European Journal of Molecular & Clinical Medicine

Objective: To compare the neonatal morbidity rates in early term versus full term born neonates.
Study design: This was a prospective study of 220 deliveries from 37 0/7 to 40 6/7 weeks of gestation from September 2020 to September 2022. After excluding anomalies, twin gestation, malpresentation, and stillbirth in parturating women in the study. Labour was monitored and newborns were assessed at birth. Neonatal morbidities of babies compared for each week of delivery.
Results: Neonatal morbidity, in the early term babies when compared with full term babies was 24.5% and 6.3% respectively. Neonatal intensive care unit admission and respiratory morbidity were lowest at or beyond 39 weeks of gestation when compared with the early term babies. Statistically significant differences in morbidity were noted between 37 and 39 weeks of gestation. Respiratory morbidity was higher at 37 than 39 weeks regardless of the route of delivery.
Conclusion: This was a prospective comparative study between early and full-term babies. We observed that the neonatal outcome was poorer in the early term group in terms of birth weight, neonatal morbidity, NICU admission rate, and respiratory distress with a statistically significant difference in comparison to full term babies.

Preterm prelabour rupture of membranes (pPROM) occurs in 2–3% of all pregnancies leading to 30–40% of preterm births. The latent period from membrane rupture to delivery is typically brief after pPROM. The present study undertaken is to identify the risk factors causing pPROM and to study fetal and maternal outcome associated with pPROM.
Materials & Methods: A hospital based prospective study done on 60 patients admitted with pPROM under the Obstetrics and Gynaecology department, at district Hospital during one year period. The onset of complications like fetal distress, fetal heart rate variations, chorioamnionitis were looked for. In cases of fetal jeopardy or any other obstetric complications, labour was cut short by the caesarean section. The babies were followed up in the postnatal period. Neonatal mortality and morbidity were noted. Neonates were monitored for the complications of birth injuries, signs of asphyxia, meconium aspiration and sepsis. Both mother and baby were followed up till their stay in the hospital. Statistical analysis was performed with SPSS statistical software with all the relevant data compiled and entered.
Results: Among the selected cases, pPROM was noted in 6 (10%) mothers in the age group of <20 years, 33 (55%) mothers in the age group of 21-25 years, 14 (23.33%) mothers were in the age group of 26-30 years, and 7 (11.66%) mothers above 30 years of age. Majority of cases belong to socioeconomic status V with a total of 39 cases (65%). Number of multigravida in the study was 22 (36.66%) and primigravida were 38 (63.33%). Out of 60 patients studied, 49 cases (81.66%) were booked and 11 cases (18.33%) were unbooked. Out of 20.58% of neonatal morbidity, complications were maximum in 35-36 weeks group. NICU admissions were more common in 28-31 weeks group. Risk factors were commonly found among 32-34 weeks group with 45%. Out of 13.33% who had latent phase of >3 days, 10% of them were of <34 weeks of gestational age.
Conclusion: We concluded that the most common age group to suffer from pPROM was 21-25 years. There were no risk factors in most of the mothers, but the risk of breech presentation can be avoided by coitus in the later weeks of pregnancy reduces the risk of pPROM. Neonatal care facilities can be improved to manage neonatal emergencies so as to reduce neonatal deaths.

Background: While carrying twin pregnancy can be exciting for the family, the risk of illnesses increase manifold when compared to singleton pregnancies. This study was conducted to know about the factors that can be associated with the determination of mortality and morbidity revolving around the twin gestation.

Background:
Aims: The aim of my study is to evaluate the maternal and perinatal outcomes in pregnant women with Sickle cell anemia and Thalassemia.
Material and methods: The present study was undertaken in Mamata General Hospital with an aim to know the occurrence of sickle cell anemia and thalassemia in antenatal women and to evaluate the maternal and perinatal outcome.
Results: Out of the 30 women considered for the study, 20 had sickle cell disease and 10 had thalassemia. Most common age group was between 21-25years of age in both groups of women with 85% and 50% in each respectively. Mean age is 23±2years. Contracted pelvis was the indication in 17% in SCD. However abnormal color doppler study was the indication in 8% of SCD women and 17% in women with thalassemia. Maternal request and abruption were the indications in 8% each in SCD group. The need for transfusion was seen in about 45% of the SCD women and in 30% of the women with thalassemia. The incidence of Low birth weight of <2.5kg was among the most probable cause for neonatal morbidity in 40% of the neonates born under in each group with SCD and thalassemia.  There was 5% intrauterine fetal death and another 5% of the women had intrauterine growth retarded babies.  In thalassemia the most common fetal complications were neonatal jaundice in 30%, low birth weight in 20% and respiratory distress in 20% respectively.  The perinatal outcome in the 20 neonates born to women with SCD, 80% neonates were alive, intrauterine death was seen in 5% and neonatal deaths were 15%. Whereas in 10 neonates born to thalassemia women 70% of the neonates were alive and 30% neonatal deaths were recorded. Among the study group, the most preferred mode of family planning for the women with SCD in the present study was permanent sterilization in 50%. Next most preferred modality was injectable (DMPA) in 45%, and remaining 5% opted for barrier method of contraception.
Conclusion:   The obstetric outcome in women with Sickle-cell disease showed significant maternal morbidity. However though low in prevalence, the obstetric outcome in the group of women with thalassemia had low incidence of complications when compared to pregnancies with SCD. However both the groups were prone to neonatal morbidity and mortality.

Aim: To assess the maternal and fetal outcome of caesarean section in second stage of labour.
Methods: This prospective observational study was carried out in the department of Obstetrics and Gynecology at VIMS, Dahanu for the period of 2 years. Total 400 patients were included into the study. All caesarean sections performed at full cervical dilatation over the time period of Two years at a VIMS hospital Dahanu.
Results: During the Two years period, a total of 24600 women delivered by caesarean section, 16800 emergency and 7800 elective cases. Of these 400 (2.38%) were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation. Among the 400 patient’s majority of them were in the age group of 20-30 years (72.5%). about 75.5% of the patients were primigravidae and only the remaining 24.5% were multigravida. The commonest indications for doing caesarean section in the second stage of labour were cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH is 48 out of 400 cases (12%). Post-operative wound infection was seen in 23(5.75%) and Post-operative fever was seen in 70(17.5%) out of 400 cases. There were no cases of maternal deaths reported. The mean operative time was 52.9 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.2 kg. 20 (5%) babies were admitted to the Neonatal Intensive Care Unit and 53 (13.25%) to neonatal nursery for management of respiratory distress, sepsis, jaundice and observation. 46 (11.5%) babies had Neonatal jaundice and there were 3 neonatal deaths reported.
Conclusion: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.

Background: There exists a high prevalence of anaemia in pregnant females owing to
multiparity, close birth spacing, lack of appropriate antenatal care, low socioeconomic status,
ignorance, and illiteracy.
Objectives: The present study was conducted to assess the incidence of severe anaemia with
having hemoglobin of less than7gm% in pregnant females and to assess the fetal outcomes
following delivery in females having severe anaemia.
Methodology: A total of 1000 pregnant subjects were screened for anaemia. The pregnant
femaleshavingHb% of <7g% in labor were included and feto-maternal outcomes in these
females were evaluated.
Results: Puerperal complications seen were wound gaping, episiotomy, lactation failure, sub
involution, sepsis, and pyrexia in 2.46% (n=2), 2.46% (n=2), 8.64% (n=7), 7.40% (n=6),
2.46% (n=2), and 7.40% (n=6) subjects respectively in severe anaemia group, and in 12.12%
(n=4), 3.03% (n=1), 15.15% (n=5), 18.18% (n=6), 6.06% (n=2), and 9.09% (n=3) subjects
respectively with very severe anaemia. Mortality was seen in 3.03% (n=1) subject with very
severe anaemia. Morbidity was seen in 27.16% (n=22) subjects with severe anaemia and in
45.45% (n=15) subjects with very severe anaemia. The fetal outcomes were also evaluated in
the study subjects. Low birth weight was seen in 7.40% (n=6) subjects with severe anaemia
and in 6.06% (n=2) subjects with very severe anaemia. Neonatal mortality and morbidity was
seen in 1.23% (n=1) and 13.58% (n=11) subjects respectively with severe anaemia, and in
6.06% (n=2) and 24.24% (n=8) subjects respectively with very severe anaemia. Fetal
complications seen in the present study were birthaplasia in 1.23% (n=1) and 3.03% (n=1)
subject with severe and very severe anaemia respectively, sepsis in 1.23% (n=1) and 3.03%
(n=1) subject with severe and very severe anaemia respectively, and IUGR in 1.23% (n=1)
subject with severe anaemia.