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Ocviyanti, Dwiana, and William Timotius Wahono. "Risk Factors for Neonatal Sepsis in Pregnant Women with Premature Rupture of the Membrane." Journal of Pregnancy 2018 (October 1, 2018): 1–6. http://dx.doi.org/10.1155/2018/4823404.
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Background. Premature rupture of the membrane (PROM) is associated with high maternal as well as perinatal morbidity and mortality risks. It occurs in 5 to 10% of all pregnancy while incidence of amniotic membrane infection varies from 6 to 10%. This study aimed to determine the incidence of neonatal sepsis in Cipto Mangunkusumo Hospital and the risk factors. Methods. A cross-sectional study was done in Cipto Mangunkusumo Hospital, Jakarta, from December 2016 to June 2017. The study used total sampling method including all pregnant women with gestational age of 20 weeks or more experiencing PROM, who came to the hospital at that time. Samples with existing comorbidities such as diabetes mellitus or other serious systemic illnesses such as heart disease or autoimmune condition were excluded from the analysis. Results. A total of 405 pregnant women with PROM were included in this study. There were 21 cases (5.2%) of neonatal sepsis. The analysis showed that risk of neonatal sepsis was higher in pregnant women with prolonged rupture of membrane for ≥ 18 hours before hospital admission (OR 3.08), prolonged rupture of membrane for ≥ 15 hours during hospitalization (OR 7.32), and prolonged rupture of membrane for ≥ 48 hours until birth (OR 5.77). The risk of neonatal sepsis was higher in preterm pregnancy with gestational age of <37 weeks (OR 18.59). Conclusion. Risk of neonatal sepsis is higher in longer duration of prolonged rupture of membrane as well as preterm pregnancy.
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الكعكي, Nahla Saleh. "Prevalence of the pattern of Pre-labor premature rupture of membranes among pregnant women at Al-Sadaqa Teaching Hospital, Aden, Yemen." Journal of medical and pharmaceutical sciences 6, no. 5 (2022): 52–65. http://dx.doi.org/10.26389/ajsrp.h050122.
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Pre-labor rupture of membranes (PROM) is the rupture of membranes before the onset of labor. It is a common obstetric problem (3 -4%) in developed and developing countries. The aim of this study to describe the pattern of PROM in pregnancies at Al-Sadaqa Teaching Hospital, Aden, Yemen from January to February 2020. This is a descriptive hospital based study of the patients diagnosed as PROMs managed in the Obstetrics and Gynecology Department. In this study 151 pregnant women with PROM comprising 11.1% of 1360 total deliveries. Only 9 (0.7%) patients presented with preterm premature rupture of membranes (PPROM) and 142 (10.4%) with term premature rupture of membranes (TPROM). The mean maternal age with PROM was 26.12 ± 6.67 years. With increasing parity, there was a decrease in the PROM; 6.0% in multipara to 4.6% in grand-multipara. The time interval from membrane rupture to delivery was >24 hours in 47% of them. Anemia was the main predisposing factor causing PROMs (47.0%) followed by history of abortion and urinary tract infection (UTI) (29.1%, and 19.9% respectively). About 81.5% of them delivered vaginally while 18.5% by lower segment cesarean section. Conclusions: The prevalence of PROM in this study was comparably higher than the international average. A higher proportion of them delivered vaginally. The major contributing factors were anemia, history of abortion and UTI and increasing risk with prolonged rupture of membrane > 24hrs. It is of paramount importance to screen for UTI with timely treatment initiation and those with recurrent abortion require close monitoring on risk of PROM during subsequent pregnancies.
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Begum, Housneara, Marlina Roy, and Nahid Reaz Shapla. "Perinatal Outcome of Premature Rupture Membrane in Pregnancy." Journal of Dhaka Medical College 26, no. 2 (2018): 135–39. http://dx.doi.org/10.3329/jdmc.v26i2.38831.
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Objective: To find out the effect of PROM on neonatal outcome so that we can pay more attention for the correct diagnosis and management of PROM in pregnancy which can reduce the perinatal mortality and morbidity caused by PROM.Methods: One hundred PROM cases were selected maintaining appropriate inclusion & exclusion criteria from the department of obstetrics & Gynaecology of BSMMU & DMCH and one hundred controlled cases were taken from the same during the period of January 2010 to December 2010. Data were analyzed with SPSS statistical program to determine the effect of PROM on neonatal health.Results: In this study, 44% babies of PROM patients had various type of morbidity compare to 24% of patients with intact membrane. In PROM patients, perinatal mortality was 7% in this study compare to 5% with intact membrane. Causes of perinatal death in PROM was severe asphyxia (4%), RDS (5%) & neonatal sepsis (6%) mainly.Conclusion: All fetal complications were significantly higher in PROM patients who received treatment after prolonged rupture of membrane. Appropriate antibiotic coverage in appropriate time will reduce fetal morbidity.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 135-139
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Dixit, Asha. "Outcomes of prolonged preterm premature rupture of the membrane: a report of six cases." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 1 (2018): 329. http://dx.doi.org/10.18203/2320-1770.ijrcog20185447.
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Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.
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Alam, Muhammad Matloob, Ali Faisal Saleem, Abdul Sattar Shaikh, Owais Munir, and Maqbool Qadir. "Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan." Journal of Infection in Developing Countries 8, no. 01 (2014): 067–73. http://dx.doi.org/10.3855/jidc.3136.
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Introduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical records of all neonates born at Aga Khan University, Karachi over a period of five years (2007-2011) with PROM (> 18 hours) were reviewed. Data about maternal and neonatal risk factors for EONS was collected and adjusted logistic regression (AOR) analysis was applied. Results:Incidence of PROM in this neonatal birth cohort was 27/1,000 live births. A total of 17 (4%) cases with blood-culture proven bacterial sepsis were identified within 72 hours of birth. Klebsiella pneumonia (n = 5; 29%) and Pseudomonas aeruginosa (n = 4; 24%) were the commonest isolates followed by group B Streptococcus (n = 3; 18%) and Escherichia coli (n = 2; 12%). Maternal fever (p = <0.001; AOR, 36.6), chorioamnionitis (p < 0.001; AOR, 4.1), PROM > 48 hr. (p < 0.001; AOR, 8.2), neonatal prematurity < 34 weeks (p < 0.001; AOR, 4.1) and low birth weight < 1,500 grams (p 0.001; AOR, 9.8) along with neonatal thrombocytopenia and raised CRP were found to be independent risk factors associated with culture-proven EONS in PROM. Conclusions: Preventive measures should focus on recognition of these high-risk infants with prompt laboratory screening for sepsis and early institution of empirical antibiotic based on local data. Such approaches would be a safe and cost-effective strategy, especially in developing countries.
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Rufaida, Zulfa. "Proporsi Asfiksia Neonatorum pada Kasus KPD dengan Non KPD di RSUD dr. Mohammad Soewandhi Surabaya." Jurnal Kebidanan Midwiferia 2, no. 1 (2016): 34–44. http://dx.doi.org/10.21070/mid.v2i1.762.
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Severe fetal or asphyxia intrauterin can be a result of cord compression and repetitive due to prolonged reduction prolapsus amniotic fluid or umbilical cord. Complications are most common in PROM before 37 weeks gestation is respiratory distress syndrome (asphyxia), which occurs in 10-40% of new born babies. Risk of infection, disability, and death was also increased in the PROM events. This research methods, analytical case control study design. Inpartu mother population in maternity hospitals VK dr. Mohamad Soewandhie Surabaya in 2008 some 2101 cases. Sampling techniques proportional stratified random sampling. Large sample of 67 cases. Independent variable, premature rupture of membranes (PROM) and the dependent variable, neonates asphyxia. Instruments used data collection sheets. Sources of data from medical records. Analysis of data using non-parametric statistical approach Chi Square. The results of 33 cases of maternal inpartu that experience premature rupture of membranes (PROM), had 20.9% asphyxia and from were 34 cases of inpartu mothers who did not KPP, 20.9% experienced not asphyxia. Chi Square test results, X2arhitetic <X2table (1.802 <3.48) means that there is no difference in incidence neonates asphyxia in premature rupture cases (KPP) and no premature rupture of membranes (non – KPP). The conclusion of this study, less than 50% of inpartu mothers who experienced premature rupture of membranes (PROM), and more than 50% occurred asphyxia was, and there was no difference in incidence neonates asphyxia in premature rupture cases (KPP) and no premature rupture of membranes (non – KPP).
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S, Jayashalini. "A Retrospective Study on Maternal and Fetal Outcomes in Premature Rupture of Membranes." Journal of Neonatal Surgery 14, no. 8S (2025): 60–68. https://doi.org/10.52783/jns.v14.2495.
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Background: Premature rupture of membranes (PROM) at term (≥37 weeks) complicates 8–10% of pregnancies and is associated with increased maternal and neonatal morbidity. The optimal management strategy—expectant management versus immediate induction—remains debated. Prolonged PROM (>24 hours) has been linked to increased risks of chorioamnionitis, postpartum haemorrhage, neonatal sepsis, and NICU admissions. This study evaluates maternal and fetal outcomes in PROM cases to guide clinical decision-making. Methods: This hospital-based retrospective study was conducted at Chettinad Health and Research Institute, Tamil Nadu, India, analysing medical records of 100 women diagnosed with PROM at ≥37 weeks gestation (January 1, 2023 – December 31, 2023). Data included maternal demographics, mode of delivery, time from PROM to delivery, maternal complications, and neonatal outcomes. Statistical Analysis: Descriptive statistics, Chi-square tests, logistic regression, Pearson correlation, and Kaplan-Meier survival analysis were performed using SPSS v26.0. A p-value <0.05 was considered statistically significant. Results: Maternal Outcomes: 72% delivered vaginally, while 28% required cesarean delivery due to fetal distress (11%), failure to progress (9%), and chorioamnionitis (5%). The mean latency period from PROM to delivery was 12.8 ± 5.6 hours. Chorioamnionitis (7%) was the most common maternal complication, significantly increasing when PROM lasted >24 hours (29% vs. 3%, p=0.004). Neonatal Outcomes: 16% required NICU admission, primarily due to respiratory distress syndrome (8%) and neonatal sepsis (6%). Prolonged PROM was significantly associated with a 5.2-fold higher risk of NICU admission (p=0.002) and a 4.7 times increased risk of neonatal sepsis (p=0.001). Perinatal mortality was 2%. Negative correlation between PROM duration and APGAR scores (r=-0.58 at 1 min, p<0.001). Kaplan-Meier analysis showed higher neonatal morbidity with PROM >24 hours (p<0.001, log-rank test). Conclusion: Prolonged PROM (>24 hours) significantly increases maternal infections and neonatal morbidity, including higher NICU admissions and neonatal sepsis risk. Timely labour induction within 12 hours may reduce these complications, supporting proactive management strategies over expectant management. Future studies should focus on optimal timing for labour induction in terms of PROM and infection prevention strategies to improve maternal and neonatal outcomes.
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Gyeltshen, Nidup, and Rojna Rai. "Maternal and fetal outcome of term pre labour rupture of membrane in a regional referral hospital in Bhutan from 2018-2020: a retrospective cross sectional study." Bhutan Health Journal 8, no. 1 (2022): 8–13. http://dx.doi.org/10.47811/bhj.131.
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Introduction: Term premature or prelabour rupture of membrane (PROM) refers to the disruption in fetal membranes before the onset of labor, after 37 weeks of gestation. PROM is commonly encountered in our practice but there is no published study on PROM in our country. This study was conducted to determine the incidence, clinical profile and it’s association with maternal and fetal outcome in term PROM in our hospital. Methods: A retrospective cross sectional study, carried out at a regional referral hospital in Bhutan. Medical records-based data was collected from clinically diagnosed cases of term PROM, from 1st January 2018 to 31st December 2020. Results: The incidence of term PROM among deliveries was 5.5 %. Unfavourable maternal outcome was seen in Primigravida (p-value=0.05), PROM duration greater than or equal to 24 hours (p-value= 0.007), Prolonged latency period of 24 hours or more (p-value=0.03), prophylactic antibiotics after 18 hours (p-value=0.05) and vaginal delivery (p-value=0.0001). Unfavourable fetal outcome was observed in cases referred in from regional health centres (p-value=0.01). Conclusions: Early initiation of appropriate prophylactic antibiotics, Early induction of labour as opposed to expectant management, Prompt referral of all PROM cases from primary health centres and district hospitals and availability of appropriate prophylactic antibiotics at all health centres may improve maternal and fetal outcome in term PROM.
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Memon, M. Hanif, Shahina Hanif, Farhan Saeed, et al. "Effect of Maternal Colonization with History of Prolonged Rupture of Membrane on Neonatal Colonization and Early Onset Sepsis." ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 24, no. 4 (2020): 195–99. http://dx.doi.org/10.58397/ashkmdc.v24i4.165.
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AbstractObjective: To determine the effect of maternal colonization with history of PROM on neonatal colonization and early-onset sepsis.Methods: A descriptive cross-sectional study was carried out at a single tertiary care hospital of Karachi from June 1st 2018 to May 31st 2019. A total of 155 patients' full-term new-borns between 37 to 41 weeks of gestation with a history of rupture of membranes more than 18 hours duration was selected by convenience sampling method. A high vaginal swab was collected from all full-term pregnant women with a history of PROM. After delivery of their new-borns, all babies were kept in the nursery under closed observation for 72 hours duration and their blood cultures, CRP (C- Reactive Protein) and CBC (complete blood count) was sent within 24 hours of delivery.Results: In our study, out of 155 PROM cases 58 (37.4) were growth positive and 50 (32.3) neonates had positive blood C/S at delivery. Out of 58 cases with suspected growth positive PROM mothers 51 had gram-negative organisms in HVS while only 7 mothers were gram-positive in HVS. Of all neonates with positive blood C/S at delivery 44 cases were gram-negative organisms in their blood.Conclusion: In our study organisms found in a high vaginal swab of the mother are similar to the organisms found in the blood culture of their new-born with early-onset sepsis.
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Shakya, Amshu, and Sweta Kumari Gupta. "Neonatal outcome of maternal premature rupture of membranes more than 18 hours." Journal of Kathmandu Medical College 9, no. 2 (2020): 81–86. http://dx.doi.org/10.3126/jkmc.v9i2.35526.
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Background: Premature Rupture of Membranes has been known to complicate pregnancy since ages. Several risk factors may be associated with occurrence of premature rupture of membranes. It is associated with varied neonatal complications, neonatal sepsis and prematurity being the most hazardous ones.
 Objectives: This study was conducted to evaluate the incidence of neonatal sepsis following premature rupture of membranes, risk factors and neonatal complications associated with premature rupture of membrane of more than 18 hours in the neonates admitted in a tertiary care center.
 Methodology: Descriptive observational study was undertaken for 18 months from August 2013 to January 2015 in the College of Medical Sciences, Chitwan, Nepal. This study included 82 neonates admitted to the Neonatal Intensive Care Unit with maternal history of premature rupture of membranes of more than 18 hours with medical conditions excluded. 
 Results: The incidence of premature rupture of membranes in this hospital was 8.9%. Frequently associated maternal risk factors were history of prior abortion (16, 19.5%), urinary tract infection (7, 8.5%), and antecedent coitus (7, 8.5%). In the study population, 68 (83%) neonates had complications and 14 (17%) neonates had no complication. The incidence of neonatal sepsis following PROM in present study was 6.1%. Neonatal sepsis was significantly associated with chorioamnionitis (p<0.001). The most frequently occurring complication was probable neonatal sepsis (53, 64.6%), followed by prematurity (31, 37.8%) and perinatal asphyxia (15, 18.3%). There was a directly proportional relation of neonatal sepsis, chorioamnionitis, respiratory distress syndrome and mortality with duration of premature rupture of membranes.
 Conclusion: Commonly occurring maternal risk factors with PROM were prior abortion, UTI and antecedent coitus. In the study population, infectious morbidity was highest. Chorioamnionitis was significantly associated with culture proven neonatal sepsis. Prolonged duration of premature rupture of membranes increased the risk of neonatal sepsis, meningitis, respiratory distress syndrome and perinatal death. Prevention of these risk factors, appropriate and timely management including improved obstetric and neonatal care can provide intact survival of the neonates.
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B, Sreelatha, and Mamatha Ch. "Assessment of Oral Misoprostol versus Oxytocin for Labor Induction in Term Prelabor Rupture of Membranes." International Journal of Toxicological and Pharmacological Research 14, no. 1 (2024): 192–96. https://doi.org/10.5281/zenodo.10971989.
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<strong>Objective:</strong> PROM at term is a common complication of pregnancy that can lead to significant perinatal morbidity and mortality, especially when accompanied by a prolonged latency period from membrane rupture to delivery. This study seeks to evaluate and compare the effectiveness and safety of oral misoprostol versus oxytocin infusion for labor induction in women experiencing prelabour rupture of membranes (PROM) at term. <strong>Methods:</strong> This prospective randomized trial involved 100 pregnant women admitted to the Department of Obstetrics and Gynecology at Prathima Institute of Medical Sciences, Naganoor, Karimnagar, with the term PROM. Participants were randomly assigned to two equal groups (groups A or B): group A received oral misoprostol at a dosage of 100 μg every 4 hours for a maximum of three doses, while group B received intravenous oxytocin infusion, starting at 4 mU/min with incremental increases of 4 mU/min every 30 minutes up to a maximum dose of 32 mU/min. The primary outcome measure was the time from induction to vaginal delivery, with secondary outcomes including mode of delivery, as well as maternal and neonatal outcomes. <strong>Results:</strong> A statistically significant contrast emerged between the two groups regarding the induction-to-delivery interval (IDI), with the mean being notably lower in the misoprostol group compared to the oxytocin group (6.45 ± 1.85 and 9.43 ± 2.19; P < 0.001), respectively. Furthermore, a highly significant difference was observed between the study groups concerning the mean IDI in nulliparous and multiparous women. <strong>Conclusion:</strong> Administering oral misoprostol at a dosage of 100 μg every 4 hours proved to be not only equally effective as oxytocin for labor induction in term PROM patients but also shortened the duration of labor, particularly in nulliparous women. Moreover, oral misoprostol demonstrated safety in terms of both maternal and neonatal outcomes. Considering these findings, oral misoprostol emerges as a viable alternative to oxytocin for labor induction in term PROM cases.
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Asogwa, Augustine O., Euzebus C. Ezugwu, George Uchenna Eleje, et al. "Association of Clinical Signs of Chorioamnionitis with Histological Chorioamnionitis and Neonatal Outcomes in Women with Premature Rupture of Membranes." Nigerian Journal of Clinical Practice 26, no. 9 (2023): 1354–60. http://dx.doi.org/10.4103/njcp.njcp_128_23.
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ABSTRACT Background: Premature rupture of membrane (PROM), especially when preterm or prolonged is associated with an increased risk of chorioamnionitis with its attendant feto-maternal complications. Aim: The study was aimed to determine the association of clinical signs of chorioamnionitis with histological chorioamnionitis and neonatal outcomes in women with PROM. Materials and Methods: Eligible participants with clinical diagnosis of PROM at gestational age of ≥28 weeks managed between December 2018 and June 2019 were consecutively recruited. Their sociodemographic characteristics, obstetrics history, and evidence of clinical chorioamnionitis using the Gibb’s criteria were obtained. Following delivery, chorioamnionitis was histologically confirmed. Primary outcome measure was the proportion of women with PROM and histological chorioamnionitis that were detected clinically. Results: Of the 136 participants analyzed, 108 (79.4%) had term PROM, while 28 (20.6%) had preterm PROM (<37 weeks). The prevalence of histological chorioamnionitis was 50.0% compared to 16.2% using clinical indicators of infection. Histological chorioamnionitis was almost two times higher in preterm than term PROM (71.4% vs 38.9%). About two-third (67.6%) of the chorioamnionitis identified histologically were missed using clinical signs of chorioamnionitis. Clinical signs of chorioamnionitis had specificity of 100.0%, but low sensitivity (35.5%) and accuracy of 70.6%. A combination of three symptoms, maternal pyrexia and tachycardia, and fetal tachycardia appears to be the most reliable clinical indicator of chorioamnionitis in women with preterm PROM. There was a significant association between low birth weight, low Apgar score, NICU admission, and the presence of histological chorioamnionitis in women that had PROM. Conclusion: Clinical signs of chorioamnionitis have a low sensitivity and are not very accuracy in diagnosing chorioamnionitis in women with PROM.
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Poondru, Mamatha, R. Kala, and A. Kumar. "Study on prevalence of prelabour rupture of membranes and its maternal and fetal outcomes." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 11 (2021): 4163. http://dx.doi.org/10.18203/2320-1770.ijrcog20214326.
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Background: The aim is to study the prevalence of prelabour rupture of the membranes (PROM), to identify risk factors, mode of delivery, and its maternal and fetal effects.Methods: This was a cross-sectional study conducted in the department of obstetrics and gynaecology at Government Head Quarters Hospital, Cuddalore, Tamil Nadu, with a duration of 6months (January 2020 – June 2020). The study was conducted on 800 pregnant women between 28-42 weeks of gestational age consecutively and those who met the inclusion and exclusion criteria were taken into study.Results: The prevalence of PROM was 27.9% (tPROM 24.6% and PPROM 3.2%). Most of the cases were primigravida (74%). Risk factors associated with PROM were low socioeconomic state (63.2%), urinary tract infection (UTI) (7.2%), vaginal infections (5.8%), and previous history of PROM (3.1%). Most of the patients were delivered by lower segment caesarean section (LSCS) (55.2%), normal vaginal delivery (39.9%) and forceps delivery (4.9%). The most common indication for LSCS was fetal distress (43.9%). Misoprostol induction was associated with more failed induction (2 times) than syntocinon. Maternal complications were post-partum haemorrhage (PPH) (8%), fever (6.7%), wound infection (6.2%), manual removal of placenta (4.4%), and puerperal sepsis (0.9%). Neonatal complications were neonatal intensive care unit (NICU) admissions (14%), respiratory distress syndrome (RDS) (11%), neonatal sepsis (2.6%). Maternal (54.5%) and neonatal (90%) morbidity were more in prolonged PROM >24 hours.Conclusions: Antenatal screening for genitourinary infections especially in cases of the previous history of abortions and PROM should be done. Oxytocin is the preferred method of induction over misoprostol in this study. Active management in term PROM cases can reduce the cesarean section rate.
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Tadesse, Temesgen, Yohannes Hawaz, and Daniel Zewdneh. "Patterns of Chest Radiographic Findings in Neonates with Respiratory Distress Admitted to the Neonatal Intensive Care Unit in Tikur Anbesa Specialized Hospital." Malaysian Journal of Medical and Biological Research 1, no. 2 (2014): 73–78. http://dx.doi.org/10.18034/mjmbr.v1i2.378.
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Background: Neonatal respiratory distress accounts for most admissions to intensive care units in the immediate newborn period. Chest radiograph is the primary and most important imaging modality in the evaluation of causes of respiratory distress (RD) and its complications. Methodology: A cross-sectional study was conducted from October 2011 to August 2012 in Tikur Anbessa Specialized Hospital (TASH). A convenient sampling method was used and 150 neonates who had chest radiographs with different causes of RD from the neonatal ICU admissions were included in the study period. Result: Of the 150 neonates with RD, chest radiographs showed 66(44%) neonates had abnormal chest radiographic findings. Pneumonia 24(36.4%) and HMD 23(34.8%) accounting the majority of causes of RD. Neonates with congenital pneumonia presented with lobar or multi lobar asymmetric consolidation in 18(75%) neonates followed by fine diffuse, bilateral, symmetrical reticulogranular and reticulonodular infiltrates with normal lung volume in 6(25%) neonates. All 23 neonates with HMD presented with fine, diffuse, bilateral reticular or reticulogranular infiltrates with decreased lung volume. There is no significant association between independent variables like maturity of neonates, premature rupture of membrane (PROM), prolonged labor or route of delivery with either clinical or radiological diagnosis of causes of RD in neonates. all 23 neonates with HMD presented with fine diffuse bilateral reticular or reticulogranular infiltrates with decreased lung volumes. There is no significant association between independent variables like maturity of neonates, premature rupture of membrane (PROM), prolonged labor or route of delivery with either clinical or radiological diagnosis of causes of RD in neonates. Conclusion: The study showed HMD and infections (EONS, pneumonia) were the most common causes of RD in neonates and most other researches also show comparable results of causes and radiographic findings of RD in neonates.
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Kaganova, M. A., N. V. Spiridonova, A. A. Bezrukova, O. M. Mednikova, and L. K. Medvedchikova-Ardia. "Features of labor course upon with preterm rupture of membranes and "mature" cervix at gestation of 37 weeks or higher." Obstetrics, Gynecology and Reproduction 14, no. 6 (2021): 646–58. http://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2020.150.
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Introduction. Management and the prevalence of labor complications in patients with premature rupture of the membranes (PROM) is a pressing issue. Aim: to assess the features of childbirth course in patients with PROM during a full-term pregnancy and a favourable cervix. Materials and methods. А prospective analysis of labor course and the postpartum period was performed in 189 patients with a singleton pregnancy with occipital presentation, at least 37-week gestation, of low and moderate risk groups, without contraindications for vaginal delivery. PROM as complicated pregnancy was found in 89 subjects (main group), whereas 100 having labor onset with intact fetal membranes were enrolled into comparison group. The features of labor course were analyzed. Results. Primiparous patients dominated in the main group (66.7 %). The latent period between amniotic fluid discharge to labor onset comprised 4.15 ± 3.48 hours and 3.40 ± 2.13 hours in primiparous and multiparous women, respectively, whereas labor activity in 19 % of women did not develop after 6 hour-latent period. The average duration of labor did not depend on the patient parity and was longer in the group with PROM: 8.06 ± 3.51 hours – in primiparous females, 7.21 ± 2.56 hours – in comparison group (T = –1.99; p = 0.04) due to prolonged first stage of labor. In patients with and without PROM, rate of poor uterine contraction strength was 24.7 % and 18.3 % (p = 0.29), cervical dystocia – 2.25 % and 0 % (p = 0.13), use of oxytocin in childbirth – 35.9 % and 18.3 % (p = 0.007), respectively. Caesarean sections in the main group were recorded in 15 cases (16.85 %), fetal vacuum extraction – 6 cases (6.74 %), whereas in the comparison group – per 2 (2,0 %) cases, respectively (χ2 = 16.13; p < 0.001). Conclusion. Patients with PROM and favourable cervix were shown to have duration of labor, occurrence of operative delivery, rupture of the cervix, and use of oxytocin lasting substantially longer compared to those with the rupture of membranes after onset of the labor. PROM with a favourable cervix occurs more often in primiparous females, which is also coupled to peak rate complications. A 6-hour expectant management is considered as insufficient, because an onset of labor activity in 15.7 % of patients developed after latent period lasting more than 6 hours.
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M, Tejashree, Shobha Bembalgi, and Preetha F. Naykar. "Randomized clinical trial of active induction versus expectant management in premature rupture of the membranes at term." Indian Journal of Obstetrics and Gynecology Research 8, no. 2 (2021): 240–43. http://dx.doi.org/10.18231/j.ijogr.2021.049.
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Immediate induction of labour in cases of pregnancy with PROM used to be a standard practice to avoid potential complications but induced labour is likely to be associated with increased risks of fetal and maternal complications due to oligohydramnios like cord compression and high rate of operative delivery. Purpose of this study is to determine in case the practice of actively inducing labour in women with PROM at term is preferable than expectant management for 12 hours and also to study the maternal and neonatal outcome. A total of 150 pregnant women were randomized into two groups who are between 18-35 years, at term gestation (37-40 weeks) having PROM irrespective of gravida. Women were immediately induced by Tab. Misoprostol(25microgrmas) in immediate induction group. Women who presented with PROM were observed for 12hrs from time of PROM without any intervention to accelerate the labour in conservative management group. An observation between the two groups of patients would be made with respect to maternal and fetal outcome. We observed that there was statistically insignificant increase in duration of labour and increased rate of caesarean section in expectant group. Maternal complications in both groups were found to be insignificant. However, women who were managed expectantly developed more puerperal pyrexia, wound infection and prolonged hospitalization than women who were managed with induction method. There was no statistically significant difference in the perinatal complications.
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Spaggiari, Eugenio, Maria Amato, Ornella Angela Ricca, et al. "Can Fraction of Inspired Oxygen Predict Extubation Failure in Preterm Infants?" Children 9, no. 1 (2022): 30. http://dx.doi.org/10.3390/children9010030.
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Background: Prolonged mechanical ventilation in preterm infants may cause complications. We aimed to analyze the variables affecting extubation outcomes in preterm infants at high risk of extubation failure. Methods: This was a single-center, observational, retrospective study. Extubation failure was defined as survival with the need for reintubation within 72 h. Successfully extubated neonates (group 1) were compared to those with failed extubation (group 2). Multivariate logistic regression analysis evaluated factors that predicted extubation outcomes. Results: Eighty infants with a birth weight under 1000 g and/or gestational age (GA) under 28 weeks were included. Extubation failure occurred in 29 (36.2%) and success in 51 (63.8%) neonates. Most failures (75.9%) occurred within 24 h. Pre-extubation inspired oxygen fraction (FiO2) of 27% had a sensitivity of 58.6% and specificity of 64.7% for extubation failure. Post-extubation FiO2 of 32% had a sensitivity of 65.5% and specificity of 62.8% for failure. Prolonged membrane rupture (PROM) and high GA were associated with extubation success in multivariate logistic regression analysis. Conclusions: High GA and PROM were associated with extubation success. Pre- and post-extubation FiO2 values were not significantly predictive of extubation failure. Further studies should evaluate if overall assessment, including ventilatory parameters and clinical factors, can predict extubation success in neonates.
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Dr., Khadija Ilyas Dr. Mamoon Mirza Dr.Arooj Anwar. "THE INCIDENCE OF EARLY NEONATAL SEPSIS (ENOS) & ITS ASSOCIATION WITH MATERNAL RISK FACTORS AS PROM, PRETERM DELIVERY & MECONIUM LIQUOR." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 10 (2018): 10946–49. https://doi.org/10.5281/zenodo.1473048.
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<strong><em>Objective: </em></strong><em>In this research, we aimed to document the maternal risk factors frequency in the confirmed cases of an early neonatal sepsis in the two hundred enrolled patients including both male and female.</em> <strong><em>Methodology: </em></strong><em>We completed this research at Allied Hospital, Faisalabad in the timeframe of September 2016 to August 2017 (</em><em>Pediatrics Department). Our research sample consisted of two hundred confirmed and diagnosed cases of early neonatal sepsis within the period of twenty-four hours. The research sample included both the genders males and females within the age bracket of (1 – 3) days in the very early lifetime. Sample selection had no gender discrimination. We documented every single maternal risk such as PROM, preterm delivery and meconium stained liquor. The research analyzed the research outcomes on SPSS software.</em> <strong><em>Results: </em></strong><em>In the research sample of two hundred participants the age bracket of (1 – 2) days included 141 patients </em><em>(70.5%); whereas, 59 cases were of three days of age at the time of disease diagnosis (29.5%). The mean age factor was (1.84 ± 0.57) years. Male to female distribution was such as that 133 cases were male (66.5%); whereas, 67 cases were female (33.5%). Research had a dominance of male population over female population. Respective maternal risk factor frequency was also available in the cases of early neonatal sepsis. Reported risk factors included PROM, preterm delivery and meconium stained liquor with respective numbers as 132, 49 and 67 and respective proportions as 66%, 24.5% and 33.5%. </em> <strong><em>Conclusion: </em></strong><em>We reported “PROM” as the most dominant and frequent risk factor in early neonatal sepsis patients. Meconium Stained Liquor was a second most leading maternal risk factor; whereas, preterm delivery was a least common maternal risk factor.</em> <strong>Keywords: </strong><em>Maternal Risk Factors, Early Neonatal Sepsis (NS), Prolonged Rupture of Membrane (PROM), Preterm Delivery and Meconium Stained Liquor.</em>
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Aashi, Gupta, Sethi RS, Shankar Chaurasiya Om, and Sethi Anuj. "Effects of Neonatal Septicemia on Renal Function." PJSR 11, no. 2 (2018): 27–31. https://doi.org/10.5281/zenodo.8239771.
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An observational hospital based prospective study was conducted on 70 neonates with sepsis admitted in the Neonatology unit, Department of Paediatrics, MLB Medical College, Jhansi from Aug. 2016 to Sep. 2017 to evaluate the incidence of renal involvement in cases of neonates with septicemia and other contributing factors complicating acute kidney injury in them Sepsis was diagnosed on the basis of either a positive sepsis screen [Immature: Total neutrophil . ratio(I:T) > 0.2, micro –Erythrocyte Sedimentation Rate (ESR) > age in days +2 mm or >15 mm, C-Reactive Protein(CRP)> 1mg/dl, Total Leukocyte Count(TLC)1.5mg/dL with or without oliguria and with or without blood urea nitrogen (BUN) >20mg/dl on two separate occasions at least 24 hours apart. Oliguria was diagnosed when urine output was less than 1ml/Kg/hr. Out of the 70 neonates with sepsis,AKI was found in 23% (n=16) cases and majority of cases i.e. 75% (n=12) were nonoliguric, only 25% (n=4) were oliguric The association of Shock,Prolonged Rupture of Membranes(PROM) and Foul . Smelling Liquor (FSL) was also significant in neonates with AKI(68.75%vs 29.63%,p<0.05,60%vs 40%, p<0.05, 100%, p<0.05 respectively). Perinatal asphyxia did not significantly increase the occurrence of AKI in septic neonates The . mortality was higher in neonates with oliguricAKI (75%) as compared to non oliguricAKI (41.66%).AKI occurred in 23% neonates with sepsis. It was observed that AKI secondary to neonatal sepsis was predominantly nonoliguric. Factors like shock, prolonged rupture of Membranes (PROM), foul smelling liquor (FSL) and culture positivity were significant risk factors for development ofAKI in sepsis.
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Olita’a, Diana, Roland Barnabas, Gamini Vali Boma, Wendy Pameh, John Vince, and Trevor Duke. "Simplified management protocol for term neonates after prolonged rupture of membranes in a setting with high rates of neonatal sepsis and mortality: a quality improvement study." Archives of Disease in Childhood 104, no. 2 (2018): 115–20. http://dx.doi.org/10.1136/archdischild-2018-315826.
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In low-income and middle-income countries, courses of antibiotics are routinely given to term newborns whose mothers had prolonged rupture of membranes (PROM). Rational antibiotic use is vital given rising rates of antimicrobial resistance and potential adverse effects of antibiotic exposure in newborns. However missing cases of sepsis can be life-threatening.This is a quality improvement evaluation of a protocol for minimal or no antibiotics in term babies born after PROM in Papua New Guinea. Asymptomatic, term babies born to women with PROM >12 hours prior to birth were given a stat dose of antibiotics, or no antibiotics if the mother had received intrapartum antibiotics, reviewed and discharged at 48–72 hours with follow-up. Clinical signs of sepsis within the first week and the neonatal period were assessed. Of 170 newborns whose mothers had PROM, 133 were assessed at 7 days: signs of sepsis occurred in 10 babies (7.5%; 95% CI 4.4% to 13.2%) in the first week. Five had isolated fever, four had skin pustules and one had fever with periumbilical erythema. An additional four (3%) had any sign of sepsis between 8 and 28 days. There was one case of bacteraemia and no deaths. 37 were lost to follow-up, but hospital records did not identify any subsequent admissions for infection. A rate of sepsis was documented that was comparable with other studies in low-income countries. This protocol may reduce antimicrobial resistance and consequences of antibiotic exposure in newborns, provided safeguards are in place to monitor for signs of sepsis.
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Hincu, Maura-Adelina, Gabriela-Ildiko Zonda, Petronela Vicoveanu, et al. "Investigating the Association between Serum and Hematological Biomarkers and Neonatal Sepsis in Newborns with Premature Rupture of Membranes: A Retrospective Study." Children 11, no. 1 (2024): 124. http://dx.doi.org/10.3390/children11010124.
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(1) Background: Neonatal early-onset sepsis (EOS) is associated with important mortality and morbidity. The aims of this study were to evaluate the association between serum and hematological biomarkers with early onset neonatal sepsis in a cohort of patients with prolonged rupture of membranes (PROM) and to calculate their diagnostic accuracy. (2) Methods: A retrospective cohort study was conducted on 1355 newborns with PROM admitted between January 2017 and March 2020, who were divided into two groups: group A, with PROM ≥ 18 h, and group B, with ROM < 18 h. Both groups were further split into subgroups: proven sepsis, presumed sepsis, and no sepsis. Descriptive statistics, analysis of variance (ANOVA) and a Random Effects Generalized Least Squares (GLS) regression were used to evaluate the data. (3) Results: The statistically significant predictors of neonatal sepsis were the high white blood cell count from the first (p = 0.005) and third day (p = 0.028), and high C-reactive protein (CRP) values from the first day (p = 0.004). Procalcitonin (area under the curve—AUC = 0.78) and CRP (AUC = 0.76) measured on the first day had the best predictive performance for early-onset neonatal sepsis. (4) Conclusions: Our results outline the feasibility of using procalcitonin and CRP measured on the first day taken individually in order to increase the detection rate of early-onset neonatal sepsis, in the absence of positive blood culture.
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Mingaleva, N. V., T. B. Makukhina, E. S. Lebedenko, et al. "Management of Gestation with Abnormal Invasive Placenta Complicated by an Extra-preterm Premature Rupture of Membranes in a Tertiary Perinatal Centre." Kuban Scientific Medical Bulletin 27, no. 3 (2020): 113–24. http://dx.doi.org/10.25207/1608-6228-2020-27-3-113-124.
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Aim. Assessment of methods for prolonging gestation after an extra-preterm premature rupture of membranes (PROM) in a patient with abnormal invasive placenta and the efficacy of a multidisciplinary approach for treatment of a combined obstetric pathology in a tertiary perinatal centre.Results. A clinical case is reported of PROM at 22+6 weeks’ gestation in a patient with two caesarean scars on the uterus and abnormal invasive placenta. In a tertiary perinatal centre, pregnancy was prolonged to 36+3 weeks’ term. The period between PROM and delivery was 96 days. A planned caesarean section and metroplasty were performed in the setting of temporary balloon occlusion of common iliac arteries. Blood loss was 75 mL/kg. Placenta increta without chorioamnionitis was confirmed histologically. The patient stayed in the intensive care unit for two days and was discharged home on the 8th day. The newborn was assigned the Apgar score of 6/6. For two days, ventilatory support was rendered in a neonatal intensive care unit. The newborn was diagnosed with congenital pneumonia, the first-degree hypoxic-ischemic damage of the central nervous system and transferred to the second phase of nursing.Conclusions. A multidisciplinary approach and high technology facilities in the setting of a tertiary perinatal centre allow to reduce perinatal losses and provide high-quality care to patients with an increased risk of massive blood loss with the capacity to manage organ-preserving operative delivery with full rehabilitation in the postoperative period.
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Yuhana, Yuhana, Tuti Farida, and Turiyani Turiyani. "Hubungan Ketuban Pecah Dini, Partus Lama, dan Gawat Janin dengan Tindakan Persalinan Sectio Caesarea di Rumah Sakit TK. IV DR. Noesmir Baturaja Tahun 2020." Jurnal Ilmiah Universitas Batanghari Jambi 22, no. 1 (2022): 78. http://dx.doi.org/10.33087/jiubj.v22i1.1735.
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Sectio Caesarea is an artificial birth, in which the fetus is born through an incision in the abdominal wall and uterine wall with the condition that the uterus is intact and the fetal weight is above 500 grams. According to WHO, national rate of cesarean delivery does not exceed 10% of all births. The mortality rate due to Sectio Caesarea delivery ranges from 40-80 people per 100,000 live births. This study aimed to determine the relationship between premature rupture of membranes (PROM), Prolonged labor, and fetal distress with Sectio Caesarea delivery at Level IV hospital of Dr. Noesmir Hospital, Baturaja in 2020. It was an analytic survey with cross sectional approach. The population in this study was all mothers giving birth at Level IV Hospital of Dr. Noesmir Hospital, Baturaja in 2020 with a total of 332 people. 77 samples were selected using Systematic Random sampling technique. The data were analyzed using Chi Square statistical test. The results showed that the factors associated with caesarean section delivery were premature rupture of membranes with a p-value = 0.028 (≤ 0,05), fetal distress with a p-value = 0.029 (≤ 0,05), whereas the factor that is not related to it was prolonged labor a p-value = 1.000 ( > 0.05). This study can be used as a reference to add insight and skills for readers and a reference to improve the quality of services in hospitals.
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Wong, Yin Ping, and T. Yee Khong. "Changing Laboratory Practice for Early Detection of a Fetal Inflammatory Response: A Contemporary Approach." Diagnostics 13, no. 3 (2023): 487. http://dx.doi.org/10.3390/diagnostics13030487.
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Neonates born with the fetal inflammatory response (FIR) are at risk of complications such as early-onset neonatal sepsis, meningitis, and pneumonia. Providing an early histopathological diagnosis of FIR is important to guide management but can be a challenge in busy laboratories. This is a retrospective cross-sectional study over a four-month duration recruiting all placental cases with histological chorioamnionitis in our institution. The diagnostic performance of the umbilical cord (UC) section in identifying FIR, relative to the corresponding subsequent placental sections, was assessed. Clinical predictors of umbilical cord FIR were also investigated. A total of 390 UC sections were analyzed, of which 206 (52.8%) were found positive for FIR: 111 cases (53.9%) stage 1, 87 (42.2%) stage 2, and 8 (3.9%) stage 3. Our data revealed a good diagnostic sensitivity, specificity, positive predictive value, and accuracy of 76.2% (95%CI: 68.6–82.7%), 82.4% (95%CI: 65.5–93.2%), 95.0% (95%CI: 90.2–97.6%), and 77.3% (95%CI: 70.6–83.1%) respectively, in cases when clinical chorioamnionitis, fever and/or prolonged rupture of membrane (PROM) were suspected, with the area under the curve of 0.793. A maternal inflammatory response (MIR) was correlated with FIR (p < 0.001). Multivariate logistic regression analysis indicated that the higher the gestational age, clinical suspicion of chorioamnionitis, fever, and/or PROM, and the higher the stage of MIR significantly increased the odds of FIR (p < 0.001). UC section diagnosis of FIR is reasonably accurate in cases with clinical chorioamnionitis, fever, and/or PROM. Changing current laboratory practice to rapid processing of UC ahead of the rest of the other placental sections can be recommended in busy pathology departments.
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Sharma, Deepika, and Ashish Batham. "Risk scoring and prediction of early onset septicaemia in neonates through study of perinatal factors." International Journal of Contemporary Pediatrics 5, no. 4 (2018): 1666. http://dx.doi.org/10.18203/2349-3291.ijcp20182586.
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Background: Diagnosis of early onset septicaemia is often difficult due to lack of specificity of clinical manifestations. Being a common but neglected problem, the present study was undertaken to develop a scoring system which can predict early neonatal septicemia.Methods: 300 newborns born out of consecutive deliveries were assessed for the total score as combination of physical factors and neuromuscular factors. Information for perinatal factors was collected on a prepared pro forma by questionnaire method. Data was tabulated and subjected to statistical analysis.Results: Incidence of neonatal infection was higher in the presence of birth asphyxia, unclean vaginal examination, presence of foul smelling vaginal discharge, or when duration of labour exceeded 24 hours as compared to prolonged rupture of membranes. Incidence of infections among babies born before 37 weeks gestation or having a birth weight of 2 kg or less was nearly the same as in the cases of premature rupture of membranes (PROM). 224 cases got score 0-3 and only 0.6% got infected, whereas out of 62 cases with score 4-5, 51.6% were infected and 14 out of 14 having score of 6 or more had infection. The sensitivity of scoring system was 96%, specificity 90%, positive predictive value of 88% and negative predictive value of 60.5%.Conclusions: Besides PROM there are many other perinatal factors which are of significance in relation to early onset infections. This led to the formulation of the presenting scoring system. Validation of this scoring system through further studies can help in early diagnosis, administration of proper antibiotics and inhibition of the irrational use of antibiotics.
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Shinwell, Eric S., Ron Dagan, David Greenberg, and Carmi Z. Margolis. "PROLONGED RUPTURE OF MEMBRANES (PROM): IMPLEMENTATION OF PRACTICE GUIDELINE ALLOWING OBSERVATION WITHOUT ANTIBIOTIC THERAPY FOR LOW RISK INFANTS 1795." Pediatric Research 39 (April 1996): 302. http://dx.doi.org/10.1203/00006450-199604001-01819.
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Hincu, Maura-Adelina, Liliana Gheorghe, Luminita Paduraru, et al. "Impact of Extended Membrane Rupture on Neonatal Inflammatory Responses and Composite Neonatal Outcomes in Early-Preterm Neonates—A Prospective Study." Diagnostics 15, no. 2 (2025): 213. https://doi.org/10.3390/diagnostics15020213.
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Background/Objectives: Prolonged prelabour rupture of membranes (PROMs), and the resulting inflammatory response, can contribute to the occurrence of adverse neonatal outcomes, especially for early-preterm neonates. This prospective study aimed to measure neonates’ inflammatory markers in the first 72 h of life based on ROM duration. The second aim was to examine the relationship between PROMs, serum inflammatory markers, and composite adverse neonatal outcomes after controlling for gestational age (GA). Methods: Data from 1026 patients were analyzed considering the following groups: group 1 (ROM < 18 h, n = 447 patients) and group 2 (ROM > 18 h, n = 579 patients). These groups were further segregated depending on the GA at the moment of membranes’ rupture into subgroup 1 (<33 weeks of gestation and 6 days, n = 168 patients) and subgroup 2 (at least 34 completed weeks of gestation, n = 858 patients). Multiple logistic regressions and interaction analyses adjusted for GA considering five composite adverse neonatal outcomes and predictors were employed. Results: PROMs and high c-reactive protein (CRP) values significantly increased the risk of composite outcome 1 occurrence by 14% (95%CI: 1.03–1.57, p < 0.001). PROMs and high CRP values increased the risk of composite outcome 5 by 14% (95%CI: 1.07–1.78, p < 0.001), PROM and leukocytosis by 11% (95%CI: 1.02–1.59, p = 0.001), and PROMs and high PCT values by 21% (95%CI: 1.04–2.10, p < 0.001). Conclusions: The combination of PROMs and high CRP values significantly increased the risk of all evaluated adverse composite outcomes in early-preterm neonates and should point to careful monitoring of these patients.
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Yadav, Meetu, Raksha Gupta, Jasbir Singh, Sameer Saraswath, Niranjan Nagaraj, and Sailen Kumar Bana. "Value of examination of the gastric aspirate for the diagnosis of neonatal infection." International Journal of Contemporary Pediatrics 5, no. 6 (2018): 2309. http://dx.doi.org/10.18203/2349-3291.ijcp20184302.
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Background: Infections in early neonatal period are one of the important factors responsible for high perinatal mortality and neonatal morbidity in developing countries. This study aims to know the role of Gastric aspirates cytology in predicting the early septicemia in newborn babies.Methods: The study will be conducted on 100 neonates with suspected septicemia and 50 normal neonates admitted to neonatology section. Gastric aspirate sample was collected for sepsis screening of neonates. All the collected data was tabulated and statistically analysed by using SPSS 2.0 software.Results: The sensitivity of gastric aspirate cytology is 50%, specificity 65.62%, positive predictive accuracy 47.6%, negative predictive accuracy of 67. 7%. The relationship between gastric aspirate cytology and maternal risk factors was found to be statistically not significant except PIH and PROM in which association is significant. The relationship of prolonged rupture of membranes with gastric aspirate cytology was found to be highly statistically significant.Conclusions: The chances of positivity of gastric aspirate increase as the duration of rupture of membranes increased. Gastric aspirate had high percentage of specificity and negative predictive accuracy. No specific and significant correlation between positive gastric aspirate cytology and rural/urban area, birth weight, sex, gestation, prolong labour, meconium stained amniotic fluid, mode of delivery was found.
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Jahedbozorgan, Tayebeh, Minoo Yaghmaei, and Maryam Naserieh. "Comparison of serum ferritin levels in pregnant women with preterm and term deliveries." Immunopathologia Persa 6, no. 2 (2020): e25-e25. http://dx.doi.org/10.34172/ipp.2020.25.
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Introduction: Despite high rates of mortality and morbidity due to preterm delivery, none of the diagnostic and biochemical tests could help to accurately identify the cases at risk of preterm delivery. Objectives: Since ferritin is an acute phase reactant, this study aimed to evaluate serum ferritin levels in women with preterm and term delivery. Methods: This study was conducted on 150 women with preterm delivery (50 cases in each of the groups 24-30, 30-34, and 34-37 weeks of pregnancy), 150 women with term delivery, and 150 pregnant women who were between 24-37 weeks of pregnancy (same as preterm delivery groups). Results: The mean ferritin level in all preterm groups was significantly higher than that in the term group, but there was no difference among the preterm groups. In addition, ferritin level in each preterm group was significantly higher than those in the normal pregnancy group at the same gestational age. In preterm deliveries, ferritin levels were significantly higher in cases with prelabor rupture of membranes (PROM) or with a prolonged leakage (longer than 12 hours). In addition, in patients with PROM or prolonged leakage, ferritin levels were significantly higher in preterm deliveries than in term deliveries. A ferritin level of 37.5 ng/mL recognized as the best cut-off for preterm delivery, as compared with term delivery, and its sensitivity, specificity, and diagnostic accuracy was 78.7%, 68.7%, and 73.6%, respectively. Conclusion: The findings of the present study showed that serum ferritin level can be used to find patients at risk of preterm delivery.
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Joshua, Omach. "Prevalence and risk factors of Preterm Births in Northern Uganda: A Hospital-Based Study at Lira Regional Referral Hospital." IDOSR JOURNAL OF EXPERIMENTAL SCIENCES 10, no. 3 (2024): 39–62. http://dx.doi.org/10.59298/idosr/jes/103.39.62.
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This study aimed to assess the prevalence, proportions of early and late preterm births, and factors associated with preterm births among women delivering at Lira Regional Referral Hospital in Northern Uganda. It was a hospitalbased cross-sectional observational and analytic study involving 382 women and their babies, with data collected via questionnaires and analyzed using STATA software version 14.0. Univariate analysis, as well as bivariate and multivariate logistic regression, were conducted to identify factors associated with preterm birth. The mean age of participants was 25.22 years, ranging from 16 to 40 years. The study found a preterm birth prevalence of 16.23% (95% CI: 12.52 – 19.94), with 66.13% (95% CI: 54.01 – 78.25) of preterm births categorized as late preterm and 33.87% (95% CI: 21.75 – 45.99) as early preterm. Factors independently associated with preterm birth included maternal age of 16 – 23 years (aOR 6.90, 95% CI: 2.08 – 22.94, P=0.002), antepartum hemorrhage (aOR 4.75, 95% CI: 1.82 – 12.40, P=0.001), prolonged pre-labor rupture of membranes (PROM) (aOR 5.70, 95% CI: 2.00 – 16.21, P=0.001), hemoglobin level <10g/dl (aOR 20.64, 95% CI: 6.19 – 68.89, P<0.001), and hypertension (aOR 7.51, 95% CI: 2.72 – 20.75, P<0.001). In conclusion, the preterm birth rate at Lira Regional Referral Hospital was 16.23%, with maternal age, antepartum hemorrhage, prolonged PROM, low hemoglobin levels, and hypertension identified as significant risk factors. Recognizing these risk factors can enhance awareness of high-risk pregnancies, improve preventive measures, and modify preterm care protocols in neonatal units. Keywords: Preterm births, Women, Maternal age, haemorrhage, Haemoglobin.
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Kosinski, Przemyslaw, Katarzyna Luterek, Michal Lipa, and Miroslaw Wielgos. "The use of atosiban prolongs pregnancy in patients treated with fetoscopic endotracheal occlusion (FETO)." Journal of Perinatal Medicine 47, no. 9 (2019): 910–14. http://dx.doi.org/10.1515/jpm-2019-0144.
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Abstract Objective To evaluate the impact of atosiban as a tocolytic agent in patients treated with the fetoscopic endotracheal occlusion (FETO) procedure due to congenital diaphragmatic hernia (CDH). As premature birth after fetoscopy remains a serious concern, an effort to reduce prematurity is required. Methods A total of 43 patients with severe CDH treated with FETO were enrolled in this study. The study group consisted of 22 patients who received atosiban during the FETO procedure and a control group of 21 patients who did not receive atosiban during the FETO procedure. Demographic data, gestational age (GA) at delivery, cervical length and GA at premature rupture of membranes (PROM) were evaluated. Results The GA at delivery was significantly different between the two groups studied. The median GA at delivery was 32.6 and 34.5 weeks in the no-atosiban vs. atosiban groups, respectively (P = 0.013). The median cervical length was 29.9 and 31.2 mm for the no-atosiban and atosiban groups, respectively, and was not statistically significant (P = 0.28). There were no significant correlations between groups for the occurrence of PROM, GA at the time of PROM, duration of the procedures, parity, maternal body mass index (BMI) or age. In the univariate linear regression model, the only factor independently associated with GA at delivery was the use of atosiban during FETO procedures (β = 0.375; P < 0.013). Conclusion In cases of severe CDH treated with FETO, the use of atosiban as a tocolytic agent during the procedure prolonged pregnancy by 2 weeks. Cervical length, duration of FETO or maternal characteristics were not associated with GA at delivery.
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Jin, Jiao, Weiwei Wu, Feng Shen, et al. "Clinical Profile and Risk Factors of Group B Streptococcal Colonization in Mothers from the Eastern District of China." Journal of Tropical Medicine 2022 (August 29, 2022): 1–6. http://dx.doi.org/10.1155/2022/5236430.
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Objective. The main aim of this study was to determine the prevalence, capsular genotyping, antimicrobial susceptibility, and associated factors of colonizing Group B Streptococcus (GBS) in pregnant women admitted to a hospital in Jinan, East China. Methods. Demographic data, clinical characteristics, and vaginal and rectal swabs were obtained from a group of expecting mothers subjected to GBS screening at the late stage of pregnancy who went into labor over the period from November 2019 to October 2020. Identification of GBS and determination of antimicrobial resistance patterns were performed using a BD Phoenix-100 system. Capsular genotypes were analyzed using polymerase chain reaction and the associated factors were evaluated via logistic regression. Result. A total of 2761 pregnant women were recruited for this study. The GBS colonization rate was 6.70% (185/2761). Among the 172 GBS strains examined, all were susceptible to vancomycin and linezolid. Resistance was the highest for erythromycin (80.2%), followed by clindamycin (75.0%), levofloxacin (65.1%), and tetracycline (57.6%). The most common serotype identified was Ia (61.0%), followed by III (29.7%), VI (4.6%), II (3.5%), VII (0.6%), and a nontypeable strain. Risk factors for maternal GBS colonization included maternal age (older than 30 years) (OR = 1.913 (1.662, 2.478)), gestational age at birth (average gestational age) (OR = 1.992 (1.445, 2.746)), and prelabor rupture of membrane (OR = 3.838 (1.619, 9.099)). Conclusion. The prevalence of GBS was relatively low. The maternal age was a factor associated with GBS colonization. Subjects showing GBS positivity during late pregnancy were prone to prolonged rupture of the membrane (PROM) and birth at lower a gestation age than the GBS-negative group. Penicillin could still be used as the first agent of choice for intrapartum antibiotic prophylaxis (IAP).
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Fony, Nasrum Massi, and Werna Nontji. "The difference between C-reactive protein (CRP) level in mother with preterm rupture membranes (PROM) and mothers with prolonged labor." Enfermería Clínica 30 (March 2020): 10–13. http://dx.doi.org/10.1016/j.enfcli.2019.07.017.
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Kobal, Mallikarjun R., Prashant S. Gadgi, Sharanabasappa S. Dhanwadkar, and Ashwini Kumari N. B. "A clinical, radiological and etiological study of neonatal pneumonia." International Journal of Contemporary Pediatrics 6, no. 6 (2019): 2309. http://dx.doi.org/10.18203/2349-3291.ijcp20194614.
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Background: Pneumonia contributes to between 7, 50,000 and 1.2 million neonatal deaths and an unknown number of stillbirths each year worldwide1. It is estimated that 3.9 million of the 10.8 million deaths in children annually worldwide occur in the first 28 days of life.2 Neonatal pneumonia can be preventable if it is diagnosed as early as possible. Early recognition and prompt management are essential for the better outcome.Aim and objective: To determine bacterial etiology of neonatal pneumonia and to study the risk factors associated with neonatal pneumonia.Methods: A prospective, descriptive study was conducted for the duration of one year from July 2014 to June 2015 in Pragna children’s Hospital, a tertiary care centre, Hyderabad, Telangana, India. A total of 100 neonates were admitted in Pragna children’s Hospital with the signs and symptoms of neonatal pneumonia. A detailed history was taken including age, obstetric history of the mother, detailed birth history including resuscitation details and gestational age assessment were evaluated.Results: Out of 100 cases, 39(39%) neonates were preterm babies and 61(61%) were term. Also found history of Prolonged Rupture of Membrane (PROM) in 22% cases, maternal fever in 18%, home deliveries in 14% and foul smelling liquor in 18%. Out of 100 cases, 51 (51%) cases had positive finding in Chest X-Ray for neonatal pneumonia and 57(57%) had pneumonia with septicemia. Out of 100 cases, 9% of cases are positive for Coagulase negative staphylococcus (CONS), 5% for Klebsiella pneumonia, 2% for Pseudomonas aeroginosa and the remaining 84% of the cases had no growth for any organism.Conclusions: Major predisposing factors included PROM, foul smelling liquor, maternal fever, and home deliveries. CONS was the commonest organism isolated in blood culture.
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Sultan, Amira M., and Wael A. Seliem. "Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit." Sultan Qaboos University Medical Journal [SQUMJ] 18, no. 1 (2018): 75. http://dx.doi.org/10.18295/squmj.2018.18.01.012.
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Objectives: Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods: This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children’s Hospital, Mansoura, Egypt. Neonates who developed HAIs due to CRAB were assigned to a case group, while those infected with carbapenem-sensitive A. baumannii (CSAB) were assigned to a control group. Results: Among the 124 neonates who developed A. baumannii-caused HAIs during the study period, 91 (73.4%) were caused by CRAB and 33 (26.6%) were caused by CSAB. Prematurity, premature rupture of the membranes (PROM), a previous stay in another hospital, prolonged NICU stay, the presence of invasive devices, previous exposure to carbapenems or aminoglycosides and prolonged antibiotic therapy before infection were significantly associated with CRAB-caused HAIs. A multivariate logistic regression analysis identified prematurity (adjusted odds ratio [aOR] = 25.3; P <0.01), mechanical ventilation (aOR = 18.9; P <0.01) and the previous use of carbapenems (aOR = 124.7; P <0.01) or aminoglycosides (aOR = 22.6; P = 0.04) to be independent risk factors for CRAB infections. Conclusion: Various risk factors were significantly associated with CRAB-caused HAIs among the studied NICU patients.
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Ying, Yingfen, Xiaosheng Lu, Huina Zhang, et al. "Clinical and perinatal outcomes of fresh single-blastocyst-transfer cycles under an early follicular phase prolonged protocol according to day of trigger estradiol levels." PeerJ 9 (July 26, 2021): e11785. http://dx.doi.org/10.7717/peerj.11785.
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Backgroud This study’s objectives were to compare the clinical, perinatal, and obstetrical outcomes of patients with different estradiol (E2) levels in fresh single-blastocyst-transfer (SBT) cycles under an early follicular phase prolonged regimen on the day of trigger. Methods We recruited patients in fresh SBT cycles (n = 771) undergoing early follicular phase prolonged protocols with β-hCG values above 10 IU/L between June 2016 and December 2018. Patients who met the inclusion and exclusion criteria were divided into four groups according to their serum E2 level percentages on the day of trigger: <25th, 25th–50th, 51st–75th, and >75th percentile groups. Results Although the rates of clinical pregnancy (85.57% (166/194)), embryo implantation 86.60% (168/194), ongoing pregnancy (71.13% (138/194)), and live birth (71.13% (138/194)) were lowest in the >75th percentile group, we did not observe any significant differences (all P > 0.05). We used this information to predict the rate of severe ovarian hyperstimulation syndrome (OHSS) area under the curve (AUC) = 72.39%, P = 0.029, cut off value of E2 = 2,893 pg/ml with the 75% sensitivity and 70% specificity. The 51st–75th percentile group had the highest rates of low birth weight infants (11.73% (19/162), P = 0.0408), premature delivery (11.43% (20/175), P = 0.0269), admission to the neonatal intensive care unit (NICU) (10.49% (17/162), P = 0.0029), twin pregnancies (8.57% (15/175), P = 0.0047), and monochorionic diamniotic pregnancies (8.57% (15/175); P = 0.001). We did not observe statistical differences in obstetrics complications, including gestational diabetes mellitus (GDM), gestational hypertension, placenta previa, premature rupture of membranes (PROM), and preterm premature rupture of membranes (PPROM). Conclusion We concluded that serum E2 levels on the day of trigger were not good predictors of live birth rate or perinatal and obstetrical outcomes. However, we found that high E2 levels may not be conducive to persistent pregnancies. The E2 level on the day of trigger can still be used to predict the incidence of early onset severe OHSS in the fresh SBT cycle.
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Lee, Young Ah, and Ramasubbareddy Dhanireddy. "Association of Prolonged Rupture of Membranes (Prom) With Bronchopulmonary Dysplasia (BPD) in Extremely Low Birth Weight (ELBW) Infants in The Post-Surfactant ERA 1287." Pediatric Research 43 (April 1998): 220. http://dx.doi.org/10.1203/00006450-199804001-01308.
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Salsabila, Jauhar Roulfia, Sumirah Budi Pertami, Supono Supono, and Kasiati Kasiati. "INDICATIONS OF AN INCREASE IN THE INCIDENT OF CAESAREA SECTIO IN THE IHC LAVALETTE HOSPITAL, MALANG CITY." Indonesian Journal of Applied Health 1, no. 1 (2024): 1. http://dx.doi.org/10.31290/ijah.v1i1.4625.
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Caesarean section confinement method is one of the alternatives for confinement. The purpose of this study was to determine what indications are related to the increasing incidence of caesarean sections at Lavalette Hospital. The type of research used in this study is descriptive research, with a cross-sectional design. The population in this study were all used as samples totaling 69 mothers giving birth. Data collection in this study used primary data by giving questionnaires to patients giving birth. Analysis was carried out using univariate, bivariate and multivariate tests. The results of the study showed that 32 (46.4%) were included in the criteria for performing a caesarean section, there was an indication of a relationship between gestational age, premature rupture of membranes (PROM), preeclampsia, breech position and prolonged labor with cesarean section procedures in mothers giving birth at Lavalette Hospital, Malang. The result of the analysis of sectio caesarea indication showed that caesarean section was the dominant indication for procedures at Lavalette Hospital, Malang, with a p-value of 0.000<0.0005 and the highest Odds Ratio value of 92. This means that mothers who experience have a 92-fold greater chance of undergoing a caesarean section compared to other variables.
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Chakravarthi, Dr G. Kalyan, and Dr S. Surya Veera Kumar. "Incidence of neonatal sepsis in relation to prolonged rupture of membranes (PROM)>18 hours and associated risk factors for early onset neonatal sepsis (EONS)." Pediatric Review: International Journal of Pediatric Research 6, no. 9 (2019): 444–53. http://dx.doi.org/10.17511/ijpr.2019.i09.02.
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Ranakesh, Ramavathu, Gupta Sapna, and Shankar Chaurasia Om. "Prevalence and Risk Factors Associated with Birth Asphyxia among Neonates Admitted in Tertiary Care Centre of Bundelkhand Region." International Journal of Pharmaceutical and Clinical Research 16, no. 9 (2024): 1582–86. https://doi.org/10.5281/zenodo.13984340.
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<strong>Background:</strong> Globally, a significant factor in neonatal mortality is birth asphyxia. Birth asphyxia is still a serious illness that causes a high rate of morbidity and mortality in India. The purpose of the study was to evaluate the relationship between newborn outcome and birth asphyxia prevalence and risk factors. <strong>Methods:</strong> The cross-sectional study was carried out on 131 neonates during September 2021 to august 2022. Data were collected using a questionnaire, check list and chart review, which was used to retrieve medical information and mother’s data. Data analyzed using SPSS-25 software. <strong>Results:</strong> It was shown that 19.3% of babies had birth asphyxia overall. Among the 181 cases of births, there were 23.04% with meconium-stained labor, 16.85 with obstructed labor, 11.77% with malpresentation, 14.12% with prolonged labor, 8.3% with anemia, 9.55% with premature delivery, 5.67% with PROM, 3.3% with preeclampsia, and 1.75% with umbilical cord prolapse. In this study, the prevalence of moderate newborn asphyxia was 59.6% and severe birth asphyxia was 40.4% overall.26 cases (49.0%) of severe newborn asphyxia were discharged, and 27 cases (51%) died; in contrast, 61 cases (70%) of moderate birth asphyxia were discharged, and 17 cases (30%) died. <strong>Conclusion :</strong> Findings indicates that birth asphyxia is still prevalent and fetal mal-presentation, premature rupture of fetal membranes, meconium stained amniotic fluid, obstructed labour and prolonged labour were significantly associated maternal risk factors for birth asphyxia in neonates. Improved maternity care is required, as is raising awareness of the causes of birth asphyxia.
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Sharief, Suchi Avnalurini, and Sitti Patimah. "Analyze the Association Between Birth Attendant, Type Relationship Helper, Type and Problems/Disturbance of Delivery with The Level of Anemia in Mothers." Ahmar Metastasis Health Journal 4, no. 1 (2024): 12–19. http://dx.doi.org/10.53770/amhj.v4i1.273.
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In Indonesia, the causes of anemia in pregnancy are multifactorial, but in general iron deficiency is considered the main cause because anemia diagnosis is generally based on hemoglobin measurements. This research aims to analyze the relationship between helper, type, and birth problems/disruptions, and the degree of anemia in the mother. The type of research was analytical observational with a cross-sectional study design, the sampling technique was purposive sampling with a research period of October-November 2023. Of the 41 in-partum mothers with anemia at RSIA Masyita, Makassar City, there were 85.4% of the mothers with mild anemia, 14.6 % had moderate anemia, and no severe anemia was found in this study. The Chi-Square test was used to see maternal outcomes. For birth attendants with a p-value of 0.01, type of birth 0.06, birth problems/disorders 0.02. There were 16 mothers with anemia who experienced problems during delivery consisting of, 3 (18.7%) experienced hypertension, 3 (18.7%) experienced umbilical cord entanglement, 3 (18.7%) experienced prolonged labor, 5 (31.3%) experienced Premature Rupture of Membranes (PROM), 1 (6.3%) experienced serotinus and 1 (6.3%) experienced placenta previa. The conclusion is that the type of anemia influences the assistance and problems/disruptions during childbirth. Future researchers are expected to carry out monitoring not only focusing on the mother but also on the baby.
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Fenta, Genet Molla, Hiwot Ketema Woldemariam, Yeshi Metaferia, Abdurahaman Seid, and Daniel Gebretsadik. "Admission Outcome and Antimicrobial Resistance Pattern of Bacterial Isolates among Neonates with Suspected Sepsis in Neonatal Intensive Care Unit at Dessie Comprehensive Specialized Hospital, Dessie, Northeastern Ethiopia." Interdisciplinary Perspectives on Infectious Diseases 2022 (July 8, 2022): 1–13. http://dx.doi.org/10.1155/2022/1318295.
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Background. Neonatal sepsis is a major cause of morbidity and mortality globally. The aim of this study was to assess admission outcome and antimicrobial susceptibility pattern of bacterial isolates among neonates with suspected sepsis at the Dessie Comprehensive specialized Hospital (DCSH), Northeastern Ethiopia. Method. Cross-sectional study was conducted from August 2017 to March 2018. Two hundred forty-six neonates were recruited, and each patient’s blood specimen was collected aseptically using bottle containing Brain Heart Infusion for blood culture. Both clinical and laboratory data such as bacterial culture growth and antimicrobial susceptibility pattern were collected from the neonate; clinical data from the mothers were also included. Antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion method. The data were analyzed using SPSS version 20. Results. Bacteria were identified from 67 (27.2%) blood cultures. The predominant pathogen was Escherichia coli (35.8%) followed by Staphylococcus aureus (26.8%), and Coagulase Negative Staphylococcus (CoNS) (19.4%). The isolated bacteria showed resistance to Ampicillin 55 (82%), third-generation Cephalosporins 21 (58.3%) and other tested antimicrobials. Overall, 68.6% bacterial isolates demonstrated Multidrug resistance (MDR) and total registered mortality rate was 12/246 (4.8%). Both neonatal factors such as neonatal temperature, septic umbilicus and utilization of indwelling medical device during delivery; and maternal factors such as age, antenatal urinary tract infection (UTI), mode of delivery and prolonged rupture of membrane (PROM) had shown statistically significant association with bacterial sepsis. Conclusion. The rate of bacterial growth was found to be high; E. coli and S. aureus were the predominant organisms. Both maternal and neonatal related data were strong predictors for bacterial infection of the neonate. Therefore, improving infrastructures for screening of bacteremia as well as active surveillance in clinical setting needed to ensure proper empirical therapy.
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Adhikari, Jyoti, and Deepak Paudel. "Hypoxic Ischemic Encephalopathy in Neonates with Birth Asphyxia - A Hospital Based Study." Journal of Nepalgunj Medical College 18, no. 2 (2021): 22–26. http://dx.doi.org/10.3126/jngmc.v18i2.38878.
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Introduction: Each year approximately 4 million babies are born asphyxiated, which results in 1 million deaths and an equal number of serious neurological sequelae. One of the commonest organs involved in birth asphyxia is brain which may lead to a syndrome of clinical manifestation called Hypoxic Ischemic Encephalopathy (HIE).
 Aims: To find out possible maternal and neonatal risk factors for Hypoxic Ischemic Encephalopathy, to analyze clinical presentations and outcome of HIE in asphyxiated newborns.
 Methods: Hospital based observational study was carried out among fifty newborns with Apgar score less than 7 at 1 minute of life admitted in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke.
 Results: The incidence of birth asphyxia and birth asphyxia with HIE were 37.2 per 1000 live births and 14 per 1000 live births with male: female ratio of 1.27:1. Most of the neonates 22(44%) were in HIE stage II. Meconium stained amniotic fluid 18 (36%) was the most common intrapartum risk factor followed by maternal use of intrapartum medications 14 (28%), Premature Rupture of Membrane (PROM) 8 (16%), prolonged labor 5 (10%) and obstructed labor 6 (12%). Four (8%) asphyxiated neonates with HIE had cord prolapse and 7 (14%) had cord around the neck. The most common resuscitation done was bag and mask ventilation (56%) (P<0.05). Majority of the studied neonates were of normal birth weight (76%) and head circumference (84%) (P<0.05) with clinical presentations of respiratory distress (88%), seizures (44%), apnea (22%), bradycardia (8%), tachycardia (6%) and bulged anterior fontanel (6%). The overall mortality of neonates with HIE was 20% of which most were of HIE stage III.
 Conclusion: Certain measures could be taken to prevent birth asphyxia: early detection and intervention of high risk pregnancy, prompt and effective resuscitation of asphyxiates newborns.
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Yadav, Nishant, and Sachin Damke. "Study of risk factors in children with birth asphyxia." International Journal of Contemporary Pediatrics 4, no. 2 (2017): 518. http://dx.doi.org/10.18203/2349-3291.ijcp20170701.
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Background: Birth asphyxia is a serious clinical problem worldwide and contributes greatly to neonatal mortality and morbidity. Perinatal asphyxia is the fifth largest cause of under-5 deaths (8.5%) after pneumonia, diarrhea, neonatal infections and complications of preterm birth. Risk factors of birth asphyxia have been divided into antepartum, intrapartum and fetal. Risk factors include increasing or decreasing ma-ternal age, prolonged rupture of membranes, meconium stained fluid, multiple births, non-attendance for antenatal care, low birth weight infants, malpresentation, augmentation of labour with oxytocin, antepartum haemorrhage, severe eclampsia and pre-eclampsia, ante partum and intrapartum anemia. The objective of this study was to study the risk factors in children with birth asphyxia.Methods: Observational prospective study was conducted on babies delivered in our hospital and requiring resuscitation (basic and/or advanced). Their clinical course was observed and studied in NICU till time of discharge or death. Detailed maternal history was taken for risk factors.Results: The mean age of mothers was 24.28 years which ranged from 20 years to 29 years. Most of the population was from the lower middle and upper lower socioeconomic status as per the Modified Kuppuswamy scale. 51% neonates were born to primiparous mothers. Anemia was widely prevalent in the moth-ers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscita-tion were PIH (23.7%) , oligohydramnios (15%),multiple gestation (3.75 %), PROM (2.5%), diabetes mellitus (2.5%) and UTI (2.5%).One third of neonates requiring resuscitation were born to unbooked mothers.In the neonates requiring resuscitation, the male to female ratio was 1:1. The fetal factors associated with resuscitation of newborns were IUGR (33.75%), fetal distress (31.25%), prematurity (26.25%), MAS (12.5%) and malpresentations (5%).Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI.IUGR was the most com-mon fetal risk factor followed by fetal distress, prematurity, MAS and malpresentations. One third of neonates requiring resuscitation were born to unbooked mothers. In There was no gender predomi-nance found in this study.
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Perlman, Jeffrey M., Rick Risser, and R. Sue Broyles. "Bilateral Cystic Periventricular Leukomalacia in the Premature Infant: Associated Risk Factors." Pediatrics 97, no. 6 (1996): 822–27. http://dx.doi.org/10.1542/peds.97.6.822.
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Background. Bilateral cystic periventricular leukomalacia (PVL) is a major cause of neurodevelopmental delay in the premature infant. Thus, early identification of the preterm infant at highest risk for the subsequent development of this lesion is critical. Objectives. The three objectives of this case-control study were: (1) to determine the basic characteristics of cystic PVL, (2) to assess the relationship of perinatal clinical events and PVL, and (3) to ascertain the feasibility of identifying early those preterm infants at highest risk for the development of PVL. Methods. The medical records and cranial ultrasound scans (HUSs) were reviewed for 632 infants weighing less than 1750 g who were admitted to the neonatal intensive care unit between January 1992 and December 1993. PVL developed in 14 infants of 1285 ± 301 g birth weight (BW) and 29.4 ± 1.5 weeks' gestational age (GA); severe intraventricular hemorrhage (n = 21) and intraparenchymal echodensity (n = 12) developed in 33 infants of 904 ± 248 g BW and 26.6 ± 1.8 weeks' GA; and 585 infants of 1315 ± 324 g BW and 29.7 ± 2.4 weeks' GA with normal HUS findings (n = 473) or grade I or II intraventricular hemorrhage (n = 112) served as a comparison group. Results. Cystic PVL was observed in 14 (2.3%) of 632 infants weighing less than 1750 g, more specifically, in 3.2% of infants weighing less than 1500 g. Cysts were noted from the 7th to 14th days of life in 10 infants and from the 20th to 46th days of life in 4 infants. Ten (70%) of the infants had relatively benign clinical courses, and most cases were detected by routine HUS surveillance. Overt hypotension in the immediate perinatal period was noted in 3 (21%) infants; late hypotension developed in 1 additional infant. Univariate analysis indicate that two clinical indicators, prolonged rupture of membranes (PROM) and chorioamnionitis, were significant predictors of PVL. For PROM, the odds ratio estimate and the 95% confidence limit are 6.59 and 1.96 to 22.10, with a sensitivity of 28.6% and positive predictive value of 11.5%. Similar values for chorioamnionitis are 6.77 (1.77 to 25.93), with a sensitivity of 21.4% and positive predictive value of 11.5%. Conclusions. (1) Most cases of symmetric cystic PVL occurred in infants with relatively benign clinical courses and were only detected by routine ultrasound screening. (2) Postnatal systemic hypotension seems to be an uncommon associated event. (3) Preterm infants born to mothers with PROM and/or chorioamnionitis seem to be at an increased risk for the development of PVL and should be carefully evaluated.
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Abdella, Mustefa Negash, Jenberu Meskelu, Alula M. Teklu, and Delayehu Bekele. "OBSTETRIC REFERRALS AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE (SPHMMC): PRE-REFERRAL CARE AND APPROPRIATENESS." Ethiopian Journal of Reproductive Health 11, no. 2 (2019): 7. http://dx.doi.org/10.69614/ejrh.v11i2.268.
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ABSTRACTBACKGROUND: Referrals between health care facilities is crucial in emergency obstetrics care to ensure appropriate level of care to women and newborns. The timely decision and appropriate pre-referral care will significantly affect maternal and perinatal outcome. OBJECTIVE: The aim of our study was to assess the pre referral care and referral appropriateness of mothers referred to SPHMMC. METHODS: A cross sectional study was conducted that involved all mothers referred to SPHMMC for obstetric emergency from January 25 to March 5, 2017. They were interviewed at emergency department and the pre-referral care given and the process of patient transfer was assessed using a structured tool. Data was entered cleaned and analyzed using SPSS Version 22. Descriptive statistics and Pearson correlation was used to present results assess the relationship between referral and arrival diagnosis.RESULT: A total of 1080 mothers were transferred to SPHMMC from BEmONC centers during the study period. Majority of clients 718(65.5%) were from outside Addis Ababa and 362 (33.5%) of clients were from Addis Ababa. Prolonged labor, PROM, PIH and abortions constitute the top referral diagnosis accounting for 21.8%, 16.5%, 10.4% &9.9% in that order. Two thirds (68.6%) of the clients were transferred without prior notifications to the hospital. Most (96.5%) of those patients transferred with prolonged or obstructed labor were transferred without attachment of their Partograph. With regards to the intervention provided at referring health facility 170 (72.3%) of prolonged/obstructed labors were transferred without intravenous access line; 90 (75.4%) of patients with premature rupture of fetal membranes were not given antibiotics before referral, 89 (79.5%) of preeclampsia/eclampsia cases were not provided with magnesium sulphate as seizure prophylaxis and of those laboring mothers diagnosed to have fetal distress on referral, 45 (60.8%) were referred without securing intravenous line for resuscitation. CONCLUSION AND RECOMMENDATIONS: We found that most clients were coming from non-catchment health facilities without prior notification. In the majority of cases essential pre-referral care were not initiated at the referring facilities for those women with obstetric complications. BEmONC facilities need to be strengthened to offer the required medical interventions to save lives at the site and during transfer of patients. KEY WORDs: BEmONC, CEmONC, SPHMMC, Ethiopia. (Ethiopian Journal of Reproductive Health; 2019; 11;2:10-16)
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Littauer, Elizabeth Q., E. Stein Esser, Olivia Q. Antao, Dahnide T. Williams, Richard W. Compans, and Ioanna Skountzou. "Systemic dysregulation of cellular immune responses to H1N1 infection during pregnancy." Journal of Immunology 196, no. 1_Supplement (2016): 208.20. http://dx.doi.org/10.4049/jimmunol.196.supp.208.20.
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Abstract The 2009 H1N1 flu pandemic demonstrated that pregnant women infected with influenza were at risk for severe respiratory distress and premature-rupture-of-membranes (PROM), leading to high incidence of hospitalization, preterm births and small for gestation age (SGA) neonates. We utilize a syngeneic BALB/c pregnant mouse model which recapitulates clinical phenotypes shown during influenza infection of pregnant women. Pregnant mice sublethally infected (0.5xLD50) with pandemic H1N1 A/California/07/09 showed higher viral titers and delayed viral clearance relative to non-pregnant mice, and increased incidence of stillbirths and SGA offspring. Lymphocytes isolated at days 7 and 14 from lungs and spleens of infected pregnant and non-pregnant female mice were analyzed for H1N1 A/Ca/07/09 specific IL-4 and IFN-γ responses. Pregnancy delayed influenza-specific cytokine secretion at the site of infection, indicating systemic dysregulation of anti-viral responses. Lymphocytes from draining mediastinal lymph nodes, spleens and lungs were used to quantify activation of B cells in germinal centers (GC), maturation into antibody secreting cells and memory B cells, and mucosal homing to lung tissue following infection. Pregnancy decreased maturation of GC+ B cells in the spleen and migration of plasma cells from the spleen to the lungs. Infected pregnant mice generated equivalent serum influenza-specific neutralizing antibody titers and increased IgA antibody secreting cells (ASC) in the lungs 6 weeks post-infection relative to infected non-pregnant mice, indicating a potential role in pregnancy favoring the development of mucosal immunity in response to prolonged viral exposure.
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Wang, Zheng-Li, Yao An, Yu He, et al. "Risk factors of necrotizing enterocolitis in neonates with sepsis: A retrospective case-control study." International Journal of Immunopathology and Pharmacology 34 (January 2020): 205873842096381. http://dx.doi.org/10.1177/2058738420963818.
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Sepsis, a severe infectious disease in the neonatal period, is considered a risk factor for necrotizing enterocolitis (NEC). To investigate the specific risk factors for NEC in septic infants, septic infants admitted to our center from January 2010 to April 2018 were included. Septic neonates with proven NEC (Bell’s stage ⩾II) were enrolled in the NEC group, and those without NEC were enrolled in the control group. Demographics, clinical characteristics, and risk factors were compared between the two groups. Univariate and logistic regression analyses were used to evaluate the potential risk factors for NEC. A total of 610 septic neonates were included, of whom 78 (12.8%) had complicated NEC. The univariate analysis indicated that infants with NEC had a lower birth weight, a lower gestational age, and older age on admission than those without NEC ( P < 0.05). Higher rates of anemia, prolonged rupture of membranes (PROM) (⩾18 h), pregnancy-induced hypertension, late-onset sepsis (LOS), red blood cell transfusion and hypoalbuminemia were observed in the NEC group than in the non-NEC group (P<0.05). Logistic regression analysis revealed LOS ( P = 0.000), red blood cell transfusion ( P = 0.001) and hypoalbuminemia ( P = 0.001) were associated with the development of NEC. Among NEC infants, those who needed red blood cell transfusion had a longer hospitalization duration than those who did not need transfusion ( P < 0.05). LOS, red blood cell transfusion and hypoalbuminemia were independent risk factors for the development of NEC in infants with sepsis. Taking measures to reduce the occurrence of hypoproteinemia and severe anemia may help to reduce the occurrence of NEC in septic neonates.
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Sandra, Atukunda. "Prevalence and Risk Factors for Caesarean Section Delivery Following Labour Induction at Mbarara Regional Referral Hospital." IDOSR JOURNAL OF SCIENTIFIC RESEARCH 8, no. 3 (2023): 59–68. http://dx.doi.org/10.59298/idosrjsr/2023/00.5.6000.
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Labour induction is one of the most common obstetric interventions. According to most current studies, the rate varies from 9-33% of all pregnancies annually. According to American Congress of Obstetricians and Gynecologists, one-fifth of all pregnancies are terminated with the induction method. The aim of induction is to prevent maternal and fetal disorders such as preeclampsia, premature rupture of membranes, intrauterine growth retardation and prolonged pregnancy. Since the purpose of induction is vaginal delivery, a number of authors consider successful induction as vaginal delivery without regarding to the time limits. Induction failure is defined as failure of induction leading to cesarean section. The aim of this study was to determine the relationship between induction and risk of cesarean section delivery for women with term pregnancies who were admitted to Mbarara Regional Referral Hospital. A hospital based retrospective cohort study was conducted using maternally-linked data from MRRH birth registry. The study was restricted to deliveries intervened by labor induction at Mbarara Regional Referral Hospital during the year 2019 to 2021. Study samples size were 180 cases using convenience sampling among eligible pregnant women admitted to MRRH for induction. Data analysis was performed using SPSS version 21. Chi-square and t-test were used to compare groups with significant levels of less than 0.05, and logistic regression test was used to determine odds ratio with 95% confidence level. The mean age of those who underwent induction were 26.7 ± 5.6 years. In terms of education, 63.3 % were at the elementary level, the majorities (94.6%) were housewives or unemployed prior to delivery, and 57.4% were nulliparous. The prevalence of cesarean section was 22.21%. The mean gestational age was 39.3 ± 2.6 weeks and post-term pregnancies (40.63%), and PROM (24.12%) were among the most common causes for induction. Dilatation and birth weight were factors predicting labour induction success. Furthermore, performing Induction in dilatation 3 cm or less was associated with an increased risk of cesarean delivery. The prevalence of caesarean section after induction of labour in this study was 22.1%. Cervical dilatation (3 cm or less) prior to induction and increasing birth weight could be the major factors leading to caesarean section, hence predicting labor induction success. More funding is necessary by the hospital to further give more light to the all-time prevalence of cesarean section following labor induction within MRRH. Keywords: Labour induction, vaginal delivery, Cesarean section, Maternal and fetal disorders, Premature rupture of membranes.
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Seth, Princee, Hanslata Gehlot, Sarita Ghasal, and Jyoti Verma. "Vitamin D status in pregnant female and its effect on the maternal and fetal outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 13, no. 12 (2024): 3677–84. http://dx.doi.org/10.18203/2320-1770.ijrcog20243604.
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Background: Vitamin D deficiency is a global public health problem and is very common in pregnancy. Vitamin D status during pregnancy is of very much importance as it’s deficiency leads to increase risk of maternal and fetal complications like hypertensive disorders of pregnancy (HDOP), gestational diabetes mellitus (GDM), preterm, prelabor rupture of membranes (PROM), caesarean section, low birth weight (LBW) babies, intrauterine growth restriction (IUGR), still birth and neonatal intensive care unit (NICU) admission. Methods: 300 pregnant women were studied to assess serum vitamin D level over period of 9 months followed by analytical study done regarding maternal and fetal outcome. Results: Study shows 250 pregnant women out of 300 were deficient in vitamin D. Most of vitamin D deficient patients were under age of 30 years, housewives from rural sector. In both groups, most of patients underwent vaginal delivery. Pregnancies with complication were more seen in vitamin D deficient patients which include higher rate of GDM and HDOP. But other pregnancy complications like preterm, abruption, and prolonged labor were not prominently associated with vitamin D deficiency. Fetal complications and higher NICU admission rate were more seen in babies of vitamin D deficient mothers but no or little effect found on birth weight. Conclusions: Our study has observed higher rate of vitamin D deficiency in pregnant women and its level had significant effect on maternal and fetal complications. Though routine screening is not beneficial attributed to its high prevalence rate and cost effectiveness but since supplementation of vitamin D is simple with low likelihood of toxicity, we recommend adequate exposure to sunlight and supplementation of vitamin D in all pregnant women to keep serum level of 25(OH)D in the normal range for adult >30 ng/ml.