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Background: Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved its genetic growth potential. FGR incidence is 6 times higher in underdeveloped and developing countries as compared to the developed world.Methods: This is a retrospective study done in the department of obstetrics and gynaecology, civil hospital and B. J. Medical college, Ahmedabad over the period of 6 months from December 2022 to May 2023. A total of 30 cases of intrauterine growth restriction (IUGR) pregnancies were studied.Results: Majority of the study population, 60% belonged to younger age group of 20-30 years. Multiparity was associated with IUGR babies. Majority of patients i.e. 76.66%. Presented at gestational age of ?37 weeks and 23.33% at <37 weeks. Most IUGR babies (73.33%) had a birth weight between 2 to 2.5 kg. One third of babies required NICU admission while the perinatal mortality was 10%. Doppler changes in umbilical artery were noted in 27% of cases of IUGR. Among risk factors anemia, preeclampsia and oligohydramnios had equal contributions at 10% each. Previous history for SGA baby is a significant association in 16% of cases. Induction of labor was done in 60% cases, 63% were delivered vaginally and rest via lower segment caesarean section (LSCS), the most common indication of LSCS was fetal distress.Conclusions: The study concluded that IUGR continues to be one of the major etiological factors for fetal morbidity and mortality and increase in rates of LSCS contributing maternal morbidity. IUGR was commonly observed in multigravida patients lacking antenatal care. Anemia and hypertensive disorders of pregnancy as well as oligohydramnios are the potential risk factors for IUGR.
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Background: Intrauterine growth restriction (IUGR) is associated with an increased risk of perinatal morbidity, mortality and impaired neurodevelopment. The objective of this study is to evaluate the role of umbilical artery S/D ratio on color doppler for monitoring of fetal well-being in patient with intrauterine growth retardation and correlation with perinatal outcome.Methods: This retrospective observational study is carried out at a tertiary health care hospital over a period of 1 year. All clinically diagnosed cases of IUGR on the basis of fundal height are included in this study. The suspected cases of IUGR, color doppler tests were done to confirm the diagnosis of IUGR. The perinatal outcomes of the pregnancy of women with abnormal doppler parameters are then compared with women with normal Doppler parameters.Results: Out of the total sample size, 58.7% of the study population had abnormal doppler findings which were suggestive of IUGR, and 41.3% had normal doppler parameters. Our study showed that 18.2% newborns of study participants with abnormal S/D ratio had APGAR score at 5 minutes less than 7 as compared to 0% neonates of study participants with normal S/D ratio. This association was statistically significant. Also, statistically significant association was seen between 40 (90.9%) participants having abnormal S/D ratio whose neonates required NICU Admission as compared to 15 (48.4%) study participants having normal S/D ratio whose babies required NICU admission.Conclusions: Ultrasound examination and Doppler monitoring provide a non-invasive repetitive method for supervising fetuses with growth restriction in order to apply an adequate management.
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Background: Majority of spontaneous pregnancy loss occur in early gestation. Early pregnancy loss causes great physical and psychological distress to couples and creates apprehension in achieving future reproductive success. Previous abortions have a definite impact on the successful outcome of future pregnancies. Hence for such pregnancies careful antenatal care is mandatory. Careful surveillances required in pregnancies preceded by spontaneous abortions, for early detection of possible complications.Methods: This was a prospective observational comparative study conducted on 184 antenatal women (92 patients with previous spontaneous abortion, no full-term delivery, selected as cases while 92 patients with previous full term normal vaginal delivery with no previous abortion selected as control) attending antenatal OPD at Holy Family Hospital, New Delhi, from October 2020 to May 2022. All women received regular antenatal care and were followed up till delivery for maternal and foetal outcome.Results: For predicting pregnancy outcome following previous spontaneous abortion showed statistically significant in term of obesity, 56.52% patients were obese in cases while in controls only 48.91%. Duration of marriage, in cases is 2.22 years, where as in controls were 4.24 years with significant result. Interpregnancy interval (months) in cases was 10.58±4.19 whereas in controls it was 32.53±14.41 with significant result. Antenatal complications in term of GDM, hypothyroidism, IUGR more in cases than controls.Conclusions: We found that prior spontaneous abortion miscarriage is definitely a risk factor for the next pregnancy, making present pregnancy a high-risk pregnancy.
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Background: Majority of spontaneous pregnancy loss occur in early gestation. Early pregnancy loss causes great physical and psychological distress to couples and creates apprehension in achieving future reproductive success. Previous abortions have a definite impact on the successful outcome of future pregnancies. Hence for such pregnancies careful antenatal care is mandatory. Careful surveillances required in pregnancies preceded by spontaneous abortions, for early detection of possible complications.Methods: This was a prospective observational comparative study conducted on 184 antenatal women (92 patients with previous spontaneous abortion, no full-term delivery, selected as cases while 92 patients with previous full term normal vaginal delivery with no previous abortion selected as control) attending antenatal OPD at Holy Family Hospital, New Delhi, from October 2020 to May 2022. All women received regular antenatal care and were followed up till delivery for maternal and foetal outcome.Results: For predicting pregnancy outcome following previous spontaneous abortion showed statistically significant in term of obesity, 56.52% patients were obese in cases while in controls only 48.91%. Duration of marriage, in cases is 2.22 years, where as in controls were 4.24 years with significant result. Interpregnancy interval (months) in cases was 10.58±4.19 whereas in controls it was 32.53±14.41 with significant result. Antenatal complications in term of GDM, hypothyroidism, IUGR more in cases than controls.Conclusions: We found that prior spontaneous abortion miscarriage is definitely a risk factor for the next pregnancy, making present pregnancy a high-risk pregnancy.
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Preeclampsia affects 3-10% of pregnancies worldwide. It has significant adverse effect on both the fetus and the neonate. Hence there is a need to study the impact of pregnancy induced hypertension (PIH) on the fetus and the neonate. Databases like PubMed and Cochrane are searched independently by two authors to identify relevant studies. Data were collected for outcomes like birth weight, gestational age, fetal death/stillbirth and intrauterine growth retardation (IUGR). Preeclampsia is associated with significant increase in the incidence of low birth weight (LBW), IUGR and prematurity compared to normotensive women. Also, there is an increased rate of fetal death/ stillbirths in preeclampsia. In addition, there is an increased need for neonatal intensive care unit (NICU) admission in neonates born to PIH mothers. Maternal preeclampsia results in significant adverse effect on the fetus and neonate. There is an increased incidence of stillbirth, LBW, IUGR and preterm deliveries in neonates born to preeclamptic mothers. There is an overall increase in the composite outcomes of neonates of PIH mothers. The objective of the study is to compare the neonatal outcomes of preeclamptic or women with gestational hypertension with that of normotensive women.
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Background : Presence of thalassaemia is considered high risk in pregnancy. The present study find out the role of antenatal and intrapartum care to improve the outcome of pregnancy in thalassaemia. Materials and Method : The prospective longitudinal study was carried out on 25 patients. CBC, LFT, Ferritin, Hb electrophoresis, serial USG was done. Chorionic villous sampling was offered to thalassaemic women to decrease the number of babies born with Thalassaemia. Furthermore, management and treatment options provided to mother to overcome the incidence of maternal and neonatal complications during current pregnancy. Results : 44% of thalassaemic pregnant women had HbE ? thalassaemia, 8% ? thalassaemia major and others had thalassaemia carriers, while only 20% of their partners showed ? thalassaemia trait. All patients were anemic and during delivery mean Hb% were 8.42 g/dl, MCH 22.09 pg, MCV 73.56 fl, MCHC 29.86 g/dl and ferritin 241.51 ng/ ml. Third trimester USG exhibited 32% developed IUGR (Intrauterine growth restriction). 40% patients received blood transfusion after delivery. ? thalassaemia trait was identified in 20% babies at 6 month. Conclusion : Postpartum haemorrhage is a major complication of thalassaemia in pregnancy. After delivery a thorough neonatal check-up and haematological work-up is important for prevention of neonatal mortality and early detection of thalassaemia.
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Background: Intrauterine growth restriction (IUGR) also known as fetal growth restriction (FGR), has been associated with a variety of detrimental perinatal outcomes. FGR is defined as estimated fetal weights (EFW) or abdominal circumference (AC) that fall within the third, or tenth percentiles with abnormal doppler parameters. FGR affects 10-15% of all pregnancies around the world.Methods: Prospective observational study of singleton pregnant women complicated by FGR were enrolled during the study period from September 2021 to August 2022. 100 patients were included in the study.Results: Abnormal umbilical artery flow was seen in 30% of cases, out of which 83% (25) had abnormal perinatal outcome. Out of 100 cases, live births were reported in 94%, stillbirths in 4%, and IUDs in 2%. There were 16 neonatal deaths and 15 neonatal complications among the adverse perinatal outcomes. Intraventricular hemorrhage and neonatal sepsis were the two leading causes of death. Neonatal sepsis, necrotizing enterocolitis and hypoxic ischemic injury was the leading cause of morbidity. Reverse end diastolic umbilical artery Doppler and bilateral uterine artery notch had 100% mortality. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of umbilical artery in predicting perinatal outcome in IUGR were 80.65%, 92.75%, 83.33% 91.43% and 89.47% respectively.Conclusions: Umbilical artery PI is the most sensitive parameter and had highest positive and negative predictive value and Accuracy in relation to adverse perinatal outcomes.
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Background: Hypertensive disorders and intrauterine growth restriction are common complications encountered during pregnancy. This study was conducted to observe the usefulness of systolic/ diastolic (S/D) ratio in umbilical artery as compared with non-stress test (NST) to predict perinatal outcome in pregnancies complicated with hypertensive disorders and intrauterine growth restriction (IUGR).Methods: It was a prospective observational which was conducted on patients undergoing antenatal visits at the department of obstetrics and gynaecology, Army hospital research and referral, New Delhi from May 2017 to April 2019. NST was started at 32 weeks twice weekly in all patients. All patients were subjected to umbilical artery Doppler velocimetry waveform on weekly basis or every third day in cases of nonreactive NST.Results: Out of 140 patients, 53 patients (37.9%) had PIH and 44 (31.4%) had IUGR. 43 cases (30.7%) had both PIH and IUGR. Among the 140 patients, 40 patients (28.6%) had non-reactive NST and 60 patients (42.9%) of the patients had abnormal doppler. Abnormal doppler and non-reactive NST were associated with APGAR score of less than 7 at 5 minutes in the newborn. Abnormal perinatal outcome was more in abnormal doppler than normal doppler and the finding was statistically significant (p<0.05).Conclusions: Overall sensitivity and diagnostic accuracy of Doppler is better as compared to that of NST in terms of detecting adverse perinatal outcomes.
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Background: Birth weight is an important predictor of an individual’s survival and well-being and the complications of children born with low birth weight (LBW) continue till adulthood. The incidence and risk factors of LBW are not known in the Andaman and Nicobar Islands and research answers can help institute appropriate preventive measures. The aim of the study was to determine the proportion of LBW due to intrauterine growth restriction (IUGR) and preterm birth (PTB) and its association with selected factors.Methods: The prospective study was conducted in Andaman and Nicobar Islands Institute of Medical Sciences amongst pregnant women admitted between January-June 2021. Women<18 years, with gestational age<28 weeks, and belonging to tribal groups were excluded. After delivery, birth-weight was recorded to the nearest 10 g in first hour.Results: The incidence of LBW was 24% with 57% due to IUGR. It was significantly higher in recent immigrants, gravidity beyond three, smokeless tobacco uses during pregnancy, high risk pregnancies including multiple miscarriages and preterm deliveries. Five or more antenatal check-ups and > 6 Kg weight gain during pregnancy were protective. Conclusions: Ensuring adequate antenatal check- ups and weight gain during pregnancy, control of tobacco exposure and quality care for women with recurrent abortions and high risk pregnancy is imperative, particularly targeting recent migrants. Strengthening ongoing family planning programmes to increase spacing, identifying pregnancies at risk of preterm deliveries and improved care of premature newborns should be a priority.
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Background:A maternal near miss case is defined as a “a woman who nearly died but survived a complication that occurred during pregnancy,child birth or within 42 days of termination of pregnancy”1.MMR is defined as ratio of number of maternal deaths per 1000 live births. All pregnant women deserve a good quality of care especially Emergency Obstetric Care including proper infrastructure, human resources that can detect and manage such complications earliest. The objective of this study was to evaluate the causes of maternal near miss cases, various management modalities performed and maternal and fetal outcome in near miss cases. Material And Methods:A retrospective study was carried out in obstetrics and gynaecology department of SCL municipal general hospital, Ahmedabad for identification of MNM as per MNM-R operational guidelines (2014) in a tertiary care hospital from August 2020 to March 2022. Result:Total deliveries during our study period were 9266 out of which 535 number of patients developed complications, 75 patients ended up becoming near miss cases and 30 maternal mortalities were observed.Hypertensive disorders (38.6%) followed by severe anemia (18.6%) and haemorrhage (13.3%) were the commonest underlying causes leading to MNM. More than one management modality was followed in one case. 25% of patients required blood transfusion. Out of which 11 patients required massive blood transfusion (>5 units of blood) and 16% of patients required blood products along with blood resulting from either severe anemia or altered coagulopathy (DIC). 69.3% of patients required ICU stay of <5 days and majority of patients required hospital stay of 9-14 days.63.6% of patients required ICU stay of 1-4 days.Live birth rate was 82.6%.Conclusion:Maternal health is the direct indicator of prevailing health status in a country. Reduction in maternal mortality is one of the targets of MILLENIUM DEVELOPMENT GOALS13for 2015 but in spite of full efforts by all the health care professionals, it still remains a challenge in developing countries.There should be prompt and proper management of high-risk groups by frequent antenatal visits. Aggressive management of each complication and close monitoring of women in labour, decision making in mode and time of termination of pregnancy are important to prevent further complications.
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OBJECTIVE@#To investigate the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) in pregnant rats on lung dysplasia of newborn rats with intrauterine growth restriction (IUGR) induced by maternal food restriction.@*METHODS@#Twenty-four female SD rats were randomly divided into a control group, a control+EA group, a model group and a model+EA group, 6 rats in each group. From the 10th day into pregnancy to the time of delivery, the rats in the model group and the model+EA group were given with 50% dietary restriction to prepare IUGR model. From the 10th day into pregnancy to the time of delivery, the rats in the control+EA group and the model+EA group were treated with EA at bilateral "Zusanli" (ST 36), once a day. The body weight of offspring rats was measured at birth, and the body weight and lung weight of offspring rats were measured on the 21st day after birth. The lung function was measured by small animal lung function detection system; the lung tissue morphology was observed by HE staining; the content of peroxisome proliferator activated receptor γ (PPARγ) in lung tissue was detected by ELISA.@*RESULTS@#Compared with the control group, the body weight at birth as well as the body weight, lung weight, lung dynamic compliance (Cdyn) and PPARγ at 21 days after birth in the model group were significantly decreased (@*CONCLUSION@#EA at "Zusanli" (ST 36) may protect the lung function and lung histomorphology changes by regulating the level of PPARγ of lung in IUGR rats induced by maternal food restriction.
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Animals , Female , Pregnancy , Rats , Acupuncture Points , Electroacupuncture , Fetal Growth Retardation/therapy , Lung , Rats, Sprague-DawleyABSTRACT
Intrauterine growth restriction (IUGR) is related to a higher risk of neonatal mortality, minor cognitive deficit, metabolic syndrome, and cardiovascular disease in adulthood. In previous studies, genetic variants in the FTO (fat mass and obesity-associated) and PPARγ (peroxisome proliferator-activated receptor-gamma) genes have been associated with metabolic disease, body mass index, and obesity among other outcomes. We studied the association of selected FTO (rs1421085, rs55682395, rs17817449, rs8043757, rs9926289, and rs9939609) and PPARγ (rs10865710, rs17036263, rs35206526, rs1801282, rs28763894, rs41516544, rs62243567, rs3856806, and rs1805151) single-nucleotide polymorphisms (SNPs) with IUGR, through a case-control study in a cohort of live births that occurred from June 1978 to May 1979 in a Brazilian city. We selected 280 IUGR cases and 256 controls for analysis. Logistic regression was used to jointly analyze the SNPs as well as factors such as maternal smoking, age, and schooling. We found that the PPARγ rs41516544 increased the risk of IUGR for male offspring (OR 27.83, 95%CI 3.65-212.32) as well as for female offspring (OR=8.94, 95%CI: 1.96-40.88). The FTO rs9939609 TA genotype resulted in a reduced susceptibility to IUGR for male offspring only (OR=0.47, 95%CI: 0.26-0.86). In conclusion, we demonstrated that PPARγ SNP had a positive effect and FTO SNP had a negative effect on IUGR occurrence, and these effects were gender-specific.
Subject(s)
Humans , Male , Female , Adult , PPAR gamma/genetics , Alpha-Ketoglutarate-Dependent Dioxygenase FTO/genetics , Brazil/epidemiology , Body Mass Index , Case-Control Studies , Genetic Predisposition to Disease/genetics , Polymorphism, Single Nucleotide/genetics , Fetal Growth Retardation/genetics , GenotypeABSTRACT
Background: The objectives of this study was to study the prevalence of thyroid disorders in high risk neonatal populations and to study association of maternal thyroid dysfunction with neonatal thyroid problems and outcome.Methods: This was an observational study, conducted in NICU at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. The study included neonates born to mothers with thyroid disorder or with clinical features suggestive of thyroid dysfunction. Neonates with history of maternal thyroid dysfunction were screened at 72 to 96 hrs of postnatal age. Those with TSH >10 mIU/L or free T4 <1.1 ng /ml were followed up after two weeks. The neonates with clinical features suggestive of thyroid dysfunction were screened at presentation and those with abnormal thyroid profile were followed up after two weeks. Results obtained were statistically analyzed using SPSS 17.0 software.Results: Out of 260 neonates screened, 208 neonates were born to mothers with hypothyroidism, 6 neonates had increased levels of TSH during first week which normalised on follow up during third week. One neonate born to hyperthyroid mother, showed increased TSH levels during first week and 2nd week which declined to normal level on follow up at 3rd week. Out of 51 neonates with clinical features suggestive of thyroid dysfunction, born to euthyroid mothers, 3 neonates had increased levels of TSH on presentation which normalised on further follow up. Thus, majority of high risk neonates at birth show transient hypothyroidism.Conclusions: None of the neonate was labelled as hypothyroid, all the 10 neonates showed transient hyperthyrotropinemia.
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Background: Intrauterine growth restriction (IUGR) is one of the major reasons for neonatal morbidity and mortality. Oligohydramnios is a common finding in IUGR. In majority of these cases diminished utero-placental blood flow is observed. However, in spite of this understanding and identification of high-risk patients, the management options are limited. Sildenafil citrate, a phosphodiesterase type-5 inhibitor improves utero-placental perfusion.Methods: We present a retrospective interventional study involving 50 adult pregnant women diagnosed with early-onset IUGR (n=38) and oligohydramnios (n=12). Vaginal sildenafil citrate 25 mg t.i.d. was started from the day of diagnosis till delivery. Primary efficacy endpoints included changes in Doppler parameters i.e., amniotic fluid index (AFI), uterine artery (UA)- pulsatility index (PI), resistance index (RI) and systolic diastolic ratio (S/D ratio). Secondary endpoints included live birth, birth weight, Apgar score at birth, neonatal survival to hospital discharge and adverse maternal side effects.Results: There was a statistically significant improvement in UA-PI, RI and S/D ratios (p<0.0001) in all cases. In oligohydramnios cases, treatment showed a statistical significant increase in AFI score (2.86±1.33 cm). The mean birth weight on delivery was 2200 gm with good Apgar scores. No major adverse effects were reported by women using sildenafil citrate vaginally.Conclusions: Sildenafil citrate, by increasing utero-placental perfusion, improves uterine artery Doppler patterns, AFI, fetal weight and overall better neonatal survival rates by reducing neonatal morbidity and mortality. Sildenafil citrate may hold a promising treatment strategy for management of IUGR and oligohydramnios.
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Background: Estimation of serum PAPP-A levels studied predictability for adverse perinatal outcome. This case control study tries to establish the association between low PAPP-A levels among the pregnant woman and adverse maternal foetal outcome.Methods: This is an case-control study during 2017-2018 in the women delivered at Department of OBG at Mehta Hospitals. Women delivered in the labour room had a first trimester screening of PAPP-A level were explained, taken informed consent, questionnaire which include detailed antenatal history, mode of delivery and baby data. Depending upon outcome, the subjects are classified as case group or control group, out of the study sample of 264 subjects, 88 patients who had complications were taken as cases and 176 patients with no complications taken as control were undertaken.Results: Low PAPP-A level (<0.5 MoM) showed high incidence of PIH and preeclampsia, followed by IUGR and Preterm. PAPP-A level >0.5 MoM, normal outcome is more than the adverse outcome. The difference in the PAPP-A levels is statistically significant. In women with low PAPP A level, low birth weight found statistically significant when compared with <0.5 PAPP A level. The sensitivity of PAPP A levels in identifying the complicated outcomes was 17.04%.The specificity was 98.85%. The positive predictive value of predicting the complications was 88.23% and negative predictive value of 70.44%.Conclusions: The low PAPP-A levels confirmed during first trimester of pregnancy is associated with adverse maternal and foetal outcome such as PIH, preeclampsia, preterm, IUGR and LBW.
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Background: In India, the maternal and infant mortality rates have been steadily decreasing in recent years, but there has been no corresponding decrease in the perinatal mortality. Hence, there is need to evaluate the factors leading to this unfortunate event. The objective of this study was to find out various factors (especially preventable) responsible for perinatal stillbirths.Methods: An analytical comparative study in a tertiary care hospital comparing fresh and macerated still births over a period of one year in 2011 and 2017 and responsible factors were analysed.Results: Amazingly, despite improvement in the antenatal services, more institutional deliveries, there is no change in the incidence of still birth rate. However, there was decrease in the rate of still births due to extreme prematurity and congenital malformations. There was no change in incidence of PIH/ Eclampsia, IUGR and placental causes but there was substantial increase in the incidence of GDM.Conclusions: Perinatal mortality can definitely be reduced by strengthening and improving quality of antenatal services, early identification of high risk pregnancies, timely referral and appropriate intervention.
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Background: Fetal growth is a complex process whichdepends on nutrient and oxygen availability and transport fromthe mother to the fetus across the placenta. This involveshormones and growth factors as well as maternal and fetalgenes. The failure of the fetus to reach his or her full potentialfor growth is called intrauterine growth restriction (IUGR) andimplies risk for adverse short- and long-term outcomes.Objective: To study the frequency, risk factors and outcome ofthe clinical management of IUGR infants in the NICU of atertiary care hospital.Methods: This case control study was conducted from August2015 to July 2016 in the department of Neonatology,Bangabandhu Sheikh Mujib Medical University (BSMMU). Priorapproval from Institutional Review Board (IRB) for this researchwork was taken.After taking consent from parents/Guardians, particulars of theneonates, antenatal, natal and postnatal history were recordedin a data collection form. All Newborn in the NICU during studyperiod were the study population. Newborn who meet theinclusion criteria were divided into two groups as case group(IUGR babies) and control group (AGA babies). The riskfactors were identified by taking face to face interview ofmother regarding prenatal period whereas the outcome ofclinical management was observed by the caution and carefulNICU follow up of the baby. Data were analyzed by statisticalpackage for social sciences (SPSS) version 20. At firstfrequency of IUGR was found among all admitted newborn.Risk factors were analyzed to calculate the odds ratio. Thenrisk factors were analyzed with chi square test to find outsignificant risk factors. P values less than 0.05 (95% CI) wereconsidered statistically significant.Results: The frequency of IUGR babies in this one year studywas found 11.86%. Congenital malformation (p=0.02) wasfound as significant fetal risk factor. Congenital CMV infectionwas found in 16.3 % case of IUGR babies. Maternal weight(p=<0.001), height (p=<0.001), socioeconomic status of mother(p=0.001), Inter pregnancy Interval (p=0.04), placentalinsufficiency (p=0.001), Pregnancy Induced hypertension(p=0.001) are significant maternal risk factor. Hypoglycemia(p=0.007) and hyperbilirubinemia (p=<0.001) were foundsignificant co-morbidities. Length of hospital stay wassignificantly higher among IUGR babies (p= 0.001) thatproclaim the outcome of clinical management. In case group16.3% and in control 8.2% babies expired even after providingall available standard clinical management. Most of thepatients died due to sepsis in both the groups. But the mortalityshowed no significant differences as outcome of clinicalmanagement.Conclusion: IUGR babies in BSMMU was 11.86%. Maternalweight, height, inter pregnancy interval, socioeconomic status,Pregnancy induced hypertension, placental insufficiency, lessANC visits were maternal risk factors for IUGR babies.
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Introduction: In today’s world, infertility is one of themajor emerging health issues which effects about 8-9% ofreproductive age group. Infertility due to certain male factorsand complete tubal obstruction may require interventionalprocedure. Increased risk of adverse perinatal outcomes areassociated with ART. Study objctive was to asses perinataloutcome in pregnant women conceived with inventionaltechniques.Material and Methods: A Retrospective study was done attertiary care hospital from January 2018 to June 2018. anddata was collected. The maternal and fetal condition werenoted as per records.Results: Women > 40 years of age had 11.53% of intrauterinedeath, 65.38% requires NICU admission, 11.53% requiresventilator support and 7.69% had neonatal death.Study alsorevealed foetal complications like intra uterine death (pvalue=0.0004), fetal anomalies, IUGR (P value=0.0003)which were atleast four times more in ART group than inspontaneous conception.Study also revealed that out of 167new born in ART group,there were 28.74% having verylow birth weight,19.76% were having low birth weight and51.50% had adequate weight, i.e around half of them werehaving weight less than 2 kgs as compared to spontaneouspregnancy group were only 5.71% i.e 6 babies were born lessthan 2 kg weight(P value < .0001 highly significant).Conclusion: Maternal age was significantly associatedwith perinatal and obstetrical complications. To improvematernal and perinatal outcomes, pre-existing diseases likehypertension, anaemia, diabetes mellitus and hypothyroidismshould be treated before conception. Overall aim should beto minimize iatrogenic preterm birth for minor ailments,close supervision of such women can add few more weeks topregnancy thus improving neonatal outcome.
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Background: Maternal Nutrition plays an important role in shaping the mother’s and fetal health. Therefore intake of high salt, high fat, high sugar in the diet might lead to over nutrition among pregnant women due to varied food choices of the since most of the subjects consumed outside food, Sugar Sweetened Beverages such as (Cola, Pepsi, Thumps Up, Soda, Sherbet etc), Processed Food such as(Ready to eat food, Mayonnaise, Cheese spread etc) which consist of increase amount of preservative which might affect the mother and foetal’s health. Since there was increase intake of above food groups and decrease intake of macro and micronutrients in the diet through food group such as Fruits, Nuts and Oilseed, Green Leafy Vegetables etc. Therefore there might be increased risk of Over nutrition among women which might lead to GDM (Gestational Diabetes Mellitus), IUGR(Intra Uterine Growth Retardation), Low Birth weight etc.Aim: To study the impact of dietary pattern on Nutritional of pregnant women in Low and High Strata. Method: A purposive random sampling was done among pregnant women because only 2ndtrimester pregnant women were selected for the study. The 50 subjects were divided into LSES (Lower Socioeconomic Strata) &HSES (Higher Socioeconomic Strata) on the basis of Kuppuswamy Index. The dietary pattern of the subjects was assessed through FFQ (Food Frequency Questionnaire) & 3 Day Diet Recall. Result: There was increase consumptionof High Fat, High Salt, High Sugar in the diet through consumption if food group such as Outside Food, Processed Food, Sugar Sweetened Beverages etc and in comparison the consumption of Macro and Micronutrient rich food group was lower which included Fruits, Green Leafy Vegetables, Nuts and oilseed etc. In Lower Strata the consumption of above food group was low because they were financially not stable therefore they were given additional services where the company paid their ration balance so that they could consume selective food group which were costing comparatively more. Since the RDA(Recommended Dietary Allowances) requirements were not met therefore the women were prescribed Iron, Calcium and Folic Acid supplements in the diet to decrease the risk ofMaternal and fetal complication such as GDM(Gestational Diabetes Mellitus), NTD(Neural Tube Defect), IUGR(Intra Uterine Growth Retardation) etc.Conclusion: Therefore to decrease the risk of Maternal and Fetal Complications intake of Macro and Micro nutritions in the diet is imperative and it is important to organize Nutrition Intervention programmes and counsel the pregnant women about Maternal Nutrition and how decrease intake of Nutrients in the diet might lead to Maternal Under nutrition and over nutrition and its related risk
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Background: Oligohydramnios is defined as when on ultrasonography the single largest pocket in horizontal and vertical diameter is less than 2cm or amniotic fluid index is less than 5cm. Normal amniotic fluid index is 5-25cm. The overall incidence is 0.5 to more than 5%. However, the incidence increases in post dated pregnancies as many as 11%. It is increasing these days because of changes in lifestyle and also reduced maternal fluid intake.Methods: A prospective randomized study was done in Dept of Obstetrics and Gynaecology, MGMMC and MYH, Indore during the period of 6 months from 1st July 2017 to 31st December 2017. It included 200 cases from all the antenatal patients attending Antenatal OPD in routine and emergency and who are admitted in MYH beyond 28 weeks of pregnancy.Results: Most of the perinatal cases nearly 64% of babies were handover, 26% were IUDs (intra uterine devices) and rest 10% requiring neonatal care in nursery. The color Doppler changes showed normal flow in 54% in cases with 26% showing early fetal hypoxia and 14% showing uteroplacental insufficiency. Rest of the 6% cases were IUD. Incidence of IUGR was 50% in babies most commonly being constitutionally small. About 8% cases were found to be associated with abruption and 24% cases were found to be associated with pregnancy induced hypertension. Most common mode of delivery was vaginal delivery in 68% cases. However, 32% cases underwent LSCS.Conclusions: There has been reported cases of sudden IUD in severe oligohydramnios presenting with loss of fetal movements.