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Cureus Jul 2023Background Isolated oligohydramnios, without any known fetal/maternal abnormality, may be associated with insufficient oral intake (such as water, glucose, and...
Background Isolated oligohydramnios, without any known fetal/maternal abnormality, may be associated with insufficient oral intake (such as water, glucose, and rehydration therapy). Therefore, the present study was conducted to assess the improvement following maternal hydration. Method A total of 50 cases of isolated oligohydramnios (other high-risk pregnancy conditions not present) were included in the study (25 in each group). Patients were encouraged for an additional 2 liters of oral rehydration solution intake daily along with regular diet. The fluid intake was unsupervised in the home group and supervised in the hospital group. Serial amniotic fluid index (AFI) measurements and fetal monitoring were performed. Birth weight and APGAR scores were recorded, and data were analyzed. Results The two groups were comparable in terms of demographics and baseline laboratory findings. AFI significantly improved in the hospital group compared to the home group (p-value: <0.001). Birth weight, placental weight, and APGAR scores were also significantly better in the hospital group than in the home group. Conclusion Maternal oral hydration therapy improves the amniotic fluid volume and subsequently improves the perinatal outcome. Due to poor compliance with home-based treatment, institution of supervised hydration therapy is recommended.
PubMed: 37539407
DOI: 10.7759/cureus.41326 -
The Journal of Maternal-fetal &... Dec 2023Apparently uncomplicated low-risk pregnancies, especially first time births, account for a significant proportion of adverse birth outcomes. Improved risk stratification...
OBJECTIVES
Apparently uncomplicated low-risk pregnancies, especially first time births, account for a significant proportion of adverse birth outcomes. Improved risk stratification with a simple bedside scan on admission in early labor could potentially reduce adverse intrapartum outcomes. The aim of this feasibility study was to assess a cohort of low-risk subjects with admission ultrasonography at the onset of labor with a view to conducting a future randomized controlled trial (RCT). The objectives were three-fold; i) to determine the logistics of performing a labor admission ultrasound scan ii) to establish whether abnormal ultrasound features can be identified and iii) whether they are associated with emergency delivery and/or poor condition of the neonate at birth.
METHODS
We performed a prospective cohort study of 295 participants with term singleton cephalic pregnancies admitted in early labor or for labor induction with non-fetal indications. The setting was a university teaching hospital in Ireland with almost 8000 births annually. A bedside ultrasound scan was performed to assess fetal biometry, amniotic fluid volume and placental maturity. Patients and their babies were followed up until hospital discharge. The outcomes of interest included image quality, time to perform a scan, oligohydramnios (Single Deepest Pool ≤ 2 cm), small for gestational age (SGA; abdominal circumference <10th centile), mature placenta (Grannum 2 or 3), pathological CTG, emergency cesarean section (CS), fetal acidosis (cord arterial pH <7.10 or base excess <-12.0), low Apgar score <7 at 5 min and neonatal unit admission.
RESULTS
Image quality was optimal in 274 of the 295 scans (93%) and 271 (92%) were completed in less than 10 min. Of this low-risk population, 67 of 294 (23%) had oligohydramnios, 11 (4%) were small for gestational age and 87 (30%) had a mature placenta (Grannum grade 2). The incidence of pathological CTG and emergency CS was higher among patients with oligohydramnios than those with a normal scan but did not reach statistical significance; Odds Ratio 3.40 (95% Confidence Intervals 0.55 to 20.92) and OR 1.43 (95% CI 0.66 to 3.08) respectively. The mean birthweight was significantly lower in those with oligohydramnios -139 g (95% CI -248 to -30) and admission scan detected SGA -357 g (95% CI -557 to -137). Adverse perinatal outcomes were uncommon with a higher incidence of fetal acidosis (pH < 7.10) in the oligohydramnios group. The incidence of neonatal unit admission >24 h was higher in the oligohydramnios group but not statistically significant; OR 3.75 (95% CI 0.61 to 22.97). Results for SGA alone were non-significant and results for oligohydramnios and SGA combined were similar to those for oligohydramnios alone.
CONCLUSIONS
Admission ultrasonography is feasible in a routine clinical setting, but evidence of benefit is weak and does not currently justify a randomized controlled trial.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Aged, 80 and over; Pregnancy Outcome; Oligohydramnios; Feasibility Studies; Ultrasonography; Amniotic Fluid; Fetal Growth Retardation; Ultrasonography, Prenatal; Gestational Age
PubMed: 37527967
DOI: 10.1080/14767058.2023.2241104 -
Reumatologia 2023
PubMed: 37522141
DOI: 10.5114/reum/167432 -
Ethiopian Journal of Health Sciences Mar 2023Meconium stained amniotic fluid (MSAF) is a commonly observed phenomenon in day-to-day practice of obstetrics. The reported prevalence of MSAF was 7-22% of all term...
BACKGROUND
Meconium stained amniotic fluid (MSAF) is a commonly observed phenomenon in day-to-day practice of obstetrics. The reported prevalence of MSAF was 7-22% of all term deliveries. Some of the factors that increases the risk of meconium stained amniotic fluid includes; advanced gestational age at delivery, prolonged rupture of membranes, intra-amniotic infection, pre-eclampsia, oligohydroamnios, and diabetes mellitus. The study aimed to determine the prevalence of meconium stained amniotic fluid and its associated factors among women who gave birth at term, from January 1 to July 30, 2020, at Adama Hospital Medical College.
METHODS
Institutional based cross-sectional study was conducted on 314 laboring women who gave birth at term. Systematic random sampling was used to select the study participants. Data entry and analysis were made by using Epi- info 7 and SPSS version 20, respectively.
RESULTS
The prevalence of meconium stained amniotic fluid was 23.9%. Late term pregnancy, Oligohydraminos, Antepartum hemorrhage, Premature rupture of membrane, and Non-reassuring fetal heart rate pattern were significantly associated with meconium-stained amniotic fluid.
CONCLUSIONS
The prevalence of MSAF was comparable with other studies. Late-term pregnancy, oligohydramnios, antepartum hemorrhage, non-reassuring fetal heart rate pattern, and premature rupture of the membrane were factors associated with an increased risk of MSAF.
Topics: Adult; Female; Humans; Young Adult; Amniotic Fluid; Pregnancy Complications; Infant, Newborn, Diseases; Ethiopia; Obstetric Labor Complications
PubMed: 37484174
DOI: 10.4314/ejhs.v33i2.6 -
JNMA; Journal of the Nepal Medical... Jun 2023Hypothyroidism is a common endocrine disorder occurring in pregnancy. Maternal and fetal complications are present in these patients. Timely identification and treatment...
INTRODUCTION
Hypothyroidism is a common endocrine disorder occurring in pregnancy. Maternal and fetal complications are present in these patients. Timely identification and treatment help in the prevention of complications. The aim of this study was to find out the prevalence of hypothyroidism among pregnant women attending the Outpatient Department of Obstetrics in a tertiary care centre.
METHODS
A descriptive cross-sectional study was conducted in a tertiary care centre after taking ethical approval from the Institutional Review Committee (Reference number: 08/2021). Data from 1 January 2016 to 31 December 2020 were collected between 1 November 2021 to 31 November 2021. All pregnant women who had undergone thyroid level assessment in each trimester (first, second and third) and had delivered in the same centre were included in the study. However, pregnant women with comorbidities like hypertension, overt diabetes mellitus, hyperthyroidism, renal disease, cardiac disease, and neurological disorder were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
RESULTS
Among 216 pregnant patients, the prevalence of hypothyroidism was 74 (34.25%) (27.92-40.57, 95% Confidence Interval). Maternal complications were seen in 33 (44.59%). The commonest complication was oligohydramnios 10 (13.51%) followed by preterm delivery 8 (10.81%).
CONCLUSIONS
The prevalence of hypothyroidism among pregnant women was found to be higher than other studies done in similar settings.
KEYWORDS
complications; hypothyroidism; miscarriage; pregnancy; thyroid.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Outpatients; Obstetrics; Cross-Sectional Studies; Pregnant Women; Tertiary Care Centers; Hypothyroidism
PubMed: 37464854
DOI: 10.31729/jnma.8184 -
JNMA; Journal of the Nepal Medical... Jun 2023Prelabour rupture of membranes is a common obstetrics problem associated with maternal and perinatal morbidity and mortality. The exact cause is not known although...
INTRODUCTION
Prelabour rupture of membranes is a common obstetrics problem associated with maternal and perinatal morbidity and mortality. The exact cause is not known although various factors are found to be related to this condition. Hence, the objective of this study was to find out the prevalence of prelabour rupture of membranes among pregnant women in a tertiary care centre.
METHODS
This was a descriptive cross-sectional study conducted from 1 November 2021 to 30 November 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: 2078/79/49). A structured proforma was filled out after taking a detailed history from each pregnant woman. Convenience sampling method was used. Point estimate and 99% Confidence Interval were calculated.
RESULTS
Among 700 pregnant women, the prevalence of prelabour rupture of membranes was 56 (8%) (5.36-10.64, 99% Confidence Interval). Among them, 40 (71.43%) occurred in the term, while preterm (before 37 weeks) occurred in 16 (28.57%) of all pregnancies. Previous miscarriage occurred in 15 (26.78%) followed by gestational diabetes mellitus 8 (14.28%).
CONCLUSIONS
The prevalence of prelabour rupture of membranes was found to be lower than other studies done in similar settings.
KEYWORDS
miscarriage; oligohydramnios; prevalence.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Pregnant Women; Fetal Membranes, Premature Rupture; Cross-Sectional Studies; Tertiary Care Centers; Abortion, Spontaneous
PubMed: 37464852
DOI: 10.31729/jnma.8186 -
Cureus Jun 2023Obesity is defined as abnormal or excessive fat accumulation that may impair health. Until recently, the only effective method for treating morbid obesity over the long...
BACKGROUND
Obesity is defined as abnormal or excessive fat accumulation that may impair health. Until recently, the only effective method for treating morbid obesity over the long term was bariatric surgery (BS). During pregnancy, obesity is correlated with higher risks for numerous complications, including gestational diabetes mellitus, pre-eclampsia, mortality, and large-for-gestational-age neonates. The most commonly reported complications among women who underwent sleeve gastrectomy and experienced pregnancy were placental bleeding, oligohydramnios, urinary tract infection, appendicitis, and recurrent abortions.
OBJECTIVES
We aim to estimate the consequence of sleeve gastrectomy and its relation with pregnancy outcomes among women in Saudi Arabia.
METHODOLOGY
This study adopted a quantitative, descriptive, cross-sectional design. It was conducted in Saudi Arabia between February and May 2023 among women who became pregnant after undergoing sleeve gastrectomy. Result: Anemia was experienced by 78.8% of the patients during pregnancy. In our study, 18% of the individuals experienced complications during or right after delivery, with postpartum hemorrhage being the most frequent (43.1%). We discovered that pre-eclampsia and delivering a baby small for gestational age were considerably more common in pregnant women who smoked (p ≤ 0.05). On the other hand, no significant association was discovered between any comorbidity and mode of delivery, birth weight, child complications, or difficulties that occurred during or right after labor.
CONCLUSION
We concluded that weight gain after sleeve gastrectomy negatively impacted pregnancy and increased the probability of several complications for the mother and fetus. Healthcare providers must inform every woman undergoing BS about the possible complication of an unhealthy lifestyle after the procedure.
PubMed: 37431342
DOI: 10.7759/cureus.40157 -
Cureus Jun 2023Obesity has become a growing pandemic with a significant increase in incidence in recent years. The complications associated with pregnancy in obese patients can lead to...
Obesity has become a growing pandemic with a significant increase in incidence in recent years. The complications associated with pregnancy in obese patients can lead to increased morbidity and mortality in pregnant women. A 41-year-old morbidly obese female with primary hypertension and 32.4 weeks pregnant, presented with severe oligohydramnios, breech presentation, and a history of previous lower segment cesarean section (LSCS). The patient experienced abdominal pain, lower backache, and leaking per vaginal, and a decision was made to perform LSCS. Challenges were encountered during the procedure related to anesthesia management and the need for specialized equipment and additional assistants. A multidisciplinary approach was chosen for managing this patient with the special role of anesthetists. Intra-operative and post-operative management was crucial for a successful recovery. Obesity during pregnancy presents unique challenges for healthcare providers, and it is necessary to increase resources and prepare skilfully to manage these patients effectively.
PubMed: 37416027
DOI: 10.7759/cureus.39958