scholarly journals A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome

2014 ◽  
Vol 6 (3) ◽  
pp. 139-143 ◽  
Author(s):  
Hema Dhumale ◽  
Yeshita Pujar ◽  
Komal Gurunath Revankar
Keyword(s):  
High Risk ◽  
Perinatal Outcome ◽  
Low Risk ◽  
Controlled Study ◽  
Third Trimester ◽  
Randomized Controlled ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
And Control

ABSTRACT Objective To assess the role of routine third trimester ultrasound in low-risk pregnancy on antenatal interventions and perinatal outcome. Design Randomized controlled study. Setting KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum. Subjects A total of 290 low-risk pregnant women between 34 and 37 weeks attending antenatal clinic and fulfilling inclusion criteria were allotted using computer-generated randomization numbers into study and control groups. Intervention In study group, third trimester ultrasound was performed to assess fetal growth, amniotic fluid index (AFI), malpresentations, and late onset fetal anomalies. In control group, no routine ultrasound was performed, unless indicated by clinical suspicion during subsequent visits. High-risk fetuses identified were managed as per the standard protocol. All women were followed to assess antenatal interventions, intrapartum events and perinatal outcome. Results Detection of high-risk fetuses antenatally in study and control groups was 17.25 and 2.07% respectively. This difference was statistically significant (p = —0.0001). Rates of antenatal interventions among study and control were 24.8 and 4.44% respectively. Prevalence of small for gestational age (SGA) fetuses among study and control was 6.9 vs 11.03% respectively. This difference was not statistically significant (p = —0.253). There was no statistical difference in adverse intrapartum events, cesarean section rate for nonreassuring cardiotocography (CTG), low Apgar score and neonatal intensive care unit (NICU) admissions among study and controls. Conclusion Routine third trimester ultrasound is a logical solution for detection of high-risk fetuses in low-risk pregnancies which would otherwise be missed by clinical examination. However, this leads to an increase in antenatal interventions without significantly influencing the perinatal outcome. How to cite this article Revankar KG, Dhumale H, Pujar Y. A Randomized Controlled Study to assess the Role of Routine Third Trimester Ultrasound in Low-risk Pregnancy on Antenatal Interventions and Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):139-143.

scholarly journals Role of admission cardiotocography and amniotic fluid index on perinatal outcome in low risk pregnancy at term

2021 ◽  
Vol 10 (4) ◽  
pp. 1591
Author(s):  
Manasi Patnaik ◽  
Tejaswini M ◽  
Sudhanshu Kumar Rath ◽  
Shaik Afrah Naaz
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Well Being ◽  
Low Risk ◽  
Amniotic Fluid Index ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

Background: Fetal surveillance even in normal or low risk pregnancy is essential to ensure safe parturition with minimum intervention. Cardiotocography (CTG) and clinical estimation of amniotic fluid volume (AFV) measured as amniotic fluid index (AFI) are two tests that are easily available in the labor room and can be used to identify fetal well-being. Our study aimed to evaluate role of admission cardiotocography (CTG) and amniotic fluid index (AFI) on perinatal outcome in low risk pregnancy at term.Methods: The study was conducted as a prospective observational study. All low risk pregnant women at term admitted to the labor ward in early or established labour between September 2018 and August 2020 were included in the study. They underwent admission CTG and AFI assessment using ultrasonography. All parameters including CTG changes, mode of delivery, AFI, presence of meconium, APGAR score at 1 and 5 mins, need for admission in neonatal ICU and perinatal mortality were recorded. Quantitative data was compared using chi square test.Results: A total of 180 patients were included in the study. Majority of the women belonged to the age group of 30-35 years. Abnormal CTG showing fetal distress was seen in 105 (58.33%) cases. Non-reactive CTG was significantly associated with meconium stained liqour, requirement for LSCS, still birth, fetal distress, APGAR <7 at 1 and 5min and NICU admission (p<0.001). The association of low AFI with non-reactive CTG had statistically significant impact on perinatal outcomes like low birth weight, requirement for LSCS, fetal distress, APGAR <7 at 1 and 5 mins and NICU admissions.Conclusions: Admission CTG is a simple non-invasive test that can serve as a screening tool in low risk obstetric population to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. Thus, it may help in preventing fetal morbidity and mortality.

scholarly journals Evaluation of levels of cortisol in saliva using electro-chemical luminescence in low-risk and high-risk pregnancies

2010 ◽  
Vol 10 (1) ◽  
pp. 69-74
Author(s):  
Ana Carla P. Montenegro ◽  
Viviane Rosado D' Assunção ◽  
Monique Gabrielli B. Luna ◽  
Pollyanna Valente N. Raposo ◽  
Francisco Bandeira
Keyword(s):  
High Risk ◽  
Diastolic Pressure ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
Test Results ◽  
Third Trimester ◽  
The Third ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
The Mean

OBJECTIVES: to compare the levels of cortisol (cortisolemia refers to the level of cortisol in blood) in women with a high-risk pregnancy compared with those with a low-risk pregnancy, by way of evaluation of levels of cortisol in saliva, using the electrochemical luminescence technique (ECL). METHODS: 38 women aged between 17 and 40 years in the third trimester of pregnancy were divided in two groups: 20 low-risk pregnancies and 18 high-risk ones. Cortisol in saliva was collected at midnight and measured using ECL. The mean levels of cortisol in saliva in the two groups were compared using the Kruskal-Wallis test. RESULTS: the mean systolic and diastolic pressure was normal in both groups. The levels of cortisol in the saliva of women with high-risk pregnancies was significantly higher than those for the low-risk pregnancy group (20.2 (±21,1) nmol/L vs 11.4(±16.2) nmol/L; p=0.007). CONCLUSIONS: a high risk pregnancy involves higher levels of cortisol than a low-risk one. The levels of cortisol in saliva, as measured using ECL, can be used to identify hypercortisolism in pregnancy.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

The Effect of Lullaby Intervention on Anxiety and Prenatal Attachment in Women with High-Risk Pregnancy: A Randomized Controlled Study

2021 ◽  
pp. 1-9
Author(s):  
Nazlı Baltacı ◽  
Mürüvvet Başer
Keyword(s):  
High Risk ◽  
Intervention Group ◽  
Group Versus ◽  
Mean Difference ◽  
High Risk Pregnancy ◽  
Controlled Study ◽  
Control Group ◽  
Prenatal Attachment ◽  
Randomized Controlled ◽  
Risk Pregnancy

<b><i>Background:</i></b> Women with high-risk pregnancy experience anxiety and low mother-fetal attachment when faced with signs of danger and health problems. This study aimed to investigate the effects of lullaby intervention on anxiety and prenatal attachment in women with high-risk pregnancy. <b><i>Materials and Methods:</i></b> This randomized controlled trial was conducted in the perinatology clinic of a state maternity hospital in Turkey. Seventy-six women with high-risk pregnancy were included. The intervention group listened to lullabies for 20 min once a day, and accompanied by lullabies touched their abdomen and thought about their babies, but the control group did not. Data were collected using the Pregnant Information Form, the State Anxiety Inventory, and the Prenatal Attachment Inventory. <b><i>Results:</i></b> Baseline anxiety did not differ in the intervention versus control group (47.83 ± 10.74 vs. 44.10 ± 8.08, mean difference 3.73 [95% Cl –1.18 to 8.64], <i>p</i> = 0.13), but after the 2nd day lullaby intervention anxiety was lower in the intervention group versus control group (33.66 ± 9.32 vs. 43.06 ± 8.10, mean difference –9.40 [95% Cl –13.91 to –4.88], <i>p</i> &#x3c; 0.01). Baseline prenatal attachment did not differ in the intervention versus control group (56.03 ± 10.71 vs. 53.86 ± 9.98, mean difference 2.16 [95% Cl –3.18 to 7.51], <i>p</i> = 0.42), but after the 2nd day lullaby intervention prenatal attachment was higher in the intervention group versus control group (66.70 ± 7.60 vs. 54.36 ± 9.52, mean difference 12.33 [95% Cl 7.87 to 16.78], <i>p</i> &#x3c; 0.01). In the within-group analysis the intervention group had lower anxiety and better prenatal attachment (<i>p</i> &#x3c; 0.01), but not in the control group (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Lullaby intervention can play an effective role in reducing anxiety and improving prenatal attachment. The use of this integrative, noninvasive, non-pharmacologic, time-efficient, and natural intervention is suggested in the care of pregnant women.

scholarly journals Anxiety and depression in women hospitalized due to high-risk pregnancy: An integrative quantitative and qualitative study

2021 ◽  
Author(s):  
Martina Smorti ◽  
Francesca Ginobbi ◽  
Tommaso Simoncini ◽  
Federica Pancetti ◽  
Alessia Carducci ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
High Risk ◽  
Risk Group ◽  
Depression Scale ◽  
High Risk Group ◽  
Low Risk ◽  
High Risk Pregnancy ◽  
Anxiety And Depression ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

AbstractLiterature has shown that hospitalized women with high-risk pregnancy tend to develop anxious and depressive symptoms. Research has used quantitative or qualitative methods. By integrating both quantitative and qualitative methods, this study aims to analyze: a) the level of depression, anxiety, and pregnancy-related anxiety in a group of women hospitalized with high-risk pregnancy (hospitalized high-risk) compared with a group of non-hospitalized women with low-risk pregnancy; b) the content of hospitalization-related emotions in a high-risk group. A cross-sectional study was conducted on 30 hospitalized high-risk pregnant women and 32 women with low-risk pregnancy. Participants completed the Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (Anxiety), and Pregnancy Related Anxiety Questionnaire. The hospitalized high-risk group also completed open-ended questions about emotions experienced during hospitalization. Univariate Analysis of Covariance showed that the hospitalized high-risk group reported higher general anxiety and depression than the low-risk pregnancy group. Low-risk group reported higher level of concerns about own appearance than high-risk group. Narratives showed that the anxious and depressive symptoms of hospitalized women are related to the loneliness of being away from family. Despite attempts to understand hospitalization, they express concerns about pregnancy. Psychological support for hospitalized pregnant women should be provided to facilitate the communication of emotions that leads women to elaborate the experience of hospitalization to better adapt and cope with the critical condition.

The marginalisation of midwifery in medicalised pregnancy and childbirth: a qualitative study

2020 ◽  
Vol 28 (11) ◽  
pp. 768-776
Author(s):  
Khadijeh Mirzaie Najmabadi ◽  
Mahmoud Ghazi Tabatabaie ◽  
Abou Ali Vedadhir ◽  
Sedigheh Sedigh Mobarakabadi
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Perinatal Care ◽  
Low Risk ◽  
Care Providers ◽  
Pregnancy And Childbirth ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
Depth Interviews

Introduction The role of midwives has changed in providing care for low-risk pregnancies and childbirth. This study explores the perceptions of perinatal care providers and recipients regarding midwifery services. Methods This study used a qualitative content analysis approach. Data were collected through 49 semi-structured in-depth interviews, and analysed with qualitative content analysis. Results The medicalisation of pregnancy and childbirth has marginalised midwifery. Midwifery, which should be at the heart of all low-risk pregnancies and childbirth, has deteriorated such that it has become disempowered in interdisciplinary relations. Conclusions Midwifery is at risk of being totally excluded from low-risk pregnancy care and childbirth.

scholarly journals Intrapartum Amniotic Fluid Volume Estimation in Low-risk Pregnancy as a Predictor of Perinatal Outcome

2014 ◽  
Vol 6 (3) ◽  
pp. 156-158
Author(s):  
J Jeanet ◽  
Santosh Joseph Benjamin ◽  
Jiji Elizabeth Mathews ◽  
Swati Rathore ◽  
Ajit Sebastian ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Fluid Volume ◽  
Volume Estimation ◽  
Low Risk ◽  
Amniotic Fluid Index ◽  
Amniotic Fluid Volume ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

ABSTRACT Objectives The study was undertaken to determine the efficacy of routine estimation of amniotic fluid volume using the amniotic fluid index (AFI) as a means of predicting an adverse perinatal outcome in low-risk pregnancies. Materials and methods Five hundred and three singleton lowrisk pregnancies with cephalic presentation between 37 and 40 weeks and 6 days of gestation with intact or ruptured membranes had AFI estimations within 36 hours of delivery. Results The frequency of nonreassuring fetal heart patterns and perinatal outcomes among patients with oligohydramnios (<5 cm), borderline oligohydramnios (5 to 8 cm) and normal (>8 cm) liquor were compared and not found to be different. Cesarean section for nonreassuring fetal status was also similar in the three groups. Conclusion This study suggests that AFI estimation during labor in low-risk pregnancies does not predict adverse perinatal outcomes. Further studies are needed to verify this impression. How to cite this article Jeanet J, Benjamin SJ, Mathews JE, Rathore S, Sebastian A, Thomas E. Intrapartum Amniotic Fluid Volume Estimation in Low-risk Pregnancy as a Predictor of Perinatal Outcome. J South Asian Feder Obst Gynae 2014;6(3):156-158.

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