Fetal and Maternal Outcomes in Women With Major Placenta Previa Among Sudanese Women: A Prospective Cross-Sectional Study.

Background Placenta previa is a major obstetric problem with high rates of fetomaternal mortality and morbidity. This study aimed to determine the prevalence and fetal and maternal outcomes of major degree placenta previa among Sudanese women. Method This is a prospective descriptive study conducted in the period from January 1 to June 30, 2109, at Omdurman Maternity Hospital, Khartoum, Sudan. Fetal and maternal complications associated with major degree placenta were analyzed using descriptive statistics. Results The total number of deliveries was 22,000, of which 87 cases were of major degree placenta previa, giving a prevalence rate of 0.4%, the hysterectomies rate was 23% (n= 20), and the total maternal deaths were 6.9% (n= 6). Intraoperative interventions used to control the bleeding were multiple hemostatic sutures in 34.5% (n=30) of cases, followed by uterine backing (20.7%; n= 18), and uterine artery ligation (12.6%; n=11). The common reported maternal complications were bladder injuries (28.7%; n= 25) followed by bowel injuries (4.6%; n=5). Of all mothers, 48.27% (n=42) were admitted to the intensive care unit (ICU). Of all deliveries, 26.4% (n=23) were preterm, and 38% (n=33) of neonates were admitted to the newborn intensive care unit (NICU), and 9.2% (n=8) were fresh stillbirth (FSB). Conclusion Neonatal complications were comparable to other studies but maternal deaths were relatively high. The study indicated the need for effective management protocols and more training of the medical staff in order to overcome the problem.

The Relationship Between the Weight of the Placenta, Body Mass Index and Fetal Birth Weight Among Sudanese Women.

Introduction: Accurate estimation of fetal birth weight is essential for the management of labor and delivery. The predictability of fetal weighs by clinical assessment and ultrasound is limited. Aim: The study aimed to evaluate the association between fetal birth weight and placental weight and other demographic characteristics. Methods: a total of 369 live born of a singleton term pregnancies (37 to 42 weeks gestations) were included in the study. Immediately after delivery, the placenta was weighed with cord and membranes. A linear regression was used to examine the effect of placental weight and other variables on fetal birth weight. Results: The mean of birth weight was 3122.5±477.8 grams. Placenta weight had a mean of 556.92±112.488 grams. The mean gestational age was 39.0543±.89642 weeks. The association between the placental weight and the birth weight was significant, and we found that for each gram increase in placental weight, birth weight is increased by 2.848g (SE = 0.178, p < 0.01). Similarly, there was a significant association between placental weight and fetal birth weight, and we found that for each kg increase in maternal weight, birth weight is increased by 17.018 g (SE = 5.281, p =0.001). Conclusion: Placenta weight and BMI are independent predictors of fetal birth weight.

Intrapartum Fetal and Maternal Complications in Low-Risk Pregnancy: Experience of a Tertiary Hospital in Low-Income Countries.

AIM: To determine the frequencies of intrapartum fetal and maternal complications in women without the identified prenatal risk factor. METHODS: We conducted a prospective cross-sectional investigation from January to June 2017 at Khartoum North Maternity Hospital in women categorised pregnancies as low risk (no prenatal risk factors). We evaluated adverse intrapartum fetal and maternal outcomes. RESULTS: Among 600 pregnancies, of these, 12.5% (n = 75) developed fetal or / and maternal complications. The Frequency of primary cesarean delivery, forceps, and ventose among low-risk pregnancies in this study were 16%, 3%, and 2% respectively. Other adverse pregnancy outcomes were PPH (5%), Blood transfusion (4.5%), admission to ICU (1.8%), while perineal tear, cesarean hysterectomy, and re-laparotomy have equal weight (0.3%). Among all births, the most common adverse fetal outcomes were birth asphyxia (3.8%), low birth weight (2%), admission to the neonatal intensive care unit (1.8%), and fresh stillborn babies (1.3%). CONCLUSION: Of all low-risk pregnancies, 12.5% were reported to have serious obstetrics and neonatal complications. This information is essential for evaluating resources in delivery centres and hospitals and to provide equipment and further training of medical personnel to provide optimal quality care and patient safety.

Blunt abdominal trauma to a pregnant woman resulting in a child with hemiplegic spastic cerebral palsy and permanent eye damage.

BACKGROUND: In today's life trauma is a common and important complication of pregnancy and remains one of the major contributors to maternal and fetal morbidity and mortality. CASE PRESENTATION: The authors reported a case of 4 years old child with hemiplegic spastic cerebral palsy and permanent left eye damage due to antenatal trauma. He was an off spring to a 33 years old woman gravida 6 para 5 from western Sudan, who sustained a domestic blunt abdominal trauma during her routine daily activities. The abdominal trauma occurred during the third trimester at 36th week gestation of the pregnancy when the mother hit herself by the woody part of an axe non intentionally. CONCLUSIONS: The findings from this case conclude that relatively minor trauma can have significant adverse effects on the fetus and can be devastating.