Study of predicting perinatal outcome in patients with oligohydraminos at term pregnancy

Background: Amniotic fluid plays a major role in the fetal growth and development. It provides the fetus with a protective low resistance environment suitable for growth and development, a cushion against the constricting confines of the gravid uterus, allowing the fetus room for the movement and growth and protecting it from external trauma. The abnormalities of the fluid volume can interfere directly with the fetal development or may be an indirect sign of underlying disorder such as fetal hypoxia, neural tube defect or gastrointestinal obstruction. Aim of this study was to determine whether an amniotic fluid level of 5cm or less can be predictor of adverse perinatal outcome in terms of fetal distress, birth weight, APGAR score and neonatal morbidity and mortality.Methods: Amniotic fluid index (AFI) was determined with a b-mode real time scanner with linear transducer operated at 3.5 MHz. AFI estimation done by four quadrant technique in supine position. The summation of measurement from each quadrant represented the amniotic fluid index in centimeters of each patient. Fetal outcome was assessed with respect to birth weight and gestational age; Apgar score at one and five minutes; any other neonatal complications intrapartum or postpartum during stay in hospital and maturity of baby - condition at the time of discharge of mother and baby.Results: The labor was induced in 28% women with AFI <5cm, out of which 19 women delivered vaginally and 9 women underwent LSCS for failure of induction. The mean birth weight was 2.61 kg in our study. Maximum number of babies i.e. 57% were with birth weight between 2.1-2.5 kg. The APGR score at 5 min was 9 in 71% cases and 8 in 21% cases. The mean APGR score at 5 min was 8.63.Conclusions: AFI can be used as an adjunct for fetal surveillance along with other methods to identify high risks foetuses to improve the perinatal outcome.

A RETROSPECTIVE STUDY TO ASSESS FETO-MATERNAL OUTCOME IN SEVERELY ILL COVID-19 POSITIVE PREGNANT FEMALES ADMITTED AT DEDICATED COVID CARE CENTER

Background - Covid 19 infection caused by corona virus SARS- COV -2To study the fetomaternal outcome in severely ill covid positive pregnant females. Methods- An Observational study was conducted at dedicated COVID care center, jhalawar from Jan 2021 to May 2021 among pregnant females. In this study we included all Severely ill symptomatic COVID positive females which could not maintain oxygen saturation, were included in this study. Results-A total of 54 pregnant women, 24women delivered with 2 twin pregnancy . Out of this 30% underwent cesarean section and 15% were delivered by vaginal route. Postpartum hemorrhage seen in 29% of patients.24% of baby were < 2.5 kg, 12% babies were admitted in NICU. Blood products transfused in 9 patients. Remdesivir were given in 26 (48%) patients. Conclusion-We found that severe COVID-19 infection in pregnancy was associated with risks of preeclampsia, stillbirth, preterm birth and NICU admission. Future studies are needed to collect more robust data to further validate or substantiate these findings, better understand the pathophysiologic pathways that explain these associations and identify effective strategies to prevent adverse outcomes in pregnant people with COVID-19