Key words: isolated oligohydramnios, amniotic fluid index, perinatal outcome Background: Pregnancies with oligohydramnios at term in the absence of fetal and maternal compromise pose a dilemma in management. Evidence regarding the outcome of these pregnancies are controversial, and it is one of the common reason for early induction of labour in the fear of adverse perinatal outcome. Outcomes of such pregnancies are not adequately studied in Sri Lankan setting.Objective: To compare the perinatal fetal outcomes of isolated oligohydramnios with normal pregnancy at term among women who were admitted to Teaching Hospital Kandy.Methods: A prospective cohort study was carried out. All the pregnant mothers admitted to ward 7 Teaching Hospital Kandy at term were routinely scanned for fetal growth and amniotic fluid volume. Women with isolated oligohydramnios (n=70) and without any other pregnancy-related complications were selected as controls. Two controls (normal pregnancy n=140) were selected per case matching the age and parity. These pregnant mothers were followed up from the date of admission to discharge. Immediate perinatal fetal and postnatal outcomes were assessed. Data were entered and analyzed by SPSS 22.0. Results:The majority of the patients (58.5%) with isolated oligohydramnios were induced early, and a significant number of these patients have undergone emergency caesarean section (X 2 =12.98, p=0.003). Although pregnancies with isolated oligohydramnios tends to have more CTG abnormalities, it was not statistically significant (X 2 =4.29, p=0.12). But, the incidence of significant meconium-stained liquor was higher than normal pregnancies (X 2 =6.02, p=0.049). However, the fetal outcome APGAR <7 at 5 minutes (X 2 =0.33, p=0.95) short term perinatal morbidities (X 2 =0.29, p= 0.59) were shown no statistical difference between both group. Neonatal special care baby unit admissions were higher in pregnancies with isolated oligohydramnios (X 2 =23.56, p=0.0001). Conclusion and recommendation:Compared to normal pregnancies, pregnancies with isolated oligohydramnios didn't show any statistically significant difference in perinatal outcome. Oligohydramnios itself doesn't indicate the fetal compromise when other growth parameters were normal. However, as there are controversies in management further researches are needed in this field.
Weight gain in pregnant mothers has several influencing factors. Studies have shown that maternal weight gain influenced both maternal and fetal immediate and future outcomes. However, the recommended amount of weight gain for optimum maternal and fetal outcome is still uncertain. A cross sectional descriptive study was carried out at Teaching Hospital Kandy, for a period of one-year to describe the influence of maternal weight gain during pregnancy in selected fetal outcome such birth weight and APGAR score at birth. 425 participants with normal pre gestational BMI (18.5 kg/m 2-24.9 kg/m 2) were selected by a systematic random sampling technique. Medical disorders complicating pregnancies, twins, previous miscarriages and fetal abnormalities were excluded. Data was extracted from the antenatal record, bed head ticket and by measuring relevant variables (birth weight and APGAR score). Maternal age distributed from 17 to 43 years (Mean=27.97 years: SD=5.72 years). Maternal height distributed from 125cm to 172cm (Mean=154.4cm: SD=5.83cm). Pre pregnancy BMI distributed from 18.5 kg/m 2 to 24.9 kg/m 2 (Mean=21.67 kg/m 2 : SD=2.2 kg/m 2). Maternal body weight at delivery distributed from 36 kg to 116 kg (Mean=63.8kg: SD= 11.82). Pregnancy weight gain distributed from 3.5kg to 24.5 kg (Mean=9.03kg: SD=3.87). Birth weight distributed from 1.24kg to 4.04 kg (Mean=2.93: SD=0.438). All exposure parameters had a positive linear correlation with birth weight. Almost all the study participants (N=423:99.5%) had achieved an APGAR score of >7 within 10 minutes of birth. In conclusion, maternal weight gain does not affect the birth weight of the newborn and no conclusion is derived on maternal weight gain causing any hypoxic situation at the time of birth. These findings are only applicable to normal pregnancies due to the exclusion criteria. Further studies are recommended with a larger sample size and a prospective cohort design with continuous follow up during the antenatal period.
Introduction: Gestational Diabetes Mellitus (GDM) affect up to approximately 10% of all pregnancies. Various markers of inflammation have been shown to predict the future diabetes risk and Neutrophil Lymphocyte Ratio (NLR) level is significantly correlated with metabolic syndrome criteria. However, very few studies investigated any possible association between NLR and development of GDM. Objectives• To compare the NLR among GDM group and control group.• To identify an optimal cut-off value of NLR in predicting GDM.Methods: A longitudinal observational study in all pregnant women who are in their first trimester at antenatal clinic, Teaching Hospital, Kandy for six months was carried out with a Full Blood Count at the first trimester and Oral Glucose Tolerance Test (OGTT) at the 24-28 weeks of gestation. Sample size was 361 and non-probability convenient sampling technique was applied.Results: Mean NLR value was 3.16 (SD=1.84) and the difference between GDM and non GDM mothers was not significant. Left upper most value for NLR of the ROC curve is 1.32 and when it is used as the cut off value the sensitivity is 99.6% and the specificity is 21.2%. Conclusions and recommendations:NLR positively correlates with the OGTT values done at 24-28 weeks of gestation, which can be used as a predictor at early booking visit. There is no significant difference between the mean value of participants with or without GDM. Prediction of GDM by NLR should be further studied in a well-targeted study population with wide methodology.
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