Overview of fetomaternal outcome in twin gestation

Background: Twin pregnancy, involving the presence of two fetuses in the uterus, has intrigued humanity across history. Key challenges presented by twin pregnancies include prematurity, low birth weight (LBW), intrauterine growth restriction (IUGR), birth trauma, asphyxia, and congenital anomalies. Preterm delivery poses the most significant risk, contributing to elevated perinatal mortality, neonatal morbidity, and long-term health issues for twins.Methods: Retrospective study at Smt NHL Municipal Medical College analyzed 80 twin pregnancies from July 2022 to January 2024. Data included patient demographics, complications, and neonatal outcomes, informing findings through data analysis.Results: In this study, the majority were under 30 years old (56%) and primigravida (68%), with 48% having a BMI over 30. Common complications included preterm labor (70%), pregnancy-induced hypertension (27.5%), and gestational diabetes (20%). Most twin pregnancies were dichorionic diamniotic (80%). Caesarean section rate was 47.5%. Deliveries mostly occurred between 33-36 weeks gestation, with cephalic-cephalic presentation being most common (40%). Neonatal complications were primarily prematurity (50%), resulting in high NICU admissions (62%) and a neonatal death rate of 13.76%.Conclusions: Multiple pregnancies require early diagnosis and vigilant care to reduce maternal and perinatal risks. Access to skilled healthcare providers and advanced facilities is crucial. Antenatal care must be strengthened for timely referrals. Ultrasonography aids early complication detection. Further advancements and awareness are essential for improved outcomes.

An overview of periodontal disease in pregnancy

Periodontal disease (PD), an inflammatory and infectious condition affecting the tissues supporting teeth, is prevalent among pregnant women due to hormonal changes. Studies indicate a link between PD and adverse pregnancy outcomes, including preterm labor and low birthweight newborns, likely due to increased inflammatory mediators. Oral pathogens like Tannerella forsythia and Porphyromonas gingivalis have been associated with these complications. The most prevalent oral conditions affecting pregnant women that may influence the course of their pregnancy are periodontitis, gingivitis, and dental caries. From supragingival plaques to subgingival infections and PD, these conditions are linked to one another. Elevated maternal serum antibodies to these pathogens and inflammatory markers correlate with poor pregnancy outcomes. Animal models further support the connection between PD and fetal health issues. While research suggests that periodontal treatment may reduce the risk, the exact mechanisms remain complex and multifactorial. Integrating dental care into prenatal care is vital for prevention and management.

FETO-MATERNAL AND NEONATAL COMPLICATIONS ASSOCIATED WITH HYPOTHYROIDISM IN PREGNANCY

Objective: To analyze and report the maternal, fetal, and neonatal complications in Antenatal hypothyroid women and to give the frequency of the co-existence of Anemia with Hypothyroidism in pregnancy.Methods: A Prospective and an observational study was conducted on 200 Antenatal hypothyroid women admitted to the Obstetrics ward. In the period of 6 mo (August 2022-January 2023), the study was carried out through the examination of medical records of Antenatal women with Hypothyroidism.Results: Of 200 Antenatal hypothyroid women enrolled in the study, Denovo Hypothyroidism was seen in 56% of women. Maternal complications reported include–(Lower Segment Cesarean Section) LSCS seen in 54.5%, Preeclampsia in 19%, mild anemia in 28%, (Post-Partum Hemorrhage) PPH in 7.5%,(Premature Rupture Of Membranes) PROM in 11.5%, Oligohydramnios in 24.5% of women. Fetal complications found were in fetal distress in 21%, in 32.5 %, Respiratory distress in 17.5%, and Low birth weight in 16% of Neonates.Conclusion: Our study concludes that the number of pregnant women affected by Hypothyroidism has increased to a larger extent. Hence, the suspected risk factors of Hypothyroidism have to be addressed and monitored closely to decrease the rate of feto-maternal and neonatal complications in pregnancy, vital for the overall well-being of hypothyroid mothers and their babies.

Third trimester HbA1c and the association with large-for-gestational-age neonates in women with gestational diabetes

ABSTRACT Objective: To evaluate the association between HbA1c levels measured in the third trimester and the risk for large for gestational age (LGA) in neonates of mothers affected by gestational diabetes mellitus (GDM). Secondarily, we aimed to identify an ideal cut-off for increased risk of LGA amongst pregnant women with GDM. Materials and methods: Observational retrospective review of singleton pregnant women with GDM evaluated in a diabetes and pregnancy clinic of a tertiary and academic hospital. From January/2011 to December/2017, 1,085 pregnant women underwent evaluation due to GDM, of which 665 had an HbA1c test in the third trimester. A logistic regression model was performed to evaluate predictors of LGA. A receiver-operating-characteristic (ROC) curve was used to evaluate the predictive ability of third trimester HbA1c for LGA identification. Results: A total of 1,085 singleton pregnant women were evaluated during the study period, with a mean age of 32.9 ± 5.3 years. In the multivariate analysis, OGTT at 0 minutes (OR: 1.040; CI 95% 1.006-1.076, p = 0.022) and third trimester HbA1c (OR: 4.680; CI 95% 1.210-18.107, p = 0.025) were associated with LGA newborns. Using a ROC curve to evaluate the predictive ability of third trimester HbA1c for LGA identification, the optimal HbA1c cut-off point was 5.4% where the sensitivity was 77.4% and the specificity was 71.7% (AUC 0.782; p < 0.001). Conclusions: Few studies in the Mediterranean population have evaluated the role of HbA1c in predicting neonatal complications in women with GDM. A third trimester HbA1c > 5.4% was found to have good sensitivity and specificity for identifying the risk of LGA.

Risk factors for cardiac, obstetric, and neonatal complications in patients with heart disease during pregnancy / Factores de riesgo para complicaciones cardíacas, obstétricas y neonatales en pacientes con enfermedad cardíaca durante el embarazo

Abstract Objective: Heart disease in pregnancy can cause clinical deterioration and maternal-fetal death. It is essential to evaluate risk factors related to complications. Methodology: This was a observational, analytical retrospective cohort study with a non-probabilistic convenience sample of pregnant women with congenital or acquired heart disease, corrected or not, or arrhythmias requiring urgent intervention. Patients with mild or moderate valvular regurgitation, mild valvular stenosis, patients without echocardiography or without delivery information were excluded from the study. The outcome was a composite of cardiac, obstetric, and neonatal events. Univariate and multivariate analyzes were performed with logistic regression model and discriminatory capacity with area under the curve and independent analysis of the modified World Health Organization (mWHO) risk classification (mWHO). Results: A total of 104 patients with an average age of 25 ± 6.5 years presented cardiac events in 13.5%, obstetric in 14.42%, and neonatal in 28.85%. The univariate analysis found an association with New York Heart Association functional status, hypertensive disorders of pregnancy, cesarean delivery, gestational age < 27 weeks, hypoxemia, and mWHO risk. In multivariate only cesarean delivery (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.05-6.86) and gestational age at delivery (OR, 0.39; 95% CI, 0.22-0.67) maintain association with outcomes. The area under the curve for the mWHO risk is 0.75. Conclusions: There is a high rate of adverse events in patients with heart disease during pregnancy. Gestational age and cesarean delivery behaved as predictors of adverse maternal-fetal outcomes. The mWHO risk classification had an acceptable prediction of adverse outcomes.

Resumen Objetivo: La enfermedad cardíaca en el embarazo puede ocasionar deterioro clínico y muerte maternofetal. Es indispensable evaluar factores de riesgo relacionados con complicaciones. Método: Estudio observacional y analítico de cohorte retrospectivo con muestra no probabilística por conveniencia de embarazadas con cardiopatía congénita o adquirida, corregida o no, o arritmias que requerían intervención urgente. Se excluyó a pacientes con insuficiencias valvulares leves o moderadas, estenosis valvulares leves, pacientes sin ecocardiografía o sin información del parto. El desenlace fue un compuesto de episodios cardíacos, obstétricos y neonatales. Se realizó análisis univariado y multivariado con modelo de regresión logística y capacidad diferenciadora con área bajo la curva y análisis independiente de la clasificación de riesgo de la OMS modificada (OMSm). Resultados: 104 pacientes con edad promedio de 25 ± 6.5 años presentaron episodios cardíacos en 13.5%, obstétricos en 14.42% y neonatales en 28.85%. El análisis univariado encontró una relación con el estado funcional de la NYHA, trastornos hipertensivos del embarazo, parto por cesárea, edad gestacional < 27 semanas, hipoxemia y riesgo de la OMSm. En el multivariado sólo el parto por cesárea (OR, 2.68; IC 95%, 1.05-6.86) y la edad gestacional al momento del parto (OR, 0.39; IC 95%, 0.22-0.67) mantienen nexo con los desenlaces. El área bajo la curva para el riesgo de la OMSm es de 0.75. Conclusiones: Hay una elevada tasa de efectos adversos en pacientes con enfermedad cardíaca durante el embarazo. La edad gestacional y el parto por cesárea se comportaron como predictores de resultados adversos maternofetales. La clasificación de riesgo de la OMSm tuvo una predicción aceptable de desenlaces adversos.

Early weight trends in preterm babies post discharge

Background: Prematurity is the major determinant of morbidity and mortality in newborns. Infants born preterm are at increased risk for impaired growth. The postnatal growth pattern is dependent on biological factors like birth weight, gestational age, sex and intrauterine growth. The present study was undertaken to study the risk factors associated with the preterm delivery and to study the weight gain pattern among the preterm neonates after NICU discharge for a period of one month. Aims and objectives to study the risk factors associated with preterm and to analyze the weight gain pattern of the preterm till one-month post NICU discharge.Methods: A total of 40 preterm were included during the study period of 2 months, the various maternal risk factors were studied and correlated with preterm delivery. The neonatal complications were studied. The neonates were divided on the basis of their gestational age and birth weight. They were then followed for a period of 1-month post NICU discharge.Results: There was significant correlation of lower gestational age with neonatal complications and prolonged duration of hospitalization. The weight gain pattern was highly variable with a maximum gain of 188 gm after first week of NICU discharge. Weight gain was significantly more in first week after discharge amongst neonates who had birth weight less than 1.5 kg and also the total weight gain was significantly more in neonates who weighed less than 1.5 kg at birth.Conclusions: Lower gestational age group 28-32 weeks was significantly associated with neonatal complications and prolonged duration of hospitalization. Immediate follow up of the preterm is necessary as there is wide variability in the weight gain pattern in various gestational age groups.

Study of fetomaternal outcome in cases of premature rupture of membrane at tertiary care rural institute of Western Uttar Pradesh, India

Background: Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Preterm PROM complicates approximately 3 percent of pregnancies and leads to one third of preterm births. It increases the risk of prematurity and leads to a number of other perinatal and neonatal complications.Methods: This was a prospective study carried out at the department of obstetrics and gynaecology, UPUMS, Saifai from April 2018 to September 2018 (6 months study). Patients with Spontaneous rupture of membranes any time beyond 28th week of pregnancy, but before the onset of labour. Patients with following conditions were excluded from the study- meconium stain liquor, cord prolapse, antepartum haemorrhage, active infection at other sites, active liver disease.Results: A total of 103 cases of premature rupture of membrane (PROM) were recorded from April 2018 to September 2019 among 1523 admitted pregnant patients. Most of the patients 56 (54.36%) were delivered by caesarean section (C/S). Previous C/S, oligohydramnios, fetal distress, chorioamnionitis were the common indications for doing C/S. Forty-seven (45.63%) patients were delivered vaginally.Conclusions: Most of the affected women belongs to 20-24 years of age (53.39%). Term PROM was more in comparison to PPROM and most of them were multigravidae. Cesarean section rate was high. Most common complication was of subclinical urogenital infection (51.02%).

Investigative Parameters, Maternal and Neonatal Outcome in Patients with Pregnancy Induced Hypertension: A Hospital Based Observational Study

Background: Pregnancy induced hypertension (PIH) occur in women with pre-existing primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. Preeclampsia is one of the maternal diseases that cause complications to mother and fetus both. Methods: An observational cross sectional study was done in ANMMCH, a tertiary care hospital in Gaya, Bihar. All PIH patients were included in the study period of one year. Investigative workup was done after due clinical check up. The maternal outcomes were further divided into normal outcome, Eclampsia and other complications Perinatal outcome measures that was studied include live births, fetal growth restriction (IGUR), still births, neonatal complications and deaths. Results: A total of 75 patients of PIH were selected for the study. Maximum (57.3%) were in age group of 25-35 year. 45.3% were from urban area while 22.7% were working. 60% were primigravida. 50.7% were delivered vaginaly. Most common presenting symptom was labour pain, followed by edema and headache. Most common complication was CNS symptom including seizure (Eclampsia) in 16% patients followed by vaginal bleeding in 9.3%. Other complications were pulmonary edema in 8% and HELLP syndrome in 2.2% patients. 5 patients died. Most common neonatal outcome was low birth weight. Renal failure was present in 6.7% patients Visible jaundice was present in 4% patients. Conclusion: Preeclampsia is associated with multiple maternal and neonatal complications. Early diagnosis and treatment through regular antenatal check-up is a key factor to prevent hypertensive disorders of pregnancy and its complications. So, complete clinical and biochemical workup is necessary for appropriate management of PIH patients.

Perinatal outcome of hypertensive pregnant women is related to the severity of preeclampsia

Introduction: Hypertension in pregnancy plays a key role in perinatal morbidity and mortality. This study aims to analyze maternal and perinatal outcomes associated with hypertension in pregnant women. Methods: A prospective longitudinal study was conducted at the University Hospital of Santa Maria, RS, Brazil, involving hypertensive pregnant women admitted for delivery. The results were analyzed using the chi-square test and the Mann-Whitney test. Results: Of the 162 hypertensive pregnant women studied, 61.1% were diagnosed with preeclampsia. Cesarean section was the most frequent mode of delivery (79.6%). Overall, 46.2% of newborns were premature; of these, 23.4% required intensive neonatal care. Preeclampsia and severe preeclampsia were associated with prematurity in 56.2% of cases (p = 0.011) and 75.7% of cases (p = 0.004), respectively. Severe preeclampsia was associated with neonatal complications (45.9%), and no neonatal complications were associated with mild preeclampsia in 78% (p = 0.014) and gestational hypertension in 96% (p = 0.001). Neonatal deaths occurred in 11.1% of cases admitted to the neonatal intensive care unit, corresponding to a neonatal mortality rate of 24 per 1,000 live births. Conclusions: The association of severe preeclampsia with prematurity and adverse perinatal outcomes corroborates the need . (AU)

¿Puede un sistema de estándares e indicadores de calidad relacionados a cesárea reducir la morbi-mortalidad materna? / Can a system of quality standards and indicators related to caesarean section reduce maternal morbidity and mortality?

Antecedentes: la aplicación de estándares e indicadores de atención materno neonatal en unidades que no utilizan parámetros de calidad mejora el cumplimiento de actividades en la atención prenatal, del parto, del posparto, del recién nacido y de las complicaciones perinatales relacionadas a cesárea. Objetivo: implementar y monitorizar la tendencia de cumplimiento trimestral de un sistema de estándares e indicadores de complicaciones obstétricas y neonatales relacionadas a cesárea y su impacto en la morbimortalidad materna ­ neonatal. Metodología: intervención de carácter prospectivo "antes y después", a realizarse en el Servicio de Obstetricia de la Unidad Metropolitana de Salud Sur de Quito durante 15 meses. Se realizó el levantamiento de la línea de base epidemiológica de cesárea; se socializó y capacitó al personal en el uso del "Manual de Estándares, Indicadores e Instrumentos para medir la Calidad de la Atención Materno-Neonatal" del Ministerio de Salud Pública y se realizaron monitoreos trimestrales de cumplimiento. Resultados: se alcanzan niveles de cumplimiento significativos (p≤0,05) hacia el noveno mes de intervención en 11 de los 17 estándares de calidad seleccionados. A corto plazo determina una reducción significativa de la razón de mortalidad neonatal y una estabilización de la mortalidad materna. No se disminuyó la frecuencia de cesáreas ni la estancia hospitalaria. Conclusión: los resultados apoyan el uso permanente de un sistema de monitorización utilizando estándares e indicadores de complicaciones obstétricas y neonatales relacionados a cesárea para mejorar la calidad de atención médica. (AU)

Background: the application of standards and indicators of maternal neonatal care in units that do not use quality parameters improves regulatory compliance activities on prenatal care, childbirth, postpartum, of the newborn and perinatal complications related to caesarean section. Objective: implement and monitor the trend of compliance quarterly of a system of standards and indicators of obstetric and neonatal complications related to caesarean section and its impact on maternal mortality and morbidity. Methodology: intervention prospective "before and after", to be held in the obstetrics service of the health South of Quito Metropolitan unit for 15 months. Was the lifting of the epidemiological baseline of Caesarea; were you socialized and trained staff in the use of the "Manual of standards, indicators and instruments to measure the quality of Maternal-Neonatal care" of the Ministry of public health; and quarterly monitoring of compliance were carried out. Results: significant levels of compliance are achieved (p≤0. 05) to ninth month of intervention in 11 of the 17 selected quality standards. To short term determines a reduction significant of the reason of mortality neonatal and a stabilization of the mortality maternal. Not decreased the frequency of caesarean section or hospital stay. Conclusion: the results support the use of a monitoring system using standards and indicators of obstetric and neonatal complications related to caesarean section to improve the quality of health care.

Neonatal outcomes in early term neonates versus term neonates in a tertiary care hospital – A cross sectional comparative study.

Background: Preterm birth is one of the chief causes of neonatal mortality and morbidity. The larger studies presented higher rate of adverse outcomes in association to term infants in contrast of neonatal mortality and morbidity. The majority of studies confirmed significantly higher rate of adverse outcomes in preterm in the contrast of neonatal mortality and morbidity. In this contest, we studied Ramprakash MA, Charanraj H, Manikumar S, Srinivasan K, Umadevi L, Giridhar S, Rathinasamy. Neonatal outcomes in early term neonates versus term neonates in a tertiary care hospital - A cross sectional comparative study. IAIM, 2016; 3(4): 21-26. Page 22 the association between different antenatal parameters between early term neonates and full term neonates and to compare neonatal complications. Materials and methods: A total 180 neonates born in the study setting, for a period of 6 months were included and study was conducted in Department of Neonatology and Obstetrics and Gynecology in a tertiary care teaching hospital in south India. A structured and validated case report form was designed for the purpose of data collection. The tool was validated by including the inputs from five experts in the subject area. Descriptive analysis of demographic parameters, antenatal and intra natal parameters were done. Chi square test was used to assess the statistical significance of the association. P value < 0.05 was considered as statistically significant. IBM SPSS version 21 was used for statistical analysis. Results: A total of 180 infants were included in the study, out of which 92 infants (51.1%) were early term and the remaining 88 (48.9%) were full term infants. The odds of early term pregnancy were 2.44 (95 % CI 1.04 to 5.7, p value 0.028) times higher in diabetic mothers, compared to mothers without diabetes. The odds of early term pregnancy was 4.08(95% CI 1.66 to 10.06, p value 0.001) for maternal hypertension and 11.81(95% CI 1.50 to 93.77, p value 0.004) for maternal anemia. The proportion of LSCS was quite high in early term pregnancy, compared to term pregnancy (52.2% Vs 18.2%, p value <0.001). The proportion of small for gestational age (SGA) babies was 29.7% in early term pregnancies (P value 0.011). The odds of hypoglycemia were 3.42 times more in ET pregnancies, compared to full term pregnancies (OR 3.423, 95 % CI 1.37 to 8.52, p value 0.006). Conclusion: The early-term delivery is associated with greater morbidity. There was reasonable relationship was evident involving maternal diabetes mellitus, hypertension, anemia, IUGR and early term pregnancy. The proportion of LSCS was reasonably high in early term pregnancy with slightly higher proportion small for gestational age babies. Neonatal intensive care admissions were found higher in early term than full term pregnancies. Further, there is continual relationship between gestational age and neonatal morbidity from early pregnancy

Resultados perinatales en gestantes con bajo peso pregestacional / Perinatal outcomes in pregnant women with low weight prior pregnancy

Introducción: la malnutrición por defecto es crítica en el período gestacional al traer consigo resultados adversos para la salud materna, fetal y del recién nacido.Objetivo: determinar los resultados perinatales en gestantes con bajo peso pregestacional en Santa Cruz del Norte durante 2 años.Métodos: se realizó un estudio analítico observacional prospectivo entre julio de 2009 y junio de 2011 a partir de un universo de 152 embarazadas con bajo peso en el momento de la captación. Se escogió una muestra al azar de 112 gestantes que conformó el grupo estudio; se dispuso de un grupo control de 219 pacientes normopeso en el mismo período, escogidas al azar de los consultorios médicos siguiendo múltiples criterios. Los datos se recolectaron mediante revisión de las historias clínica y obstétrica y se procesaron empleando medidas estadísticas descriptivas e inferenciales.Resultados: en las pacientes con bajo peso pregestacional se observó de manera significativa la amenaza de parto pretérmino en 20,5 porciento; rotura prematura de las membranas en 17,9 porciento; ganancia insuficiente de peso en 43,8 porciento; restricción del crecimiento en 14,3 porciento; malformaciones congénitas en 2,7 porciento; parto pretérmino en 6,3 porciento y bajo peso al nacer en 8,9 porciento; el distrés respiratorio fue la complicación significativa del recién nacido con 10,7 porciento y la endometritis y sepsis urinaria, en las puérperas con 16,1 porciento y 5,4 porciento respectivamente.Conclusiones: los trastornos nutricionales por defecto al inicio de la gestación traen consigo un aumento en la morbilidad materna y perinatal al incrementar el riesgo de afecciones obstétricas, fetales, puerperales y del recién nacido

Introduction: default malnutrition is critical in the gestational period since it results adversely for maternal, fetal and newborn health.Objective: to determine the perinatal outcome in pregnant women with low weight prior pregnancy in Santa Cruz del Norte for 2 years.Methods: we performed a prospective observational analytical study from July 2009 to June 201. Our universe was 152 pregnant women with low weight when recruiting, a sample of 112 pregnant women were chosen to formed the study group and a control group of normal-weight 219 patients was formed randomly from the medical practices following multiple criteria. The data were collected by the review of clinical and obstetric records and they were processed using descriptive and inferential statistics.Results: significantly, patients with low pre-pregnancy weight were observed to have preterm labor (20.5 per cent), premature rupture of membranes (17.9 per cent), insufficient weight gain (43.8 per cent), growth restriction (14.3 per cent), congenital malformations (2.7 per cent), preterm delivery (6.3 per cent), and low birth weight (8.9 per cent). Respiratory distress was a significant complication in newborns (10.7 per cent), and endometritis and urinary sepsis in the postpartum women (16.1 per cent and 5.4 per cent respectively).Conclusions: nutritional disorders at the beginning of pregnancy bring an increase in maternal and perinatal morbidity, since the risk of obstetrical, fetal, postnatal and newborn conditions increased

Prevalencia de controles prenatales incompletos en un servicio de maternidad y su relación con complicaciones neonatales / Prevalence of prenatal complete care in a Maternity and their relationship to neonatal complications

El control prenatal reduce la morbilidad y mortalidad materna y perinatal, partos prematuros y el número de productos con bajo peso al nacer, a la vez que permite identificar factores de riesgo, lo cual hace posible establecer acciones preventivas y terapéuticas oportunas durante el embarazo. Se considera control prenatal completo (CPC) al que cumple con las siguientes premisas: precoz, periódico, completo y de amplia cobertura. Con el objetivo de determinar la prevalencia de CPC en la población de embarazadas que consultaron al servicio de maternidad del hospital “Ángela I. de Llano” y establecer la relación entre el número de controles y complicaciones neonatales precoces, se llevó a cabo un estudio retrospectivo en el que se analizaron las historias clínicas del periodo junio a diciembre de 2010. Sobre 823 mujeres incluidas en el estudio, el 51% no presentó controles que cumplieran con los criterios de precocidad,cantidad, distribución, integralidad y calidad; las complicaciones neonatales fueron mayores en el grupo de controles incompletos. El 6,2% de los recién nacidos en el grupo sin control presentó bajo peso. El ingreso a neonatología fue del 9,7% en el grupo de controles incompletos y del 4,9% en el de controles completos. El porcentaje de óbitos fetales fue del 1,1% en el grupo de controles incompletos. Puede concluirse que los controles prenatales en la población estudiada se asocian con un mejor control y salud fetal neonatal, menor número de complicaciones y menos óbitos y fetos muertos, lo cual coincide con lo encontrado enotros lugares del país y de Latinoamérica.

Prenatal care reduces morbidity and both maternal and perinatal mortality, premature births and the number of products with low birth weight; additionally, it helps to identify risk factors making possible to establish appropriate preventive and therapeutic actions during pregnancy. Prenatal care is considered complete with the following premises: early, periodic, complete and comprehensive coverage. To determine the prevalence of complete prenatal care (CPC) among pregnant women and to establish the relationship between the number of controls and early neonatal complications, we performed a retrospective study analyzing the medical records of the Service of Maternity of the Hospital “Angela I. Llano”, in a period from June to December 2010.Among 823 studied women, the 51% had no controls that met the criteria of precocity, quantity, distribution, integrity and quality, so we can also see that neonatal complications were higher in the group of controls incomplete. We found that the 6.2% of newborns in the uncontrolled group had low birth weight. The entrance to the nursery was 9.7% in the control group and 4.9% among the incomplete control group.The percentage of stillbirths was 1.1% in the incomplete control group. In conclusion, we found that prenatal care was associated with better fetal control and neonatal health, fewer complications, deaths and stillbirths, which agree with that found elsewhere in the country and Latin America

Perinatal Complications of Mothers and Neonates Resulting from Inadequate Prenatal Care / 대한주산의학회잡지

OBJECTIVE: With improvement in the social and economic states of Korea, most of the pregnancies have been appropriately examined but there are a few mothers and newborns who have not received proper prenatal care. The aim of this study was to investigate obstetrical and neonatal complications resulting from inadequate prenatal care. METHODS: The medical records of 107 neonates who had received prenatal care lesser than 3 visits and admitted to the neonatal intensive care units of Korea University Ansan Hospital from January 2004 to December 2009 were retrospectively reviewed. Obstetrical complications, neonatal gestational age, birth weight, neonatal complications were analyzed. We compared neonatal complications of the inadequate prenatal care group and those of the adequate prenatal care group lesser than 34 weeks' gestational age neonates. RESULTS: In obstetrical complications, there were twenty women with anemia, fifteen cases with premature rupture of membranes, and fourteen chorioamnionitis. In neonatal complications, there were forth-four premature infants, and forty-four low birth weight infants. Respiratory distress syndrome, small for gestational age, severe intraventricular hemorrhage were more common in the inadequate prenatal care group than the adequate prenatal care group. Thirty-seven infants (34.5%) were sent to the adoption agency. Fifty infants (46.6%) received medical expense support by the social service. CONCLUSIONS: Obstetrical and neonatal complications and social burden were increasing when the pregnancies had not received adequate prenatal care. To reduce perinatal complications of mothers and neonates in low socioeconomic classes, practical nation's policies and social supports for adequate prenatal care should be provided.

Estado nutricional y complicaciones inmediatas en neonatos de madres adolescentes / Nutritional status and immediate complications in newborns of adolescents mothers

Introducción: En Venezuela, el 21% de todos los nacidos vivos, son hijos de madres adolescentes. El embarazo en adolescentes constituye un problema social, económico y de salud pública que trae un mayor riesgo de morbi-mortalidad materna, fetal y neonatal,debido a la mayor prevalencia de prematuridad, bajo peso al nacer, restricción del crecimiento intrauterino y complicaciones médicas asociadas. Considerando la influencia del embarazo en adolescentes sobre el producto de la concepción, particularmente sobre su estado nutricional, se planteó el presente trabajo. Objetivos: Determinar la influencia del embarazo durante la adolescencia sobre el estado nutricional del recién nacido, su relación conla presencia de complicaciones neonatales inmediatas e identificación de posibles factores de riesgo sociodemográficos asociados alestado nutricional del neonato. Metodos: Estudio prospectivo y descriptivo de 102 hijos de madres adolescentes entre 14 y 19 años, nacidos en el Hospital “Dr. Pastor Oropeza” (agosto - octubre 2007), evaluados antropométricamente (peso, talla, circunferencia cefálica y media del brazo) en las primeras48 horas de vida. Se aplicó estadística descriptiva básica: medidas de tendencia central y de dispersión, pruebas de contraste de medias(t de Student) y de asociación de variables (Pearson y Chi cuadrado para p < 0,05). Resultados: La edad materna promedio fue de 17,05 años. La mayoría de los neonatos resultaron a término (11,8%, pretérmino). Deltotal, 79,4% clasificó como adecuados para la edad gestacional, 13,7% grandes y 6,9% pequeños para la edad gestacional, con diferencias significativas entre las distintas variables e indicadores antropométricos al clasificarlos según edad gestacional y peso para la edad gestacional...

Introducction: In Venezuela, 21% of all live births are born to teenage mothers. The teen pregnancy is a social, economic and public health problem resulting in a higher risk of maternal, fetal and neonatal morbidity and mortality due to the higher prevalence ofprematurity, low birth weight, intrauterine growth restriction and medical complications. Objective: To determine the influence of pregnancy during adolescence on the nutritional status of the newborn, its relationship with the risk of complications and identification of potential risk factors associated with this condition.Methods: Descriptive and prospective study of 102 children of teenage mothers between ages 14-19, born in the Hospital “Dr. Pastor Oropeza" (August-October 2007), assessed anthropometrically (weight, height, head and average arm circumference) during the first 48 hours of life. Statistical analysis included: measures of central tendency and dispersion as well as evidence of contrast medium (Studentt) and the association of variables (Pearson and Chi square for p < 0,05). Results: Most of the infants were born at term (only 11.8% preterm). Of the total, 79.4% classified as suitable for gestational age,followed by large 13.7% and 6.9% small, with significant differences among different variables and anthropometric indicators to classifythem according to their gestational age...