Online ISSN: 2515-8260

Keywords : Primigravida


Clinical profile and prognosis of prenatal and postnatal women who presented with seizures in a central India tertiary care hospital

Dr. Sarika Rawat, Dr. Avinash Balraj, Dr. Pooja Jain, Dr Roshan Mandloi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 1110-1114

Background: Convulsions during pregnancy is major cause of maternal and fetal morbidity and mortality. the various causes of seizures during pregnancy include anti-phospholipid syndrome, eclampsia, cerebral vein thrombosis(CVT), thrombotic thrombocytopenic purpura, cerebral infarction, drug and alcohol withdrawal, and hypoglycaemia
Objective: To record and analyze continuous and category variables of antenatal and postnatal patients presenting with seizures.
Materials and Methods: Methodology- the present study conducted in the tertiary care hospital total 270 patient presented with seizure and patient/relative were ready to give consent were included in the study. Study Design: - observational Cross-sectional study.
Result- 65% of the participant were belong to age group of 20-25 years the mean age the mean age of participant with 90 % CI was 23.4667 ±0.7 (±2.98%).64.4% cases were primigravida,and 35.6% were multigravida. morbidity seen in most of cases out of all participant 59.25% were become morbid ,40(29.6%) were remain uncomplicated and 11.11%were died. The mortality rate were observed in our study is 11.11%.Fetal outcome at time of birth the out of all delivery 222 were live birth while 48 were IUD/still birth.
Conclusion- Seizure is serious threat to the maternal and fetal/neonatal health and major contributor of maternal mortality and neonatal mortality.prompt diagnosis and treatment required for it.

EFFECTIVENESS OF CHILDBIRTH EDUCATION PROGRAMME ON KNOWLEDGE, INTRAPARTUM BEHAVIOR, AND PREGNANCY OUTCOME AMONG SELECTED PRIMIGRAVIDA MOTHERS AT AIIMS, JODHPUR

Neha Sharma, Himanshu Vyas, Pratibha Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1680-1690

Introduction: A childbirth education programme empowers the women to participate in the birthing process with complete psychological preparation, helping to preserve her energy and gain control over the birthing process. Knowledge about labor process affects possible pregnancy outcome in Primigravida mothers.
Methods: This experimental study with Non- equivalent post test only design was conducted on a sample of 200 Primigravida mothers, assigned into two groups, 100 in experimental group (implementation of child birth education programme) and 100 in control group (routine care). Data was collected at Department of Obs. and Gynae. AIIMS Jodhpur.
Results: Personal variables were comparable between experimental and control group. Significant difference was observed in knowledge score (Z score (N=200) =16.83, p<0.05), intrapartum behaviour (Z score (N=200) =14.80, p<0.05), and pregnancy outcome (Z score (N=200) =4.30, p<0.05) in control and experimental group. There is a Moderate positive correlation(r=0.611) between the knowledge score and intrapartum behavior.
Conclusion: The study concluded that childbirth education programme was found to be effective in significantly improving knowledge, intrapartum behavior and pregnancy outcome among Primigravida mothers. This study recommends that childbirth education programme need to be included as an essential part of antenatal care.

TEENAGE PREGNANCY - ITS EFFECT ON MATERNAL AND FETAL OUTCOME

G.Kesava Chandra, K. Madhavi, Shanmuki Sree

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2391-2406

Background: To find complications associated with teenage pregnancies. To find the effects on maternal and fetal outcomes.
Materials and Methods: It was a Quantitative, observational, analytical, prospective cross-sectional study. 100 Study populations were taken by randomization, after applying exclusion criteria. The study was carried out during the year from October 2019 – September 2021 At GGH, Kadapa.
Results: In the present study, 2% of total deliveries conducted in our institution are of teenagers. 74% of pregnant teenage women were 19 years and 18 years old, 4% were under 15 years, and 22% were in the 15-18 years age group. 85% belong to primigravida in our study, and the remaining were high order pregnancies. In our study, 1% is pregnant out of wedlock. The mean age of marriage is 17 years in our study. Only 7% had an occupation in our study.  All pregnant teenage women in our study belong to low socioeconomic status. 95% of our study had poor knowledge regarding pregnancy and delivery. 31% of teenage pregnancies were booked. 2% came directly during labour, remaining 67% registered late in pregnancy.  Only 4% are short-statured in our study.  4% are undernourished in our study, and 12% are overweight.  73% are anaemic in our study according WHO guidelines. 26% of our study has PIH disorders.  26% had oligohydramnios as a risk factor in our study population . There was a 1% antepartum haemorrhage. In addition, 1% had twins as a risk factor. Malpresentation was seen in 5% of cases. CPD was noted in 19% of the study population. 8% of our study group had premature rupture of membranes.  60% of our study population underwent LSCS,1% had instrumental deliveries. 39% had a vaginal delivery.  Indications for c-section are CPD, which is 19%, followed by oligohydramnios, malpresentation and prior LSCS. 15% of babies in our study were below 2.5 kg. 1% had a congenital anomaly.7% of babies admitted in NICU.
Conclusion: Teenage pregnancy is a severe social problem prevalent in rural India. Educating on STDs and measures to prevent them together can reduce teenage pregnancies, by which complications of teenage pregnancy can be prevented.

A prospective study of coagulation profile in patients of pregnancy induced hypertension

Dr. Manoj Kumar, Dr. Ramesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11030-11035

Introduction: The most common disorders that are associated with pregnancy are
Eclampsia. Hypertensive disorders of pregnancy affect about 10% of all pregnant
women globally. The prevalence of Pregnancy Induced Hypertension in India ranges
from 5 - 8%. Hypertensive disorders of pregnancy are the frequent cause of severe
acute morbidity, long term disability and death among pregnant mothers and
babies.Abnormal coagulation of blood can be a cause of frequent haemorrhages in
women. There is a strong association between the two most important causes of
maternal mortality and morbidity globally such as Preeclampsia and Postpartum
haemorrhage. Recently, there is no observable screening test that would help in
identifying which pregnancy will be affected with PIH or assess its
severity.Hypertension prior to 20 weeks gestation is almost always is due to chronic
hypertension; preeclampsia is rare prior to the third trimester.5 Hence this study was
done to study the platelet and coagulation abnormalities occurring in patients of PIH
including platelet count, PT and APTT parameters.

FETO maternal outcome in programmed labour protocol

Dr. Ravi Karad, Dr. Vijaya Harsoor, Dr. Amrutha AV

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2514-2520

Background: Labour pain is among the maximum excruciating pain experienced by all women. Labour pain impacts maternal psychology and course of labour causing apprehension, tension, and strain. Pain relief throughout labour is predicted to lessen maternal strain and improve maternal and perinatal outcome. Many Nonpharmacological & Pharmacological methods of pain relief available. In this study we are comparing efficacy & safety of Paracetamol & Tramadol as labour analgesics.
Objective: To analyse the outcome of Programmed labour protocol vs expectant management of labour with respect to
1. Mean rate of cervical dilatation.
2. Mean duration of first, second, third stage of labour.
3. Pain relief in labour.
4. Mode of Delivery.
5. APGAR scores at 1min and 5min.
Methods: All women admitted in the labour room, meeting the inclusion criteria and willing to participate in study are categorized into group A and group B.
Programmed labor group(A) and expectant group. (B)
The study group A includes primigravida at term in active phase. Admitted in labor who will receive Programmed labor protocol. And group B will be managed expectantly.
After obtaining informed consent all women willing to participate will be examined according to protocol.
Results: In our study both the groups were comparable in relation to age, gestational weeks and cervical dilatation. Most common mode of delivery was vaginal in both the groups. Duration of first stage of labour and second stage of labour is significantly reduced compared to control group. Pain relief scoring in study group moderate to complete pain relief is 85.7%.
Mean cervical dilatation among the study group was 2 cm/hour which is higher compared to the control group (1 cm/hour). In study group-11.5% underwent LSCS which is lesser compared to the control group (15.5%). All the babies had Apgar score of 7-9 at one and five minutes. 4babies in the control group had Apgar score of six at one minute and on resuscitation, they had Apgar score of 8-9 at 5 minutes. Mean Apgar of the babies at one and five minutes in both the groups were comparable.
Conclusion: Programmed labor is an easier, safer means for ensuring less painful delivery. It reduces the duration of the labour without serious maternal and neonatal side effects. Pain relief is effective with minimal maternal side effects due to the drugs used. Labour and childbirth are cherished by the mother and her family. It can be adapted safely in all Maternity hospitals in low risk gravid woman.

Comparision of Progression of Labour and Fetomaternal Outcome Between Spontaneous and Induced Labour

Kesavachandra Gunakala, P.M.Rekha Rao, Mude Vennela, Haneesha M.S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6045-6051

Background:Induction of labour is artificial initiation of uterine contractions prior to
spontaneous onset leading to progressive dilatation and effacement of cervix. Induction
of labour process whether by administering foley bulb induction, stripping, oxytocin
(or) prostaglandin. Labour induction is indicated where the benefits of either the
mother or fetus outweighs the benefit of continuing pregnancy. Aims and Objective:
The aim of the study is to analyze the progression of labour and comparison of fetal and
maternal outcome between spontaneous and induced labour.
Materials and Methods: Present study is a prospective comparative study involving 200
participants divided into induction (study) and spontaneous (control) groups. Data was
collected on socio demographic factors, maternal complications and fetal outcome
.Those women who had spontaneous onset of labour and reached >4cm of cervix
dilatation were included in study group. Progress of labour is monitored by modified
WHO partographs. Women on induction reached >4cm dilatation of cervix were
included in control group. Informed consent taken from every participant in the study.
Results: In the study group, the mean duration of active phase in primigravida was
6.2hours and in multigravida was 3.7hours. In control group, the mean duration of
active phase in primigravida was 4.7hours and in multigravida was 2.5hours.In study
group, the duration of second stage in primigravida and multigravida was 46minutes
and 25minutes respectively whereas in control group, it is 40 minutes for primigravida
and 21 minutes for multigravida. Induced labour is associated with higher cesarean
section rates. Cephalopelvic disproportion was the most common indication for
cesarean section followed by failed induction.
Conclusion: The mean duration of active phase and second stage of labour is longer in
study group compared to control group. Neonatal outcome was similar in both groups
except for 1minute and 5-minute APGAR scores which were significantly higher in
spontaneous group. Augmentation of labour is frequently required in study group
rather than control group. Occurrence of maternal complications like PPH, fever,
vomiting and hyperstimulation of uterus showed no significant difference in both the
groups.

Comparative study of serum magnesium levels between low dose mgso4and Pritchard regimen in treatment of eclampsia

Dr.PeruguSravani,Dr. MahitaRaniKatasani,Dr. K. Sharada

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 736-741

tonicclonicconvulsionsunrelatedtoothermedicalconditionsinwomenwithhypertensivedisorderof
pregnancy.Although10%ofpregnanciesarecomplicatedbyhypertensivedisorders,eclampsia
continuesto occur in 0.8% of women with hypertensivedisorders.
Objectives:TocomparetheserummagnesiumlevelsinPritchardregimenandlowdose
MgSO4regimen. To compare the maternaland fetalcomplicationsin both groups.
MaterialandMethods:ThisisaProspectivestudyconductedintheDepartmentofObstetrics
andGynaecologyatTertiarycareteachinghospitaloveraperiodof1yearoneclampticpatients
whogotadmittedindepartmentofobstetricsandgynecology.Standardprinciplesof
managementofeclampsiawillbefollowed.Patientsaredividedintotwogroupsascases&
controlalternatively.Groupsarechosenbasedoninclusion&exclusioncriteria.GroupI
ControlwillfollowPritchardstandardregimen.GroupIICaseswillreceivelowdose
magnesiumsulphateregimen.
Conclusion:Theoccurrenceofeclampsiaintwogroupswasmorecommonintheagerange of 20 to
26yearsamongtheprimigravidaand with previoushistory ofPIH. Thereisnomajor
differenceintheoutcomeofmaternalandfetalinbothgroups.Nonethelessthemagnesium
levelsamonglowdosegrouparesignificantlylowerincomparisonwithstandardregimen group. In
casesand controlsthe magnesium levelsare maintained in normal therapeuticrange.
Lowdoseregimenisbetter alternative tocontrolseizuresin eclampticpatients.

Platelet Indices and Serum Uric Acid in Preeclampsia Prediction and its Severity in Primigravida

Ali Al-Shabrawy Ali, Hend Salah Abdo, Mohamed Al –Housseiny Alkodousy, Noha Moustafa Esmaeel

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4078-4086

Background: Preeclampsia (PE) is a multisystem disorder that complicates 5%–
10% of pregnancies and constitutes a major source of morbidity and mortality
worldwide. Primigravidae are high risk group for development of PE and are
almost four times as likely to develop the disease with its adversematernal and fetal
outcome. Our study aimed to evaluate the platelet indices and serum uric acid and
their significance in prediction of preeclampsia and assessment of its severity.
Patients and methods: this study was included 108 primigravida at gestatational age
(24-28) weeks at the first visit and divided into: group (1): including 54 pregnant
women with pregnancy induced hypertension (PIH) of varying severity; group (2):
including 54 normotensive pregnant women. Full history taking, complete clinical
examination and laboratory investigations including platelet indices (platelet count
(PC), mean platelet volume (MPV), platelet distribution width (PDW) and serum
uric acid was estimated. Results: Age was distributed as 27.07±3.44 and 27.0±3.45
respectively between Preeclampsia group and Control group without significant
difference and GA at start of the study was 26.01±1.49 and 26.11±1.40 respectively
with no significant difference. SBP and DBP were significantly higher among
Preeclampsia group. There was no significant difference between cases or control.
PLT was significantly higher among control at all times but MPV and PDW were
significantly higher among cases at al times. Low APGAR1, preterm, CS delivery
type and PPH were significantly associated with preeclampsia group. Conclusion:
The estimation of platelet indices and serum uric acid can be considered as an
early, economical and rapid procedure for assessment of Preeclampsia in pregnant
women. Thus platelet indices can have a significant impact on maternal and
perinatal outcome.