Study of the effect of maternal panic disorders on pregnancy and its outcome

The occurrence of panic disorders during pregnancy raises a number of clinical challenges including the effects of these diseases and their treatment due to the prenatal exposure of psychotropic drugs on fetus and pregnant women. The objective of the study was to evaluate the possible association between panic disorders during pregnancy and pregnancy complications, as well as birth outcomes regarding gestational age and birth weight. A sample of fifty five women was selected from the private maternity clinics at Zagazig city. A control group of 33 pregnant women without panic disorder were included in the study. The study tools included a questionnaire sheet, concerning demographic information, life stresses and anxiety scale and maternal observation sheet until delivery and neonatal assessment using newborn weight and gestational age. The data were collected from February 2006 to the end of November 2006. The results revealed that among pregnancy complications anemia had a higher prevalence in women with panic disorder. Some pregnant women with panic disorders had a shorter gestational age and a larger proportion of preterm births. However, there was a significant difference between the two groups regarding drugs used for panic disorders. Panic disorders during pregnancy were associated with anemia, a shorter gestational age and a proportion of preterm birth. Further studies are needed to confirm and explain the effect of panic disorders during pregnancy on birth weight, gestational age and preterm birth

Problems encountered among women with gestational diabetes and pregnancy outcome

Gestational diabetes mellitus is the most common medical complication of pregnancy. It occurs in women who have insulin resistance and a relative impairment of insulin secretion. Identifying this group of women is important in not only preventing prenatal morbidity but also improving long-term outcomes for the mothers and their children[1]. Diagnosis and treating pregnancies complicated by gestational diabetes mellitus [GDM] are important for preventing adverse perinatal outcomes. Diagnosis is usually accomplished early in the third trimester of pregnancy because the insulin content of the amniotic fluid starts to increase between the 24[th] and 28[th] week of gestation[2]. The goals of treatment are to maintain blood glucose levels within normal limits during duration of the pregnancy or labor and ensure the well being of the fetus and mothers[3]. This study was conducted to identify problems that are found among parturient with gestational diabetes and assess pregnancy outcomes among parturient with gestational diabetes. A sample of 200 parturient women was selected from Zagazig University hospital or public Zagazig hospital with the following criteria: The women being in labor, having gestational diabetes and being either primigravida and multigravida. The women were selected from labor unit. The study tools included a questionnaire sheet. Maternal assessment sheet and neonatal assessment sheet using Apgar scoring, estimation of blood glucose level and assessment of the anthropometric measurements. The data were collected over a period of 12 months starting from May 2004 to the end of April 2005. The results revealed that, the most common maternal problems among parturient women on admission were polyhydramnios and vaginal infection in 20% and 22% respectively. Moreover, the quarter of the sample [25%] had preterm labor. Also three fourths of parturient women have encountered problems during labor [75%], the most frequent of these problems was cesarean section [60%]. Regarding the neonatal outcome, the results illustrated that the majority of neonates [82%] had their Apgar score at first minute between 5 and 7, at the fifth minute still about one third were in the range 0-4 while 24% reached the range 8-10. The most common neonates problems were hypoglycemia [54%], [50%] had macrosomia, 25% were preterm, and congenital anomalies accounted for 10% of the cases. So, it is recommended that women with gestational diabetes should be counseled regarding the potential hazards and risks involved for both maternal and neonatal outcome. Proper care during prenatal, natal and postnatal period can prevent maternal, fetal and neonatal complications through identifying those with higher risk of developing such complications, they should have a clear protocol for management of these complications

Outcome of preterm premature rupture of membranes

Preterm premature rupture of membranes is commonly used to refer to rupture of the membranes when it occurs before term. The period between preterm rupture of membranes and the onset of labor is called latency period. Membrane rupture may occur for a variety of reasons: weakening of the membranes or intrauterine infection. The complications resulting from premature rupture of membranes include preterm labor and delivery, intra uterine infection, and umbilical cord compression secondary to umbilical cord prolapse or oligo hydramnios. This study was conducted to identify the optimal outcome preterm premature rupture of membranes. A sample of fifty women was selected from the maternity hospital at Zagazig university hospitals with the following criteria: women with gestational age range from 32-36 weeks and with the diagnosis of preterm premature rupture of membranes. Setting: the women where selected from delivery unit. The study tools included a questionnaire sheet, maternal observation sheet until delivery, mode of deliver, and neonatal assessment using Apgar scoring and weight. The data were collected over period of 6 months starting from May 1[st], 2003. the results revealed that in more than three quarter [80%] of the women the temperature was up to 37 °C and only 10% of them had high blood pressure [140/90]. Also, more than half of the women were delivered by caesarian section [CS], the most common cause for CS was fetal distress. Regarding neonatal outcome, the results illustrated that 24% of the neonates needed NICU care, and 20% of them had high temperature. So, it is recommended that women with premature rupture of membranes [PROM] should be counseled regarding the potential hazards and risks involved for both maternal and neonatal outcome and they must be observed and managed at hospital with adequate intensive care facilities