Pregnancy on Intensified Hemodialysis: Fetal Surveillance and Perinatal Outcome

2007 ◽  
Vol 22 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Christian Bamberg ◽  
Fritz Diekmann ◽  
Michael Haase ◽  
Klemens Budde ◽  
Berthold Hocher ◽  
...  
2006 ◽  
Vol 28 (4) ◽  
pp. 489-490
Author(s):  
C. Bamberg ◽  
F. Diekmann ◽  
M. Haase ◽  
K. Budde ◽  
B. Hocher ◽  
...  

Author(s):  
K. P. Sowmya ◽  
S. R. Mudanur ◽  
Padmasri R. ◽  
Lalitha S.

Background: Fetal biophysical profile is a well-established method of antepartum surveillance in high risk pregnancy. Classical biophysical profile with all parameters (fetal breathing movements, fetal tone, fetal gross body movements, amniotic fluid volume and non-stress test) needs two phase testing by ultrasound and external Doppler monitor to record fetal heart rate, is more cumbersome, time consuming and expensive.Methods: This study was a prospective clinical study which consisted of 70 patients having pregnancy with high risk factors. The patients were evaluated with the modified biophysical profile consisting of NST recording for 20mins, followed ultrasound assessment of amniotic fluid volume, using four quadrant technique.Results: When the Modified biophysical profile is normal, it gives reassurance that the fetal status is good with good perinatal outcome. When the MBPP is abnormal there is increased incidence of perinatal morbidity as well as mortality.Conclusions: Modified biophysical profile is an effective primary antepartum fetal surveillance test in high risk pregnancies in predicting perinatal outcome.


Author(s):  
Nikita Gandotra ◽  
Neha Mahajan ◽  
Aakriti Manhas

Background: Oligohydramnios is a severe and common complication of pregnancy and its incidence is reported to be around 1 to 5% of total pregnancies. The aim of this study was to perinatal outcome of oligohydramnios (AFI <5) at term.Methods: A prospective study was conducted in which 200 patients at term with oligohydramnios AFI <5 cm with intact membranes were analyzed for perinatal outcome.Results: There were increased chances of FHR decelerations, thick meconium, increased LSCS, low Apgar score at 5 minutes, birth weight <2.5 kg, admission to NICU in pregnancy with oligohydramnios.Conclusions: An amniotic fluid index (AFI) of <5 cm detected after 37 completed weeks of gestation is an indicator of poor perinatal outcome. Determination of AFI can be used as an adjunct to other fetal surveillance methods that helps to identify those infants at risk of poor perinatal outcome.


2021 ◽  
Vol 10 (23) ◽  
pp. 1746-1750
Author(s):  
Vanaja Gundu ◽  
Ganga Devi Chikile ◽  
Geetha Kumari Ponnada

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


2021 ◽  
Vol 8 (2) ◽  
pp. 235-239
Author(s):  
Mahesh Babu ◽  
Bhavya H U ◽  
Shyam Sundar S

IUGR is one of the most common pregnancy complications which substantially increase risk of adverse neonatal outcome. The sequelae of IUGR include stillbirth, neuro-developmental delay in childhood and high risk of diseases like hypertension, diabetes in adulthood. Therefore, IUGR in pregnancy warrants intensive antepartum fetal surveillance to ensure optimal perinatal outcome.To evaluate the tests of antepartum fetal surveillance like AFI, BPS and Doppler ultrasound, alone and in combination for predicting adverse perinatal outcome in pregnancy with IUGR.This was a prospective observational study done on 100 pregnant IUGR women &#62; 34weeks of gestation, at a tertiary care centre in Karnataka, from June 2017 till December 2018. They were monitored by tests of fetal surveillance like Amniotic Fluid Index (AFI), Bio Physical score (BPS) and Doppler ultrasound. Tests done within 48 hours before labour and its relation to perinatal outcome were assessed. Continuous data such as age, height, weight were described by mean and standard deviation. The sensitivity specificity, positive and negative predictive value were calculated for each test.The statistical difference between the normal and abnormal tests of antepartum fetal surveillance in relation to perinatal outcome was significant. Diagnostic accuracy of Doppler was 67%, BPS and AFI was 69%. In case of combination of findings of BPS and Doppler, the accuracy rose to 75%.Biophysical profile was most reliable diagnostic method than Doppler in predicting adverse outcome. Sensitivity increased when BPS and Doppler was combined which is beneficial in predicting perinatal outcome.


Author(s):  
Jankidevi S. Borade ◽  
Sushma P. Sharma

Background: The goal of antepartum fetal surveillance is early identification of the compromised fetus and timely intervention when the fetus is at risk, but still in an uncompromised state. Modified Biophysical Profile (MBPP) includes Amniotic Fluid Index (AFI) and non stress test (NST). AFI is a marker of long term placental function and NST is a marker of short term fetal condition. The aim of this study is to assess the role of Modified Biophysical Profile in high risk pregnancies and assess perinatal outcome and to study the impact of NST and AFI individually in high risk pregnancies.Methods: 100 ANC patients with high risk factors were evaluated with modified biophysical profile 37 week onwards with non stress test (NST) for 20 mins and amniotic fluid index (AFI) with 4 quadrant technique. High risk pregnancies include preeclampsia, IUGR, oligohydramnios, postdated pregnancy, etc. and various parameters were assessed to determine perinatal and maternal morbidity. All parameters were statistically analyzed.Results: The above study states that need for LSCS, intrapartum fetal distress, meconium stained liquor, APGAR score, need for neonatal resuscitation and perinatal morbidity were definitely higher in cases with abnormal MBPP.Conclusions: Thus MBPP is an easy, cost effective and time saving measure and hence can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.


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