scholarly journals Diagnostic efficacy of biophysical tests and cerebral-umbilical index when assessing fetal oxygenation

2013 ◽  
Vol 66 (7-8) ◽  
pp. 292-296
Author(s):  
Branka Cancarevic-Djajic ◽  
Rade Vilendecic
Keyword(s):  
Antenatal Care ◽  
Diagnostic Procedure ◽  
Statistical Significance ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Colour Doppler ◽  
Biophysical Profile ◽  
Doppler Evaluation ◽  
Fetal Oxygenation ◽  
Fetal Acidosis

Introduction. Perinatal morbidity and mortality are the ultimate indicators of antenatal care today, whose responsible task is to assess the respiratory function of the placenta, fetal growth and placental maturation in order to provide conditions for the delivery of a living and viable newborn. The diagnostic procedures of antenatal care tested within this study were the biophysical tests of cardiotocography and the fetal biophysical profile, along with the colour doppler evaluation of the cerebral-umbilical ratio. The objective of this study was to determine the most effective diagnostic procedure when assessing fetal oxygenation. Materials and Methods. The prospective study included 119 pregnant women. They all underwent cardiotocography, biophysical profile and colour doppler evaluation of the cerebral-umbilical ratio. The babies? umbilical artery blood pH was determined in the first minute upon birth, along with the Apgar score. Results. The results were processed statistically and the most effective diagnostic procedure for the evaluation of fetal oxygenation was selected, after which the rates of perinatal morbidity and mortality were calculated. The findings revealed that cardiotocography was the most sensitive antepartal predictor of fetal acidosis, while the fetal biophysical profile proved the most specific. The rates of perinatal morbidity and of perinatal mortality were 24.37% and 1.68%, respectively. Conclusion. The findings analysis revealed a high statistical significance of both biophysical tests and the cerebral-umbilical ratio evaluation as predictors of the fetal distress syndrome. The analysis of the cerebral-umbilical ratio and biophysical tests showed that the cerebral-umbilical ratio evaluation not only was more sensitive as a parameter compared to biophysical tests but it was also more specific than cardiotocography. Cardiotocography is the most sensitive antepartal predictor of fetal acidosis, followed by the cerebral-umbilical ratio, and the biophysical profile as the least sensitive. The biophysical profile proved to be the most specific, followed by the cerebral-umbilical ratio, and cardiotocography as the least specific.

scholarly journals Cervical sonomorphometric evaluation of normal and preterm labour by transvaginal and transabdominal sonography

2017 ◽  
Vol 6 (2) ◽  
pp. 417
Author(s):  
Khusboo . ◽  
Dinesh Kumar ◽  
Ashish Verma ◽  
Suman Chaurasia ◽  
Ramvilas Nag
Keyword(s):  
Imaging Modality ◽  
Statistical Significance ◽  
Cervical Length ◽  
Morbidity And Mortality ◽  
Transvaginal Sonography ◽  
Perinatal Morbidity ◽  
Doppler Measurement ◽  
Full Bladder ◽  
Significant Difference ◽  
Patients At Risk

Background: Preterm delivery is major cause of perinatal morbidity and mortality. Measuring cervical length (CL) with ultrasonography has become increasingly acceptable as an early diagnostic procedure in patients at risk for PTL, with transvaginal ultrasonography (TV Us) being considered as the gold standard for the CL assessment.Methods: A cohort of women with singleton pregnancies, and confirmed gestational age by first or early second trimester ultrasonography, last menstrual period & clinical assessment were selected to undergo transvaginal and transabdominal sonographic measurement of cervical length between 16 and 34 week gestation. Cervical length was first measured by transabdominal route (TAS) using a 3.5 MHz curved electronic array transducer with the patient in the supine position and with a full bladder, transvaginal sonography (TVS) was done by a 7.5 MHz probe attached to an ultrasound machine. The probe was covered with a latex condom and gel placed between the transducer and the cover and also on the surface. It was then gently inserted in the vagina to obtain a sagittal view of the cervix. Doppler measurement were taken by both transabdominal and transvaginal route.Results: Gradual decrease in cervical length is seen with advancement of gestation weeks. TA Us cervical length values are noted higher than TV Us however significance is seen only at 24 weeks and cervical width are showing gradual increase with advancement of gestation weeks without significant difference between them. The study compared the mean spectral Doppler parameters RI, PI and S/D Ratio at different weeks & observed that TV Us values are more at each gestation weeks than TA Us showing significant difference 24 weeks onwards.Conclusions: Although discrepancy in statistical significance, short cervical length, funneling and gland area are important to recognize for prediction of premature onset of labour, owing to the potential for perinatal morbidity and mortality and socioeconomic burden. Transvaginal sonography remains the dominant imaging modality for evaluation of the cervix. It is operator dependent modality so care should be taken to evaluate each morphologic character.

scholarly journals Multiple gestation and perinatal outcome in the Federal Medical Centre, Yenagoa, South-South, Nigeria: A 5-year review

2021 ◽  
Vol 3 (1) ◽  
pp. 001-011
Author(s):  
Peter Chibuzor Oriji ◽  
Dennis Oju Allagoa ◽  
Datonye Christopher Briggs ◽  
Judith Isioma Adhuze ◽  
Tornubari Romeo Mbooh ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Medical Centre ◽  
Morbidity And Mortality ◽  
High Rate ◽  
Gravid Uterus ◽  
Categorical Variables ◽  
Multiple Gestation ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Risk Pregnancy

Background: Multiple gestation occurs when the gravid uterus harbours more than one foetus. It is a high-risk pregnancy, because of the associated adverse pregnancy outcomes culminating in some cases, in a high rate of maternal and perinatal morbidity and mortality. Objective: To determine the incidence of multiple gestation, and maternal and perinatal outcomes associated with it at the Federal Medical Centre, Yenagoa, South-South, Nigeria, over a five-year period. Materials and Methods: This retrospective study was carried out between 1st January, 2016 and 31st December, 2020. Data were retrieved and entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables, and mean and standard deviation for continuous variables. Results: One hundred and sixty-three women had multiple gestation in the period under review, out of a total of 4,571 pregnancies, which represented a case incidence rate of 35.6 multiple gestations per 1,000 deliveries in the Centre. Incidence rates for twins and triplets were 32.5 and 3.5 per 1,000 deliveries, respectively. About 51.5% were unbooked for antenatal care in the index pregnancy. The most common (47.2%) complication was preterm delivery. There were 342 neonates from 163 multiple gestations. There was death of 20 (5.8%) babies. Conclusion: The significant maternal and perinatal morbidity and mortality associated with multiple gestation can be reduced by early diagnosis, specialized antenatal care, skilled intrapartum, postpartum and neonatal care in centres with a full complement of skilled obstetricians, anaesthetists and neonatologists.

Maternal and Perinatal Outcome in Severe Pre-eclampsia and Eclampsia

2009 ◽  
Vol 1 (3) ◽  
pp. 25-28 ◽  
Author(s):  
Anshu LNU ◽  
Deepika LNU
Keyword(s):  
Pulmonary Embolism ◽  
Antenatal Care ◽  
Pulmonary Edema ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Perinatal Complications ◽  
Function Tests

ABSTRACT Background Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. Present study was planned to find the maternal and perinatal outcome in patients of severe pre-eclampsia and eclampsia. Methodology It is a prospective study, carried out on 100 pregnant women admitted with severe pre-eclampsia and eclampsia at a tertiary care referral unit. Detailed history and examination was carried out. Investigations like complete hemogram, liver function tests, renal function tests, coagulation profile, fundus and 24 hours urine for protein were done. Obstetric management was done as per existing protocol in the department, magnesium sulphate was the drug of choice for controlling convulsions, and blood pressure was controlled either by oral nefidipene or methyl dopa. Maternal and perinatal complications were noted down. Results The majority of the patients was unbooked (82%), belonged to lower socioeconomic status (84%) and had rural background (84%). Headache was the most common antecedent symptom (44%) followed by epigastric pain (20%), oliguria (9%), blurring of vision (8%) and ascitis (5%). There was high incidence of maternal complications like PPH (31%), abruption placentae (11%), renal dysfunction (8%), pulmonary edema (8%), pulmonary embolism (4%), HELLP syndrome (2%) and DIC (2%). Maternal mortality was 8% and the causes were pulmonary embolism in four women, DIC in two, HELLP and pulmonary edema in one each. Perinatal complications were also high 71.43% were low birth weight, 66% had preterm delivery, 52.4% babies had birth asphyxia and 28.57% were still born. Maternal and perinatal outcome was much poorer in eclampsia as compared to severe pre-eclampsia. Conclusion There is a very high maternal and perinatal morbidity and mortality and 82% patients had no antenatal care. Good antenatal care could have been prevented severe pre-eclampsia and eclampsia to some extent. Thus it is suggested that developing countries have to go a long way to create awareness about importance of antenatal check ups and take measures for implementation.

scholarly journals Prevention of Preeclampsia

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sammya Bezerra Maia e Holanda Moura ◽  
Laudelino Marques Lopes ◽  
Padma Murthi ◽  
Fabricio da Silva Costa
Keyword(s):  
Secondary Prevention ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Nutritional Supplementation ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Primary And Secondary Prevention ◽  
Care Change

Preeclampsia (PE) affects around 2–5% of pregnant women. It is a major cause of maternal and perinatal morbidity and mortality. In an attempt to prevent preeclampsia, many strategies based on antenatal care, change in lifestyle, nutritional supplementation, and drugs have been studied. The aim of this paper is to review recent evidence about primary and secondary prevention of preeclampsia.

Medically indicated late preterm delivery and its impact on perinatal morbidity and mortality: a retrospective population-based cohort study

2018 ◽  
Vol 32 (19) ◽  
pp. 3278-3287 ◽  
Author(s):  
Limor Besser ◽  
Liat Sabag-Shaviv ◽  
Maayan Yitshak-Sade ◽  
Salvatore Andrea Mastrolia ◽  
Danielle Landau ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Delivery ◽  
Population Based ◽  
Late Preterm ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity

Willingness of antenatal care attendees towards voluntary HIV counseling and testing, Southern Ethiopia

2020 ◽  
Vol 6 (4) ◽  
pp. 104-112
Author(s):  
Sintayehu Assefa ◽  
Dubale Dulla
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Information Dissemination ◽  
Statistical Significance ◽  
Southern Ethiopia ◽  
Cross Sectional ◽  
Care Clinic ◽  
Hiv Counseling And Testing ◽  
Hiv Counseling ◽  
Counseling And Testing

Background: Voluntary counseling and testing (VCT) is an entry point for the prevention of HIV transmission from mother to child and accessing VCT benefit from PMTCT services. Even though, some pregnant women clearly know the benefits /advantages of PMTCT services, they are not willing to test and access the services. Hence, this study was aimed to assess the willingness of pregnant women attending antenatal care towards VCT/PMTCT at Adare general hospital in southern Ethiopia. Method: An institution-based cross-sectional study was conducted at Hawassa Adare hospital, southern Ethiopia from February to April/2018. A total of 338 randomly selected pregnant women who were attending antenatal care clinic were included. Data was collected using structured and pretested questionnaire; entered and analyzed using SPSS version 20 computer software. Important descriptive and logistic models were used for data analysis assuming statistical significance at p < 0.05. Result: A total of 338 mothers were interviewed with a response rate of 100%. The willingness towards voluntary HIV counseling and testing among study participants was 82.2%. Participants who attended primary and High school and above were 3.9 (AOR= 3.87, 95% CI- 1.705, 8.782) and 9.5 times (AOR 9.53 at 95% CI- 3.155, 28.76); those who had good knowledge about VCT/PMTCT were 3.47 times (AOR=3.47, 95% CI-1.721, 7.003); women who followed two to three ANC visit, were 5.1 times more likely have willingness towards VCT/PMTCT (AOR 5.11 at 95% CI -1.095, 23.81) more likely willing to be tested than their counterparts respectively. Conclusion: Willingness towards voluntary HIV counseling was encouraging however it needs advancement. Since boosted knowledge and awareness promote willingness to VCT/PMTCT uptakes, initiation of community-based information dissemination, increased quality of ANC service, and empowering women to be educated could be effective in order to promote high VCT and PMTCT program uptakes

Modern concepts of etiology, pathogenesis and risk factors for preeclampsia

2021 ◽  
Vol 70 (5) ◽  
pp. 105-116
Author(s):  
Maria Yu. Abramova ◽  
Mikhail I. Churnosov
Keyword(s):  
Risk Factors ◽  
Social Issue ◽  
Chronic Diseases ◽  
Molecular Mechanisms ◽  
Current Understanding ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Distant Future

Preeclampsia is a serious complication of pregnancy and complicates its course in 2-8% of all cases. According to the literature, the disease is associated with an increase in maternal and perinatal morbidity and mortality, and is a predictor of the development of chronic diseases in the distant future, which is an important medical and social issue. Of particular interest is the study of the molecular mechanisms of etiopathogenesis and risk factors for preeclampsia, which, unfortunately, are currently poorly studied and understood, thus dictating the need for further study of this complication of pregnancy. This article discusses the current understanding of the etiology, pathogenesis and risk factors for preeclampsia.

scholarly journals Editorial–Special Issue

2016 ◽  
Vol 19 (3) ◽  
pp. 167-167 ◽  
Author(s):  
Mark P. Umstad ◽  
Ricardo Palma-Dias ◽  
Asma Khalil
Keyword(s):  
Well Being ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Special Issue ◽  
Monochorionic Twin ◽  
Editorial Special Issue ◽  
Twin Pregnancies

Monochorionic twin pregnancies are subject to unique complications that can threaten the life and well-being of both fetuses, resulting in a disproportionate increase in perinatal morbidity and mortality.

scholarly journals Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

2018 ◽  
Vol 7 (11) ◽  
pp. 4604
Author(s):  
Mahantappa A. Chiniwar ◽  
Joe Kaushik M. ◽  
Sharada B. Menasinkai
Keyword(s):  
Amniotic Fluid ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Research Centre ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Chi Square

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

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