization of pooling fluid in the posterior vaginal fornix through the cervix after artificial rupture of membrane by sterile hook. Results There were no statistical significance differences between two groups regarding demographic characteristics, endometritis, cord-prolapse and abruptio placenta. Maternal septicemia was absent in both groups. Chorio-amnionitis, cesarean section rate, episiotomy infection, NICU admission, neonatal sepsis, neonatal hypoxia and intraventricular hemorrhage were significantly less frequent in prophylaxis group. Conclusion Using of prophylactic antibiotics with amniotomy in pregnant women during labor reduced maternal and neonatal morbidities as chorio-amnionitis, endometritis, cesarean section rate, episiotomy infection, NICU admission, neonatal sepsis, neonatal hypoxia and intraventricular hemorrhage. On the other side it had no proved protective effect against maternal septicemia, cord-prolapse and abruptio placenta.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Husam Salama ◽  
◽  
Amani Saeed ◽  
Amr Moussa ◽  
Mai Al Qubasi ◽  
...  

Background: HIE remains a significant cause of mortality and long-term disability in late preterm and term newborns. At birth, the only available distinction between mild, moderate, and severe HIE is based on the clinical ground. Nevertheless, mild HIE can be presented with subtle or subjective clinical features which may mislead the treating physician and delay his decision to intervene. Methods: This is a retrospective descriptive study examined all inborn newborns ≥ 35 weeks gestational age born at a single, tertiary level Neonatal Intensive Care Unit (NICU) in women’s hospital. The study revised newborns who were admitted to NICU during the period from November 2014 till November 2020 under the diagnoses of mild HIE. The decision to start therapeutic hypothermia in cases of mHIE was off-label and it was taken according to the clinical judgment of the treating team. Results: Out of the 265 newborns admitted with a history suggestive of HIE or neurological deficits, only 116 newborns matched the diagnosis of mHIE according to the above-mentioned exclusions. 19 newborns out of the 116 mHIE cases received therapeutic hypothermia. Antepartum and or intrapartum complications were recorded in 48 mothers including an infant of insulin-dependent diabetic mother 12, pre-eclampsia 3, cord prolapse 2, shoulder dystocia 2, antepartum hemorrhage 8, chorioamnionitis 6, poor CTG tracing 13, and ruptured uterus 2. Mean gestation was 38±2 weeks, mean birth weight was 3.0±0.5 kg, Cesarean section was 57 % in the un-cooled group vs 75% in the cooled group. Mean Apgar score at 10th minute was 7.9±1.8 vs 5.3±2.2 in the un-cooled vs cooled group, the p-value is 0.002. Arterial cord pH was 7.15±0.3 vs 6.92±0.26. The base deficit in the first-hour blood gas was -7.83±5 vs -12± 5.6 (P=0.005). The Total number of cooled newborns was 19 (16%). Respiratory support was required in 76% of un-cooled newborns vs 95 % of cooled newborns. Most of the newborns have achieved full sucking power within 10 days (99%). Cooled newborns had to stay longer in the NICU because of the added number of cooling where the length of stay was 11±4.7 days vs 6.9±4.7 days in un-cooled newborns. The MRI brain was done on 25 newborns, 12 MRIs were reported as abnormal (48 %) and consistent with hypoxic-ischemic changes, 5/97 in the un-cooled cases and 7 in the cooled cases. Neurodevelopmental assessments at 12 months and 18 months of age were abnormal in 14/116 newborns (12%). Conclusion: The current assumptions about the benignity of mild form of HIE may not be accurate. More attention to this category of HIE, clear diagnostic criteria, longer clinical observation, and vigilant neurological assessment are all required.


Author(s):  
P. C. Oriji ◽  
D. O. Allagoa ◽  
D. C. Briggs ◽  
M. N. Chika ◽  
A. E. Ubom ◽  
...  

Background: Umbilical cord prolapse is an obstetric emergency when the foetus is still alive, and it is associated with high foetal morbidity and mortality. If umbilical cord prolapse occurs outside the hospital, mortality rate can be as high as 44% – 70%, and as low as 3% when it occurs in the hospital. Objective: To determine the incidence of umbilical cord prolapse and the perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria over 5 years. Materials and Methods: This retrospective survey was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Results: Forty-one women had umbilical cord prolapse out of 4,571 deliveries, giving a case incidence rate of 8.9 per 1,000 deliveries. About three-quarters (75.6%) of the women were multiparous. A fifth (21.9%) of the foetuses died in-utero, while 27 (65.9%) babies survived. Five (15.6%) babies had severe birth asphyxia, and died (early neonatal death) in the special care baby unit. Decision-to-delivery interval was ≤ 30 minutes in only 12.5% of patients. Conclusion: Umbilical cord prolapse is associated with significant perinatal morbidity and mortality. Prompt diagnosis and intervention are very key in preventing adverse perinatal outcomes.


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