Online ISSN: 2515-8260

Keywords : maternal outcome


IMPACT OF CAESAREAN DELIVERIES ON FETOMATERNAL OUTCOMES IN THE LIGHT OF RISING PRIMARY CAESAREAN SECTIONS

Dr. Akanksha Verma, Dr. Swati Lal, Dr. Tanvi Nijhawan, Dr. Himadri Bal .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 4038-4048

Objective: To analyse rising rates of caesarean section, its indications and effect on maternal and neonatal outcomes viz a viz vaginal deliveries with special focus on primary caesarean section.
Study design: This was a prospective observational study of 1000 deliveries after 28 weeks’ gestation. The different modes of deliveries were studied with respect to their antepartum, intrapartum and postpartum feto-maternal outcomes. A comparative analysis of caesarean and vaginal deliveries was carried out with particular focus on primary caesarean sections.
Results: The caesarean section rate was 47.1% out of which 66.2% were primary caesarean sections(PCS). The most common indication of PCS was found to be foetal distress (34.2%) and blood loss, febrile morbidity, SSI were more in caesarean sections compared to vaginal deliveries (VD). Neonatal outcomes too were relatively worse in caesarean sections compared to VD.
Conclusion: There has been an unacceptably high rise in caesarean section rates globally. It has been accepted that maternal and neonatal outcomes remain comparatively favourable with vaginal deliveries. Hence there is a need to have a closer look at the various indications of caesarean deliveries with regular caesarean audits at all levels of health care with a targeted focus on PCS, which is the genesis of the rising rates. CS should be resorted to only when there is an evidence based indication with the aim of improving the reproductive years of the mother and future development of the newborn.

To compare fetomaternal outcome of twin pregnancies with singleton pregnancies: A prospective study done in Nalanda medical college and hospital, Patna

Dr. Bushra Nahid; Dr. Anupam; Dr. Bindu Arya; Dr. Mamta Singh .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 8798-8802

Background: The purpose of this study was to compare fetomaternal outcome of twin pregnancies with singleton pregnancies
Material and method: This was the prospective study done on patients coming to antenatal clinic and labour room emergency of Nalanda Medical College And  Hospital, Patna. Consecutive sampling was done till sample size reached 50 for both twin pregnancies and singleton pregnancies >28 weeks of gestation. Patients fulfilling the inclusion criteria were divided into two groups:
GROUP A: 50 patients of twin pregnancies
GROUP B: 50 patients of singleton pregnancies
Result: The incidence of twin in this study was1.9%, mean maternal age 27.6±3 years for twin pregnancies and 22.5±3years  for singleton pregnancies, twin were seen more in multigravida (60%). Anaemia(50%), preterm labour (30%), hypertensive disorder(10%), APH(2%)were the common complications of twin pregnancies. Mean weight of first twin was2.12±0.35 kg kg and that of second twin was1.97±0.3 kg. Caesarian section occurred in 60% of twin pregnancy and the most common indication being malpresentation (24%). Significantly higher incidence of IUGR(10%), birth weight discordance (20%), early neonatal death(5%) and higher rate of NICU admission in twins were recorded
Conclusion: Despite improvement in antenatal and neonatal care, twin pregnancy posses a higher threat to maternal and child outcome than singleton pregnancies.

Study of fetomaternal outcome in pregnant women with severe anemia at a tertiary hospital

Pankaj Narayan Baravkar, Tanavi Pankaj Baravkar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 604-609

Background: Anemia in pregnancy is defined as hemoglobin levels less than 11gm/dL. Severe anaemia is responsible for 20-40% of direct and indirect maternal deaths because of increased susceptibility to cardiac failure, sepsis and association with preeclampsia, antepartum haemorrhage, postpartum haemorrhage and thrombo-embolism. Present study was carried out to fetomaternal outcome in pregnant women with severe anemia at a tertiary hospital.
Material and Methods: Present study was single-center, prospective, observational study, conducted in pregnant women with Hb < 7gm/dL, with gestational age > 28 weeks, delivered at our hospital.
Results: Total 72 women with severe anemia were studied, majority were from 19-25 years age group (52.78 %), mean age was 25.4 ± 3.5 years, had completed primary education (70.83 %), from lower Socio-economic status (84.72 %). Though Un-booked (13.89 %) pregnancies were less than booked cases (86.11 %), majority had less than 4 antenatal visits (75 %). Majority of patients were Para 2 (34.72 %), Para > 2 (31.94 %), had spacing between pregnancy was < 2 years (71.93 %). Vaginal (70.83 %) was most common Mode of delivery, followed by LSCS (26.39 %) & Instrument delivery (2.78 %). In present study, maternal complication/ high risk factors noted were premature delivery (52.78 %), postpartum hemorrhage (34.72 %), preeclampsia (20.83 %), prolonged labor (19.44 %), congestive cardiac failure (16.67 %), puerperal pyrexia (15.28 %).  One maternal mortality (1.39 %) was noted. We noted total 7 deaths (3 Intrauterine fetal death/ Stillbirth & 4 Early neonatal deaths), while Low birth weight (<2500 gm) (65.28 %), NICU admission (48.61 %), Apgar score <7 (at 5 minute) (8.33 %).
Conclusion: Anemia in pregnancy is a major health problem in developing countries. Severe anemia during pregnancy is associated with maternal and fetal health outcomes fetomaternal morbidity and mortality.

A Study on Maternal and Fetal Outcome in Women with Severe Anaemiain Labour

Viplava, Siddula Shireesha, Leela Regalla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 825-834

Background: In pregnancy, anaemia has a significant impact on the health of fetus as
well as that of mother. It is one of the leading causes responsible for maternal and
perinatal morbidity and mortality. The objectives of the study are to find out the effect
of severe anaemia on women in labour affecting maternal and fetal outcome.
Materials and Methods: This a prospective case control study undertaken in the
Department of Obstetrics and Gynaecology, Govt Maternity Hospital, Petlaburz
attached to Osmania Medical College, Hyderabad. The period of study was from 1st
December 2019 to 31st December 2021.There were a total of 160 study subjects, 80 cases
of severe anaemia (Hb<7gm %) and 80 non anaemic controls (Hb≥ 11gm %).
Results: Low socio economic status (86.25%), inadequate antenatal care (38.75%),
multiparity (71.25%) and no iron supplementation (52.5%) were associated with severe
anaemia cases. Microcytic hypochromic anaemia was more prevalent (76.25%),
suggesting nutritional inadequacies as a cause of anaemia. It was seen that the incidence
of preterm labour (22.5%), atonic PPH (2.5%), sub involution of the uterus (2.5%),
CCF (1.25%), abruptio placentae (1.25%) and maternal mortality (1.25%) was more in
cases of severe anaemia than in the control group. Adverse fetal outcome in the form of
preterm birth (22.5%), low birth weight babies (41.25%), IUGR (13.75%), birth
asphyxia (11.25%), and perinatal mortality (11.25%) was more in the anaemic group
than the controls.

Correlation of Clinical, Hematological and Biochemical Parameters in Women with Severe Preeclampsia and Maternal Outcome: An Observational Study

Guruprasad Hosamani,Dr. Niranjan C. S., Anuja Sagamkunti, Sushrit A. Neelopant, Rashmi M. B

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 292-301

Background: To find correlation of clinical, hematological and biochemical parameters
in women with severe preeclampsia and maternal outcome and to study the maternal
and perinatal outcome in severe preeclampsia and.
Materials and Methods: The study was done in the Department of Obstetrics and
Gynaecology, Raichur Institute of Medical Sciences, Raichur. 140 patients with blood
pressure ≥ 160/110 mm of hg with proteinuria or Blood pressure ≥ 140/90 mm of hg
with proteinuria of ≥ 2+ were involved in the study. Statistical analysis was done by
applying chi-square.

A Hospital Based Observational Study to Evaluate the Effect of Prelabour Body Mass Index on the Mode of Delivery

Dr. Ramdas Garg, Dr. Avantica Agarwal

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2679-2684

Background: Pre-pregnancy obesity is strongly associated with certain pregnancy
complications and perinatal conditions. Placental structure and function are important
for maternal and fetal health both during and after pregnancy. The aim of this study to
evaluate the effect of prelabour body mass index on the mode of delivery.
Materials and Methods: An hospital-based prospective study involving pregnant women
at term (33-37 weeks) admitted to gynaecology ward in district hospital Dholpur,
Rajasthan, India during one-year period. A total of 120 cases in the age group of 18-40
years included in the study. Patients were classified into 3 categories based on their first
trimester BMI. Category I included normal women (BMI 20- 24.9 kg/m2), Category II
included overweight women (BMI 25-29.9 kg/m2) and detailed history and clinical
examination including general physical, obstetrical and systemic examinations.
Category III included obese women (BMI >30 kg/m2). Data were analysed statistically
by Chi-square test of the dependence of variables and a p-value of less than 0.05 was
considered as statistically significant.
Results: Under anthropometric parameters, the differences in mean age, mean weight,
mean height and mean BMI among the three categories women were statistically
significant (p<0.001**), In this study, it was observed that overweight and obese women
were slightly older and short in stature when compared with women with normal BMI.
There was increased incidence of antepartum complications in Category III women as
compared to Category II and Category I women. The difference in the onset of labour
as well as mode of delivery among the three categories was statistically significant
(p<0.05*).
Conclusion: As obesity is a modifiable risk factor all attempts should be made to
maintain a normal BMI in women of childbearing age. Pre–pregnancy counselling,
health programme and appropriate multidisciplinary management should be done.

Maternal and perinatal outcomes of pandemic Covid-19 in pregnancy in Basrah

Maysoon Sharief, C.A.B.O.G.; Gufran Jaafar, C.A.B.O.G.,; Alla Hussan, M. B. Ch. B., D.O.G

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 517-529

To evaluate the maternal, fetal and neonatal complications in pregnant women with Covid-19 infection. Setting and design: A prospective descriptive study was carried out in Basrah Teaching Hospital, Iraq during the period 15/3/2020 till 1/11/2020. There were 135 infected pregnant women with Covid-19. The maternal information's were obtained included Age, parity, residence, travel history, gestational age at time of diagnosis. The pregnancy measures of interest were evaluated according to the severity of the disease, medical disease, history of antepartum hemorrhage, mode of delivery, type of delivery, post-natal complication and admission to
intensive care unit and maternal death. The neonatal outcomes of interest were fetal weight, neonatal Apgar
score, admission to neonatal intensive care unit and neonatal death. Results: The mild type of the disease was common (41.48%) in comparison to severe conditions (17.77%).