Online ISSN: 2515-8260

Keywords : fetal outcome


Dr. G. Vanaja,Dr. N. Manasa, Dr. Y.V.L. Bhavani .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 22-31

Background :
The umbilical cord is the lifeline of the fetus and one of the most important parts of the fetoplacental unit. Short cord length has been associated with delivery complications and adverse fetal outcomes.
Aims and objectives: To find out the correlation between umbilical cord length and fetal outcome.
Methodology :
This is a prospective study conducted in the Department of Obstetrics and Gynaecology of Government Medical College, Srikakulam from November 2022 to January 2023. All cases admitted in the labour room and fulfilling the inclusion and exclusion criterias were taken into the study. The length of umbilical cord was measured after delivery along with other parameters like sex, weight and length of new born, Apgar score and postnatal follow up. Statistical analysis was done using chi-square test and a value of p<0.05 was considered statistically significant.
Short cord length was associated with low Apgar at 1 min and 5 min(p value 0.03) and lower birth weight of the new born(p value 0.03). Adverse perinatal outcomes like stillbirth and NICU admissions were more common in the short cord group (p value 0.02).
Conclusion :
The present study showed that there is a positive correlation between cord length and birth weight of the babies, the Apgar score at 1 and 5min, NICU admission and perinatal outcome. Measurement of umbilical cord length offers an explanation when no apparent intrapartum complication is found for adverse perinatal outcome.

A clinical study of abruptio placentae and its maternal and perinatal outcome in tertiary care centre

Dr. N Adalarasan, Dr. K Thilakavathi, Dr. R Suresh Kumar, Dr. S Sridevi, Dr. Janakiraman, Venkataraman Padmanaban

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 278-286

Abruptio placenta is the complete or partial separation of the normally implanted placenta before delivery of the fetus. It is one of the commonest causes of antepartum hemorrhage affecting maternal and fetal outcomes. Early detection and timely intervention of abruptio placenta in daily clinical practice are important to improve maternal and perinatal outcomes. The objective of the study was to find out the prevalence of abruptio placenta among the pregnant women admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre.
Methods: A cross-sectional study was done among the pregnant women admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre where data from medical records was taken after taking ethical approval from the Institutional Review Committee. Demographic details of the patients including age and parity were recorded. Convenience sampling was done.
Results: The results of my studies are summarized as follows:Overall incidence of Antepartum hemorrhage is 3.6% with abruptio placenta about 1.2. Hypertension is the most common etiology recognized in all studies.The incidence in our study is 54.8%.
Conclusions: The prevalence of abruptio placenta among pregnancies was similar to the studies done in similar settings

Clinical and Echocardiographic Assessment of all Cases of Valvular Heart Disease During Pregnancy in a Urban South Indian Population Between 2020-2021 and the Effect of Valvular Heart Disease on Maternal and Fetal Outcome of Pregnancy

Dr. J. Nambirajan, Dr. Lichumo T. Murry, Dr. P. Balaji Pandian, Dr. J. Jegadeesh, Dr. Abhishek Kumar Tiwari

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 1330-1341

Pregnancy adaptations are well tolerated in healthy women but it rapidly decompensate in pregnants with valvular heart disease resulting in maternal and perinatal morbidity2. Multidisciplinary approach and proper guideline is a necessity to reduce the adverse outcome.
Aims and Objectives: Clinical and echocardiographic assessment of valvular heart disease during pregnancy, in south Indian population and its effect on maternal and fetal outcome. Thereby provide local layout of disease burden and help develop patient centric management plan.
Materials and Methods: 77 pregnant women admitted with valvular heart disease in Coimbatore Medical College Hospital were recruited during period of 2020-2021. Clinical  and Echocardiographic correlation with Maternal and fetal outcome were studied.
Results: In our study, 70.1% of pregnants had Rheumatic heart disease and 23.4% had Congenital heart disease, with ratio of 3:1; 70.3% were diagnosed during index pregnancy.
 Mitral valve was the most common valve involved (84.4%) with Mitral Regurgitation being the predominant lesion (62.3%); Aortic valve involvement (14.3%); Both Aortic and Mitral valve involvement (3.9%). Functional class deterioration were seen in pregnants with critical stenotic lesions and severe insufficiency. Increase in valvular gradient in stenotic lesions is associated with congestive failure. Maternal outcome:  63.6% had caesarean section; 31.7% had cardiac indications; 7.8% had instrumental delivery; 1 maternal death; 23.4% had Congestive Cardiac Failure. Fetal outcome: 71% had term delivery; 28.6% had preterm delivery; 11(14.3%) had fetal loss; 48% low birth weight; 5.2% Intrauterine growth retardation; Perinatal mortality was 7.5% in NYHA class I, II and 42.1% in class III, IV.
Conclusion: High transvalvular gradient, Depressed LV function and increased LV volume, especially in patients with stenotic lesion is associated with life threatening complications in the course of pregnancy. Regurgitant lesion have better tolerability and outcome as compared to obstructive lesion.  There was close association of NYHA class and maternal and fetal outcome, with higher risk in NYHA class III and IV.  

Role of uterine artery doppler in pregnancy induced hypertension: A prospective study from North India

Dr Farah Nabi, Dr Rafia Aziz, Dr Afak Yusuf Sherwani, Dr Parvaiz Ahmed Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3109-3116

Background: The triad of pregnancy induced hypertension (PIH), infections, and hemorrhages constitutes a significant proportion in the maternal mortality and morbidity. About 5 to 10 percent of pregnancies are complicated by the PIH. It is being observed that the sensitivity of this screening test is increased in detecting adverse perinatal outcome, if the doppler ultrasound is performed at gestational period of 23 to 26 weeks instead of 19 to 22 weeks. So, present study was conducted with an aim to evaluate the association of the deranged uterine artery velocity indices on doppler ultrasound with maternal and fetal outcomes among pregnant women with PIH.
Methods: The present prospective study was conducted among 132 singleton pregnant women (patient age: 19 to 33 years and gestational age: 25-39 weeks) with PIH in the department of Obstetrics and Gynecology in tertiary care teaching hospital of North India for 12 months (January 2021 to December 2021) after obtaining the ethical approval from the institutional ethical committee.The ultrasound examination was performed using a GENERAL ELECTRIC LOGIQ P5 ultrasound scanner machine.Chi square test was used to find association between uterine artery indices and fetal outcome and a p value of <0.05 was considered as statistically significant.
Results: The mean age of pregnant women was 24.8±3.7 years.In our study 40.8% of subjects were nulliparous, 43.9% of subjects were having parity of 1, 12.2% of subjects were having parity of 2.In our study, the doppler ultrasound was conducted among pregnant women with PIH for various indices. The uterine artery doppler ultrasound showed that 35.7% of subjects were having normal uterine artery indices, whereas 36.7% and 27.6% of subjects were having bilateral abnormal uterine artery indices and unilateral abnormal uterine dopplerrespectively.The chi-square analysis showed statistically significant association between perinatal mortality and abnormal uterine artery indices (p<0.05).
Conclusion: Doppler study for fetal surveillance in pregnancy-induced hypertension is a very useful device and abnormal uterine artery velocimetry also seems to have worse pregnancy outcomes in the present study.

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.