Vaginal deliveries in a tertiary centre: a current profile

Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.

Materanal and neonatal outcomes of triplet gestation in a tertiary care centre: a retrospective study

Background: A significant rise in triplet pregnancy rate has occurred recently. This rise is of concern, as these infants are frequently reported as a risk factor of adverse outcome. The aim of this study was to retrospectively study the outcomes of triplet births.Methods: A retrospective study was undertaken to analyze the clinical data of all patients with triplet gestation admitted to the labour room of Dr. Baba Saheb Ambedkar Hospital, Delhi to study the maternal and fetal outcomes. Authors retrospectively observed and analyzed the database to examine triplet gestations delivered between January 2014 and December 2018.Results: Over the five-year study period, there were total 44,011 deliveries. Out of these, there were 35 (0.079%) triplet pregnancies. Of all the triplet pregnancies studied 80% resulted from ovulation induction and assisted reproductive technology. The mean gestational age at delivery was 31.6±3.0 weeks, and the mean birth weight was 1,594±460 gm. The most common maternal complications were Preterm labour in 32 pregnancies (92%), anemia in 17 (49%), pre-eclampsia in 11 (31%), post-partum hemorrhage in 8 (22%). Of the total deliveries neonatal complications included Respiratory distress syndrome in 44 (42.2%), Hyperbilirubinemia in 41 (39%), Intrauterine growth restriction in 19 (18.1%). The perinatal mortality rate was 10.5%.Conclusions: Higher order pregnancies are associated with maternal and neonatal complications. These high risk women need more care and the neonates require intensive care and monitoring after birth, most commonly due to prematurity and low birth weight.

A cohort study on risk factors for preterm births in rural Gujarat

Background: Prematurity is one of the leading causes of neonatal and under-five mortalities globally and also in India. It is an important determinant of short- and long-term morbidities in infants and children. Unfortunately, risk factors of majority of preterm births (PTBs) remain unexplained which calls for appropriate action. There is a dearth of community-based research on PTB and its risk factors, especially in high burden countries like India. Objectives: The objective of the study was to explore different risk factors for PTB. Methods: A cohort of 1977 antenatal mothers was enrolled at household level by trained field investigators and was followed up in four districts of Gujarat, India, to document the outcome of pregnancy. Pretested and structured questionnaires were used to collect information. A hierarchical regression model was used to analyze the risk factors for PTB. Results: Proportion of PTB was 9% among the enrolled cohort. Risk factors which were found to be significant on applying the hierarchical model were periodontal disease, long sleep duration, and sex during any trimester. Conclusions: The study suggests an urgent need for strengthening of existing guidelines for effective, evidence-based, and culturally appropriate interventions for prevention of PTB. Maintenance of good oral hygiene should find a place in routine recommendations for pregnant women, and antenatal examinations should include screening for oral hygiene also.

Changes in Neonatal Epidemiology during the Last 3 Decades in Korea

Neonatal intensive care units have been present in Korea since the past 30 years, after their introduction in the 1980s. Neonatal and infant mortality rates have remarkably reduced with improvement in the survival rates of high-risk infants such as very-low-birth-weight infants and early preterm infants, as a result of recent advance in therapeutic modalities, equipment, and support systems. It may be useful to summarize the statistical changes that have occurred over the past 30 years in neonatal outcomes with respect to neonatal epidemiology. The present review aims to summarize these outcomes with respect to neonatal epidemiology, such as analysis of the number of births; crude birth rate; incidence of preterm-birth, multiple-birth, and low-birth-weight infants; neonatal and infant mortality; survival rate and morbidity of very-low-birth-weight-infants; and changes in neonatal causes of death. This review is intended to contribute to further development in neonatal intensive care as well as normal nursery care by summarizing the the historical neonatal epidemiologic data for the last 3 decades in Korea.

Comparison of Respiratory Morbidity in Late Preterm and Term Infants at a Single Institution

OBJECTIVE: This study was carried out to evaluate short-term respiratory morbidity in late preterm births compared with term births at a single center in Korea. METHODS: In retrospective study, we reviewed medical records of neonates that were born at Soonchunhyang University Bucheon Hospital from January 2002 to January 2011 and their mothers. The neonates were divided into two groups by their gestational age (GA): 535 late preterm births (GA, 34+0 to 36+6 weeks) and 3,037 term births (GA, 37+0 to 41+6 weeks). We compared late preterm births and term births in regard to maternal characteristics, neonatal characteristics, respiratory morbidities, and respiratory supports. RESULTS: Of 535 late preterm births, 117 (21.9%) had respiratory tract disease. Of 3,037 term births, 105 (3.5%) had respiratory tract disease. Compared term births, late preterm births had significantly more respiratory diseases such as apnea (odds ratio [OR], 37.3), respiratory distress syndrome (OR, 34.0), transient tachypnea of newborn (OR, 5.9), and pneumonia (OR, 2.2). Duration of oxygen supply was longer in term than in preterm births. Oxygen supply through isolette and use of surfactant were more frequent in late preterm than term births. It was not differ from two groups to use continuous positive airway pressure and mechanical ventilation. CONCLUSION: This study showed that late preterm births had significantly higher respiratory morbidity than term births. Therefore, we should have more attention to evaluate and manage when late preterm birth occur than before. Also it is necessary to study long-term respiratory outcomes of late preterm births and discuss about perinatal care system.