A Prospective Study to Find Out the Perinatal and Maternal Outcome in Patients with Polyhydramnios: A Institutional Based Study

Background: Polyhydramnios is the term for abnormalincrease in the amniotic fluid. With better facilities for detailedinvestigation of mother and fetus, more causative factors canbe identified and this helps in the counseling of parentsregarding etiology of polyhydramnios, fetal prognosis,recurrence risk and different management options for the babyif it needs medical & surgical care after birth. The aim of thisstudy to find out the perinatal and maternal outcome in patientswith polyhydramnios.Material & Methods: This is a prospective study done on 100unselected pregnancies attending the antenatal clinic inDepartment of Obstetrics and Gynecology department of RNTMedical College Udaipur. All patients attending ANC wereasked to participate at the time of booking (between 16 to 20weeks gestation) and were subjected to USG to rule outcongenital anomalies. We than investigated the relative risks ofthese events to adverse perinatal outcome by adjusting thevariants.Results: In our study, there were 30% preterm deliveries, 4%cases have small for gestational age babies, 5% had large forgestational age babies, 10% had meconium for which they hademergency caesarean section, 16% cases were admitted inNICU , for respiratory distress syndrome and prematurity. 45%of the patient had anemia, 12% were Rh negative while 43%had no associated abnormality. There were many perinatalcomplications. Out of them preterm birth was the mostcommon complication.Conclusion: We concluded that PPROM, Preterm labor andPPH were the major maternal complications during pregnancy.Polyhydramnios is associated with high perinatal mortality rate

Flora vaginal anormal y resultado perinatal adverso / Abnormal vaginal flora and adverse perinatal outcome

El parto pretérmino y sus complicaciones constituyen uno de los problemas más relevantes en el campo de la atención perinatológica. Se ha demostrado su estrecha relación con la infección intraútero, de manera que las alteraciones de la flora vaginal son la puerta de entrada. El objetivo de esta revisión es actualizar a la comunidad médica de esta disciplina en la necesidad de identificar la vaginosis bacteriana y la vaginitis aeróbica, tanto en el nivel primario de atención como en el secundario, lo cual permitirá realizar acciones preventivas y terapéuticas en la etapa preconcepcional, a fin de minimizar las infecciones intraútero y su relación con el nacimiento pretérmino, así como las complicaciones a corto y largo plazo. Se concluye que el diagnóstico de ambas afecciones necesita de un control preventivo y terapéutico para la reducción de las complicaciones perinatales.

Preterm birth and its complications are one of the most important problems in the field of perinatology care. Its close relationship with intrauterine infection has been demonstrated, so that changes of vaginal flora are the gateway. The purpose of this review is to update the medical community of this specialty on the need for identifying bacterial vaginosis and aerobic vaginitis, both at the primary and secondary care, allowing to perform preventive and therapeutic actions on the preconception stage, in order to minimize intrauterine infections and their relation to preterm birth and complications in the short and long term. It is concluded that the diagnosis of both conditions requires a preventive and therapeutic control for reducing perinatal complications.

Obstetric and Neonatal Outcomes of the Teenage Pregnancy

PURPOSE: In recent years, Korea has showed a steady increase in the frequency of teenage births, while the overall birth rate has declined. As the teenage birth is known as a high risk pregnancy itself, we examined perinatal complications of teenage mothers and whose neonates in aspects of medical problem, and social status and support. METHODS: We examined the perinatal characteristics of teenage mothers and whose babies, who were hospitalized at Korea University Ansan Hospital from January 2004 to July 2009 using medical records retrospectively. Twenty-seven teenage mothers and their 28 babies were enrolled in this study. RESULTS: Teenage mothers were all unmarried and showed high rates of preterm labor, maternal anemia, and unexpected delivery. Among them, 11 (40.7%) were from families that were separated. Eleven mothers (40.7%) did not have any antenatal care. There were high rates of prematurity and low birth weight (60.7% and 64.3%, respectively). The complication included: respiratory distress syndrome, patent ductus arteriosus and necrotizing enterocolitis. Fourteen babies (51.9%) were not going to be brought up by their biological parents. CONCLUSION: Teenage pregnancy had high rates of preterm labor and associated complications, often caused by the lack of proper antenatal care. Babies from unmarried mothers were likely to be adopted and this could be a social burden. Therefore, to reduce unplanned teenage pregnancy and births, sex education and social supports should be provided to all teenagers.

Perinatal Effects of Persistent Intrauterine Infection with Antibiotic Administration in The Rabbit / 대한산부인과학회잡지

OBJECTIVE: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. METHODS: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. RESULTS: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). CONCLUSION: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.

Cord blood levels of IL-6 in Neonates with Perinatal Complication

PURPOSE: IL-6 is one of the cytokines which is important mediators of host response to stress and infection. But, little is known about the activities of IL-6 in neonates with complicated course. So, We measured Il-6 levels in cord blood serum and which were compared neonates with perinatal complication with healthy neonats. METHOD: In a prospective study, level of IL-6 were measured in cord blood serum from 29 neonates (38.8+/-2.66wks, 3075.52+/-669.37gm) by specific immunoassay (Quantikine Human IL-6 immunoassay, RandD systems Inc., D6050), who delivered in Wonkwang University Hospital from May 1995 to July 1995. Statistical significance was analyzed with Mann-Whitney U test. RESULT: 1) IL-6 serum level in cord blood did not differ in neonates born by varying type of delivery. 2) IL-6 serum levels in cord blood were not related to perinatal complications. 3) IL-6 serum levels in cord blood were significantly higher in the neonates with infectious complication(128.0+/-29.74pg/ml) than non-infecatious complication(54.63+/-11.63pg/ml, p<0.05) and in healthy neonates (49.46+/-20.89pg/ml, p<0.02) CONCLUSION: Levels of IL-6 in cord blood serum were elevated in neonates with infectious complication. So, prospective measurement of IL-6 in cord blood may be useful in infection of perinatal period.