Adverse Fetal Outcomes Research Articles

Pregnancy Outcomes Among Teenagers at a National Referral Hospital in Uganda.

Introduction: Teenage pregnancy is a global public health challenge, and it is a major contributor to the high maternal and neonatal morbidity and mortality rates reported in sub-Saharan Africa and Uganda. However, there is a paucity of data regarding pregnancy outcomes and their associated factors among teenagers in Uganda. The purpose of this study was to determine the prevalence and factors associated with pregnancy outcomes among teenagers who delivered at a National Referral Hospital in Kampala, Uganda. Materials and Methods: This cross-sectional study was conducted among teenage mothers who delivered at a National Referral Hospital in Kampala, Uganda. Consecutive participant recruitment was done for those who fulfilled the eligibility criteria. The outcomes of interest included adverse maternal outcome with obstructed labor being used as a proxy and adverse fetal outcomes with birth asphyxia used as a proxy. Logistic regression analysis was used to determine the association between independent and dependent variables with a 5% level of statistical significance (α = 0.05). Results: Teenage pregnancy was associated with adverse maternal outcomes which included obstructed labor (18%) and preterm labor (5.5%). There were no maternal deaths during the study period. Adverse fetal outcomes observed in this study population included low birth weight (83%), birth asphyxia (18%), and stillbirth (4%). The only factor associated with adverse maternal outcome was gestational age where teenage mothers had 4 times likelihood of delivering before 37 weeks. Relatedly, teenage mothers had an 81% chance of having a preterm birth. Conclusion: Teenage pregnancy was generally not associated with adverse maternal or fetal outcomes except for preterm birth. The reasons for adverse pregnancy outcomes may reflect a combination of gynecological and biological immaturity, as well as adverse socioeconomic pressures.

Adverse pregnancy, fetal and neonatal outcomes in women with sickle cell disease in a Middle Eastern country.

Sickle cell disease in pregnancy is associated with high maternal and fetal mortality. However, studies reporting pregnancy, fetal, and neonatal outcomes in women with sickle cell disease are extremely limited. The objectives of the study are to determine whether women with sickle cell disease have a greater risk of adverse pregnancy, fetal, and neonatal outcomes than women without sickle cell disease and identify the predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. A retrospective pair-matched case-control study was conducted to compare 171 pregnant women with sickle cell disease to 171 pregnant women without sickle cell disease in Muscat, Sultanate of Oman. All pregnant Omani women with sickle cell disease who delivered between January 2015 and August 2021 at Sultan Qaboos University Hospital and Royal Hospital, who were either primipara or multipara and who had a gestational age of 24-42 weeks, were included as patients, whereas women who had no sickle cell disease or any comorbidity during pregnancy, who delivered within the same timeframe and at the same hospitals, were recruited as controls. The data were retrieved from electronic medical records and delivery registry books between January 2015 and August 2021. Women with sickle cell disease who had severe anemia had increased odds of (χ2 = 58.56, p < 0.001) having adverse pregnancy outcomes. Women with sickle cell disease had 21.97% higher odds of delivering a baby with intrauterine growth retardation (χ2 = 17.80, unadjusted odds ratio = 2.91-166.13, p < 0.001). Newborns born to women with sickle cell disease had 3.93% greater odds of being admitted to the neonatal intensive care unit (χ2 = 16.80, unadjusted odds ratio = 1.97-7.84, p < 0.001). In addition, the children born to women with sickle cell disease had 10.90% higher odds of being born with low birth weight (χ2 = 56.92, unadjusted odds ratio = 5.36-22.16, p < 0.001). Hemoglobin level (odds ratio = 0.17, p < 0.001, 95% confidence interval = 0.10-3.0), past medical history (odds ratio = 7.95, p < 0.001, 95% confidence interval = 2.39-26.43), past surgical history (odds ratio = 17.69, p < 0.001, 95% confidence interval = 3.41-91.76), and preterm delivery (odds ratio = 9.48, p = 0.005, 95% confidence interval = 1.95-46.23) were identified as predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. As pregnant women with sickle cell disease are at increased risk for pregnancy, fetal, and neonatal adverse outcomes; improved antenatal surveillance and management may improve the outcomes.

Combined impact of Hepatitis B virus and gestational diabetes mellitus on ultrasound-measured fetal growth and adverse perinatal outcomes: A seven-year retrospective study

AimsTo investigate the impact of pregnancy with combined hepatitis B virus (HBV) infection and Gestational diabetes mellitus (GDM) on fetal growth and adverse perinatal outcomes. MethodsAll the pregnant women with HBV infection and/or GDM who delivered at Women’s Hospital, Zhejiang University between January 2015, and September 2022 were included. A total of 1633 pregnant women were recruited in the final analysis, including 409 women with HBV infection and GDM, 396 with HBV infection only, 430 with GDM only, and 398 without HBV infection and GDM. Linear and logistic regression models were used to study the impact of pregnancy with combined HBV infection and GDM on fetal growth and adverse perinatal outcomes. ResultsPregnancy with combined HBV infection and GDM was associated with increased Z-scores on primary fetal ultrasound parameters and significantly increased the risk of fetal femur length overgrowth (OR: 2.88, 95 % CI: 1.13 ∼ 7.35), placental abruption (OR: 3.64, 95 % CI: 1.18 ∼ 11.22), and macrosomia (OR: 4.19, 95 % CI: 1.66 ∼ 10.56) compared to pregnancy without HBV infection and GDM. ConclusionsBoth maternal HBV infection and GDM are independently associated with adverse perinatal outcomes. Their combination further increases the risk of adverse perinatal outcomes.

An Overview of Environmental Tobacco Smoke Exposure During Pregnancy: Lower Birth Weight and Height as the Main Health Effect on Human Fetus

Background: Exposure to environmental tobacco smoke (ETS) during pregnancy also poses serious health risks for mother and baby. No study has comprehensively compiled these health effects. In this review, we conducted a narrative scientific review to investigate the results of studies conducted on the effect of mothers’ exposure to ETS on the weight and height of infants and fetuses during pregnancy. Materials and Methods: The literature search was conducted in March 2024 in Web of Science, Scopus, PubMed, and Google Scholar databases. After considering the criteria of the study, 29 papers were included in this overview. Results: ETS exposure is associated with different adverse fetal outcomes. Most studies that examine the effects of passive maternal smoking on fetal growth show that ETS increases the risk of lower mean birth weight and or length. Conclusion: Pregnant women exposed to ETS and their fetuses are as susceptible groups against ETS exposure. Other health consequences on babies due to involuntary exposure of pregnant mothers to ETS should be investigated in future studies.

Adverse perinatal outcomes in gestational diabetes mellitus with and without SARS-CoV-2 infection during pregnancy: results from two nationwide registries in Germany

IntroductionPregnancy is a known independent risk factor for a severe course of COVID-19. The relationship of SARS-CoV-2 infection and gestational diabetes mellitus (GDM) on neonatal outcomes is unclear. Our aim...

Study of Severity of Anemia during Pregnancy and Adverse Maternal and Fetal Outcomes at Tertiary Care Centre

Study of Severity of Anemia during Pregnancy and Adverse Maternal and Fetal Outcomes at Tertiary Care Centre

Sex-Specific Dysregulation of Placental Lipid Metabolism in Preeclampsia.

Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with adverse maternal and fetal outcomes. While placental dysfunction is implicated in PE pathogenesis, the impact of PE on placental lipid metabolism and its potential sexual dimorphism remains poorly understood. We conducted a comprehensive analysis of term placentas from PE and normotensive pregnancies with male and female fetuses. Lipid profiles were quantified using mass spectrometry, and mRNA expression of genes involved in fatty acid oxidation, esterification, and transport was assessed using qPCR. Placentas from PE pregnancies exhibited elevated lipid levels, with male placentas showing a more pronounced increase in triacylglycerols, cholesteryl esters, and free cholesterol compared to female placentas. Gene expression analysis revealed sexually dimorphic alterations, with male PE placentas exhibiting upregulation of genes involved in fatty acid uptake, oxidation, and esterification, while female PE placentas showed a more complex response with both upregulation and downregulation of certain genes. Notably, peroxisomal fatty acid oxidation was upregulated in male PE placentas but suppressed in female PE placentas. Our findings reveal sexually dimorphic alterations in placental lipid metabolism in PE, suggesting that male placentas may be more vulnerable to lipotoxicity. These insights may have implications for understanding the pathogenesis of PE and developing sex-specific interventions to improve maternal and fetal outcomes.

Adverse maternal and fetal outcomes among pregnant women with uterine scar and placenta previa in the third trimester: a cross -sectional study at zonal referral hospital

Adverse maternal and fetal outcomes among pregnant women with uterine scar and placenta previa in the third trimester: a cross -sectional study at zonal referral hospital

Investigating the Impact of Pregnancy-Induced Hypertension on Fetal Outcomes: A Comprehensive Study in Maternity Hospitals

Background: Hypertension in pregnancy is a major obstetric complication that poses a significant risk to maternal and fetal health, leading to increased morbidity and mortality. According to the World Health Organization, hypertensive disorders of pregnancy (HDP) claim the life of at least one woman every seven minutes. HDPs are associated with an increased risk of adverse fetal and neonatal outcomes, including preterm birth, intrauterine growth restriction (IUGR), perinatal mortality, and maternal morbidity and mortality. Prompt recognition and management of PIH are essential to mitigate these complications and ensure optimal maternal and fetal outcomes. Hence the study was undertaken to assess the impact of Pregnancy Induced Hypertension on fetal outcome among Antenatal mother with PIH at maternity hospital of Anand and Kheda district. Objectives: To assess the clinical presentation among mother with PIH at maternity hospital; To assess the impact of Pregnancy Induced Hypertension on fetal outcome. Methodology: A Prospective study was conducted at Dr. N. D. Desai hospital, Nadiad. Sample size was 30. Sample was selected by Consecutive Sampling Technique. The data regarding Demographic variable, Obstetric History, Classification of PIH, Blood pressure, Drug Received &amp; Fetal outcomes was collected using Structured Interview Scheduled. The result is computed by using descriptive and frequency and percentage using tables, graph etc. Data were analysed according to objectives of the study. Results: In present study, the incidence of gestational hypertension, pre-eclampsia, and eclampsia was 10%, 86.66%, and 3.33%, respectively. These conditions were more common in primipara. The symptoms of pregnancy-induced hypertension (PIH) included pedal edema (60%), vomiting (43.33%), blurry vision (6.66%), convulsions (3.33%), and dizziness (6.66%), as well as epigastric pain (16.66%) and lower abdominal pain (36.66%). Most mothers (83.33%) received antihypertensive medication. The study also found that fetal complications included preterm births (66.66%) and low birth weight (56.66%). Additionally, 63.33% of babies required NICU admission, and there were cases of post-term birth (3.33%), congenital abnormalities (3.33%), birth asphyxia (3.33%), and neonatal deaths (10%). Conclusion: Pregnancy-induced hypertension is a common and serious condition that can have devastating effects on both mothers and babies. To combat this, we need to raise awareness and take action at both community and hospital levels to reduce the risks and improve outcomes.

Correlation of Cross-sectional Area of the Umbilical Cord on Antenatal Ultrasound with Neonatal Birth Weight in Pregnant Women with and without Gestational Diabetes Mellitus: A Prospective Cohort Study

Introduction: Many foetal and maternal complications, such as polyhydramnios, macrosomia, birth injuries, and operative interference, are linked with Gestational Diabetes Mellitus (GDM). Among these, macrosomia is particularly significant, as it increases the risk of shoulder dystocia, brachial plexus injury, birth asphyxia, and maternal complications, including emergency Lower Segment Caesarean Section (LSCS), Postpartum Haemorrhage (PPH), and perineal trauma. Therefore, one of the most essential perinatal goals in GDM is to predict macrosomia by estimating birth weight, thereby preventing adverse maternal and foetal outcomes. Aim: To evaluate whether there is a correlation between the cross-sectional area of the Umbilical Cord (UCA) and the Neonatal Birth Weight (NBW) in pregnant women with GDM. Materials and Methods: A prospective cohort study was conducted in the Departments of Radiology and Obstetrics Bangalore Medical College, Bengaluru, Karnataka, India. A total of 100 pregnant women (50 with GDM and 50 without GDM) were recruited from July 2021 to July 2022. Ultrasound examination (USG) was performed on pregnant women after 36 weeks of gestation. The UCA was measured in a free-floating loop, and the NBW was measured using a digital scale. The correlation coefficient was calculated to determine the degree of correlation between UCA and NBW. Results: The mean age of the subjects was 26.5±3.9 years. The frequency of macrosomia was higher in the GDM group (8%) compared to the control group (4%). A strong positive correlation was observed between UCA and NBW in both diabetics (r=0.819) and control groups (r=0.736). Conclusion: A strong positive correlation exists between UCA and NBW in women with GDM. Therefore, it should be estimated during routine antenatal USG for the prediction of birth weight in such women.

Adverse maternal and fetal outcomes following acute burns injury in pregnancy: Experience from a private burns facility in rivers state

Adverse maternal and fetal outcomes following acute burns injury in pregnancy: Experience from a private burns facility in rivers state

Adverse pregnancy outcomes associated with endometriosis in Ukraine: results a multicenter study.

Aim: To estimate pregnancy outcomes associated with endometriosis in Ukraine. Materials and Methods: We performed the multicentre prospective cohort study during the period from January 1st, 2019 to December 31st, 2021. The study included pregnant women aged ≥18 years hospitalized in 17 hospitals from 15 regions of Ukraine. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Results: Of the 27,558 women, 990 (3,6%) reported a diagnosis of endometriosis before pregnancy. In 990 deliveries, women with endometriosis had a higher risk of hypertension in pregnancy (OR 1.2, 95% CI 1.0-1.3), preeclampsia (OR 1.4, 95% CI 1.3-1.5), severe preeclampsia (OR 1.7, 95% CI 1.5-2.3), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), birth before 34 weeks (OR 3.2, 95% CI 2.8-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). Conclusions: Pregnant women with endometriosis are at elevated risk for serious and important adverse maternal, fetal and neonatal outcomes. The magnitude of these complications calls for more intensive antenatal care of pregnant women with endometriosis.

The predictive value of thromboelastography, routine blood indices, ultrasound parameters, and placental thickness in determining fetal outcome.

To evaluate the predictive value of thromboelastography, routine blood indices, ultrasound measurements, and placental thickness for fetal outcome. A retrospective analysis of 218 expectant mothers at our hospital from April 2020 to June 2022 was conducted. Mothers were classified into favorable (n=164) and adverse (n=54) fetal outcome groups. We compared thromboelastography, blood counts, and ultrasound parameters, including placental thickness, between the two groups. Predictive models using lasso regression were developed for individual assessment type and their combinations. Model efficacies were evaluated by ROC curves and Delong's test. Thromboelastography indicated significantly higher values of R (P=0.004), Angle (P<0.001), and MA (P=0.002) while notably lower K (P<0.001) in the adverse outcome group compared to the favorable outcome group. Peripheral blood analysis showed elevated levels of WBC (P<0.001), CRP (P=0.001), and PLR (P<0.001) in the adverse outcome group. Ultrasound assessments revealed significant increases in S/D (P<0.001), PI (P=0.016), RI (P<0.001), and placental thickness (P<0.001) in the adverse outcome group. The areas under the curve (AUCs) for the thromboelastography (4 features), peripheral blood indices (3 features), ultrasound parameters (4 features), and combined index model (11 features) were 0.774, 0.779, 0.961, and 0.978, respectively. Delong's test indicated that the combined model's AUC did not significantly differ from that of the ultrasound parameters (P>0.05) but was superior to the models based on thromboelastography, peripheral blood indices, and placental thickness alone (P<0.001). This study underscores the unparalleled predictive value of ultrasound metrics in identifying the risk of adverse pregnancy outcomes, highlighting their critical role in prenatal risk assessment and monitoring frameworks.

Current Screening and Management Practices for Gestational Diabetes Mellitus in Public Hospitals of South India

Background Gestational Diabetes Mellitus GDM leads to adverse maternal and foetal health outcomes. There are several benefits of screening pregnant women for GDM including reducing the impact and timing of GDM-associated complications. However there is limited evidence regarding GDM screening and management in public hospitals in low- and middle-income countries. Therefore we aimed to understand the current GDM screening and management practice in public hospitals in South India through the study of pregnant women in Bangalore.Methods We conducted a cross-sectional study in all the six tertiary-level public hospitals of Bengaluru which were providing antenatal services during September 2017. We compared the results of GDM screening in five of these hospitals with a tertiary public hospital wherein a cohort of women were studied during the same time wherein voluntarily consented women were subjected to GDM screening and were followed up through their pregnancy and post-partum.Results Among the 186 pregnant women included in the cross-sectional study 41.4 n77186 had undergone random blood sugar test and 22 n39186 underwent a confirmatory test in the form of either a Glucose Challenge Test GCT or Oral Glucose Tolerance Test OGTT for diagnosis. Similarly pregnant women underwent capillary blood glucose testing 5.1 n9186 fasting blood sugar 1.7 n3186 urine glucose and albumin level 1.7 n3186 testing. The prevalence of GDM in this cross-sectional study obtained via routine screening in public hospitals was 4.3 n8186 while in comparison the prevalence of GDM was 15.4 n1571019 in the ongoing cohort. Furthermore only 22.9 of cohort women diagnosed with GDM received any follow-up treatment in public hospitals. We also found that 12.1 and 7 of women achieved glucose control in the antenatal and postnatal period respectively.Conclusion Our results suggest that most women with GDM attending public hospitals may be ldquomissedrdquo from GDM diagnosis and treatment even in the major public hospitals in Bangalore. Therefore strengthening the GDM screening and management in public hospitals is imperative to avert the adverse risks of GDM among women and their children in urban areas.

Effect of Maternal Pre-Pregnancy Body Mass Index on Longitudinal Fetal Growth and Mediating Role of Maternal Fasting Plasma Glucose: A Retrospective Cohort Study.

To assess the impact of maternal pre-pregnancy body mass index (BMI) on longitudinal fetal growth, and the potential mediation effect of the maternal fasting plasma glucose in first trimester. In this retrospective cohort study, we collected pre-pregnancy BMI data and ultrasound measurements during pregnancy of 3879 singleton pregnant women who underwent antenatal examinations and delivered at Peking Union Medical College Hospital. Generalized estimation equations, linear regression, and logistic regression were used to examine the association between pre-pregnancy BMI with fetal growth and adverse neonatal outcomes. Mediation analyses were also used to examine the mediating role of maternal fasting plasma glucose (FPG) in first trimester. A per 1 Kg/m² increase in pre-pregnancy BMI was associated with increase fetal body length Z-score (β 0.010, 95% CI 0.001, 0.019) and fetal body weight (β 0.017, 95% CI 0.008, 0.027). In mid pregnancy, pre-pregnancy BMI also correlated with an increase Z-score of fetal abdominal circumference, femur length (FL). Pre-pregnancy BMI was associated with an increased risk of large for gestational age and macrosomia. Mediation analysis indicated that the associations between pre-pregnancy BMI and fetal weight in mid and late pregnancy, and at birth were partially mediated by maternal FPG in first trimester (mediation proportion: 5.0%, 8.3%, 1.6%, respectively). Maternal pre-pregnancy BMI was associated with the longitudinal fetal growth, and the association was partly driven by maternal FPG in first trimester. The study emphasized the importance of identifying and managing mothers with higher pre-pregnancy BMI to prevent fetal overgrowth.

Macroscopic Changes in the Human Placenta in Hypertensive Disorders of Pregnancy in Indian Women: A Cross-sectional Study

Introduction: Hypertension (HTN) is a common complication in 6-10% of pregnancies and is one of the prime factors for foetal, as well as, maternal fatalities and morbidities. Significant pathological changes are seen in the placenta in hypertensive pregnancies before affecting the foetus. These changes may serve as an early warning system for detecting foetal issues like low birth weight and growth restriction. Early detection and intervention of morphological changes in the placenta and umbilical cord can help prevent adverse foetal outcomes. Aim: To study the macroscopic changes in the placenta in women with HTN induced by pregnancy compared to non hypertensive pregnant women. Materials and Methods: The present cross-sectional descriptive study was conducted in the Department of Anatomy and the Department of Obstetrics and Gynaecology, Ramaiah Medical College Hospital, Bengaluru, Karnataka, India, between December 2017 and January 2019. A sample size of 43 each was taken for non hypertensive and hypertensive subjects, including those with preeclampsia and chronic HTN with superimposed preeclampsia. The placental morphological parameters, routine biochemical tests and neonatal outcomes of both groups were analysed statistically using the Shapiro-Wilk test, Independent t-test and Chi-square test. A probability value less than 0.05 was considered for statistical significance. Results: The mean age of participants was 28.35±3.026 years in the hypertensive group and 26.23±2.636 years in the control group. The circular, oval and irregular shapes were 29 (65.9%), 10 (22.7%) and 4 (9.3%) in non hypertensive subjects and 33 (78.6%), 7 (16.27%) and 3 (7.1%) in the hypertensive subjects, respectively. The surface area (mean-142.44±49.69; p-value&lt;0.001), radius (mean-6.622±1.24; p-value&lt;0.001), circumference (mean-37.419±6.091; p-value&lt;0.001), the quantum of cotyledons (mean-13.09±3.344; p-value&lt;0.001) were lesser in the hypertensive group than the non hypertensive subjects. There were differences in placental and foetal weight among non hypertensive and hypertensive subjects, but the differences were insignificant. The Appropriate for Gestational Age (AGA) babies were more in non hypertensive subjects. Conclusion: The present study found hypertensive pregnancies to be associated with a greater occurrence of unfavourable foetal outcomes. Furthermore, it highlights the importance of investigating the placenta’s physical attributes and their association with foetal outcomes to develop standard operating protocols for diagnostic and therapeutic approaches in normal/ complicated pregnancies.

Emergency department management of acute agitation in the reproductive age female and pregnancy.

Agitation is a common presentation within emergent departments (EDs). Agitation during pregnancy should be treated as an obstetric emergency, as the distress may jeopardize both the patient and fetus. The safety of psychotropic medications in the reproductive age female has not been well established. This review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during pregnancy. A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant female. While nonpharmacological management is preferred, ED visits for agitation often require medical management. Medication should be selected based on the etiology of agitation and the clinical setting to avoid major adverse effects. Adverse effects are common in pregnant females. For mild to moderate agitation in pregnancy, diphenhydramine is an effective sedating agent with minimal adverse effects. In moderate to severe agitation, high-potency typical psychotropics are preferred due to their neutral effects on hemodynamics. Haloperidol has become the most frequently utilized psychotropic for agitation during pregnancy. Second generation psychotropics are often utilized as second-line therapy, including risperidone. Benzodiazepines and ketamine have demonstrated adverse fetal outcomes. While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation, animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in utero. As the fetal risk associated with multiple doses of psychotropic medications remains unknown, weighing the risks and benefits of each agent, while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.

Adverse Maternal and Fetal Outcomes in Teenage Pregnancy

INTRODUCTION: Teenage pregnancy is a major public health issue these days and is associated with adverse maternal and fetal outcomes. This study was conducted to determine the adverse maternal and fetal outcomes in teenage pregnancy. MATERIALS AND METHODS: This was a hospital based descriptive cross-sectional study. All the teenage pregnant women (15-19 years of age) with a singleton pregnancy coming to antenatal ward of Birat Medical College Teaching Hospital from 22nd December 2022 to 21th December 2023 were enrolled in the study, irrespective of their APGAR score at birth, NICU admission and early neonatal death and intrauterine fetal death were noted after delivery. RESULTS: The incidence of teenage pregnancy was 1.7%, and the mean age was 18.36±.83 years. Majority (53.3 %) of the women had normal vaginal delivery. The most common maternal complication was preterm labor (26.7%), while the most common fetal complication was low birth weight (38.7%). 29.3% were admitted to NICU, 25.3% had low APGAR score, 2.7% had stillbirth, 1.3% had early neonatal death. CONCLUSION: Teenage pregnancy was associated with a high rate of adverse maternal and fetal outcomes like premature delivery, anemia, pregnancy induced hypertension, instrumental deliveries, lower segment cesarean section (LSCS), low birth weight, low APGAR score at birth and NICU admission.

Analyzing Fetal Outcomes Variability in Women with Short Inter-Pregnancy Intervals: A Cross-Sectional Study

The optimal interpregnancy interval (IPI) of 18-23 months is crucial for a mother's health, preventing adverse perinatal outcomes. Short IPI, particularly in females with a history of Cesarean section opting for vaginal birth, is associated with a 2 to 3 times increased risk of uterine rupture and other major morbidities. Objective: To assess the frequency of various fetal outcomes in women with short inter-pregnancy intervals. Methods: The study employed a Non-probability Consecutive sampling technique over nine months, from September 28, 2020, to June 20, 2021, comprising 170 female subjects who met inclusion criteria and provided informed consent, parameters such as parity, gestational age, and details about previous births were investigated. Presenting complaints were recorded using data collection proforma. The assessments included a thorough physical examination, per abdomen evaluation based on gestational age, and vaginal examination. Results: Maternal age data were analyzed using SPSS version 21.0 categorized into four groups, with mean age of 30 ± 1.27. Gravidity status was divided into three categories: 77.65% were multigravida, 18.82% were grand multigravida, and 3.53% were great grand multigravida among patients. Notably, 32.35% of females experienced preterm premature rupture of membranes, 38.82% had neonates born preterm, 12.35% suffered early neonatal death, and 25.29% had newborns with less weight at birth. Conclusions: The research concluded that short IPI is a significant factor in adverse fetal outcomes, negatively impacting maternal and child well-being.

Study of Feto-Maternal Outcome in Pregnancy with Subclinical Hypothyroidism

Background: Hypothyroidism has a great impact on pregnancy. But there is a controversy about the maternal and perinatal outcomes of subclinical hypothyroidism (SCH). This study was placed to know the significant effects. Methods and Materials: A descriptive longitudinal study was held in Z. H. Sikder Women’s Medical College &amp; Hospital, Dhaka, Bangladesh. 400 pregnant women were included in this study with purposive sampling. All antenatal patients from booking visit at 1st trimester to delivery were monitored by serum TSH and serum FT4 levels in each trimester and fetal outcomes were also monitored. 200 pregnant women were diagnosed as subclinical hypothyroidism (SCH) with random screening of initial thyroid function tests. Another 200 pregnant women were euthyroid. The study period was 3 years, from January 2020 to December 2022. To evaluate the thyroid status, maternal serum samples were collected in each trimester, total three times. Maternal outcomes, which we studied, were gestational hypertension, gestational diabetes mellitus, maternal anemia, antepartum hemorrhage, postpartum hemorrhage, placental abruption, preterm delivery, premature rupture of membranes (PROM), caesarean deliveries; perinatal outcomes were low birth weight (LBW), intrauterine growth restriction (IUGR), low Apgar score, stillbirth, congenital anomaly and NICU admission. Result: This study includes 400 pregnant women, among which 200 were euthyroid and 200 were with SCH. The mean age was 27.12 ± 0.05 years in pregnancy with euthyroid group and 26.31 ± 0.25 in pregnancy with SCH group. Among the pregnancy with euthyroid group, 141 women were nullipara and 59 women were nullipara. Among the pregnancy with SCH group, 87 women were nullipara and 113 women were nullipara. Serum TSH level was 4.44 ± 0.11 in 1st trimester, 4.74 ± 0.19 in 2nd trimester, 5.45 ± 0.17 in 3rd trimester. Serum free T4 level was 8.29 ± 0.13 in 1st trimester, 6.65 ± 0.15 in 2nd trimester, 6.67 ± 0.34 in 3rd trimester. In pregnancy with SCH group gestational hypertension, miscarriage, placental abruption and premature rupture of membranes (PROM) were significantly higher (p&lt;0.001). Antepartum hemorrhage (APH), preterm delivery and Caesarian deliveries were also higher in this group (p&lt;0.05). Among the neonatal outcomes, low birth weight and intrauterine growth restriction (IUGR) babies were more born in pregnancy with SCH group. Anti TPO antibody titer was significantly higher in pregnant women with SCH. Conclusion: Subclinical hypothyroidism (SCH) is associated with increased risk of gestational hypertension, premature rupture of membranes (PROM), abruptio placentae and fetuses have more risk of IUGR and LBW. Therefore, routine maternal thyroid function test should be done to protect from adverse maternal and fetal outcome.