Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, ...Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distress syndrome (RDS), Intrauterine fetal death (IUFD), and congenital anomaly were found with a higher percentage in overt hypothyroidism. Conclusion: Since the impact of hypothyroidism on fetomaternal morbidities have been identified so screening for hypothyroidism to be included as a routine screening test and should be treated accordingly to improve maternal and fetal outcome.展开更多
Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to...Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.展开更多
Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1...Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1000 per 100,000 births, compared to approximately 5 - 10 in developed countries. Over decades in Sub Saharan Africa preventive measures and treatment protocols have been made to reduce maternal mortality caused by PPH. While rates of postpartum hemorrhage have continued to rise, there is a need to evaluate if its etiology and patterns have changed over time. Broad Objective: This study aims at describing trends in incidence, causes and maternal outcomes of Postpartum Hemorrhage at Muhimbili National Hospital for a period of 7 years. Methodology: This is a retrospective descriptive hospital-based study that has included all cases of postpartum hemorrhage at Muhimbili National Hospital, a tertiary hospital in Tanzania from 2014 to 2020. The data was analyzed using SPSS Version 26 and presented using frequency tables, figures and percentages. The trends of postpartum hemorrhage over time were determined using chi-square test and P-value where less than 0.05 was considered statistically significant. Results: Overall, the incidence of postpartum hemorrhage has been fluctuating over the years with minimum of 1.78% and maximum of 2.87% with no statistical significance. Out of 1113 enrolled cases of PPH, 422 (37.9%) were attributed to genital tears followed by uterine atony 285 (25.6%). A statistically significant increase in linear trend was observed in the postpartum hemorrhage cases due to uterine atony, uterine rupture and sub analysis on genital tears (cervical tear). Overall, there was a statistically significant change in trend of maternal outcomes throughout the years, with a P-value < 0.001 and likelihood of complications increasing over time. Conclusion: The trend in the incidence of postpartum hemorrhage has been fluctuating over the years during the study period. The leading cause of postpartum hemorrhage was genital tears, followed by uterine atony with a significant increase in adverse maternal outcomes over the years. Continuous health education to medical personnel to improve timely and proper diagnosis of women in danger of PPH and timely referral, thus improve maternal morbidity and mortality.展开更多
Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal &...Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal & maternal outcome or any complications among the pregnant woman who had undergone emergency caesarean section. Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006. The patients underwent emergency caesarean section for any indication during the mentioned period of study was selected as study population. Among them, 100 cases were recruited in this study. Result: Among the cases, maternal morbidity was as high as 64% which were due to haemorrhage, post-operative infection, rise of blood pressure and other complications. Regarding fetal outcome, 92% babies were born with normal birth weight, 33% babies were developed complications which were mostly due to birth asphyxia and prematurity. Conclusion: In conclusion, emergency caesarean section has maternal morbidity as well as fetal and neonatal adverse outcome.展开更多
Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, ...Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, 2022 pregnant women 100 cases, combined with the difference of the care mode will be divided into two groups: control group (routine midwifery care) and observation group (midwifery care). Each group has 50 cases, statistical comparison two groups of natural delivery rate, neonatal Apgar score, 2h postpartum bleeding volume, neonatal asphyxia rate, labor time and satisfaction. Results: in terms of natural delivery rate, neonatal Apgar score, and nursing satisfaction, the observation group was significantly higher than the control group, with significant differences, statistical advantages, p0.05;for the neonatal asphyxia rate and labor time, the observation group was significantly smaller than the control group, with significant differences and statistical advantages, p0. 05 Conclusion: applying the responsibility system care mode to obstetric maternal can greatly affect the delivery mode, maternal and infant outcomes. Specifically, it is beneficial to improve the maternal natural delivery rate, neonatal Apgar score, satisfaction, etc., but also can effectively reduce maternal 2h postpartum blood loss, neonatal asphyxia rate, labor time, etc., so has a strong application value.展开更多
Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women ...Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.展开更多
Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was e...Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.展开更多
Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. ...Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The results of this study will enable us to update the frequency of AMA pregnancies in our environment. The socio-demographic and clinical profile of these pregnancies will be determined. The main maternal-fetal complications associated with AMA in our setting and the associated factors will be identified.展开更多
Background Preeclampsia is a common disease in pregnant women,characterized by clinical manifestations such as hypertension and proteinuria,which not only seriously affect the safety of pregnant women,but also jeopard...Background Preeclampsia is a common disease in pregnant women,characterized by clinical manifestations such as hypertension and proteinuria,which not only seriously affect the safety of pregnant women,but also jeopardize the safety of the fetus,threatening maternal and infant safety.Currently,in addition to routine hypoglycemic and antihypertensive treatments,auxiliary treatment methods such as exercise and diet are gradually gaining clinical recognition.Therefore,this study aimed to observe the effects of comprehensive nutrition care during pregnancy on weight control during pregnancy and maternal and infant outcomes in patients with pregnancy-induced hypertension syndrome.Methods A total of 100 cases of preeclampsia patients in our hospital from August 2021 to May 2022 were selected and randomly divided into a nutrition group and a conventional group,with 50 cases in each group.The conventional group received routine care,while the nutrition group received additional comprehensive nutrition care during pregnancy based on routine care.The weight control and blood pressure control during pregnancy and maternal and infant outcomes of the two groups were observed.Results The weight control during pregnancy in the nutrition group was significantly better than that in the conventional group(P<0.05).There was no significant difference in systolic and diastolic blood pressure between the two groups before intervention(P>0.05),but both systolic and diastolic blood pressure in both groups were lower after intervention,with the nutrition group significantly lower than the conventional group(P<0.05).The incidence of neonatal asphyxia,placental abruption,postpartum hemorrhage,and cesarean section in the nutrition group was significantly lower than that in the conventional group(P<0.05).Conclusions Comprehensive nutrition care during pregnancy can effectively control weight and blood pressure levels in patients with preeclampsia,and improve maternal and infant outcomes.[S Chin J Cardiol 2024;25(3):156-161]展开更多
BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is ver...BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.展开更多
Since the first report of COVID-19 in December 2019, our knowledge and treatment modalities have</span><span style="font-family:""> </span><span style="font-family:Verdana;&quo...Since the first report of COVID-19 in December 2019, our knowledge and treatment modalities have</span><span style="font-family:""> </span><span style="font-family:Verdana;">evolved at great pace understanding its impact on the maternal and neonatal outcomes. Whilst pregnant patients are not more susceptible to acquiring the infection as compared to the general population, they may be at higher risk of developing severe symptoms given the physiological changes, relative immune-compromised state of pregnancy, and their neonates at risk of consequent iatrogenic preterm deliveries. Our review article discusses outcomes of pregnant women and neonates with COVID-19 from several countries including the UK, USA, France, Italy and China</span><span style="font-family:""> </span><span style="font-family:Verdana;">and provides a narrative review of literature from November 2019 till December 2020.展开更多
Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonat...Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonatal outcome among term mothers with anaemia compared to non-anaemic pregnant women at a tertiary care centre in Sri Lanka. Method: A comparative cross-sectional study was performed by recruiting anaemic and non-anaemic term mothers who delivered at the Teaching Hospital Peradeniya during the period March 2018-March 2019. Pregnant mothers whose haemoglobin level was less than 10.5 g/dl were considered as anaemic and compared with the mothers whose haemoglobin level was above this level. With written consent, demographic data, etiological factors, maternal and neonatal outcomes of term mothers were evaluated by an interview and blood samples were withdrawn to carry out anaemia related investigations. Results: Among 2854 pregnancies, a total of 234 (8.19%) term pregnant mothers were anaemic and they were and compared with 199 non-anaemic mothers. Out of the anaemic mothers (Hb < 105 g/l), 133 (56.76%) had moderate anaemia, 100 (42.79%) had mild anaemia and 1 mother (0.45%) had severe anaemia. Low monthly family income was significantly associated with the incidence of anaemia. Anaemia was also associated with low weekly consumption of red meat (OR 8.994;95% CI, 5.74 - 14.09, p < 0.05) and high weekly tea intake (OR 0.217;95% CI 0.144 - 0.327, p < 0.05). Among anaemic mothers, 215 (67.44%) had low serum ferritin (<30 ng/mL) while most of them were diagnosed with iron deficiency anaemia (58.24%) (n = 113) based on haemoglobin. Most anaemic mothers had undergone elective caesarean section (46.26%) while vaginal deliveries (33.33%) were common among non-anamic group. Conclusions: A moderate prevalence of anaemia among term pregnant women in Peradeniya, Sri Lanka was observed and was associated with low socio economic status, low consumption of tea and poor nutrition lacking in red meat.展开更多
Objectives: Emergency cesarean is performed, when a situation requires immediate action in order to reduce the risk to mother and/or child, while urgent cesarean is done if a non-life threatening but compromising situ...Objectives: Emergency cesarean is performed, when a situation requires immediate action in order to reduce the risk to mother and/or child, while urgent cesarean is done if a non-life threatening but compromising situation occurs. The aim of the study was to investigate the maternal and fetal outcome for emergency and urgent cesarean. Study Design: A retrospective case-control study was performed;cases underwent emergency cesarean section, while controls underwent urgent cesarean section. We included 303 cases of women and 336 cases of children, and controls were matched. Maternal and fetal outcome parameters for singleton and twin pregnancies were investigated using the Wilcoxon test and the Chi-square-test. Results: Maternal outcome: Higher?blood loss (cases: mean 383.12 ± 232.89, range 100 - 2500 vs. controls: 336.06 ± 129.19, range 100?- 1000, p = 0.008), hemorrhage (34 vs. 11, p < 0.001) and puerperal anemia (30 vs. 10, p < 0.001). Neonatal outcome: One, five, and ten minutes Apgar levels and umbilical cord pH values are lower for cases (p < 0.001 and p < 0.001, respectively). Twins had lower five and ten minutes Apgar levels (p = 0.040 and 0.002), but higher umbilical cord pH values than singletons (p < 0.001). The perinatal mortality among singletons was 3.8%, among twins 8.1%. For cases the perinatal mortality among singletons was 5.7% and 17.14% for twins (control group 1.41% and 2.63%, respectively). Conclusion: The maternal and fetal outcome is poorer in emergency cesarean section. Especially the perinatal mortality is high in emergency cesarean section, particular for twins.展开更多
BACKGROUND The risk of severe coronavirus disease 2019(COVID-19)in pregnant women is elevated.AIM To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications,while providing...BACKGROUND The risk of severe coronavirus disease 2019(COVID-19)in pregnant women is elevated.AIM To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications,while providing a brief review of current literature.METHODS The study included pregnant women presenting from April 2020 to February 2022 to the emergency department(ED)of a tertiary hospital.We retrospectively recorded the maternal and perinatal files,including patient epidemiological and clinical characteristics,laboratory values,outcomes,treatment modalities and associations were explored.RESULTS Among the 60 pregnant women,25%required hospitalization,all of whom were symptomatic.Preterm delivery occurred in 30%of cases.Ten percent of neonates required admission to the neonatal intensive care unit,and 5%were classified as small for their gestational age.All mothers survived COVID-19 and pregnancy,with 6.6%requiring invasive mechanical ventilation.Preterm delivery rates did not differ between hospitalized and non-hospitalized pregnant women;composite unfavorable perinatal outcomes,including stillbirth,small for gestational age,or neonatal intensive care unit(ICU)admission,did not significantly increase in the cases hospitalized for COVID-19(P=0.09).The odds of hospitalization increased 2.3-fold for each day of delayed ED presentation[adj.OR(95%CI:1.46-3.624),P<0.001].Comorbidity status was an independent predictor of hospitalization,albeit with marginal significance[adj.OR=16.13(95%CI:1.021-255.146),P=0.048].No independent predictors of adverse fetal outcome(composite)were identified,and eventual hospitalization failed to reach statistical significance by a slight margin(P=0.054).CONCLUSION Delayed ED presentation and comorbidities increase hospitalization odds.This study highlights the importance of continuous and specific guidance for managing pregnant COVID-19 patients,including timely and appropriate interventions to minimize maternal and perinatal morbidity and mortality.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
[Objectives]To explore the efficacy of Danshen Injection combined with phosphocreatine disodium in treating frequent premature contractions during pregnancy and its effect on maternal and infant outcomes.[Methods]A to...[Objectives]To explore the efficacy of Danshen Injection combined with phosphocreatine disodium in treating frequent premature contractions during pregnancy and its effect on maternal and infant outcomes.[Methods]A total of 200 pregnant women with normal pregnancy and frequent premature contractions who were treated in the outpatient department of internal medicine in Women and Children's Hospital of Hubei Province and Xinzhou District People's Hospital of Wuhan Central Hospital during September 2015 and October 2018 were selected and randomly divided into the control group and observation group,100 cases for each group.The observation group was treated with Danshen Injection combined with phosphocreatine disodium,and the control group was treated with phosphocreatine disodium alone.The course of treatment in both groups was one week.During the treatment,the changes of heart rate,heart rhythm,electrocardiogram and 24-h dynamic electrocardiogram(DCG)of both groups were observed.[Results]After treatment,the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).There were no adverse drug reactions in both groups.However,in the control group,non-sustained ventricular tachycardia(NSVT)was found in 24-h dynamic electrocardiogram(DCG)of 2 pregnant women with premature ventricular contraction.The pregnancy process was smooth,with full-term natural delivery and no fetal malformation.There was no significant difference in gestational age and neonatal weight between the two groups(P>0.05).However,there was a statistically significant difference in Apgar score between the two groups(P<0.05).During the 6-month postpartum follow-up,the mother and child were unharmed,and examination of repeated electrocardiograms showed that the conditions were normal.[Conclusions]Danshen Injection combined with phosphocreatine disodium has better efficacy in the treatment of frequent premature contractions during pregnancy and the maternal and infant outcomes than the treatment with phosphocreatine disodium alone,and it has good safety and can prevent premature contractions from progressing to tachyarrhythmias.展开更多
Objective:To explore the clinical manifestations as well as maternal and infant outcomes of pregnancy complicated with thrombocytopenia.Methods:A total of 478 pregnant women with thrombocytopenia,treated in Shaanxi Pr...Objective:To explore the clinical manifestations as well as maternal and infant outcomes of pregnancy complicated with thrombocytopenia.Methods:A total of 478 pregnant women with thrombocytopenia,treated in Shaanxi Provincial People's Hospital from July 2019 to June 2021,were selected as the research group,while 200 nonnal pregnant women,treated during the same period,were selected as the control group to analyze gestational thrombocytopenia(GT),idiopathic thrombocytopenic purpura(ITP),pregnancy-induced hypertension(PIH),adverse maternal and infant outcomes,etc.Results:Among the 478 patients in the research group,the main causes of pregnancy complicated with thrombocytopenia were GT,ITP,and PIH,accounting for 75.51%,6.49%,and 8.79%,respectively,while other causes accounted for 9.21%.There was no significant difference between the research group and the control group in the amoxmt of intrapartum bleeding,premature delivery,stillbirth,thrombocytopenia,and neonatal asphyxia,but there was significant difference in the mode of delivery(P<0.05)・Conclusion:The traditional indexes of coagulation function are not abnormal with decreased platelets in pregnant women with thrombocytopenia,but the indexes of thromboelasticity are abnormal and can reflect the changes of coagulation function.The cesarean section rate of patients with thrombocytopenia in pregnancy increases with the decrease of platelet count,but the mode of delivery should be determined in consideration of specific conditions.展开更多
Objective: to study and analyze the effects of perinatal comprehensive management on glucose and lipid metabolism and maternal and infant outcomes in patients with gestational diabetes. Methods: 60 patients with gesta...Objective: to study and analyze the effects of perinatal comprehensive management on glucose and lipid metabolism and maternal and infant outcomes in patients with gestational diabetes. Methods: 60 patients with gestational diabetes admitted to our hospital from February 2020 to may 2022 were included. They were divided into the observation group and the control group (n 30) by double-blind random method. The control group carried out routine treatment of gestational diabetes, and the observation group carried out comprehensive perinatal management on the basis of routine treatment. Statistics and comparison were made on insulin related indicators, glucose and lipid metabolism levels, and maternal and infant outcomes between the two groups. Results: around 24 hours after delivery, the insulin resistance index of the observation group was lower than that of the control group. After delivery, the fasting blood glucose, glycosylated hemoglobin, total cholesterol and other glycolipid metabolism indexes of the observation group were lower than that of the control group. The incidence of adverse maternal and infant outcomes was lower than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: the application of perinatal comprehensive management in patients with gestational diabetes is helpful to improve insulin resistance index, glucose and lipid metabolism and maternal and infant outcomes.展开更多
Objective: to analyze the causes of maternal and infant outcomes and quality of life of early onset severe preeclampsia patients with predictive nursing. Methods: 72 patients with early onset severe preeclampsia admit...Objective: to analyze the causes of maternal and infant outcomes and quality of life of early onset severe preeclampsia patients with predictive nursing. Methods: 72 patients with early onset severe preeclampsia admitted to our hospital from May 2020 to April 2021 were randomly selected as the main research object. They were equally divided into the conventional group and the research group according to the way of drawing lots, with 36 patients in each group. For the patients in the conventional group, the conventional nursing mode was adopted, and the patients in the research group were given more predictive nursing on the basis. The maternal and infant pregnancy outcomes and their own quality of life of the two groups of patients were compared. Results: (1) the incidence of high-temperature intravascular coagulation, postpartum acute hemorrhage, liver/kidney function damage, cardiac function damage and placental abruption in the study group patients decreased significantly (P < 0.05), with statistical significance. (2) The Apgar score at 1 min after birth in the research group was significantly better than that in the conventional group, and the asphyxia rate was significantly lower than that in the conventional group. P < 0.05, with statistical significance. There was no significant difference between the two groups in the statistics of neonatal mortality (P > 0.05). (3) The quality of life scores of the patients in the study group were significantly better than those in the conventional group. P < 0.05, with statistical significance. Conclusion: predictive nursing measures can effectively help improve the outcome of mother and infant, and improve the survival and healthy quality of life of patients.展开更多
Objective: to evaluate the effect of antibiotic application duration on maternal and infant outcome in non-term treatment. Methods: a total of 100 cases of non-term membrane premature rupture were included, divided in...Objective: to evaluate the effect of antibiotic application duration on maternal and infant outcome in non-term treatment. Methods: a total of 100 cases of non-term membrane premature rupture were included, divided into 50 cases / groups according to the application time of antibiotics. The control group applied antibiotics after 12h and antibiotics within 12h in the observation group. Results: the observation group had longer membrane rupture, lower maternal complications, and neonatal complications were lower than the control group (p <0.05);there was no significant difference in neonatal mortality between the two groups (p> 0.05).Conclusion: antitreatment within 12h after premature rupture without term can greatly improve maternal and infant outcome.展开更多
文摘Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distress syndrome (RDS), Intrauterine fetal death (IUFD), and congenital anomaly were found with a higher percentage in overt hypothyroidism. Conclusion: Since the impact of hypothyroidism on fetomaternal morbidities have been identified so screening for hypothyroidism to be included as a routine screening test and should be treated accordingly to improve maternal and fetal outcome.
文摘Background: The timing of elective repeat cesarean delivery at 38 weeks versus 39 weeks is still a debatable subject, both regarding maternal and neonatal outcomes. In the Saudi context, there is lack of local data to aid decision-making regarding the timing of elective repeat cesarean delivery. Objectives: To estimate the rate of spontaneous onset of labor before the planned gestational age for repeat cesarean section in women who were booked at gestational age of (39 0/7 - 39 6/7) weeks (W39) versus (38 0/7 - 38 6/7) weeks (W38) and to compare the rate of maternal composite outcome between these groups. Design: Retrospective cohort. Setting: This study was conducted at King Abdulaziz Medical City, Jeddah, KSA. Method: Delivery registry books were reviewed to identify all deliveries from 1 January 2014 to 31 December 2016 (3 years). All low-risk pregnant women who had 2 or more cesarean deliveries and who met the inclusion criteria were included. Results: A total of 440 women were included of whom 318 (72.3%) were planned for elective cesarean section at W38 gestational age and 122 women at W39 gestational age. Mothers planned at W39 had higher rate of emergency cesarean deliveries versus those planned at W38 (18.0% versus 10.4%, p = 0.030;RR = 13.06), most frequently due to early onset of contractions (16.4% versus 8.2%, p = 0.012;RR = 12.17) or cervical dilatation (11.6% versus 5.4%, p = 0.024, RR = 16.15). No difference in the incidence of individual or composite maternal complications was noted between the two groups. Mother’s age (OR 0.93, p = 0.018) and schedule date at W39 (OR = 1.94, p = 0.028) were independently associated with spontaneous onset of labor before the scheduled gestational age, while no association was found with parity, previous number of spontaneous vaginal deliveries, number of previous cesarean deliveries or interval from last cesarean delivery. Conclusion: Elective cesarean section scheduled at 39 weeks of gestation or beyond carries a higher risk of emergency cesarean section, with no significant increase in maternal complications. The identification of factors associated with spontaneous onset of labor before the planned gestational age should be carefully identified to determine the optimal timing.
文摘Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1000 per 100,000 births, compared to approximately 5 - 10 in developed countries. Over decades in Sub Saharan Africa preventive measures and treatment protocols have been made to reduce maternal mortality caused by PPH. While rates of postpartum hemorrhage have continued to rise, there is a need to evaluate if its etiology and patterns have changed over time. Broad Objective: This study aims at describing trends in incidence, causes and maternal outcomes of Postpartum Hemorrhage at Muhimbili National Hospital for a period of 7 years. Methodology: This is a retrospective descriptive hospital-based study that has included all cases of postpartum hemorrhage at Muhimbili National Hospital, a tertiary hospital in Tanzania from 2014 to 2020. The data was analyzed using SPSS Version 26 and presented using frequency tables, figures and percentages. The trends of postpartum hemorrhage over time were determined using chi-square test and P-value where less than 0.05 was considered statistically significant. Results: Overall, the incidence of postpartum hemorrhage has been fluctuating over the years with minimum of 1.78% and maximum of 2.87% with no statistical significance. Out of 1113 enrolled cases of PPH, 422 (37.9%) were attributed to genital tears followed by uterine atony 285 (25.6%). A statistically significant increase in linear trend was observed in the postpartum hemorrhage cases due to uterine atony, uterine rupture and sub analysis on genital tears (cervical tear). Overall, there was a statistically significant change in trend of maternal outcomes throughout the years, with a P-value < 0.001 and likelihood of complications increasing over time. Conclusion: The trend in the incidence of postpartum hemorrhage has been fluctuating over the years during the study period. The leading cause of postpartum hemorrhage was genital tears, followed by uterine atony with a significant increase in adverse maternal outcomes over the years. Continuous health education to medical personnel to improve timely and proper diagnosis of women in danger of PPH and timely referral, thus improve maternal morbidity and mortality.
文摘Background: Caesarean Section done in emergency basis can result some adverse outcome to both the fetus & mother & complications may arise. Objective: The purpose of the present study was to see the fetal & maternal outcome or any complications among the pregnant woman who had undergone emergency caesarean section. Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006. The patients underwent emergency caesarean section for any indication during the mentioned period of study was selected as study population. Among them, 100 cases were recruited in this study. Result: Among the cases, maternal morbidity was as high as 64% which were due to haemorrhage, post-operative infection, rise of blood pressure and other complications. Regarding fetal outcome, 92% babies were born with normal birth weight, 33% babies were developed complications which were mostly due to birth asphyxia and prematurity. Conclusion: In conclusion, emergency caesarean section has maternal morbidity as well as fetal and neonatal adverse outcome.
文摘Objective: to consider the impact of responsibility system midwifery care on obstetric maternal delivery mode and maternal and infant outcomes. Method: screening out between our hospital obstetric March, 2021- March, 2022 pregnant women 100 cases, combined with the difference of the care mode will be divided into two groups: control group (routine midwifery care) and observation group (midwifery care). Each group has 50 cases, statistical comparison two groups of natural delivery rate, neonatal Apgar score, 2h postpartum bleeding volume, neonatal asphyxia rate, labor time and satisfaction. Results: in terms of natural delivery rate, neonatal Apgar score, and nursing satisfaction, the observation group was significantly higher than the control group, with significant differences, statistical advantages, p0.05;for the neonatal asphyxia rate and labor time, the observation group was significantly smaller than the control group, with significant differences and statistical advantages, p0. 05 Conclusion: applying the responsibility system care mode to obstetric maternal can greatly affect the delivery mode, maternal and infant outcomes. Specifically, it is beneficial to improve the maternal natural delivery rate, neonatal Apgar score, satisfaction, etc., but also can effectively reduce maternal 2h postpartum blood loss, neonatal asphyxia rate, labor time, etc., so has a strong application value.
文摘Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.
文摘Objective: To examine the effects of comprehensive nursing interventions on maternal and infant outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: A quasi-experimental design was employed, involving 60 pregnant women with GDM who were purposively selected and randomly allocated into experimental and control groups, each comprising 30 participants. The experimental group received comprehensive nursing interventions and pregnancy monitoring, while the control group received standard nursing care. Data collection was conducted using demographic questionnaires, pregnancy indicators, and maternal-infant outcome measurement tools. The collected data were analyzed using Microsoft Excel and the Statistical Package for Social Sciences (SPSS). Results: The findings indicated significant improvements in fasting blood glucose, postprandial blood glucose, amniotic fluid index, and neonatal birth weight in the experimental group compared to the control group. However, no statistically significant differences were observed in body mass index (BMI) or pregnancy weight gain. Comprehensive nursing interventions were associated with a significant reduction in maternal complications, including polyhydramnios, postpartum hemorrhage, and preeclampsia, as well as neonatal complications such as neonatal pneumonia, macrosomia, and hypoglycemia. Conclusion: Comprehensive nursing interventions have a positive impact on maternal and neonatal outcomes in pregnant women with GDM.
文摘Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The results of this study will enable us to update the frequency of AMA pregnancies in our environment. The socio-demographic and clinical profile of these pregnancies will be determined. The main maternal-fetal complications associated with AMA in our setting and the associated factors will be identified.
文摘Background Preeclampsia is a common disease in pregnant women,characterized by clinical manifestations such as hypertension and proteinuria,which not only seriously affect the safety of pregnant women,but also jeopardize the safety of the fetus,threatening maternal and infant safety.Currently,in addition to routine hypoglycemic and antihypertensive treatments,auxiliary treatment methods such as exercise and diet are gradually gaining clinical recognition.Therefore,this study aimed to observe the effects of comprehensive nutrition care during pregnancy on weight control during pregnancy and maternal and infant outcomes in patients with pregnancy-induced hypertension syndrome.Methods A total of 100 cases of preeclampsia patients in our hospital from August 2021 to May 2022 were selected and randomly divided into a nutrition group and a conventional group,with 50 cases in each group.The conventional group received routine care,while the nutrition group received additional comprehensive nutrition care during pregnancy based on routine care.The weight control and blood pressure control during pregnancy and maternal and infant outcomes of the two groups were observed.Results The weight control during pregnancy in the nutrition group was significantly better than that in the conventional group(P<0.05).There was no significant difference in systolic and diastolic blood pressure between the two groups before intervention(P>0.05),but both systolic and diastolic blood pressure in both groups were lower after intervention,with the nutrition group significantly lower than the conventional group(P<0.05).The incidence of neonatal asphyxia,placental abruption,postpartum hemorrhage,and cesarean section in the nutrition group was significantly lower than that in the conventional group(P<0.05).Conclusions Comprehensive nutrition care during pregnancy can effectively control weight and blood pressure levels in patients with preeclampsia,and improve maternal and infant outcomes.[S Chin J Cardiol 2024;25(3):156-161]
文摘BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.
文摘Since the first report of COVID-19 in December 2019, our knowledge and treatment modalities have</span><span style="font-family:""> </span><span style="font-family:Verdana;">evolved at great pace understanding its impact on the maternal and neonatal outcomes. Whilst pregnant patients are not more susceptible to acquiring the infection as compared to the general population, they may be at higher risk of developing severe symptoms given the physiological changes, relative immune-compromised state of pregnancy, and their neonates at risk of consequent iatrogenic preterm deliveries. Our review article discusses outcomes of pregnant women and neonates with COVID-19 from several countries including the UK, USA, France, Italy and China</span><span style="font-family:""> </span><span style="font-family:Verdana;">and provides a narrative review of literature from November 2019 till December 2020.
文摘Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonatal outcome among term mothers with anaemia compared to non-anaemic pregnant women at a tertiary care centre in Sri Lanka. Method: A comparative cross-sectional study was performed by recruiting anaemic and non-anaemic term mothers who delivered at the Teaching Hospital Peradeniya during the period March 2018-March 2019. Pregnant mothers whose haemoglobin level was less than 10.5 g/dl were considered as anaemic and compared with the mothers whose haemoglobin level was above this level. With written consent, demographic data, etiological factors, maternal and neonatal outcomes of term mothers were evaluated by an interview and blood samples were withdrawn to carry out anaemia related investigations. Results: Among 2854 pregnancies, a total of 234 (8.19%) term pregnant mothers were anaemic and they were and compared with 199 non-anaemic mothers. Out of the anaemic mothers (Hb < 105 g/l), 133 (56.76%) had moderate anaemia, 100 (42.79%) had mild anaemia and 1 mother (0.45%) had severe anaemia. Low monthly family income was significantly associated with the incidence of anaemia. Anaemia was also associated with low weekly consumption of red meat (OR 8.994;95% CI, 5.74 - 14.09, p < 0.05) and high weekly tea intake (OR 0.217;95% CI 0.144 - 0.327, p < 0.05). Among anaemic mothers, 215 (67.44%) had low serum ferritin (<30 ng/mL) while most of them were diagnosed with iron deficiency anaemia (58.24%) (n = 113) based on haemoglobin. Most anaemic mothers had undergone elective caesarean section (46.26%) while vaginal deliveries (33.33%) were common among non-anamic group. Conclusions: A moderate prevalence of anaemia among term pregnant women in Peradeniya, Sri Lanka was observed and was associated with low socio economic status, low consumption of tea and poor nutrition lacking in red meat.
文摘Objectives: Emergency cesarean is performed, when a situation requires immediate action in order to reduce the risk to mother and/or child, while urgent cesarean is done if a non-life threatening but compromising situation occurs. The aim of the study was to investigate the maternal and fetal outcome for emergency and urgent cesarean. Study Design: A retrospective case-control study was performed;cases underwent emergency cesarean section, while controls underwent urgent cesarean section. We included 303 cases of women and 336 cases of children, and controls were matched. Maternal and fetal outcome parameters for singleton and twin pregnancies were investigated using the Wilcoxon test and the Chi-square-test. Results: Maternal outcome: Higher?blood loss (cases: mean 383.12 ± 232.89, range 100 - 2500 vs. controls: 336.06 ± 129.19, range 100?- 1000, p = 0.008), hemorrhage (34 vs. 11, p < 0.001) and puerperal anemia (30 vs. 10, p < 0.001). Neonatal outcome: One, five, and ten minutes Apgar levels and umbilical cord pH values are lower for cases (p < 0.001 and p < 0.001, respectively). Twins had lower five and ten minutes Apgar levels (p = 0.040 and 0.002), but higher umbilical cord pH values than singletons (p < 0.001). The perinatal mortality among singletons was 3.8%, among twins 8.1%. For cases the perinatal mortality among singletons was 5.7% and 17.14% for twins (control group 1.41% and 2.63%, respectively). Conclusion: The maternal and fetal outcome is poorer in emergency cesarean section. Especially the perinatal mortality is high in emergency cesarean section, particular for twins.
基金the institute ethics committee of the University Hospital of Patras(Approval No.:477/24.11.2022).
文摘BACKGROUND The risk of severe coronavirus disease 2019(COVID-19)in pregnant women is elevated.AIM To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications,while providing a brief review of current literature.METHODS The study included pregnant women presenting from April 2020 to February 2022 to the emergency department(ED)of a tertiary hospital.We retrospectively recorded the maternal and perinatal files,including patient epidemiological and clinical characteristics,laboratory values,outcomes,treatment modalities and associations were explored.RESULTS Among the 60 pregnant women,25%required hospitalization,all of whom were symptomatic.Preterm delivery occurred in 30%of cases.Ten percent of neonates required admission to the neonatal intensive care unit,and 5%were classified as small for their gestational age.All mothers survived COVID-19 and pregnancy,with 6.6%requiring invasive mechanical ventilation.Preterm delivery rates did not differ between hospitalized and non-hospitalized pregnant women;composite unfavorable perinatal outcomes,including stillbirth,small for gestational age,or neonatal intensive care unit(ICU)admission,did not significantly increase in the cases hospitalized for COVID-19(P=0.09).The odds of hospitalization increased 2.3-fold for each day of delayed ED presentation[adj.OR(95%CI:1.46-3.624),P<0.001].Comorbidity status was an independent predictor of hospitalization,albeit with marginal significance[adj.OR=16.13(95%CI:1.021-255.146),P=0.048].No independent predictors of adverse fetal outcome(composite)were identified,and eventual hospitalization failed to reach statistical significance by a slight margin(P=0.054).CONCLUSION Delayed ED presentation and comorbidities increase hospitalization odds.This study highlights the importance of continuous and specific guidance for managing pregnant COVID-19 patients,including timely and appropriate interventions to minimize maternal and perinatal morbidity and mortality.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
基金the Project of National Natural Science Foundation of China(81370337&81970331).
文摘[Objectives]To explore the efficacy of Danshen Injection combined with phosphocreatine disodium in treating frequent premature contractions during pregnancy and its effect on maternal and infant outcomes.[Methods]A total of 200 pregnant women with normal pregnancy and frequent premature contractions who were treated in the outpatient department of internal medicine in Women and Children's Hospital of Hubei Province and Xinzhou District People's Hospital of Wuhan Central Hospital during September 2015 and October 2018 were selected and randomly divided into the control group and observation group,100 cases for each group.The observation group was treated with Danshen Injection combined with phosphocreatine disodium,and the control group was treated with phosphocreatine disodium alone.The course of treatment in both groups was one week.During the treatment,the changes of heart rate,heart rhythm,electrocardiogram and 24-h dynamic electrocardiogram(DCG)of both groups were observed.[Results]After treatment,the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(P<0.01).There were no adverse drug reactions in both groups.However,in the control group,non-sustained ventricular tachycardia(NSVT)was found in 24-h dynamic electrocardiogram(DCG)of 2 pregnant women with premature ventricular contraction.The pregnancy process was smooth,with full-term natural delivery and no fetal malformation.There was no significant difference in gestational age and neonatal weight between the two groups(P>0.05).However,there was a statistically significant difference in Apgar score between the two groups(P<0.05).During the 6-month postpartum follow-up,the mother and child were unharmed,and examination of repeated electrocardiograms showed that the conditions were normal.[Conclusions]Danshen Injection combined with phosphocreatine disodium has better efficacy in the treatment of frequent premature contractions during pregnancy and the maternal and infant outcomes than the treatment with phosphocreatine disodium alone,and it has good safety and can prevent premature contractions from progressing to tachyarrhythmias.
文摘Objective:To explore the clinical manifestations as well as maternal and infant outcomes of pregnancy complicated with thrombocytopenia.Methods:A total of 478 pregnant women with thrombocytopenia,treated in Shaanxi Provincial People's Hospital from July 2019 to June 2021,were selected as the research group,while 200 nonnal pregnant women,treated during the same period,were selected as the control group to analyze gestational thrombocytopenia(GT),idiopathic thrombocytopenic purpura(ITP),pregnancy-induced hypertension(PIH),adverse maternal and infant outcomes,etc.Results:Among the 478 patients in the research group,the main causes of pregnancy complicated with thrombocytopenia were GT,ITP,and PIH,accounting for 75.51%,6.49%,and 8.79%,respectively,while other causes accounted for 9.21%.There was no significant difference between the research group and the control group in the amoxmt of intrapartum bleeding,premature delivery,stillbirth,thrombocytopenia,and neonatal asphyxia,but there was significant difference in the mode of delivery(P<0.05)・Conclusion:The traditional indexes of coagulation function are not abnormal with decreased platelets in pregnant women with thrombocytopenia,but the indexes of thromboelasticity are abnormal and can reflect the changes of coagulation function.The cesarean section rate of patients with thrombocytopenia in pregnancy increases with the decrease of platelet count,but the mode of delivery should be determined in consideration of specific conditions.
文摘Objective: to study and analyze the effects of perinatal comprehensive management on glucose and lipid metabolism and maternal and infant outcomes in patients with gestational diabetes. Methods: 60 patients with gestational diabetes admitted to our hospital from February 2020 to may 2022 were included. They were divided into the observation group and the control group (n 30) by double-blind random method. The control group carried out routine treatment of gestational diabetes, and the observation group carried out comprehensive perinatal management on the basis of routine treatment. Statistics and comparison were made on insulin related indicators, glucose and lipid metabolism levels, and maternal and infant outcomes between the two groups. Results: around 24 hours after delivery, the insulin resistance index of the observation group was lower than that of the control group. After delivery, the fasting blood glucose, glycosylated hemoglobin, total cholesterol and other glycolipid metabolism indexes of the observation group were lower than that of the control group. The incidence of adverse maternal and infant outcomes was lower than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: the application of perinatal comprehensive management in patients with gestational diabetes is helpful to improve insulin resistance index, glucose and lipid metabolism and maternal and infant outcomes.
文摘Objective: to analyze the causes of maternal and infant outcomes and quality of life of early onset severe preeclampsia patients with predictive nursing. Methods: 72 patients with early onset severe preeclampsia admitted to our hospital from May 2020 to April 2021 were randomly selected as the main research object. They were equally divided into the conventional group and the research group according to the way of drawing lots, with 36 patients in each group. For the patients in the conventional group, the conventional nursing mode was adopted, and the patients in the research group were given more predictive nursing on the basis. The maternal and infant pregnancy outcomes and their own quality of life of the two groups of patients were compared. Results: (1) the incidence of high-temperature intravascular coagulation, postpartum acute hemorrhage, liver/kidney function damage, cardiac function damage and placental abruption in the study group patients decreased significantly (P < 0.05), with statistical significance. (2) The Apgar score at 1 min after birth in the research group was significantly better than that in the conventional group, and the asphyxia rate was significantly lower than that in the conventional group. P < 0.05, with statistical significance. There was no significant difference between the two groups in the statistics of neonatal mortality (P > 0.05). (3) The quality of life scores of the patients in the study group were significantly better than those in the conventional group. P < 0.05, with statistical significance. Conclusion: predictive nursing measures can effectively help improve the outcome of mother and infant, and improve the survival and healthy quality of life of patients.
文摘Objective: to evaluate the effect of antibiotic application duration on maternal and infant outcome in non-term treatment. Methods: a total of 100 cases of non-term membrane premature rupture were included, divided into 50 cases / groups according to the application time of antibiotics. The control group applied antibiotics after 12h and antibiotics within 12h in the observation group. Results: the observation group had longer membrane rupture, lower maternal complications, and neonatal complications were lower than the control group (p <0.05);there was no significant difference in neonatal mortality between the two groups (p> 0.05).Conclusion: antitreatment within 12h after premature rupture without term can greatly improve maternal and infant outcome.
