Aims: This study was done to determine the relationship between maternal haemoglobin and fetal weight. Methods: This study was carried out at Paropakar Maternity and Women’s Hospital in 491 primigravidas with full term singleton pregnancy. The study population was divided into two groups, one who had haemoglobin 10 gm% or more and the other women having haemoglobin less than 10 gm%. Fetal weight as the outcome variable was compared between anaemic and nonanaemic mothers and the relation between maternal haemoglobin and fetal weight was studied. Results: The prevalence of anaemia was 46.2% out of which 99.5% had mild anaemia and 0.5% had moderate anaemia. Mean haemoglobin level was 11.54 gm% among non anaemic women and mean birth weight was 2.9 kg in this group whereas mean haemoglobin level was 9.2 gm% in anaemic women and mean birth weight was 2.6 kg in this group and 60% babies had low birth weight (<2.5 kg) born to anaemic women (haemoglobin <10 gm%), and 40% babies had fetal weight >2.5 kg. Similarly babies born to nonanaemic women (haemoglobin >10 gm%) 18.1% had LBW and 81.9% had fetal weight >2.5 kg. The risk of low birth weight was 6.8 times higher among anaemic mothers as compared to non- anaemic mothers which was statistically significant with p-value of 0.0001 (OR 6.80 95% CI, 3.83-12.12). Conclusions: Anemia in pregnancy is one of the causes for poor fetal outcome. Proper antenatal care and counseling can reduce the incidence of anaemia in pregnancy. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 37-40 DOI: http://dx.doi.org/10.3126/njog.v8i1.8860
Introduction: : In a developing country like Nepal maternal morbidity in the post partum period is a major healthcare concern. This study aims to analyze the maternal morbidities in women following delivery at Shree Birendra Hospital.Methods: This is a prospective, observational, hospital based study, carried out at Shree Birendra Hospital from 13th August 2012 to 13th Feb 2016. Women who underwent delivery in Shree Birendra Hospital with subsequent morbidities within the study period were included in this study. The variables considered in this study were pattern of postpartum morbidities, age, parity, mode of delivery and average duration of hospital stay.Results: During the study period, a total number of 3407 deliveries were conducted in Shree Birendra Army Hospital. Out of these, 54 patients (1.58%) had postpartum morbidities. Puerperal sepsis was the most frequent diagnosis seen in 18 patients (33.3%), followed by surgical wound infection in 14 (25.9%) and secondary postpartum hemorrhage (PPH) in 10 (18.5%).Conclusion: Puerperal sepsis remains the most common cause of postpartum morbidity.
Aims: This study was done to find the relation of raised uric acid with fetal outcome in hypertensive disorders of pregnancy and to compare the fetal outcome with normal and raised uric acid level . Methods: This was a hospital based cross-sectional prospective comparative study done in Paropakar maternity and Women’s hospital conducted over three month period. Results: During the study period, a total of 126 cases of hypertensive disorders of pregnancy were identified among 3819 obstetric cases. The incidence of hypertensive disorders of pregnancy in this study was 3.3%. Fifty seven of them were found to have serum uric acid level <5.5 mg% (Group A), 43 of them were found to have serum uric acid level ≥5.5mg% (Group B). In those developing hyperuricemia 54.81% had mild hypertension, 40.91% had severe hypertension. Adverse perinatal outcome with serum uric acid level ≥5.5mg/dl had stillbirth in 7%, had low birth weight in 27.9%, 11.6 % were admitted in special care baby unit and 18.6 % had apgar <7 at five minute. Conclusions: Perinatal morbidity and mortality was increased in women with raised uric acid level except admission to special baby care unit Hypertensive disorders of pregnancy are associated with high maternal and perinatal morbidity and mortality. DOI: http://dx.doi.org/10.3126/njog.v9i1.11196 NJOG 2014 Jan-Jun; 2(1):78-81
Introduction: High risk pregnancy is a major cause of morbidity and mortality in a developing country. These patients are recognized in the initial prenatal office visit as they have a poor obstetrical history or a well recognized medical complication however; pregnancy becomes high risk because they develop unexpected complications in the course of otherwise normal pregnancies. The objective of this study is to identify various type of high risk pregnancy and fetal outcome. Methods: This was a descriptive study conducted in Shree Birendra military hospital over a period of 9 months. Patients were recognized as high risk during antenatal visit and during admission. They were followed till delivery. The case records of all high risk pregnancy with their fetal outcome were analyzed. Statistical analysis was done using simple percentage. Results: Total deliveries during study period was 626. High risk pregnancy identified were 99 (15.81%). Previous lower segment cesarean section was the most common identified high risk pregnancy 34 (5.43%) followed by young primigravida 3.19%, breech 2.23%. There were total 13 low birth weight baby (13.13%) and 2 stillbirth (2%) as fetal outcome. Conclusion: Identification of high risk pregnancy during antenatal period will reduce adverse perinatal outcome.
Introduction: Obstetric Services commenced at the teaching institute where this study was conducted from Aug 2012. Hence, a review of the data of C-section in this hospital is needed for standardisation of the obstetric services in terms of the rate of C-section, its various clinical indications and maternal and fetal outcomes.Methods: This is a retrospective study carried out over a period of 5 years from Aug 13, 2012 to Aug 11, 2017. All hospital deliveries conducted during the study period were included in this study and the patients’ details obtained from hospital records. All data obtained was recorded in master charts and analysed using SPSS version 23. The caesarean rate, its indications were calculated and categorised into groups according to Robson’s 10-group classification. Results: A total number of 4892 deliveries were conducted over this 5-year study period. C-section was performed in 1104 patients, giving a C-section rate of 22.57%. The most common indications were previous C-section (25.4%), fetal distress (14.3%) and breech presentation (10.3%). Robson’s Group 1 was the highest contributors to the overall CS rate, contributing 28% of all C-sections, followed by Group 5 (26.8%) and Group 3 (15.5%).Conclusions: Nulliparous and multiparous women in term pregnancy in labor and women with previous C-section contribute to more than 70% of overall C-sections at our centre. Hence, close monitoring of these groups of patients, increasing the use of instrumental delivery and practice of vaginal birth after C-section can significantly reduce the C-section rate in our centre.
Aim: To study the prevalence of induction of labor and obstetric and neonatal outcome among delivery cases in the maternity unit of a tertiary care center. Methods: This is a prospective cross-sectional study conducted on pregnant ladies presenting to maternity unit of Shree Birendra Hospital, Chhauni over a period of six months from March to August 2017. All pregnant ladies in labor during the study period were enrolled. Induction of labor, mode of delivery, perinatal outcome (gestational age at delivery, birth weight), and maternal complications if any were recorded. Results: Among 497 deliveries in the study period, induction of labor was performed in 117 (23.5%) cases with post-date pregnancy being the most common indication. Induction was successful with vaginal deliveries in 82(70.1%) cases, while in the rest, IOL failed. Among the induced cases, 17 (14.5%) neonates had poor APGAR at 5 minutes and there was significant association of IOL with low APGAR. There was normal post-natal recovery in 108 (92.3%) induced cases while 9 (7.7%) cases developed some maternal complications. IOL has no significant association with maternal and neonatal complications or perineal injury (p>0.05). Conclusions: The prevalence of induction in this center is slightly higher than other centers. The IOL has significant association with low APGAR at 5 minutes but no significant association with the neonatal and maternal complications.
Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who are overweight or obese before pregnancy are more at risk of GDM irrespective of other factors.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending antepartum clinic, in a tertiary level hospital of Lalitpur for one-year. All overweight (prepregnancy body mass index; BMI >23) women at 24 -28 weeks of gestation were enrolled. Fasting blood glucose, screening 50 gm oral glucose challenge test (OGTT) and 2 hour OGTT following overnight fasting was done and GDM was diagnosed based on standard guidelines. Results:Out of 256 women, majority had BMI >25 kg/m 2 (n = 180), 59% were multiparous and 41% were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically nonsignificant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01). Conclusion:This study showed a high pre-pregnancy BMI and the incidence of GDM. However, the difference is not statistically significant The rate of positive screening test is also higher than the previous studies.
Aim: To assess the effects of planned early birth (active treatment within 24hrs) compared to expectant management (without active treatment within 24hrs) for women at term with Prelabor Rupture of Membrane (PROM) on maternal and fetal outcomes. Methods: This is an observational comparative study carried out in all the pregnant women who present in maternity ward of Shree Birendra Hospital with PROM at 37-41 weeks of gestation with vertex presentation during the study period between 13 April 2020 to 13 April 2021.They were randomly placed into (A) active treatment group and (B) expectant treatment group. Group (A) was induced with 25mcg of PGE1 (Misoprostol) depending on cervical score, whereas group (B) was expectantly managed for 24 hrs. PROM to delivery interval, maternal and fetal outcomes were then evaluated in both the groups. Results: 79.5% of group A and 71.8% in group B delivered through vaginal route. 20.5% patients in group A and 28.2% patients in group B underwent Cesarean section. The average PROM to delivery interval was 15.6 hours in group A, as compared to 16.8 hours in group B. Only 2 babies in group B had an Apgar score of less than 7 at five minutes. Subsequently, in both the groups, two babies required NICU admission for respiratory distress syndrome with no neonatal mortality in both the groups. Conclusion: Expectant management up to 24 hours can be safely offered to a woman with term PROM.
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