Online ISSN: 2515-8260

Keywords : Perinatal mortality


Clinical study of fetomaternal outcome of postdated pregnancy in a tertiary care center

Dr. Chaitali R Pandav, Dr. Varsha L Deshmukh, Dr.Shrinivas Gadappa, Dr.PratikshaKandalkar .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1741-1748

Background: Postdated pregnancy is one of the commonest obstetric condition. The pregnancy beyond 40 weeks of gestation is called as post dated pregnancy. Post dated pregnancy increases risk to mother and fetus. In mother there is increased risk of induced labour, instrumental delivery and LSCS and associated morbidities. The risks to the fetus also increases inpostdated pregnancy mainly due to increasing fetal weight, decline in placental function, oligohydramnios which increase chances of cord compression, and meconium aspiration.
Methods: This cross sectional observational study of feto-maternal outcome in post dated pregnancy (Women beyond 40 weeks of gestation) was carried out in the department of obstetrics and gynaecology in tertiary care centre from October 2019 to September 2021, willing to participate and fulfilling the inclusion and exclusion criteria in the study period. Results:  Out of total 300 patients,118 patients (60.82%) went into spontaneous labour and delivered vaginally, whereas 102(34%) patients required caesarean section. Induction of labour was done  in 76(39.17%) patients.Conclusions: The present study, we conclude that, the post dated pregnancy can be considered as a high risk factor as there is more fetal morbidity.

A prospective study of factors affecting maternal and perinatal outcome in eclampsia at government medical college/hospital Nizamabad

Dr Neelima Singh, Dr.Mounika, Dr Badhe Rekha, Dr.N.Sreedevi, Nidhi Singh, Dr Tharani Badikela

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5124-5135

Introduction: Eclampsia is one of the commonest causes of maternal deaths. The
various factors influencing maternal and perinatal outcome were evaluated in the
present study.
Aim: To determine the factors affecting maternal and perinatal outcomein Eclampsia.
Materials and methods: Present study is a prospective observational study of factors
affecting maternal and perinatal outcome in Eclampsia for a period of 6 months.
Results: The incidence of eclampsia in 1.42%. Hypertension, oedema and proteinuria
are important signs in eclampsia. The incidence of maternal mortality in the present
study was 4% and the common causes of death were acute renal failure and pulmonary
oedema. The maternal mortality in correlation with age, parity, blood pressure,
duration of labour is not statistical significant. The perinatal mortality in the present
study was 24% and corrected perinatal mortality, excluding cases of absent FHS at
admission was 18%. Prematurity was the most important cause of neonatal deaths.
Perinatal mortality was maximum in unbooked cases (37%) and is statistically
significant. Perinatal mortality was maximum, when the number of convulsions were
maximum that is in between 6-10 (100%) and it is statistically highly significant.
Conclusions: Prompt control of convulsions and blood pressure along with steps to
initiate delivery are the cornerstone and critical in Management of eclampsia.

Risk factors of perinatal mortality in a tertiary care centre: A case control study

Sunita S, Priyanka Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2653-2660

Background: Perinatal mortality has remained a major public health problem in India, this study aims to analyze the perinatal deaths and the risk factors attributed to perinatal mortality.
Methodology: This is a case-control study, we studied 72 cases and 72 controls. Cases were the patients admitted in labour room with gestational age >28 weeks who gave birth to stillborn or whose babies died within first 7 days of life and controls were ones who gave birth to live babies and whose babies survived more than 7 days of life. The analysis was done using appropriate epi info statistical package and regression analysis was done to quantify independent risk factors in perinatal mortality.
Results and Interpretation: Of the 72 cases, 55 cases had stillbirths contributing to 76.3% and the 17 cases had early neonatal deaths contributing to 23.7% of perinatal mortality. The mean maternal age for cases was 26.4 and for controls, it is 25.1. Controls had regular ANCs (75%) compared to cases (45.4%) with OR of 0.26(0.10-0.67). Cases that were referred to as IUDs contributed majorly for perinatal mortality. Early preterm births were more common among cases (58.3%) with OR 34.82(11.06-109.6) and P value <0.001. Gestational hypertension was the most common medical complication found among the cases (15.3%). 10 Anomalous babies were seen in cases. (48.6%) of cases had preterm delivery compared to controls with (8.3%) and rate of LSCS was high 7.3 times higher in cases compared to the control group. Low birth weight babies were 7.7 times more common among cases with P <0.001. Low APGAR at birth was more among cases compared to controls. Birth asphyxia was the commonest factor found in early neonatal deaths and 41.1% of babies died on day 1.
Conclusions: Lack of regular ANCs, late referrals of high-risk patients, complications like gestational hypertension, IUGR, prematurity, anomalies among babies, low birth weight, low APGAR score at birth, birth asphyxia were some of the factors found ascribed to perinatal mortality.

MATERNAL AND FETAL OUTCOME IN TWIN PREGNANCY IN TERTIARY CENTER

Neha Majotra, Aakanksha Mahajan, Rishu Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1888-1898

Background: Multiple births are much more common today than they were in the past. The incidence of twin gestation has increased mainly due to advanced maternal age and assisted reproductive technology Throughout the world, the prevalence of twin births varies from approximately 2-20 /1000 birth. This delayed childbearing has resulted in an increased maternal age at conception. Twin gestation is considered as high-risk pregnancy as it contributes significantly to adverse maternal and perinatal outcomes. This study was conducted to evaluate the risks of pregnancy complications and adverse perinatal outcome in women with twin pregnancy. Multiple pregnancies are associated with an increased risk of obstetric complications as well as perinatal morbidity and mortality especially in developing countries.
Materials and Methods: Present study is a retrospective study of 223 cases of twin pregnancies admitted at our institute from Sept 2020 to Oct 2021 including all emergency as well as registered cases. In all cases a detailed history was taken, all routine and specific investigations were done. We studied maternal factors like age, parity, complications, mode of delivery and perinatal morbidity and mortality. Main outcome measures were maternal complications (i.e., anaemia, preterm labour, pregnancy induced hypertension, postpartum haemorrhage etc.) perinatal morbidity and mortality.
Results: In this retrospective study we observed 223 cases of twin pregnancies. In this study most of the patients (45.7%) delivered at 37- 42 weeks of gestation. 5% of patients had abortion at an early gestation. Majority of the patients delivered vaginally (51.56%), followed by LSCS (Lower Segment Caesarean Section) (48.43%). In this study low birth weight babies were the most common (138 babies) to the extent of 73.29%. We had 0.05% (13) extremely low birth weight babies. There were 38 neonatal deaths. We observed the highest incidence of twins in the age group of 26-30 years. The least were below the age of 20 years.
Conclusions: Most of the complications in multiple gestations can be prevented. High risk units in the obstetric ward and well developed NICU set up would reduce the maternal, perinatal morbidity and mortality. Good antenatal care, with increased rest and nutritional supplementation, early detection of fetal and maternal complications together with thorough intranatal and postnatal vigilance, can lower both maternal and fetal dangers.