ABSTRACT
This study was conducted to evaluate the management of postdate pregnancy. Ninety-nine patients with a firmly established gestational age of more than 294 days were admitted to the Department of Obstetrics and Gynecology, Assiut University. They had no other complications. They compromised two groups, Group I consisted of 49 patients who were actively managed due to the presence of an abnormal finding suggesting fetal compromise. Group II consisted of 50 patients who were managed conservatively without intervention until the spontaneous onset of labor. The mean age, parity and gestational age were significantly higher in group II. The mean duration of the second stage of labor was longer in group I. Spontaneous vaginal delivery was more in group II, while ventouse extraction was more in group I. The mean birth weight was higher in group I. The mean Apgar score was significantly higher in group II. Meconium aspiration was present in eight babies of group I and in none of group II. Nineteen babies in group I needed admission to the Neonatal Intensive Care Unit, while only five in group II needed so. The incidence of CS was significantly higher among patients more than 30 years. Postdating was more in younger age group. The incidence of vaginal delivery was significantly higher in younger age group while that of CS showed the reverse
Subject(s)
Fetal Monitoring/standards , Practice Management, Medical/standards , PregnancyABSTRACT
Una de las preocupaciones mayores en perinatología es detectar en forma precoz los factores de riesgo maternofetales y las alteraciones placentarias que puedan deteriorar el bienestar fetal. Al respecto se han ideado múltiples formas de valoración del mismo, que van desde la percepción de movimientos fetales por la madre hasta el estudio de la circulación fetal con doppler, pasando por pruebas bioquímicas, valoración del líquido amniótico, monitoría fetal electrónica y perfil biofísico, las cuales tienen lugar en la práctica médica, de acuerdo al grado de tecnología disponible, pero siempre con criterio clínico. En esta revisión se describe el estado actual de todas estas pruebas, sus indicaciones, limitaciones y una guía para el tratamiento del sufrimiento fetal
Subject(s)
Humans , Female , Pregnancy , Fetal Distress/diagnosis , Fetal Monitoring , Fetal Monitoring/standards , Fetal Monitoring/trends , Fetal Monitoring/statistics & numerical dataABSTRACT
This study aimed at testing the value of daily fetal movement counting [DFMC] as a clinical method of antepartum fetal assessment in high risk pregnancy and its potential use as a screening test in low risk pregnancy. The study included comparison between DFMC and the more sophisticated methods as nonstress test [NST] and biophysical profile [BPP] regarding the perinatal outcome. A pilot phase including 100 normal pregnant women showed that time interval to perceive 10 fetal movements [FM] was 36 +/- 22 minutes [mean +/- SD]. A study phase including 40 high risk and 10 normal pregnant women showed that there was a significant association between decreased FM, nonreactive NST, poor BPP [<6/8] and poor perinatal outcome. Perinatal outcome was poor in as high as 50% of cases with decreased FM, while it was poor in only 2% of cases with normal FM. These results indicated that decreased FM places the fetus in a high risk category necessitating further evaluation of fetal condition. It is concluded that count-to- ten method of FMC is potentially useful in fetal assessment. Being reliable, simple, easy, inexpensive and noninvasive method, it can be used as a screening test on a wide scale. However, further larger study is recommended before extrapolation of the results
Subject(s)
Fetal Monitoring/standards , Pregnancy Complications , Prenatal Care/methodsABSTRACT
En la actualidad las altas tasas de mortalidad tanto materna como fetal de la diabetica embarazada se han reducido hasta casi igualarlas con la embarazada no diabetica gracias a los avances logrados en los metodos de control de la diabetes y la monitorizacion fetal. Sin embargo para lograr estos resultados es requisito indispensable el manejo estricto de la diabetes durante todo el embarazo de acuerndo a ls normas establecidas en la actualidad y ojala en unidades especializadas organizadas pra tal fin. De lo contrario la mortalidad especialmente perinatal seguira tan alta como siempre dependiendo de la severidad de la diabetes y el grado de control durante el embarazo. Ademas es importante la motivacion e informacion de la paciente quien debera asumir un papel activo en su control