OUTCOME OF SECOND BABY OF TWIN IN A RURAL TEACHING HOSPITAL OF WEST BENGAL, INDIA

2021 ◽  
pp. 4-7
Author(s):  
Kajal Kumar Patra ◽  
Anirban Mandal ◽  
Thyadi Himabindu

Background: Multiple pregnancies are a high-risk situation because of its inherent risks to mother and the fetus. Twin or multiple pregnancies are gaining importance worldwide because of the attributable rise in treatment of infertility including assisted reproductive technologies. Twin pregnancies are associated with increased fetal loss, prematurity, structural abnormalities, and fetal growth restriction. Complications associated with twin pregnancy. The conduct of a twin delivery remains one of the most challenging events in the current obstetric practice. This Methods: study was an Hospital-based cross-sectional descriptive study conducted in the Department of Obstetrics & Gynaecology of Bankura Sammilani Medical College and Hospital, Bankura, West Bengal from January 2020 to December 2020. 238 patients were included in the study after informed consent from the patient about being a part of this study. Template was generated in MS excel sheet and analysis was done on SPSS software. Results: Majority 154 (64.7%) of women belonged to age group 21-30 years. Gestational age of 159 (66.8%) mothers were < 37 weeks. Perinatal outcome of second twin was highest in the maternal age group 20 years. Perinatal outcome of second twin was highest in the birth weight of the 2nd twin < 2500 grams. Delivery time interval between the babies was maximum 175 (73.5%) is < 10 minutes. Gestational age, Conclusions: presentation, mode of delivery, and birth weight are the signicant determinants of perinatal outcome of the second twin. The second twin is at higher risk of perinatal morbidity and mortality than the rst twin. Frequent antenatal care should be advised to the mothers.

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 


Author(s):  
Sunanda N. ◽  
Akhila M. V.

Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1779
Author(s):  
Meltem Dinleyici ◽  
Vicente Pérez-Brocal ◽  
Sertac Arslanoglu ◽  
Ozge Aydemir ◽  
Sibel Sevuk Ozumut ◽  
...  

The human milk (HM) microbiota is a significant source of microbes that colonize the infant gut early in life. The aim of this study was to compare transient and mature HM virome compositions, and also possible changes related to the mode of delivery, gestational age, and weight for gestational age. Overall, in the 81 samples analyzed in this study, reads matching bacteriophages accounted for 79.5% (mainly Podoviridae, Myoviridae, and Siphoviridae) of the reads, far more abundant than those classified as eukaryotic viruses (20.5%, mainly Herpesviridae). In the whole study group of transient human milk, the most abundant families were Podoviridae and Myoviridae. In mature human milk, Podoviridae decreased, and Siphoviridae became the most abundant family. Bacteriophages were predominant in transient HM samples (98.4% in the normal spontaneous vaginal delivery group, 92.1% in the premature group, 89.9% in the C-section group, and 68.3% in the large for gestational age group), except in the small for gestational age group (only ~45% bacteriophages in transient HM samples). Bacteriophages were also predominant in mature HM; however, they were lower in mature HM than in transient HM (71.7% in the normal spontaneous vaginal delivery group, 60.8% in the C-section group, 56% in the premature group, and 80.6% in the large for gestational age group). Bacteriophages still represented 45% of mature HM in the small for gestational age group. In the transient HM of the normal spontaneous vaginal delivery group, the most abundant family was Podoviridae; however, in mature HM, Podoviridae became less prominent than Siphoviridae. Myoviridae was predominant in both transient and mature HM in the premature group (all C-section), and Podoviridae was predominant in transient HM, while Siphoviridae and Herpesviridae were predominant in mature HM. In the small for gestational age group, the most abundant taxa in transient HM were the family Herpesviridae and a species of the genus Roseolovirus. Bacteriophages constituted the major component of the HM virome, and we showed changes regarding the lactation period, preterm birth, delivery mode, and birth weight. Early in life, the HM virome may influence the composition of an infant’s gut microbiome, which could have short- and long-term health implications. Further longitudinal mother–newborn pair studies are required to understand the effects of these variations on the composition of the HM and the infant gut virome.


2016 ◽  
Vol 27 (2) ◽  
pp. 57-62
Author(s):  
Saria Tasnim ◽  
FM Anamul Haque ◽  
Sameena Chowdhury

Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62


1970 ◽  
Vol 19 (4) ◽  
pp. 3038-3044
Author(s):  
Helen Chioma Okoye ◽  
Chilota Chibuife Efobi ◽  
Josephat Maduabuchi Chinawa ◽  
Odutola Israel Odetunde ◽  
Awoere Tamunosiki Chinawa ◽  
...  

Background: Maternal factors are determinants of birth outcome which includes birth weight, haematological indices and mode of delivery of their babies.Objectives: To determine the impact of parity and gestational age of hypertensive mothers on some neonatal variables.Methods: A hospital based cross-sectional study of measurement of neonatal variables (birth weight, red blood cells and mode of delivery) among hypertensive mothers and their controls was conducted over a period of six months. Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 20.Results: There were statistically significant differences in means between the neonates of the hypertensive group and non-hypertensive group for maternal age (t =1.61, p = 0.002), baby weight (t =2.87, p < 0.001), haemoglobin (Hb) (t =4.65, p = 0.010) and packed cell volume (PCV) (t =4.75, p = 0.009), but none for gravidity (t =1.95, p = 0.927)For all subjects, there was poor correlation between gestational age and variables; birth weight , haemoglobin (Hb), packed cell volume (PCV), nucleated red blood cell (nRBC) and parity. Likewise, parity poorly correlated with variables; age, birth weight, Hb, PCV, and nRBC. There was a statistically significant association between mode of delivery and hypertension (χ2 =53.082, p <0.001) but none with having a family history of hypertension (χ2 =1.13, p = 0.287).Conclusion: Parity and gestational age of mothers with hypertension have no impact on birth weight and red cells when compared with their non-hypertensive counterparts. However, mothers of babies delivered by elective and emergency caesarean section were about 2-3 times more likely to be hypertensive than those that delivered through spontaneous vertex delivery.Keywords: Hypertension; neonate; gestational age; parity.


2018 ◽  
Vol 18 (3) ◽  
pp. 539-547
Author(s):  
Micaely Cristina dos Santos Tenório ◽  
Marilene Brandão Tenório ◽  
Raphaela Costa Ferreira ◽  
Carolina Santos Mello ◽  
Alane Cabral Menezes de Oliveira

Abstract Objectives: to analyze the factors associated with the birth of small for gestational age (SGA)infants, in a Northeastern Brazilian capital. Methods: a cross-sectional study was carried out with 331 pregnant women and their newborns attending the public health network in the city of Maceió, in 2014. Maternal antenatal data were collected (socioeconomic, lifestyle, clinical and nutritional) as well as data of the newborns (gestational age, mode of delivery, sex, birth weight and length), after delivery. Birth weight was classified according to the INTERGROWTH-21st curves, being considered SGA those below the 10th percentile according to gestational age and gender. The results were analyzed by Poisson regression using a hierarchical model and were expressed as prevalence ratios (PR) and their respective 95% confidence intervals (CI95%). Results: it was verified that 5.1% of the newborns were SGA. Regarding the associated factors, after adjustment of the hierarchical model, the variable working outside the home was associated with the endpoint studied [PR = 0.14; (CI95% = 0.02-0.75); p=0.022]. Conclusions: it was verified a low frequency of SGA infants in the evaluated population. The fact that the mother works outside the home proved to be a protective factor for this condition.


2020 ◽  
Vol 51 (02) ◽  
pp. 120-128 ◽  
Author(s):  
Veronka Horber ◽  
Asma Fares ◽  
Mary Jane Platt ◽  
Catherine Arnaud ◽  
Ingeborg Krägeloh-Mann ◽  
...  

Abstract Objective This article describes associated impairments in children with cerebral palsy (CP) and its subtypes. Method Children born between 1990 and 2006 recorded in the Surveillance of Cerebral Palsy in Europe common database were studied. An “impairment index” characterized severity of impairments and their combinations. Results Amongst the 11,015 children analyzed, 56% (n = 5,968) could walk unaided, 54% (4,972) had normal or near-normal intellect (intelligence quotient ≥ 70). Except for ataxic CP, associated impairments were less frequent when walking ability was preserved. The impairment index was low (walking unaided and normal or near-normal intellect) in 30% of cases; 54% (n = 1,637) in unilateral spastic, 24% (n = 79) in ataxic, 18% (n = 913) in bilateral spastic, and 7% (n = 50) in dyskinetic CP. Around 40% had a high impairment index (inability to walk and/or severe intellectual impairment ± additional impairments)—highest in dyskinetic (77%, n = 549) and bilateral spastic CP (54%, n = 2,680). The impairment index varied little in birth weight and gestational age groups. However, significantly fewer cases in the birth weight group ≤ 1,000 g or gestational age group ≤ 27 weeks had a low impairment index compared to the other birth weight and gestational age groups (23 and 24% vs. between 27 and 32%). Conclusion Thirty percent of the children with CP had a low impairment index (they were able to walk unaided and had a normal or near-normal intellect). Severity in CP was strongly associated to subtype, whereas the association was weak with birth weight or gestational age.


Author(s):  
Nishu Bhushan ◽  
Surinder Kumar ◽  
Dinesh Kumar ◽  
Reema Khajuria

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Obesity is a chronic illness which is associated with metabolic disease, nutritional deficiency, musculoskeletal complications and carcinomas. The aim of the study was to evaluate and compare the maternal and perinatal outcome in patients with BMI 20-24.9 kg/m2 (normal), with BMI 25-29.9 kg/m2 (overweight) and with BMI >30 kg/m2 (obese).Methods: This cross-sectional study was conducted on 300 singleton pregnant women with gestational age>37 weeks with cephalic presentation. The selected women were categorized into three groups of 100 each according to their BMI: Category I included normal women (BMI 20-24.9 kg/m2), Category II included overweight women (BMI 25-29.9 kg/m2) and Category III included obese women (BMI >30 kg/m2).Results: There was increased incidence of antepartum complications in obese women. The difference in the occurrence of pre-eclampsia among the three categories was statistically significant (p=0.001). Similarly, more obese women had eclampsia (5%) and gestational diabetes mellitus (6%) as compared to overweight and normal women and the difference was statistically significant in both these complications (p=0.02 for each). The risk of induction of labour was highest in obese women and so was the incidence of caesarean and instrumental deliveries and the difference was statistically significant. The difference in the onset of labour as well as mode of delivery among the three categories was statistically significant (p<0.05). In perinatal outcomes, the difference in mean birth weight of the babies among three categories was statistically significant (p<0.0001). The difference in incidence of low birth weight (<2.5 kg) as well as macrosomia (>4 kg) among babies of three BMI categories was statistically significant (p<0.05). The difference in the incidence of NICU admissions was statistically significant (p=0.02).Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence preventable steps should be taken for reducing the maternal and perinatal morbidity and mortality.


2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)


Author(s):  
Susithra Saravanan ◽  
Malarvizhi Loganathan

Background: Multifetal gestation in addition to perinatal mortality and morbidity, attributable to preterm delivery they are more vulnerable to unique complications such as, structural malformations and twin- twin transfusion syndrome so that still birth rates are also appreciably increased. The incidence of multifetal gestation following conventional gonadtropin therapy is 16-40% with 75% being twins, with super ovulation it is 25-30%. The incidence of twins and triplets with embryo transfer 22-24% and 26% respectively.Methods: The clinical material taken from institute of Obstetrics and Gynaecology, Egmore Maternity, Chennai. Material for this study consists of 100 multiple pregnancies from May 2001 to April 2002. During this study period 19,617 patients admitted for delivery. There were 99 seats of twins and 1 Triplets.Results: During the period of 1 year, 150 cases were analyzed. During the period 148 cases 2 cases of tripelets studied, no cases of quadruplets were reported during this period.Conclusions: Multifetal gestation is one of the high-risk pregnancies. Hence women with multifetal gestation should ideally receive antenatal care in special twin clinics to meet their special needs. The multi-disciplinary team should be lead by an obstetrician, should include midwives, USG, Neonatologists, social workers and anesthetists. Women followed in twin clinic had significant improvement in women outcome which includes increased mean birth weight, decreased low birth weight and low ICU admissions.


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