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Atkinson, D. "Improving cause-of-death statistics: the case of fetal deaths." American Journal of Public Health 83, no. 8 (August 1993): 1084–85. http://dx.doi.org/10.2105/ajph.83.8.1084.
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Moaddab, Amirhossein, Gary Dildy, Michael Belfort, Haleh Sangi-Haghpeykar, Christina Davidson, and Steven Clark. "Maternal and Fetal Death on Weekends." American Journal of Perinatology 36, no. 02 (July 17, 2018): 184–90. http://dx.doi.org/10.1055/s-0038-1667030.
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Background Higher mortality rates have been reported in patients admitted to the hospital on weekends. This study aimed to compare maternal mortality ratio (MMR), fetal mortality ratio, and other maternal and neonatal outcomes by day of death or delivery in the United States. Methods Our database consisted of a population-level analysis of live births and maternal and fetal deaths between 2004 and 2014 in the United States from the Centers for Disease Control and Prevention's National Center for Health Statistics. We also examined the relationship between these deaths and various documented maternal and fetal clinical conditions. Results A total of 2,061 maternal deaths occurred on weekends and 5,510 deaths on weekdays. During the same period of time, 65,063 and 210,851 cases of fetal demise were delivered on weekends and on weekdays, respectively. Maternal mortality was significantly higher on weekends than weekdays (22.9 vs. 15.3/100,000 live births, p < 0.001) as was fetal mortality (7.21 vs. 5.85/100,000, p < 0.001), despite a lower frequency of serious comorbidities among women delivering on weekends. Conclusion Our data demonstrate a significant increase in the U.S. MMR and stillbirth delivery on weekends. Relative representation of antepartum, intrapartum, and postpartum deaths cannot be ascertained from these data.
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Pharoah, Peter O. D. "Fetal Death Registration in Multiple Births: Anomalies and Clinical Significance." Twin Research and Human Genetics 9, no. 4 (August 1, 2006): 587–90. http://dx.doi.org/10.1375/twin.9.4.587.
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AbstractTrends in the civil registration of fetal death in multiple gestations that has occurred before, but expelled from the womb after, 24 weeks' gestation are examined using England and Wales 1993–2004 registration obtained from the Office for National Statistics. Count was made of fetal death registrations in which fetus papyraceous, fetal death before 24 weeks' gestation or fetocide before 24 weeks' gestation was recorded. There were 3700 fetal death registrations among 217,595 twin, triplet and higher order multiple births in England and Wales between 1993 and 2004. In 354 (9.6%) of these fetal deaths, death was recorded as having occurred before 24 weeks' gestation. There has been a threefold increase in such fetal death registrations. It is a legal requirement of parents to register a fetal death. The definition of a fetal death that meets formal registration criteria is that the fetus is expelled from the womb after 24 weeks' gestation. However, if the fetal death occurs before 24 weeks, there is confusion, nationally and internationally, whether or not registration is legally required. Fetal death in a multiple gestation has serious clinical implications for a surviving co-conceptus and failure to inform parents of an early death in a multiple gestation may have important repercussions. Legal definition for the registration of fetal death requires international agreement and application.
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Shew, Alison, Anny-Claude Joseph, and Edward Springel. "410: A vital statistics study of birth weight centile and fetal death risk." American Journal of Obstetrics and Gynecology 222, no. 1 (January 2020): S269—S270. http://dx.doi.org/10.1016/j.ajog.2019.11.426.
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SEPKOWITZ, SAMUEL. "International Statistics—Incomparable." Pediatrics 92, no. 4 (October 1, 1993): 637. http://dx.doi.org/10.1542/peds.92.4.637.
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Howell and Vert are hard-put to compare the incomparable: United States perinatal mortality rates from Michigan and French rates from Lorraine. How can you compare perinatal mortality rates meaningfully between two countries when the definitions of fetal deaths are dissimilar, when there are markedly different registration systems for vital events, and when the United States natality registration system has been in place since 1950 and a French system had to be set up just for this study? To make the data comparable, 34% of all Michigan deaths were eliminated, that is, all infants weighing <500 g. These deaths were concentrated in 0.47% of all births. How comparable the remaining birth and death events >500 g would be remains open to question.
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Lee, Erica, Amita Toprani, Elizabeth Begier, Richard Genovese, Ann Madsen, and Melissa Gambatese. "Implications for Improving Fetal Death Vital Statistics: Connecting Reporters’ Self-Identified Practices and Barriers to Third Trimester Fetal Death Data Quality in New York City." Maternal and Child Health Journal 20, no. 2 (October 30, 2015): 337–46. http://dx.doi.org/10.1007/s10995-015-1833-8.
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Shuai, H., L. Ya-jun, P. Yan-na, and Z. Zhong-yi. "Statistics and Reevaluation of the Risk of Fetal Death and Malformation After Q Fever." Clinical Infectious Diseases 59, no. 9 (July 17, 2014): 1347. http://dx.doi.org/10.1093/cid/ciu563.
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Fordyce, Lauren. "Accounting for fetal death: Vital statistics and the medicalization of pregnancy in the United States." Social Science & Medicine 92 (September 2013): 124–31. http://dx.doi.org/10.1016/j.socscimed.2013.05.024.
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Оshovskyy, V. I. "Analysis of the results of a retrospective cohort study of the course of pregnancy, childbirth and the postpartum period in high-risk patients to identify factors of unfavorable outcomes and build a predictive model of fetal loss." Reproductive health of woman 2 (April 1, 2021): 47–52. http://dx.doi.org/10.30841/2708-8731.2.2021.232552.
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Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of <34 weeks and <37 weeks of gestation, the remaining 9 cases – in terms of> 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.
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Aruna, Gollapalli, Revu Subhashini, Bandaru Asha Poornima, and Usha Prasad. "ROLE OF MODIFIED BIOPHYSICAL PROFILE IN PREDICTING PERINATAL OUTCOME IN HIGH RISK PREGNANCY." International Journal of Advanced Research 10, no. 7 (July 31, 2022): 934–38. http://dx.doi.org/10.21474/ijar01/15116.
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Background: In order to achieve the target of having a healthy mother and healthy baby there is a need to identify pregnant woman with high risk factors.Ante natal foetal monitoring is aimed at identifying foetus that are at high risk of suffering from intrauterine hypoxia. Aims and Objectives: To evaluate the role of modified biophysical profile in predicting perinatal outcome in high risk pregnant women Material and methods: This is a hospital based observational study in the department of Obstetrics and Gynaecology , Victoria Government Hospital , Visakhapatnam, from January 2022 to May 2022.A total of 96 high risk pregnant women were included in this study. Inclusion criteria was Singleton pregnancy ,risk factors like[pre eclampsia,gestational hypertension,diabetes mellitus,anemia,past dates,post cesarian section.breech,bad obstetric history and pre term,Exclusion criteria was multifetal gestation,intrauterine death,fetal anomalies. Detailed history was taken and relavent investigations were sent. Results: 16.9% of cases had meconium stained liquor (normal CTG and AFI), 36% with meconium stained liquor had normal AFI but abnormal CTG, 40% with meconium stained liquor had abnormal AFI but normal CTG, 50% with meconium stained liquor had abnormal AFI and abnormal CTG 0% of babies had perinatal death when AFI and CTG was normal, 100% of babies had perinatal death when AFI and CTG was abnormal Conclusion: Modified bio physical profile is a easy ,time saving and cost effective procedure and can used as a test of antepartum fetal surveillance in order to predict perinatal outcome in high risk pregnancy.
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Costa, Mayanna Karlla Lima, Vilena Aparecida Ribeiro Silva, and Raimunda Alves Silva. "FETAL DEATHS IN MARANHÃO STATE (BRAZIL), IN THE YEARS OF 2000, 2010 AND 2014." Journal of Geospatial Modelling 2, no. 3 (December 9, 2017): 33. http://dx.doi.org/10.22615/2526-1746-jgm-2.3-6864.
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The occurrence of a high number of fetal deaths is present throughout the world. It is estimated that more than 2 million fetal deaths occur each year on the globe, where 98% predominate in developing countries. This research aimed to carry out the survey of the fetal deaths number in Maranhão state, as a way to bring contributions to theprevention and health care actions. Data from DATASUS were used for the survey of fetal deaths occurring in the 217 municipalities in Maranhão state in the years 2000, 2010 and 2014, as well as the fetal mortality rate. The program SURFER® version 11.0 were usedfor descriptive statistics analysis and construction of the mean distribution map of cases. The fetal mortality rate in Maranhão has increased over the years, not following the national trend of reduction of intrauterine mortality rates, being required greater investment in public policies to analyze the main risk factors in the state.Key words: fetal death, public health, fetal mortality rate.
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Wegman, Myron E. "Annual Summary of Vital Statistics—1993." Pediatrics 94, no. 6 (December 1, 1994): 792–803. http://dx.doi.org/10.1542/peds.94.6.792.
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A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100 000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined, more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.
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Fitzgerald, Edward, Daniel Wartenberg, W. Douglas Thompson, and Allison Houston. "Birth and Fetal Death Records and Environmental Exposures: Promising Data Elements for Environmental Public Health Tracking of Reproductive Outcomes." Public Health Reports 124, no. 6 (November 2009): 825–30. http://dx.doi.org/10.1177/003335490912400610.
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Objectives. We inventoried and reviewed the birth and fetal death certificates of all 50 U.S. states to identify nonstandard data items that are environmentally relevant, inexpensive to collect, and might enhance environmental public health tracking. Methods. We obtained online or requested by mail or telephone the birth certificate and fetal death record forms or formats from each state. Every state data element was compared to the 2003 standards promulgated by the National Center for Health Statistics to identify any items that are not included on the standard. We then evaluated these items for their utility in environmentally related analyses. Results. We found three data fields of potential interest. First, although every state included residence of mother at time of delivery on the birth certificate, only four states collected information on how long the mother had lived there. This item may be useful in that it could be used to assess and reduce misclassification of environmental exposures among women during pregnancy. Second, we found that father's address was listed on the birth certificates of eight states. This data field may be useful for defining paternal environmental exposures, especially in cases where the parents do not live together. Third, parental occupation was listed on the birth certificates of 15 states and may be useful for defining parental workplace exposures. Our findings were similar for fetal death records. Conclusion. If these data elements are accurate and well-reported, their addition to birth, fetal death, and other health records may aid in environmental public health tracking.
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Marques, Lays Prazeres, Conceição Maria de Oliveira, and Cristine Vieira do Bonfim. "Completitude e concordância dos instrumentos da vigilância do óbito infantil: estudo transversal." Online Brazilian Journal of Nursing 15 (November 30, 2016): 538. http://dx.doi.org/10.17665/1676-4285.20165668.
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Aim: to evaluate the completeness and compliance of research instruments for the Surveillance of Child and Fetal Death. Method: This is a cross-sectional census study in which all 183 Confidential Sheets and Synthese Records of the Investigation of Death Surveillance of Fetuses and Infants under one year of life in Recife (PE) in 2014 will be analyzed. The completeness of the variables on Confidential Research Records will be assessed from the proportion of ignored and/or blank fields. The Summary Sheet Research will have the agreement verified by the Kappa Index and the intraclass correlation coefficient. Expected results: The intention is to contribute to the improvement of surveillance, by improving the quality of care for maternal and child health, with the improvement of vital statistics and the prevention of avoidable deaths.
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Ekblom, Annette, Mats Målqvist, Rejina Gurung, Angela Rossley, Omkar Basnet, Pratiksha Bhattarai, and Ashish K. C. "Factors associated with poor adherence to intrapartum fetal heart monitoring in relationship to intrapartum related death: A prospective cohort study." PLOS Global Public Health 2, no. 5 (May 23, 2022): e0000289. http://dx.doi.org/10.1371/journal.pgph.0000289.
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Background Poor quality of intrapartum care remains a global health challenge for reducing stillbirth and early neonatal mortality. Despite fetal heart rate monitoring (FHRM) being key to identify fetus at risk during labor, sub-optimal care prevails in low-income settings. The study aims to assess the predictors of suboptimal fetal heart rate monitoring and assess the association of sub-optimal FHRM and intrapartum related deaths. Method A prospective cohort study was conducted in 12 hospitals between April 2017 to October 2018. Pregnant women with fetal heart sound present during admission were included. Inferential statistics were used to assess proportion of sub-optimal FHRM. Multi-level logistic regression was used to detect association between sub-optimal FHRM and intrapartum related death. Result The study cohort included 83,709 deliveries, in which in more than half of women received suboptimal FHRM (56%). The sub-optimal FHRM was higher among women with obstetric complication than those with no complication (68.8% vs 55.5%, p-value<0.001). The sub-optimal FHRM was higher if partograph was not used than for whom partograph was completely filled (70.8% vs 15.9%, p-value<0.001). The sub-optimal FHRM was higher if the women had no companion during labor than those who had companion during labor (57.5% vs 49.6%, p-value<0.001). After adjusting for background characteristics and intra-partum factors, the odds of intrapartum related death was higher if FHRM was done sub-optimally in reference to women who had FHRM monitored as per protocol (aOR, 1.47; 95% CI; 1.13, 1.92). Conclusion Adherence to FHRM as per clinical standards was inadequate in these hospitals of Nepal. Furthermore, there was an increased odds of intra-partum death if FHRM had not been carried out as per clinical standards. FHRM provided as per protocol is key to identify fetuses at risk, and efforts are needed to improve the adherence of quality of care to prevent death.
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Pharoah, Peter O. D., and Mary J. Platt. "Sudden Infant Death Syndrome in Twins and Singletons." Twin Research and Human Genetics 10, no. 4 (August 1, 2007): 644–48. http://dx.doi.org/10.1375/twin.10.4.644.
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AbstractTwins compared with singletons and monozygous (MZ) compared with dizygous (DZ) twins are at increased risk of fetal and infant death, cerebral palsy and many congenital anomalies. The aim of this study is to investigate whether zygosity is a risk factor for the sudden infant death syndrome (SIDS). Birth registration data and draft infant death certificates for all multiple births in England and Wales 1993 to 2003 were provided by the Office for National Statistics. As a partial proxy for zygosity, same-sex was compared with opposite-sex twins for birthweight-specific mortality and mortality attributed to SIDS. Data on singleton infants were obtained by subtraction of multiple births from routinely published population births and infant deaths. SIDS mortality among low birthweight infants was significantly less in twins than singletons. The twin-singleton relative risk was reversed in infants of normal birthweight. Among infants of normal birthweight, neonatal SIDS was significantly more common in same- compared with opposite-sex pairs. Among infants of low birthweight, postneonatal SIDS was significantly more common in same- compared with opposite-sex pairs. The difference in birthweight distribution of same- compared with opposite-sex twins for neonatal SIDS suggests that zygosity is a risk factor for SIDS. As congenital cerebral anomalies are a feature of many monozygous twin conceptions, a detailed macro- and microscopical examination of the brain in twin SIDS may indicate an otherwise unrecognised pathology.
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Alalageri, Kavya M., Shobha ., and Ranganath Timmanahalli Sobagaih. "A study to assess premature mortality and years of potential life lost among the mortality victims of Victoria Hospital, Bengaluru." International Journal Of Community Medicine And Public Health 4, no. 10 (September 22, 2017): 3927. http://dx.doi.org/10.18203/2394-6040.ijcmph20174276.
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Background: Premature mortality by age 60 accounted for one-third of total deaths in low and middle income countries in 2008. While under-5 mortality as a proportion of premature mortality remains high in some countries, premature adult mortality is also increasing. Non-communicable diseases (NCDs) are the leading cause of death and primarily affect those of productive age. India is also experiencing rapid demographic and epidemiological transition. Although evidence suggests recent reductions in infant and child mortality, little is known about the age and sex patterns of premature deaths in India.Methods: Record based study was conducted from 4 months mortality statistics who belong to less than 69 yrs during the period June-September 2016 at Victoria Hospital. Data is entered in MS-Excel and analyzed in the form of descriptive statistics. Data is presented in the form of figures, tables, charts and percentages wherever necessary.Results: There were total of 1265 deaths in 4 months, among them 890 deaths occurred <69 yrs of age. Most of them belong to 45-54 yrs which is the income generating age-group. Most of them belong to 45-54 yrs which is the income generating age-group. Most of the mortality victims admitted in hospital for <24 hrs (45.28%) followed by a week (45.05%). Infectious diseases, burns, hypertension, and alcohol related complications and poly trauma are the top 5 causes of premature deaths. Mean years of potential life lost (YPLL) due to NCDs like cardiovascular diseases, diabetes mellitus and hypertension is 20.92 yrs.Conclusions: Health system should gear up at all levels of health care in order to reduce mortality due to NCDs and thus to increase life-expectancy.
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Fatkullin, I. F., N. R. Akhmadeev, E. V. Ulyanina, L. Kh Islamova, and L. S. Fatkullina. "The diagnostic Value of Vascular Endothelial Growth Factor in Women with Growth-Restricted Fetuses." Doctor.Ru 19, no. 8 (2020): 44–48. http://dx.doi.org/10.31550/1727-2378-2020-19-8-44-48.
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Study Objective: To assess delivery outcomes in women with slow fetal growth (ICD-10 code P05) and study serum levels of vascular endothelial growth factor (VEGF) and its diagnostic value in patients with growth-restricted fetuses that have constitutional low weight, in order to choose an approach to pregnancy management. Study Design: This was a prospective and retrospective comparative study. Materials and Methods: The medical charts of 782 women who had given birth to low-weight babies in 2013 and 2014 were reviewed retrospectively. The prospective part of the study involved measuring serum levels of VEGF in 150 pregnant women: 50 women with growthrestricted fetuses (Group I), 50 women with low-weight fetuses without hemodynamic disruptions or placental abnormalities (Group II), and 50 women with healthy pregnancies (Group III). Based on the babies’ gestational term at birth, the women in each group were divided into two subgroups: between 22 weeks and 0 days and 31 weeks and 6 days (subgroup 1) and ≥32 weeks and 0 days (subgroup 2). The data obtained were processed using descriptive statistics and compared with data obtained through other fetal assessments. Study Results: The pregnant women with growth-restricted fetuses had higher VEGF levels by a statistically significant margin (p<0.00001) than the women in groups II and III: median levels were 310 (Q1–Q3: 270–508), 33 (Q1–Q3: 31–38), and 36 (Q1–Q3: 32–40) pg/mL, respectively, in subgroups 1 and 174 (Q1–Q3: 100–214), 78 (Q1–Q3: 73–86), and 82 (Q1–Q3: 78–88) pg/mL, respectively, in subgroups 2. VEGF levels ≥100 pg/mL were associated with fetal growth restriction (FGR) (p = 0.0001) and levels ≥200 pg/mL with a high risk of antenatal fetal death (p = 0.026) or early neonatal death (p = 0.03). Conclusion: For women with growth-restricted fetuses, VEGF serum levels ≥200 pg/mL are an additional risk factor for unfavorable perinatal outcomes, which helps to optimize obstetrical management for these patients. Keywords: low-weight fetus, fetal growth retardation, vascular endothelial growth factor.
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Morgulis, R. A. "TO THE TREATMENT OF INCOMPLETE ABORTION." Journal of obstetrics and women's diseases 6, no. 10 (August 27, 2020): 921–30. http://dx.doi.org/10.17816/jowd610921-930.
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Abortion is one of the most common sufferings of the female genital area. According to Hegar's statistics, there is 1 abortion for every 8-10 cases of normal birth. In the vast majority of cases, abortions are caused by various painful changes in the genital area. This includes mainly inflammatory forms of uterine diseases: metritis, endometritis; curvature of the uterus, rupture of the cervix, etc. All these diseases can be the direct cause of abortion, directly causing contraction of the uterus, or by preliminary disturbance of nutrition and death of the fetus, which in this case is a foreign body in the uterus and causes its contraction. Fetal death as one of the causes of abortion may depend on other, besides the above, local, as well as general diseases. Such are, for example, various forms of infection of the egg membranes, lues, high febrile state, strong degree of anomia, etc.
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Gundu, Vanaja, Ganga Devi Chikile, and Geetha Kumari Ponnada. "Evaluation of Doppler Study of Umbilical Artery in Prolonged Pregnancy– A Study from Andhra Pradesh, India." Journal of Evolution of Medical and Dental Sciences 10, no. 23 (June 7, 2021): 1746–50. http://dx.doi.org/10.14260/jemds/2021/361.
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BACKGROUND The American College of Obstetricians and Gynecologists (ACOG) and WHO (World Health Organization) define a pregnancy continuing two weeks beyond expected date of delivery as post term pregnancy. Any pregnancy which has passed beyond the expected delivery date is defined as prolonged or post-dated pregnancy. Application of Doppler ultrasound allows for examination of blood flow direction, velocity and volume of various vessels. Doppler velocimetry of umbilical artery in post-dated pregnancy has been suggested as a means of assessing fetal wellbeing. In prolonged pregnancy, the first step of management is an accurate diagnosis and antenatal care includes accurate dating of pregnancy, fetal surveillance and the option of induction of labour or expectant management or Caesarean section. We wanted to analyse the blood flow in umbilical artery using Doppler ultrasound in post-dated pregnancy and analyse the perinatal outcome in post-dated pregnancies with respect to normal and abnormal doppler wave forms. METHODS This is a prospective study conducted at Department of Obstetrics and Gynaecology, Government Victoria Hospital (GVH), Visakhapatnam, from April 2016 to April 2017. 110 pregnant women who were beyond the expected date of delivery (EDD) according to menstrual history and early weeks scan were selected from the antenatal ward and labour room. RESULTS In the present study, 52.73 % women with prolonged pregnancy were primi gravida and 67.27 % women were between the gestational ages of 40 - 41 weeks. Doppler studies were abnormal in 13.64 % (15 women). 78.1 % women with prolonged pregnancy had normal vaginal delivery, Caesarean section was done in 17.3 % and 4.6 % had instrumental delivery. 99.09 % of babies were live born and one was stillborn. Two babies died in early neonatal period due to meconium aspiration. CONCLUSIONS Doppler study of umbilical arteries is a useful noninvasive procedure to reduce the perinatal morbidity and mortality in prolonged pregnancy. KEY WORDS Antepartum Fetal Surveillance, Birth Asphyxia, Doppler Study, Intrauterine Death, Perinatal Outcome, Prolonged Pregnancy, Pulsatility Index, Resistance Index
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Heráclio, Isabela De Lucena, Ana Paula Timóteo Vieira, Aline Luzia Sampaio Guimarães, Conceição Maria de Oliveira, Paulo Germano de Frias, and Cristine Vieira do Bonfim. "Vigilância do óbito evitável: comparação entre fetal e neonatal precoce." Revista Recien - Revista Científica de Enfermagem 11, no. 34 (June 27, 2021): 354–63. http://dx.doi.org/10.24276/rrecien2021.11.34.354-363.
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Comparar características sociodemográficas, assistenciais e epidemiológicas de óbitos fetais e neonatais precoces evitáveis investigados. Estudo transversal, cuja fonte de dados foi a ficha de investigação do óbito fetal, em menor de um ano, preenchida pela vigilância do Recife (PE). Procedeu-se a comparação entre os grupos de óbitos fetais e neonatais precoces evitáveis, utilizando o teste Qui-quadrado de Pearson, com a=5%. Dos 117 óbitos analisados, 94 (80,3%) eram fetais. A avaliação da assistência à saúde evidenciou falhas em 95,6% dos óbitos perinatais, destacando-se a assistência ao pré-natal, com falhas em 75,6% dos fetais e 90% nos neonatais precoces. Os óbitos reduzíveis por adequada atenção à mulher na gestação constituíram o principal grupo de evitabilidade (64,1%). Houve falhas na assistência na quase totalidade dos óbitos. A comparação entre os óbitos perinatais evitáveis permitiu avaliar a qualidade da assistência e pode contribuir com a elaboração de estratégias de redução.Descritores: Mortalidade perinatal, Saúde Materno-infantil, Estatísticas Vitais, Vigilância em Saúde Pública. Preventable death surveillance: a comparison between fetal and neonatalAbstract: To compare sociodemographic, health care and epidemiologic characteristics of investigated preventable fetal and premature neonatal deaths. Cross-sectional study, whose data source was the fetal death investigation form, in less than a year, filled out by Recife’s surveillance (PE). Then, a comparison proceeded between fetal and premature neonatal preventable death groups, utilizing the Pearson’s Chi-square test, with a=5%. From 117 analyzed deaths, 94 (80.3%) were fetal. The evaluation of healthcare presented failures in 95.6% of perinatal deaths, emphasizing the assistance to prenatal, with failures of 75.6% of fetal and 90% in premature neonatal deaths. Deaths reducible by adequate assistance for women during pregnancy were the main preventable group (64.1%). There were deficiencies in the assistance in almost all deaths. The comparison among avoidable perinatal deaths allowed the evaluation of care quality and may enable contributions towards the elaboration of reduction strategies.Descriptors: Perinatal Mortality, Maternal and Child Health, Vital Statistics, Public Health Surveillance. Vigilancia del óbito evitable: comparación entre fetal y neonatal precozResumen: Comparar características sociodemográficas, de auxílio social y epidemiológicas de óbitos fetales y neonatales precoces evitables investigados. Estudio transversal, cuya fuente de datos fue la ficha de investigación del óbito fetal, en menor de un año, rellenada por la vigilancia de Recife (PE). Se procedió a la comparación entre los grupos de óbitos fetales y neonatales precoces evitables, empleando el test Qui-cuadrado de Pearson, con a=5%. De los 117 óbitos analizados, 94 (80,3%) eran fetales. La evaluación de la asistencia a la salud denotó fallos en 95,6% de los óbitos perinatales, destacándose la asistencia prenatal con fallos en el 75,6% de los óbitos perinatales y 90% de los neonatales precoces. Los óbitos reductibles por atención adecuada a la mujer gestante constituyeron el principal grupo de evitabilidad (64,1%). Hubo fallos en la asistencia en la casi totalidad de los óbitos. La comparación entre los óbitos perinatales evitables permitió evaluar la calidad de la asistencia y puede enriquecer la elaboración de estrategias de reducción. Descriptores: Mortalidad perinatal, Salud Materno-Infantil, Estadísticas Vitales, Vigilancia en Salud Pública.
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Pham, Tony, Caitlin Young, Noel Woodford, David Ranson, Carmel M. F. Young, and Joseph E. Ibrahim. "Difference in the characteristics of mortality reports during a heatwave period: retrospective analysis comparing deaths during a heatwave in January 2014 with the same period a year earlier." BMJ Open 9, no. 5 (May 17, 2019): e026118. http://dx.doi.org/10.1136/bmjopen-2018-026118.
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ObjectivesTo describe the characteristics of deaths reported to the Coroners Court of Victoria (CCOV) during Victoria’s last heatwave (14–17 January 2014) and subsequent 4 days (18–21 January) using medicolegal data obtained from both the police investigation report and the pathologist’s report.Design, setting and participantsA single-jurisdiction population-based retrospective analysis of consecutive heat-related deaths (HRDs) reported to the CCOV between 14 and 21 January 2014 with a historical comparison group.Main outcome measuresDescriptive statistics were used to summarise case demographics, causes of death and the types of investigations performed. The cases from 2014 were subgrouped into HRD and non-HRD.ResultsOf the 222 cases during the study period in 2014, 94 (42.3%) were HRDs and 128 (57.7%) were non-HRDs. HRDs were significantly older than non-HRDs (70.5 years: SD=13.8 vs 61.0 years: SD=22.4, t(220)=3.60, p<0.001, 95% CI 4.3 to 14.6). The most common primary cause of death in HRDs was circulatory system disease (n=57, 60.6%), which was significantly higher when compared with non-HRDs (n=39, 30.5%; χ2=20.1, p<0.001, OR 3.5, 95% CI 2.0 to 6.2). HRDs required significantly greater toxicology investigation (89.4% (n=84) vs 71.9% (n=92); χ2=10.9, p<0.001, OR 3.3, 95% CI 1.54 to 7.03) and greater vitreous biochemistry testing (40.4% (n=38) vs 16.4% (n=21); χ2=16.0, p<0.001, OR 3.5, 95% CI 1.9 to 6.5).ConclusionsA heatwave places a significant burden on death investigation services. The inclusion of additional laboratory tests and more detailed circumstantial information are essential if the factors that contribute to HRDs are to be identified.
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Tegegne, Kaleab Tesfaye, Abiyu Ayalew Assefa, Andualem Zenebe, Wosenyeleh Semeon Bagajjo, Musie Rike, Alelign Tadele Abebe, and Sintayehu Assefa. "Effect of Anemia on Birth Weight among Pregnant Women Attending ANC Clinic at Public Hospitals of Sidama Region, Ethiopia, 2022; A Prospective Cohort Study Protocol." Middle East Research Journal of Nursing 1, no. 1 (December 27, 2021): 10–20. http://dx.doi.org/10.36348/merjn.2021.v01i01.003.
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Abstract: Background: Anemia is the main cause of morbidity and mortality among pregnant women in developing countries with maternal and fetal consequences, which leads to premature births, low birth weight, fetal cognitive impairment and death. Objective: To establish association between anemia and birth weight among pregnant women attending ANC clinic at public hospitals of Sidama region, Ethiopia, 2022. Methods and Materials: a prospective cohort study design will be conducted from March 1, 2022 to November 30, 2022 in public hospitals of Sidama region. A total of 12 Midwives and 6 supervisors will be involved in the data collection process. Exposed (pregnant women having anemia) and non-exposed (pregnant women not having anemia) will be selected by using simple random sampling technique from the prior three months ANC register of each selected public hospital. The data will be entered into Epidata software and exported to SPSS software for windows version 23 for analysis. Descriptive statistics will be computed and both bivariable and multivariable logistic regression will be employed to assess effect of anemia on birth weight among pregnant women. The output will be presented using adjusted odds ratio (AOR) with the respective 95% confidence interval (CI).
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Warner, Rachelle, Jodie C. Avery, Susan Neuhaus, and Michael J. Davies. "Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes." Fertility & Reproduction 02, no. 02 (June 2020): 53–60. http://dx.doi.org/10.1142/s2661318220500085.
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Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.
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Ch. Sudhakarbabu and M. Indira. "Study of Morphology and Morphometry of Placenta." Academia Anatomica International 6, no. 1 (July 5, 2020): 54–57. http://dx.doi.org/10.21276/aanat.2020.6.1.12.
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Introduction: The placental examination provide significant information related to intrauterine foetal death, Intrauterine Growth Retardation, Malformations, infections and effects of maternal diseases on fetal growth. The magnitude of the clinical problems related to the development and the functions of the placenta is so vast that it worth undertaking morphological aspect of Human placenta A thorough examination of the placenta is neglected often underestimated by the Physician and Gynecologist Pediatrician and pathologist despite its invaluable role in the fetal development. Subjects and Methods: In our present study, 50 freshly delivered placentae have collected The placenta and the umbilical cord were examined to look for any abnormalities in the shape, cord insertion, and vessels in the cord, placenta weight, its circumference, diameter, volume, and thickness at the level of cord insertion were also noted. Baby's weight at birth and age in weeks, maternal history about diabetes and hypertension were also recorded down. IBM SPSS Statistics for Windows version 20.0, USA was used to do statistical analysis of the measurements. Results: In the present study, the placenta weight, volume, diameter, and circumference show a strong correlation with fetal weight. We found the placenta of round and abnormal shapes in 88% and 12% of cases, respectively. In 77% of cases, we got normal cord insertion and in 23% of cases, abnormal cord insertion. Statistical analysis of all the parameters of the placenta was done. Conclusion: In our study, Placental weight, volume, diameter, and circumference showed a strong correlation with fetal weight. The knowledge of these measurements on the placenta and umbilical cord will be helpful to the pediatrician and obstetrician in clinical practice.
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Depar, Asma Ali, Hina Habib, Nazneen Hameed, Hiba Arshad Shaikh, and Aisha Altaf. "Comparison of Maternal and Fetal Outcome in Pregnant Women with BMI ≤ 25 KG/M2 and > 25 KG/M2 at Tertiary Care Hospital, Karachi." Pakistan Journal of Medical and Health Sciences 16, no. 8 (August 31, 2022): 868–71. http://dx.doi.org/10.53350/pjmhs22168868.
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Objective: To compare the frequency of maternal and fetal outcome in pregnant women with BMI ≤ 25 kg/m2 and > 25 kg/m2 at Tertiary Care Hospital, Karachi. Study Design: Descriptive study. Place and Duration: Study was conducted at Department of Gynaecology and Obstetrics, Aga Khan University Hospital. Duration was six months after approval from 7th November, 2019 till 7th May 2020. Subjects and Methods: Data was prospectively collected from patients after taking a verbal consent. 201 patients who met the diagnostic criteria were included. Brief history was taken and demographic information was entered in the performa. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification. Post stratification chi square test and t test was applied taking p-value of ≤0.05 as significant. Results: A total of 201 patients were included in this study. Mean age in < 25 kg/m2 and > 25 kg/m2 BMI groups in our study was 27.21±6.24 years and 26.48±8.41 years. Out of 90 patients with BMI < 25kg/m2, 12.2%, 1.1%, 1.1%, 8.9%, 16.7%, 16.7%, 1.1%, 1.1% and 1.1% had gestational diabetes postpartum hemorrhage, pregnancy induced hypertension, anemia, birth weight < 2500 gm, perinatal mortality, still birth and early neonatal death. Whereas out of 111 patients with BMI > 25kg/m2, 26.1%, 7.2%, 18%, 15.3%, 18.9%, 1.8%, 2.7% and 1.8% had gestational diabetes postpartum hemorrhage, pregnancy induced hypertension, anemia, birth weight < 2500 gm, perinatal mortality, still birth and early neonatal death. Conclusion: Obesity is a risk factor for maternal and fetal is evident from our study. Pre-pregnancy dietary counseling, regular physical activity, and a healthy lifestyle could help to reduce the incidence of gestational obesity and the incidence of perinatal complications as well. Keywords: Body Mass Index, Maternal Outcomes and Fetal Outcomes.
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Rahman, Fahd Ur, Mohsin Saif, Ismail Ahmed Khan, Muhammad Bilal Siddique, Husnain Yousaf, Waqas Alam, Shoaib Iqbal Safi, Aleena Khan, Naseer Ahmed Samore, and Naseem Azad. "Maternal and Neonatal Outcomes in Pregnant Patients with Pre-Existing Cardiac Diseases." Pakistan Armed Forces Medical Journal 72, SUPPL-3 (November 21, 2022): S439–44. http://dx.doi.org/10.51253/pafmj.v72isuppl-3.9528.
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Objective: To assess the maternal and fetal outcome in pregnant patients with preexisting cardiac conditions and to determine the prevalence of different cardiac diseases among pregnant patients.
Study Design: This was across sectional study.
Place and Duration of Study: Tertiary Cardiac Care Center in Rawalpindi Pakistan, from Dec 2021 to Apr 2022.
Methodology: This was across sectional study done in a tertiary cardiac care center in Rawalpindi. A total of (n=100) pregnant patients with pre-existing cardiac diseases were included in the study from Dec 2021 to Apr 2022 over a period of 5 months. Prospective data including patients' demographics and their outcomes was collected using preformed proformas. Data was analyzed by SPSS version-23. Prevalence of maternal death, fetal death, maternal complications and neonatal complications were the primary outcomes of study. Descriptive statistics were run to present categorical data in frequencies and percentages. Chi-square and Fisher Exact Test was applied to find the association between study variables at 95% CI and 5% margin of error (α=5%).
Results: A total of (n=100) patients were included in our study which was conducted from Dec 2021 to Apr 2022. Maternal mortality was observed in 6% (n=6) of patients. Maternal outcomes of pulmonary edema were seen in 24% (n=24) of patients and post-partum hemorrhage was seen in 14% (n=14) patients. Three parameters of perinatal outcome were studied i.e., low birth weight, preterm delivery and death. 39% (n=39) neonates were found to have low birth weight, 22% (n=22) were preterm and perinatal mortality was 21% (n=21). The primary results of our study showed 6% (n=6) maternal mortality and 21% (n=21) perinatal mortality.
Conclusion: Overall maternal mortality was 6% while perinatal mortality was 21%. There existed a statistically significant (p<0.05) association of age and neonatal outcome with maternal complications. With proper counseling, some of the avoidable maternal and perinatal deaths can be prevented.
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Rana, Shraddha, and Pramod Kattel. "Eclampsia at a tertiary care hospital of Nepal: A five year study." Janaki Medical College Journal of Medical Science 6, no. 2 (December 18, 2018): 14–21. http://dx.doi.org/10.3126/jmcjms.v6i02.22056.
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Background and Objectives: Eclampsia poses a global threat in terms of feto-maternal morbidity and mortality and all medical practitioners fear the ailment. It is one of the major causes behind preventable maternal death. Etio-pathogenesis of the disease condition is ambiguous and is considered to be multi-factorial. This study was done to analyze cases of eclampsia in relation to maternal and fetal outcomes at a tertiary level care hospital.
Materials and Methods: A descriptive cross-sectional observational study was carried out in patients developing eclampsia over a period of five years starting from July 2011 to June 2016 at National Medical College and Teaching Hospital, Birgunj. Relevant data were collected from the statistics section of hospital reviewing the case sheets.
Results: There were 291 cases of eclampsia out of 16,445 deliveries and prevalence of eclampsia was calculated to be 1.77%. Fourty-five percent of eclamptic women had age less than 20 years and two-third was primigravida. Approximately 84% of women were unbooked. Antepartum eclampsia was observed in 78.8% followed by postpartum eclampsia (14.8%) and intrapartum eclampsia (6.5%). At the time of admission systolic blood pressure more than 140 mmHg and diastolic blood pressure more than 90 mmHg were noted in 79% and 92.1% cases respectively. Caesarean section was the preferred mode of delivery and was performed in 62.9% cases. ICU admission was required in 35.7% and remaining cases were managed in general/eclampsia ward. Renal failure was the most common cause of maternal mortality seen in 29.4%. Still birth was noted in 13.4%.
Conclusion: Institutional obstetric patients are gradually facing eclampsia as prime cause of maternal death and unfortunately most of the cases are primigravid at younger age. All health care professionals should be proficient to manage eclamptic women instantaneously.
Key words: Eclampsia; Fetal Mortality; Maternal Mortality; Pre-Eclampsia
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Yasmin, Shakila, Rukhsana Aziz, Muhammad Hassan, and Mehak Fatima. "TERMINATION OF PREGNANCY." Professional Medical Journal 25, no. 06 (June 10, 2018): 952–58. http://dx.doi.org/10.29309/tpmj/2018.25.06.287.
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Objectives: To compare efficacy of extra-amniotic Foley’s catheter balloon aloneversus combined use of Foley’s catheter balloon and extra-amniotic instillation of prostaglandinF2-alpha in therapeutic termination of second trimester pregnancy. Study Design: Randomizedcontrolled trial. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital,Bahawalpur. Period: Two years. July 2014 to June 2016. Sample Technique: Non-probability,consecutive sampling technique. Patients & Methods: A total of 256 patients, 16 to 38 years ofage with fetal death or missed abortion on ultrasonography in 2nd trimester (14-24 gestationalweeks) of pregnancy were included in the study. Patients with previous uterine surgery, multiplepregnancies and parity>3 were excluded. Then selected patients were placed randomly intotwo groups i.e. Group A (extra-amniotic Foley’s catheter balloon alone) & Group B (Foley’scatheter balloon along with extra-amniotic instillation of prostaglandin F2-alpha), by using lotterymethod. Outcome variables like efficacy i.e. expulsion of fetus within 24 hours of induction, werenoted. Results: The mean age of women in group A was 24.51 ± 4.77 and in group B was 24.29± 4.48 years. The mean gestational age in group A was 21.65 ± 2.01 weeks and in group Bwas 21.28 ± 1.93 weeks. Efficacy was 103 (80.47%) in group A (extra-amniotic Foley’s catheterballoon alone) and 119 (92.97%) in group B (combined use of Foley’s catheter balloon andextra-amniotic instillation of prostaglandin F2-alpha) with p-value of 0.003. Conclusion: Thisstudy concluded that combined use of Foley’s catheter balloon and extra-amniotic instillationof prostaglandin F2-alpha is better and more efficacious than extra-amniotic Foley’s catheterballoon alone in therapeutic termination of second trimester pregnancy.
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Morisaki, Naho, Tetsuya Isayama, Osamu Samura, Kazuko Wada, and Satoshi Kusuda. "Socioeconomic inequity in survival for deliveries at 22–24 weeks of gestation." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 3 (August 28, 2017): F202—F207. http://dx.doi.org/10.1136/archdischild-2017-312635.
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ObjectiveGuidelines recommend individual decision making on resuscitating infants of 22–24 weeks’ gestational age (GA) at birth. When the decision not to resuscitate is made, infants would likely die soon after delivery, and under some circumstances such neonatal deaths may be registered as stillbirths occurring during delivery (intrapartum stillbirth). Thus we assessed whether socioeconomic factors are associated with peridelivery deaths (during or within 1 hour of delivery) of infants delivered at 22–24 weeks’ gestation.MethodsWe analysed 14 726 singletons of 22–24 weeks’ GA using the 2003–2011 Japanese vital statistics, and assessed how maternal characteristics influence risk of peridelivery death as well as intrauterine fetal death (IUFD) and death after 1 hour of age until 40 weeks postmenstrual age.ResultsLiving in a municipality with low-average income (lowest tertile (risk ratio 1.32, 95% CI 1.20 to 1.44), middle tertile (risk ratio 1.08, 95% CI 0.98 to 1.19)), younger maternal age (age <20 (risk ratio 1.43, 95% CI 1.17 to 1.75), age 20–34 (risk ratio 1.14, 95% CI 1.03 to 1.27)) and having previous live births (risk ratio 1.08, 95% CI 1.01 to 1.17) increased risk of peridelivery deaths, but did not increase risk of IUFD or deaths after 1 hour of age. Peridelivery death was twice as likely to occur in births to multiparous teenage mothers in a low-income municipality, compared with those of older primiparous mothers in a wealthier municipality.ConclusionsSocioeconomic factors substantially influence whether births of 22–24 weeks’ GA survive delivery and the first hour of life. Such disparities may reflect the impact of socioeconomic situations on decision making for resuscitation.
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Nazeer, Muhammad Atif, Muhammad Mohsin, and Abdur Rehman. "Identifying the Causes and Protective Measures of Road Traffic Accidents (RTAs) in Bahawalpur City, Pakistan." Vol 3 Issue 4 3, no. 4 (December 31, 2021): 208–17. http://dx.doi.org/10.33411/ijist/2021030407.
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Road Traffic Accident (RTA) is a growing public issue and fall among the four top causes of mortality and morbidity globally. The main objective of this study was to identify the causes and protective measures of road traffic accidents in Bahawalpur City. Primary data was gathered through a structured questionnaire during a field survey in selected five public places as sample sites i.e. Larry Ada, University Chowk, Bahawal Victoria Hospital (BVH), One Unit Chowk, and Melad Chowk. Secondary data of road accidents was gathered form National Highway and Motor Way Police (NH&MP) while primary data was gathered from 150 respondents (30 from each study site) and analyzed in SPSS software by applying descriptive statistics and road accident risk index (RARI). Findings revealed that the main causes of these accidents include increase in population (62.66%), increase in demand for vehicles (22%), bike drivers (69.33%), overtaking of the vehicles (51.33%), over speed and hustle to reach the destination (34.66%). One wheeling is also a major reason, which results in the death of teenage drivers (52%), violation of the traffic rules (25.33%). RARI results also suggest the relationship between the affected persons and the road traffic accidents. Lastly, few suggestions were proposed to overcome the ratio and severity of road traffic accidents because these accidents are predictable and largely preventable through multi-disciplinary coherent strategies.
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Durairaj, Anitha. "Management of preterm severe preeclampsia: interventional versus expectant management." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 10 (September 26, 2018): 3931. http://dx.doi.org/10.18203/2320-1770.ijrcog20183891.
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Background: Management of preterm severe preeclampsia is challenging. This study aims to determine the maternal and perinatal outcomes in interventional and expectant management.Methods: This was a prospective study conducted at Institute of obstetrics and gynecology, Chennai over a period of three years. Patients with preterm severe preeclampsia of gestational age 28 weeks to 31 weeks and 6 days who had interventional and expectant management were recruited. Clinical details relevant to maternal, fetal and neonatal outcome were collected and the data were analyzed using IBM.SPSS statistics software 23.0 Version.Results: Termination of pregnancy in the expectant management was done mostly for maternal indications (66%). The mean prolongation of pregnancy in the expectant management was 7.67 days and it was statistically significant. Though maternal complications were slightly higher with the expectant management, but it was not statistically significant. Early neonatal death, perinatal death and mean NICU stay were lower in the expectant management with statistical significance. Mean gestational age at delivery, mean birth weight and neonatal survival rate were statistically significantly higher in the expectant management than the interventional management.Conclusions: Optimizing maternal and perinatal outcome is the key in the management of preterm severe preeclampsia. Expectant management of preterm severe preeclampsia results in a better obstetric outcome and should be done only in well selected patients in a tertiary care centre.
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Yasmin, Shakila, Saba Nadeem, Aisha Javed, Najm us Sehar, Sadia Shakeel, and Amna Anum. "A Clinical Study on Thyroid Dysfunction in Pregnancy and its Effect on the Fetomaternal Outcome." Pakistan Journal of Medical and Health Sciences 16, no. 4 (April 26, 2022): 323–25. http://dx.doi.org/10.53350/pjmhs22164323.
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Background: Thyroid gland is the power house of human body. It provides energy for the various biochemical processes of the body and helps to maintain basal metabolic rate. Objective: To estimate the prevalence of thyroid dysfunction in pregnancy and to evaluate the obstetric and perinatal outcomes in such pregnancies Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital Bahawalpur from 15 January 2021 to 15 JUNE 2021 Study Design: A Descriptive Case Series. Materials and Methods: A total of 292 cases of antenatal patients, irrespective of their period of gestation were enrolled in this study by random sampling method. Patients with multiple pregnancies and having bad obstetrical history were excluded. Detailed history and obstetrical examination, routine blood test and serum TSH were performed. These patients were followed during labour, delivery and puerperium and maternal outcome and neonatal outcomes were noted. Results: In this study we enrolled two hundreds and ninety two (292) antenatal women. Out of total 292 patients only 61 (20.9%) were nulliparous and rest of the patients were multiparous. The prevalence of thyroid dysfunction in pregnancy was 8.2%. Out of this, 2.74 % patients had sub clinical hypothyroidism (SCH). Overt hypothyroidism (OH) was seen in 2.40%, sub clinical Hyperthyroidism in 1.71% & the incidence of overt hyperthyroidism was 1.37%. Maternal complication included: abortion (5.5%), pre-eclampsia (3.4%), abruption-placentae (4.1%), preterm labour (4.5%), PPH (4.2%) and puerperal sepsis (2.8%). Neonatal outcomes included: preterm births (5.4%),LBW (5.1 %), IUGR (6.2%), still birth (4.4%), neonatal death (5.1%), low APGAR score ( <7 at 5 minutes ) (6.9%). Conclusion: Thyroid dysfunction in pregnancy, though has a low incidence, but is associated with adverse maternal and fetal complications. Thus thyroid screening should be done in antenatal period to improve fetomaternal outcome. Keywords: Thyroid dysfunction, Hypothyroidism, Hyperthyroidism, Fetomaternal outcome, Overt Hypothyroidism, Subclinical Hypothyroidism.
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Nunes, Joana Sousa, Rita Ladeiras, Luísa Machado, Diana Coelho, Carla Duarte, and José Manuel Furtado. "The Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 42, no. 10 (June 19, 2020): 607–13. http://dx.doi.org/10.1055/s-0040-1710300.
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Abstract Objective The present study aims to analyze adverse fetal or neonatal outcomes in women with gestational diabetes, including fetal death, preterm deliveries, birthweight, neonatal morbidity and mortality, as well as the synergic effect of concomitant pregnancy risk factors and poor obstetric outcomes, as advanced maternal age, maternal obesity and pre-eclampsia in their worsening. Methods The present cohort retrospective study included all pregnant women with gestational diabetes, with surveillance and childbirth at the Hospital da Senhora da Oliveira during the years of 2017 and 2018. The data were collected from the medical electronic records registered in health informatic programs Sclinico and Obscare, and statistical simple and multivariate analysis was done using IBM SPSS Statistics. Results The study participants included 301 pregnant women that contributed to 7.36% of the total institution childbirths of the same years, in a total of 300 live births. It was analyzed the influence of pre-eclampsia coexistence in neonatal morbidity (p = 0.004), in the occurrence of newborns of low and very low birthweight (p < 0.01) and in preterm deliveries (p < 0.01). The influence of maternal obesity (p = 0.270; p = 0.992; p = 0.684) and of advanced maternal age in these 3 outcomes was also analyzed (p = 0,806; p = 0.879; p = 0.985).Using a multivariate analysis, the only models with statistic significance to predict the three neonatal outcomes included only pre-eclampsia (p = 0.04; p < 0.01; p < 0.01). Conclusion Only coexistence of pre-eclampsia showed an association with adverse neonatal outcomes (neonatal morbidity, newborns of low and very low birthweight and preterm deliveries) and can be used as a predictor of them in women with gestational diabetes.
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Федина, N. Fedina, Ткаченко, T. Tkachenko, Дмитриев, A. Dmitriev, Гудков, and R. Gudkov. "Regional aspects of the epidemiology and clinics of syphilis in children." Journal of New Medical Technologies. eJournal 9, no. 4 (December 8, 2015): 0. http://dx.doi.org/10.12737/16783.
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The purpose of this study was clinical and epidemiological analysis of the incidence of syphilis in children and adolescents in the Ryazan region over a 12 year period. In a retrospective study the authors used the data from regional statistical reports, medical records of newborns, the data on infectious diseases of the Federal State Statistics Service. The analysis of the data for all age groups, including children and pregnant women was carried out. It was noted a substantial reduction in the number of reported cases of syphilis, including among adolescents and youth. The proportion of non-residents and rural residents in the total of patients with syphilis is increasing. In the pediatric population, the leading mode of transmission is vertical (53% of all cases). Among children born from pregnant patients with syphilis, there are 78% of the verified congenital syphilis, and only 5% the classical picture of the disease. It was established a substantial reduction of cases of congenital syphilis, the absence of cases of fetal death and postnatal mortality in recent years. However, the retention of latent forms and late detection of syphilis in pregnant women poses a threat of infection and determines the social significance of the problem. Effective control of congenital syphilis is ensured by the collaboration of obstetriciansgynecologists, dermatologists and neonatologists.
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Grabich, Shannon C., Whitney R. Robinson, Charles E. Konrad, and Jennifer A. Horney. "Impact of Hurricane Exposure on Reproductive Health Outcomes, Florida, 2004." Disaster Medicine and Public Health Preparedness 11, no. 4 (January 17, 2017): 407–11. http://dx.doi.org/10.1017/dmp.2016.158.
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AbstractObjectivePrenatal hurricane exposure may be an increasingly important contributor to poor reproductive health outcomes. In the current literature, mixed associations have been suggested between hurricane exposure and reproductive health outcomes. This may be due, in part, to residual confounding. We assessed the association between hurricane exposure and reproductive health outcomes by using a difference-in-difference analysis technique to control for confounding in a cohort of Florida pregnancies.MethodsWe implemented a difference-in-difference analysis to evaluate hurricane weather and reproductive health outcomes including low birth weight, fetal death, and birth rate. The study population for analysis included all Florida pregnancies conceived before or during the 2003 and 2004 hurricane season. Reproductive health data were extracted from vital statistics records from the Florida Department of Health. In 2004, 4 hurricanes (Charley, Frances, Ivan, and Jeanne) made landfall in rapid succession; whereas in 2003, no hurricanes made landfall in Florida.ResultsOverall models using the difference-in-difference analysis showed no association between exposure to hurricane weather and reproductive health.ConclusionsThe inconsistency of the literature on hurricane exposure and reproductive health may be in part due to biases inherent in pre-post or regression-based county-level comparisons. We found no associations between hurricane exposure and reproductive health. (Disaster Med Public Health Preparedness. 2017;11:407–411)
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Schummers, Laura, Michele R. Hacker, Paige L. Williams, Jennifer A. Hutcheon, Tyler J. Vanderweele, Thomas F. McElrath, and Sonia Hernandez-Diaz. "Variation in relationships between maternal age at first birth and pregnancy outcomes by maternal race: a population-based cohort study in the United States." BMJ Open 9, no. 12 (December 2019): e033697. http://dx.doi.org/10.1136/bmjopen-2019-033697.
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ObjectiveTo estimate absolute risks of obstetric outcomes in the USA according to maternal age at first birth from age 15 to 45 separately by maternal race.Design and settingPopulation-based cohort study.SettingVital statistics Birth Cohort-Linked Birth- Infant Death Data Files and Fetal Death Data Files in the USA.Participants16 514 849 births to nulliparous women from 2004 to 2013.Outcome measuresWe estimated absolute risks of obstetric outcomes (multiple gestations, caesarean delivery, early and late preterm birth, small for gestational age birth, stillbirth, neonatal mortality, postneonatal infant mortality) at each year of maternal age from 15 to 45 years using logistic regression in the overall population and stratified by maternal race. We modelled maternal age flexibly to allow curvilinear shapes and plotted risk curves for each outcome.ResultsIn the overall population, multiple gestations, caesarean delivery and stillbirth risks were lowest at young maternal ages with linear or quadratic increases with age. Curves for preterm birth, small for gestational age, neonatal mortality and postneonatal mortality were u or j shaped, with nadirs between 20 and 29 years, and elevated risks at both younger and older maternal ages. In race-stratified analyses, the shapes of the curves were generally similar across races. Risks increased for all women for all outcomes after age 30. However, increased risks at young maternal ages were most pronounced for white and Asian/Pacific Islander women, for whom young childbearing was least common. Conversely, risks at older ages were more pronounced for Black and American Indian/Alaska Native women, for whom delayed childbearing was least common.ConclusionOur findings confirm risks associated with first births to women younger than 20 and older than 30 years, provide easily interpretable risk curves and illuminate variability in these relationships across categories of maternal race in the USA.
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Víctor Manuel, Vargas Hernández, Luján Irastorza Jesús Estuardo, Durand Montaño Carlos, Hernández Ramos Roberto, Ávila Pérez Felipe de Jesús, Guerrero Vargas José Juan, Kava Braverman Alejandro, Ávila Rebollar Daniela, and Pariente Fernández Maruxa. "Prevalence of the type of delivery in Mexican patients at the private level." Obstetrics & Gynecology International Journal 12, no. 3 (May 10, 2021): 124–28. http://dx.doi.org/10.15406/ogij.2021.12.00564.
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Background: Childbirth is a physiological event for the expulsion of the fetus. It has a low maternal morbidity or mortality, does not present problems in subsequent pregnancies and it has a lower risk of fetal death and neonatal morbidity. Despite this, there are circumstances where cesarean section is the best option. Objective: To determine the prevalence of delivery and cesarean section, and identify whether maternal age is an influencing factor when choosing the route of birth. Methods: Retrospective, observational and cross-sectional study, carried out in Mexican women in private institutions during the period from 2015 to 2019. Inclusion criteria: women who attended the private hospital and had a medical history including maternal age, gestational age, number of deliveries and cesarean sections (emergency and elective) were included. Exclusion criteria were twin pregnancies and preterm births. Three age study groups were formed for deliveries and caesarean section A) 18 to 29years of age, B) 30 to 39 years of age and C) 40 to 45years of age and differences between deliveries and caesarean sections were compared. The SPSS Statistics package, version 25, was used; Descriptive statistics were performed including mean (±) standard deviation or percentage and comparison of groups by Chi-squared test. Results: The decrease in childbirth is directly proportional to the increase in maternal age, with a higher prevalence of childbirth in women between 18 and 29years of age (Group A=60.79%) and a higher prevalence of cesarean delivery in women between 40 and 45years of age, age (Group C=48.19%). A statistically significant difference was found only in Groups A vs B, when comparing the prevalence of deliveries (60.79 vs 51.81%, p=0.05) and cesarean sections (29.21 vs 48.19%, p=0.05). Conclusions: physiological delivery is preferred in our private institution; although, complications during pregnancy and childbirth associated with maternal ageing influence the higher rate of cesarean section.
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Durr, Andrya J., Elizabeth A. Critch, M. Paula Fitzgerald, Kelly M. Devlin, Kylie A. Fuller, and Roberta I. Renzelli-Cain. "Untangling the roots of the West Virginia opioid crisis: relationships in adolescent pregnancy, drug misuse, and future outcomes." Journal of Osteopathic Medicine 121, no. 2 (January 1, 2021): 191–98. http://dx.doi.org/10.1515/jom-2020-0247.
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Abstract Context West Virginia (WV) is afflicted by high rates of teenage pregnancy and births, opioid usage during pregnancy, and Neonatal Abstinence Syndrome births. Current efforts are ineffective at reducing teenage pregnancy and opioid misuse. While pregnancy and opioid usage may appear to be separate issues, a number of associations suggest adolescent pregnancy, opioid use, and other health-related outcomes are part of a cluster of negative health conditions that should be addressed holistically. Objective To determine whether there is an association between teenage pregnancy and negative health outcomes, including opioid misuse, among WV adolescent girls. Methods This study was conducted from July 2018 to March 2019. We obtained the most recently-available aggregate data at the county level for each of the 55 WV counties from the WV Department of Health and Human Resources (WVDHHR) on July 30, 2018, and we analyzed it during the fall of 2018. Raw data regarding pregnancy-related outcomes included WV girls between the ages of 15 and 19, was acquired between 2014 and 2017 by county, and was provided by the WVDHHR as a mean taken across all four years. Raw data regarding opioid misuse outcomes and heart-health variables included WV girls and women of all ages, was collected between 2014 and 2017 by county, and was provided by the WVDHHR as a mean taken across all four years, unless stated otherwise. Pearson correlation analysis was utilized to examine the associations between the teenage pregnancy and birth rates, opioid misuse, pregnancy, and heart-health-related statistics, as well as environmental variables. Results Teenage pregnancy and birth rates were positively associated with fetal death rates (r=0.308, p<0.05 and r=0.261, p<0.10, respectively). The rate of fetal death among mothers aged 15–19 years was higher in counties with higher teenage pregnancy and birth rates. As the pregnancy and birth rates increased, the rate of abortion increased even more (r=0.434 and r=0.304 respectively, both p<0.05). Teenage pregnancy and birth rates were associated with opioid overdose death rates for all WV girls and women (Pearson correlations, r=0.444 and 0.418 respectively, both p<0.01). WV counties with higher pregnancy and birth rates among girls aged 15–19 years had a greater proportion of women dying from opioid overdose. Teenage pregnancy and birth rates were both positively correlated with obesity, physical inactivity, high cholesterol, and high blood pressure (all r>0.39, all p<0.05). Neither the high-school dropout rate nor the number of WVDHHR listed clinics were associated with teenage pregnancy or birth rates (p>0.10). Conclusion Reduction of unintended teenage pregnancy may be viewed as a nontraditional, holistic, method of ameliorating the opioid misuse crisis in the state of WV. This recommendation should be part of a multi-pronged approach to mitigating the opioid epidemic in WV and all of Appalachia.
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Sinha, Surbhi, and Vilas N. Kurude. "Study of obstetric outcome in pregnancies with intrauterine growth retardation." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 5 (April 28, 2018): 1858. http://dx.doi.org/10.18203/2320-1770.ijrcog20181918.
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Background: The prevalence of low birth weight affects approximately 3-10% of live-born newborns in developed countries and 15-20% of newborns.in developing countries. The most common cause of low birth weight is considered to be intrauterine foetal growth restriction. IUGR being an outcome of multiple etiologies and as indicated by the literature survey varies upon population statistics in terms of economic status as well as maternal health conditions.Methods: This study includes 100 patients with foetal growth restriction in a tertiary health care centre in Mumbai over a period of 11/2 year (Jan 2015 to July2016) and the relevant data of these patients such as indoor registration number, maternal age, parity, antenatal registration and referral details, medical, obstetric, social risk factors and feto-maternal outcome were collected using a predesigned proforma.Results: Incidence of IUGR in our study population was found to be 2.13% of which maximum number of cases (48%) were seen in the age group of 21-25 years. Low socio-economic group, maternal high-risk factors like Pre-eclampsia and eclampsia were associated with low Mean Birth weights of babies. Symphysio-fundal height was found to be a sensitive predictor of IUGR and the ratio HC/AC was associated with prediction of type of IUGR (p=0.000). 83% cases were found to have asymmetric IUGR while 17% cases had symmetric IUGR. The Perinatal Mortality Rate was found to be 1.92 per 1000 live births with 5% still births and 8% neonatal deaths, the most common causes of neonatal death being sepsis (44.4%) and respiratory distress syndrome (44.4%).Conclusions: Accurate dating, provision of early registration with regular antenatal checkup, clinico- sonographic evaluation and correlation for fetal growth in high risk patients and strict antepartum surveillance after IUGR has been identified are recommended. Integration of foetal anatomy assessment, amniotic fluid dynamics, uterine, umbilical, and foetal middle cerebral artery Doppler is the most effective approach to differentiate potentially manageable placenta-based Fetal Growth Restriction(FGR) from IUGR due to aneuploidy, non- aneuploid syndromes, and viral infection.
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Aminu, Muhammad B., Mohammed Alkali, Bala M. Audu, Toyin Abdulrazak, and Dauda Bathna. "Prevalence of hyperemesis gravidarum and associated risk factors among pregnant women in a tertiary health facility in Northeast, Nigeria." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 9 (August 27, 2020): 3557. http://dx.doi.org/10.18203/2320-1770.ijrcog20203827.
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Background: One of the commonest symptoms observed in pregnant women before the 20th week of gestation is nausea and vomiting, an exaggeration of these symptoms hyperemesis gravidarum (HEG) could result in maternal and fetal catastrophes and even death. The objective of this study was to determine the prevalence and associated risk factors for hyperemesis gravidarum among pregnant women at booking.Methods: A prospective institutional based study design was done among 452 pregnant women seen at booking in a tertiary hospital in Northeast Nigeria from the 1st February 2019 to 30th June 2019. Data was summarized using descriptive statistics. OR was used to measure significant risk.Results: The observed prevalence of hyperemesis gravidarum among pregnant women in the study is 44.9%. The Majority (81.4%) of these women were between the age range of 21 and 35 years. Mean age of 27 years. Multiparity (33.4%), previous (44.9%) and family history of HEG (31.6%) were identified as important risk factors for developing HEG. Grand multiparity (11.5%) and gestational age less than 13 weeks (6.64%) were however less likely observed to be risks for HEG.Conclusions: HEG is a common problem in pregnancy with almost half of the number of pregnant women at booking affected. Multiparity and past history of HEG are pointers to developing the condition and it should be looked out for among at risk group of pregnant women, so that early intervention can be instituted to avoid any possible adverse outcome.
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JABEEN, SALMA, SOHAIL MEHMOOD CH., SARWAT FARIDI, and Afzaal Ahmed. "MATERNAL MORBIDITY AND MORTALITY;." Professional Medical Journal 19, no. 06 (November 3, 2012): 797–803. http://dx.doi.org/10.29309/tpmj/2012.19.06.2460.
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Objective: To assess the demographic features of unsafe abortion and associated maternal morbidity and mortality, andavailability of post abortion care. Study Design: A Case-Series. Place and Duration of Study: The study was carried out in Gynae Unit-1 ofBahawal Victoria Hospital (BVH), Bahawalpur from 1st January 2009 to 31st December 2009. Material and Methods: Patients admitted withcomplicated unsafe abortion were evaluated regarding age, parity, marital status, educational status, socio-economic status, indication ofabortion, qualification of abortionist and method used for abortion, contraceptive usage, immediate complications and death rate in abortionseekers. Descriptive statistics were used for describing variable. Results: 119 patients were admitted with unsafe abortion. The mean age was28.5 years. 90.8% women were married, 59.6% multiparous, 21% got secondary and higher education, 62 belonged to poor socio-economicstatus. In 72% cases unsafe abortion was done during 1st trimester and 80% of women had previous history of unsafe abortion, 95%approached unqualified / semi skilled abortion providers who used instrumentation in 53% cases. The most common reason for abortion wasmultiparity (48%),& poor socio-economic status (19%), only 26.5% were using some kind of contraception. Most common complications werecontinued ongoing haemorrhage (incomplete abortion in 44%), followed by septic complications in 25% of cases and trauma to urogenital tract(22%) which also involved gut in 6% of cases. 2.5% patients reached in very critical stage & could not survived. Post abortion care provided toall patients of which 22% managed conservatively & 78% managed surgically. Contraception services offered to all but 24% refused themtotally. Conclusions: Unsafe abortion constitutes a major threat to health and lives of women. Most of them are multiparous, married at peak oftheir reproductive life and belong to poor economic status. The associated immediate morbidity is much higher than mortality in terms ofcontinued haemorrhage, sepsis, and trauma. The study focused on the need of post abortion care and easy accessibility to contraception toimprove quality of life.
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Brohi, Sumera, Shazia Ahmed Jatoi, Saeed U. Nisa Sangi, Shaista Tabasum Abro, Rukhsana Shaikh, and Ayesha Jalbani. "Prevalence of Teenage Pregnancy & Its Outcome at Shaikh Zaid Women Hospital Larkana." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1461–63. http://dx.doi.org/10.53350/pjmhs221651461.
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Background: Teenage adolescent pregnancy is an important community health issue globally. Research shows that mothers in teenage period are at a higher risk of maternal death and complications related with pregnancy in comparison to the mothers who are adult. Therefore, this research was directed to examine the sociodemographic profile and fetal and maternal outcomes related with teenage pregnancy and their comparison with mothers of 20-30 years of age. Study Design: A comparative cross-sectional study. Place and Duration: In the obstetrics and Gynecology department of Sheikh Zaid Women Hospital Larkana for one-year duration from March 2021 to February 2022. Methods: A total of 60 teenage mothers ≤19 and 60 mothers who were 20-30 years of age respectively, were nominated as controls and cases. Data on the obstetric complications, fetal outcomes and sociodemographic profile were collected through face-to-face interviews using a pre-tested, pre-designed, partially structured questionnaire. The statistics were analyzed by entering data in the excel sheet of Microsoft. Results: In this study, 18.1 years was the mean age in teenage pregnant females and 24.3 years in the control group. 17.8 years was the mean age at which teenage mothers were married and for adults it was 20.1 years. 66.7% of teenage mothers and 61.7% of the control group are of high-low socioeconomic status. 80% of teenage pregnant females and 75% of control group were from rural areas. The mainstream of teenage mothers (70%) and control mothers (58.3%) are housewives by profession. The consanguineous marriages were observed in 33.3% of adolescent pregnant females and 41.7% in the control group. In this study, 38.3% and 46.7% of the mothers in adolescent and control group respectively had ante-natal checks during their pregnancy. Stillbirth / miscarriage were reported in 13.3% of adolescent mothers and 25% in the control group. 63.3% of teenage mothers had mild anemia and 53.3% in controls. The incidence of malnutrition (40% vs 15%, p <0.05), PPH (25% vs 6.7%, p <0.05), PROM (20% vs 3.3%, p <0.05) was significant in teenage mothers in comparison to mothers who were adults. The incidence of PIH was lower significantly in mothers during adolescence in comparison to adult mothers (13.3% vs. 31.7%, p <0.05). Conclusions: Complications such as PROM, maternal malnutrition, premature delivery, PPH and low birth weight occurred more frequently in adolescent mothers than in mothers who were adults. The adult mother’s higher proportion of PIH than in teenage mothers. Keywords: Adult pregnancy, teenage pregnancy, sociodemographic factors, adverse fetal and maternal outcomes.
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Brohi, Sumera, Shazia Ahmed Jatoi, Saeed U. Nisa Sangi, Shaista Tabasum Abro, Rukhsana Shaikh, and Ayesha Jalbani. "Prevalence of Teenage Pregnancy & Its Outcome at Shaikh Zaid Women Hospital Larkana." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1461–63. http://dx.doi.org/10.53350/pjmhs221651461.
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Background: Teenage adolescent pregnancy is an important community health issue globally. Research shows that mothers in teenage period are at a higher risk of maternal death and complications related with pregnancy in comparison to the mothers who are adult. Therefore, this research was directed to examine the sociodemographic profile and fetal and maternal outcomes related with teenage pregnancy and their comparison with mothers of 20-30 years of age. Study Design: A comparative cross-sectional study. Place and Duration: In the obstetrics and Gynecology department of Sheikh Zaid Women Hospital Larkana for one-year duration from March 2021 to February 2022. Methods: A total of 60 teenage mothers ≤19 and 60 mothers who were 20-30 years of age respectively, were nominated as controls and cases. Data on the obstetric complications, fetal outcomes and sociodemographic profile were collected through face-to-face interviews using a pre-tested, pre-designed, partially structured questionnaire. The statistics were analyzed by entering data in the excel sheet of Microsoft. Results: In this study, 18.1 years was the mean age in teenage pregnant females and 24.3 years in the control group. 17.8 years was the mean age at which teenage mothers were married and for adults it was 20.1 years. 66.7% of teenage mothers and 61.7% of the control group are of high-low socioeconomic status. 80% of teenage pregnant females and 75% of control group were from rural areas. The mainstream of teenage mothers (70%) and control mothers (58.3%) are housewives by profession. The consanguineous marriages were observed in 33.3% of adolescent pregnant females and 41.7% in the control group. In this study, 38.3% and 46.7% of the mothers in adolescent and control group respectively had ante-natal checks during their pregnancy. Stillbirth / miscarriage were reported in 13.3% of adolescent mothers and 25% in the control group. 63.3% of teenage mothers had mild anemia and 53.3% in controls. The incidence of malnutrition (40% vs 15%, p <0.05), PPH (25% vs 6.7%, p <0.05), PROM (20% vs 3.3%, p <0.05) was significant in teenage mothers in comparison to mothers who were adults. The incidence of PIH was lower significantly in mothers during adolescence in comparison to adult mothers (13.3% vs. 31.7%, p <0.05). Conclusions: Complications such as PROM, maternal malnutrition, premature delivery, PPH and low birth weight occurred more frequently in adolescent mothers than in mothers who were adults. The adult mother’s higher proportion of PIH than in teenage mothers. Keywords: Adult pregnancy, teenage pregnancy, sociodemographic factors, adverse fetal and maternal outcomes.
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van der Vegt, A. N., R. de Vries, J. Osinga, N. Grun, T. J. Postma, P. F. de Haan, M. E. van Linde, W. P. Vandertop, M. Schuur, and M. C. M. Kouwenhoven. "P14.51 Can patients with a suspected high-grade glioma receive tumor treatment during pregnancy safely?" Neuro-Oncology 23, Supplement_2 (September 1, 2021): ii47. http://dx.doi.org/10.1093/neuonc/noab180.163.
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Abstract BACKGROUND Diagnosis of a glioma during pregnancy has ethical and medical dilemmas; treatment of the mother may harm the unborn child, but a too conservative approach towards tumor treatment can compromise the survival of the mother. In patients with a suspected high-grade glioma, postponing tumor treatment is undesirable. We collected published cases to describe the given treatments during pregnancy and the outcomes for mother and child. METHODS From Pubmed, Embase and Web of Science, 122 cases were extracted from 65 reports published between 1999 and 2020. We added 7 cases from our center. Cases came from: North-America (54/129), Europe (47/129), Asia (13/129), Middle-East (3/129) and one from Oceania and Africa each; 10 cases were from an unspecified country. The data were analysed with descriptive statistics. RESULTS The median age of the pregnant women was 30 (range 17–48) years; at the time of publication 42% of mothers had deceased. Most frequent symptoms at presentation were high intracranial pressure (35%), seizures (30%) or focal deficits (19%). Patients were diagnosed in each phase of the pregnancy - 30% in the first, 35% in the second and 35% in the last trimester. Twenty-two women decided to terminate the pregnancy (North America 9; Europe 9; international unspecified, Africa, Asia and Middle-East each one case). In sixty-seven percent of women, tumors were operated while pregnant, 70% of those were planned surgery, while in 30% surgery was in performed in an emergency setting. Most women received a resection. In 6 patients tumor surgery was combined with a caesarian section. Histological diagnosis of the tumor was available in 112 patients: anaplastic oligodendroglioma (n=10), anaplastic astrocytoma (n=30), glioblastoma (n=66) or high-grade glioma NOS (n=6). In 10 patients there was a suspected high grade glioma based on MRI imaging. Only 20 patients were treated after surgery whilst still pregnant with either radiotherapy (15/20, 75%), chemotherapy (2/20, 10%) or a combination of radiotherapy and chemotherapy (3/20, 15%) Other patients received additional treatment after delivery (109/129; 84%). Delivery method was a caesarian section in 60% and vaginal delivery in 21%- in 19% delivery method was not described. In 63% of cesarean sections were brought forward either because of rapid maternal deterioration or to enable maternal treatment after delivery. In 92% a healthy child was born, 7% had a intrauterine fetal death and 1% the child was stillborn. None of the patients who experienced intrauterine fetal death had received radio- or chemotherapy during pregnancy. CONCLUSIONS The majority of pregnant women continue their pregnancy when facing a diagnosis of a high grade glioma. Tumor surgery seemed safe during pregnancy. No adverse events were reported in the limited patients who received radiotherapy (n=15) during pregnancy. For chemotherapy we could not draw any conclusions.
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P, Yadav, Basnet T, Sha M, and Yadav SP. "Outcome of Subsequent Pregnancy in Women with Previous Caesarean Delivery: A Retrospective Study." International Research Journal of Multidisciplinary Scope 03, no. 02 (2022): 29–34. http://dx.doi.org/10.47857/irjms.2022.v03i02.074.
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Introduction: Previous caesarean section poses risk to both mother and neonates in the subsequent pregnancy. This study aimed to study the obstetric and neonatal outcome in a pregnancy with previous caesarean section (CS). Methods: A retrospective chart review was conducted in pregnant women with previous CS, admitted from 15thOctober 2020 to 14thApril 2020. Collected data were analyzed regarding maternal and perinatal outcome using appropriate statistics. Results: Among total of 322 cases, vaginal birth after caesarean were conducted in 3.7% and majority 78.2% went through emergency CS, rest were elective. Total CS was done in 96.2%, because 58.7% did not meet VBAC criteria and 40.3% refused VBAC. 36.6% had preterm delivery. Of 310 cases that underwent CS, common complications reported were: intra operative hemorrhage (20), scare dehiscence (12), urinary bladder injury (4), placenta praevia (11), uterine rupture (2), adherent placenta (5), postpartum hemorrhage (PPH) (13), abruptio placentae (6) and hysterectomy (1). 3 mothers required ICU admissions. Complications among neonates were: low birth weight 14.2%, birth asphyxia 3.1%, 5.2% required NICU admissions. (8/322) pregnancy had intra uterine fetal death and there was 1 still birth. Perinatal mortality were higher among female with previous LSCS less than 2 years (p=0.02) and those with more than once LSCS had significant proportion of intraoperative haemorrhage (p=0.01), PPH (p=0.04) and placenta praevia (p=0.04). Conclusions: Delivery among pregnant with previous CS have significant operative challenges and perioperative complications among mother and neonates. Anticipation of common complications and preparedness beforehand could improve both maternal and neonatal outcome.
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U. Nnadozie, Ugochukwu, Charles C Maduba, Gabriel M. Okorie, Lucky O. Lawani, Anikwe C Chidebe, Obiora G. K Asiegbu, and Amaechi Ugbala. "Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria." Malawi Medical Journal 33, no. 3 (September 27, 2021): 204–9. http://dx.doi.org/10.4314/mmj.v33i3.8.
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BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ.
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Serrano, Rosa, Guillermo J. Pons-Estel, Gerard Espinosa, Rosana M. Quintana, Joan C. Reverter, Dolors Tassies, Joan Monteagudo, and Ricard Cervera. "Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center." Lupus 29, no. 9 (June 14, 2020): 1050–59. http://dx.doi.org/10.1177/0961203320933009.
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Objective The objective of this paper is to assess the prevalence of the main clinical manifestations and laboratory features at disease onset and during the ensuing 10 years of a large cohort of patients with antiphospholipid syndrome (APS) from a single center. Methods The study included all consecutive APS patients followed longitudinally in our center from 2003 to 2013. Descriptive statistics for demographics, clinical and laboratory features and mortality were performed. Results A total of 160 patients were included. Most of them, 128 (78.8%), were women and the mean (SD) age at diagnosis was 39.1 (14.0) years. The majority of them, 104 (65.0%), had primary APS, 36 (22.5%) had APS associated with systemic lupus erythematous, and 20 (12.5%) had APS associated with other autoimmune disease. During the study period, thrombotic events occurred in 27 (16.9%) patients, the most common being strokes, nonbacterial thrombotic endocarditis and deep venous thrombosis. Regarding obstetric morbidity, 18 women (14.3%) became pregnant and 90% of pregnancies succeeded in having live births. The most common obstetric complication was early pregnancy loss (15% of pregnancies). Prematurity (11.1% of live births) and intrauterine growth restriction (5.6% of live births) were the most frequent fetal morbidities. Ten (6.3%) patients died and the most frequent causes of death were severe thrombosis, hemorrhage, and cancer. Three (0.9%) cases of catastrophic APS occurred. The survival probability at 10 years was 93.8%. Conclusions Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications.
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Hardin, Jill, Suzan L. Carmichael, Steve Selvin, and Gary M. Shaw. "Trends in the Probability of Twins and Males in California, 1983–2003." Twin Research and Human Genetics 12, no. 1 (February 1, 2009): 93–102. http://dx.doi.org/10.1375/twin.12.1.93.
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AbstractThis study examines the probability of twins by birth year, maternal race–ethnicity, age, and parity and the influences of these demographic factors on the probability of male in twins and singletons in a large, racially diverse population. Recent publications note steep increases in twin births while the probability of male births has been reported to vary by parental race–ethnicity and age and birth order. Probability of male stratified by plurality has not been investigated in California prior to this study. Cubic spline estimates and Poisson regression techniques were employed to describe trends in twins and males using California vital statistics birth and fetal death records over the period from 1983–2003. This study includes 127,787 twin pair and 11,025,106 singleton births. The probability of twins varied by birth year, maternal race–ethnicity, age, and parity. The probability of twins increased by 10.1% from 1983–1992 and increased by 20.1% from 1993–2003, nearly doubling the previous increase. All maternal race–ethnicity groups showed increases in probability of twins with increasing maternal age. Parous women compared to nulliparous women had larger increases in the probability of twins. The probability of males in twins decreased from 1983–1992 and increased from 1993–2003; while in singletons the probability appeared unchanged. These findings show increases in the probability of twins in California from 1983–2003 and identify maternal age, race–ethnicity, and parity groups most likely to conceive twins. The cause of the increase in twins is unknown but coincides with trends towards delayed childbearing and increased use of subfertility treatments.
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Srinivasa, S., and Muragesh Awati. "Perinatal outcomes of hypertensive disorders of pregnancy." Karnataka Pediatric Journal 35 (January 25, 2021): 105–9. http://dx.doi.org/10.25259/kpj_21_2020.
Full textAbstract:
Objectives: Hypertensive disorders of pregnancy (HDP) are multisystem diseases, which include chronic (preexisting) hypertension, gestational hypertension, pre-eclampsia, eclampsia, and pre-eclampsia superimposed on chronic hypertension. These disorders may complicate 5%–10% of all pregnancies and are leading causes of maternal and perinatal mortality and morbidity worldwide. This study was done to assess the incidence of HDP and perinatal outcomes in comparison to normal pregnancy. The objectives of this study were to assess the incidence of HDP and its correlation with perinatal outcome. Materials and Methods: Eighty patients were enrolled for the study, Group A (cases) – 40 patients of HDP and Group B (controls) – 40 normotensive controls, these 40 normotensive controls were properly matched with Group A with respect to age and gestational age. The collected data were analyzed with IBM SPSS statistics software 23.0 Version XVII. Results: In Group A, 45% were gestational hypertensive patients, 35% were pre-eclamptic patients, 12.5% eclampsia, and 7.5% chronic hypertension. Perinatal morbidity and mortality were increased in HDP when compared with age and gestational age-matched controls. Perinatal mortality was seen in 10% in Group A. In Group B(controls) there were no perinatal mortalities. Conclusion: The study demonstrated that high parity, low gestational age, lack of antenatal care, having eclampsia, pre-delivery onset of HDP, vaginal delivery, low fetal birth weight, and maternal death were independent predictors of perinatal mortality. The majority of perinatal mortality predictors were also predictors of stillbirths. The strong association of perinatal mortality with eclampsia (a late complication of HDP in the majority) and lack of antenatal care is an indirect evidence for the delay in the utilization of obstetric services.