Postdated pregnancy: its maternal and fetal outcome

Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.

Correlation of gestational age assessed by last menstrual period and New Ballard’s Score in pre term babies

Background: Gestational age is a critical factor in the management, decision making and follow up of new born infants. Identification of gestational age especially within 48 hours of life is crucial for new born. Since decades attempts have been made to find an alternative measurement for gestational age and birth weight estimation of the newborns. Last menstrual period is an inexpensive method and potentially efficient for calculating gestational age. Objective of this study was to the present study aims to compare the gestational age by New Ballards score with LMP, in pre term babies.Methods: A total 150 pre term babies who are born to mothers remembering LMP were enrolled for the study group. During the study period new Ballard scoring was done for babies within 48hrs and Gestational age was compared with LMP. The collected data was analyzed by using SAS-6.50 version. Study design a prospective observational study was conducted over a period of one year from January 2018 till December 2018 at Rajarajeswari Medical College and Hospital, Bengaluru, IndiaResults: The New Ballard score is found to be significantly correlated with GA above 29 weeks (p<0.01). The LMP mean was 35±2.0 weeks. Total 60.6 % of the childbirth is lead to normal vaginal delivery. The analysis shows LMP were found to be strongly correlated with GA (p<0.01).Conclusions: LMP alone can be reliably used in assessing the gestational age and can be assessed more accurately and be confirmed with new Ballard’s scoring for preterm babies of >29 weeks.

A Study on Obstetric Outcome of Postdated Pregnancy among Private Hospital Patients in Sylhet

Introduction: Any pregnancy which has passed beyondexpected date of delivery (EDD) is called postdated pregnancyor prolonged pregnancy.Objective: Main goal of this study is to evaluate obstetricoutcome in postdated pregnancy.Method: This was a prospective observational type study.Patients whose pregnancy extended beyond 40 weeks ofgestational age, patients who were sure of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in theDepartment of Obstetrics and Gynecology, of different privatehospital Sylhet for study duration of 3 years. Total 223 caseswere selected purposively for this study.Results: The study result shows fetus condition among the223 pregnant women highest 96.41% were alive and only3.59% were dead. Male baby and female baby was almostsame male 49.33% and female baby 50.67%. After deliverybaby admitted in hospital 76.23%, NICU 6.28% not admitted17.49%. Most of the pregnant women’s (88.34%) managementwas oligo induction failure and rest was laparoscopy. Peroperative finding of the patients shows highest 74.89% pretermpre-mature rapture of membrane, 18.83% Ectopic pregnancyand 6.28% rapture uterus.Conclusion: Postdated pregnancy having 50% risk ofrecurrence in next pregnancy. It is a high risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also increases rate ofinstrumental delivery and operative delivery.

A Clinical Study of Post-dated Pregnancy among Government and Private Hospital Patients in Patuakhali

Introduction: Any pregnancy that has passed past expecteddate of delivery (EDD) is called post-dated pregnancy orprolonged pregnancy.Objective: The main objective of this study is to appraiseobstetric outcome for post-dated pregnancy in Patuakhali.Method: This was a potential observational type study.Patients whose pregnancy protracted beyond 40 weeks ofgestational age, patients who were certain of the date of lastmenstrual period (LMP) along with 1st trimester obstetrics scanwere included for this study. Patients not sure of LMP wereexcluded in this study. The study was conducted in thedepartment of obstetrics and gynaecology, of different privatehospital Patuakhali for study duration of 2 years. Total 150cases were selected purposively for this study.Results: Age segmentation of patients where the age ofpregnant women ranged from 16 to 30 years. Among the 150pregnant women highest 64% were in the age of 26-30 years.Delivery method amongst the 150 pregnant women are highestat 86% were caesarean delivery followed by normal deliveryonly 14%. Parity distribution among the 150 pregnant womenhighest 57.33% were Primigravida followed by Multigravida41.34% and 2nd pregnant were only 1.33%. Babies’ conditionamongst the 150 pregnant women, highest 96.30% foetuswere alive upon delivery and only 3.70% of the foetus weredead. In the gender distribution of the foetus, 49.33% wereborn as male and 50.67% were female. After delivery, thebabies that were admitted in hospital were 76.40%, in NICU6.40%, and not admitted in the hospital after delivery were at17.20% and 88.40% of the pregnant women’s managementresulted in oligo induction failure and the rest 11.60% wereconducted upon laparoscopy. Per operative findings of theselected patients show that the highest 74.40% were pretermpre-mature rupture of membrane, 18.80% were ectopicpregnancy and 6.80% had ruptured uterus.Conclusion: Post-dated pregnancy having almost 50% risk ofrecurrence in next pregnancy. It is a high-risk pregnancy thefoetal complication in the form of foetal distress, meconiumaspiration syndrome, birth trauma etc. It also raises rate ofinstrumental delivery and operative delivery.

Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients

Background: Diabetes Mellitus is a complex disease with varying degree of systemic and oral complications. The prognosis is quite favorable if a disease is diagnosed in early stages. Since a large number of patients seek dental treatment routinely, screening procedures for early detection of subclinical cases can help in diagnosis of asymptomatic diabetes. Aim: The present study was undertaken to evaluate if gingival crevicular blood can be used for the estimation of blood glucose levels in periodontitis patients. Material and Methods: A prospective study was carried out comprising 150 patients Group A comprised of 75 subjects with gingivitis and group B comprised of 75 subjects with periodontitis. For gingival crevicular blood glucose (GCBG) level estimation, the blood was drawn onto the glucometer strip after gently probing the gingival sulcus and the readings were recorded. At the same time, blood Vijayendra Pandey, Akhilesh Chandra, Deepak Kumar, Anup Kumar Singh, Priyankesh, Alok Kumar Gupta. Estimation of gingival blood glucose using a sensitive self-monitoring device in periodontitis patients. IAIM, 2019; 6(6): 51-56. Page 52 was also collected from the index finger onto the glucometer strip for the capillary finger-prick blood glucose (CFBG) sample. Both the values were compared and statistical analysis of data was performed. Results: The mean GCBGL and CFBGL in group A was 98.43 mg/dl ± 18.62 and 103.48 mg/dl ± 13.90 respectively, while in group B it was 136.37 mg/dl ± 36.95 and 141.62 mg/dl ± 51.84, respectively. There was no statistically significant difference (p> 0.05) between the two values in both the groups. Conclusion: It can be concluded that GCBG levels are positively correlated with CFBG levels. Therefore, clearly indicating that gingival crevicular blood collected during diagnostic periodontal examination may be an excellent source of blood sample for glucometric analysis.

Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period.

The validity of three methods (last menstrual period [LPM], Ballard and Dubowitz scores) for assessment of gestational age for premature infants in a low-resource setting was assessed, using antenatal ultrasound as the gold standard. It was hypothesized that LMP and other methods would perform similarly in determining postnatal gestational age. Concordance analysis was applied to data on 355 neonates of <33 weeks gestational age enrolled in a topical skin-therapy trial in a tertiary-care children’s hospital in Bangladesh. The concordance coefficient for LMP, Ballard, and Dubowitz was 0.878, 0.914, and 0.886 respectively. LMP and Ballard underestimated gestational age by one day (±11) and 2.9 days (±7.8) respectively while Dubowitz overestimated gestational age by 3.9 days (±7.1) compared to ultrasound finding. LMP in a low-resource setting was a more reliable measure of gestational age than previously thought for estimation of postnatal gestational age of preterm infants. Ballard and Dubowitz scores are slightly more reliable but require more technical skills to perform. Additional prospective trials are warranted to examine LMP against antenatal ultrasound for primary assessment of neonatal gestational age in other low-resource settings.

Comparison of Ultrasonographic Biometry and Regular Last Menstrual Period as Predictors of Day of Delivery in the Spontaneous Onset of Labor / 대한산부인과학회잡지

OBJECTIVES: To evaluate whether the day of delivery for women with regular menstrual history was predicted best from the last menstrual period (LMP), crown rump length (CRL) and or biparietal diameter (BPD). METHODS: All of 561 women had estimated the day of delivery by LMP, CRL in the first trimester (In case of 217 women, it was available) and BPD in the second trimester. The accuracy of each method in predicting the day of delivery was determined. Those who were delivered after the spontaneous onset of labor were included. Differences among these methods were evaluated with nonparametric tests. RESULTS: The percentage of women who delivered within 3 days of the estimated day of delivery was 254(45.3%) and 216(38.5%) of the women with pregnancies by BPD and LMP, respectively. And within 7days of the estimated day were 408(72.7%), 390(69.5%) of the women from BPD and the LMP. In the women, the BPD estimate was significantly better predictor within the 7days of the day of delivery than LMP estimate (p=0.027). Compared to LMP estimate, CRL and BPD estimates seemed to be advanced the day of delivery about 2.6 days in CRL, and 0.9 days in BPD (p=0.004, p=0.034). But we could not find any advantage of the CRL measurement in first trimester than single BPD measurement in the second trimester for the predictor of the day of delivery. CONCLUSIONS: When the difference between the methods in predicting the day of delivery was less than 7 days, the BPD measurement was better than the last menstrual period.