Newborn Apgar Scores Research Articles

The impact of asphyxia on the development of hyperbilirubinemia in newborns: An observational study

Asphyxia is still a major cause of morbidity and mortality in newborns in both developing and developed countries. The prevalence of asphyxia in provincial referral hospitals in Indonesia is 41.94%. The purpose of this study was to determine the correlation between the first minute Apgar score and bilirubin levels in newborns at Margono Soekarjo Hospital, Purwokerto. The type of research used is analytic observational with a cross sectional approach. The population in this study were newborns who were cared for in the perinatal room at Margono Soekarjo Hospital Purwokerto in 2021-2022 with a total of 3824 babies. The sample size was 156. Data analysis used the Pearson Product Moment test. The results showed that the lowest Apgar score was 1 and the highest Apgar score was 8, the average Apgar score was 5. The lowest bilirubin level was 0.1 mg/dL and the highest bilirubin level was 24.16 mg/dL, the average bilirubin level was 10.68 mg /dL. There is a significant correlation between Apgar scores and bilirubin levels in newborns at Margono Soekarjo Hospital, Purwokerto, with a weak correlation (-0.231). Conclusion: The greater the Apgar score, the lower the bilirubin level.

Serum Uric Acid in Women with Preeclampsia and its Relation to Perinatal and Maternal Outcomes

Background and objective: Preeclampsia is a dangerous, progressive condition that is linked to maternal and neonatal death and morbidity. The purpose of this study was to determine the association between serum uric acid levels in preeclampsia with maternal and fetal outcomes. Method: A case-control study was conducted on 300 women delivered at the labour room of Duhok Obstetrics and Gynecology Hospital, from 1st of April 2021 to 1st of April 2022. The study participants were divided into two groups, pregnant women with preeclampsia and normotensive women. The serum uric acid levels of these women were estimated with the impact on fetal and mother outcomes. Results: There was a highly significant association between preeclamptic and normotensive women in relation to mean serum uric acid (5.862 ±1.416) mg/dL and (3.570 ±0.982) mg/dL respectively. A highly significant association was seen between uric acid test levels and maternal eclamptic fit, HELLP syndrome and admission to intensive care unit. A highly significant association also seen with newborn birth weight, APGAR scores and admission to neonatal intensive care unit. Conclusion: The current study demonstrates a significant raise in serum uric acid level in preeclamptic women and associated with adverse perinatal and maternal outcomes.

Impact of SARS-CoV-2 infection and vaccination on cesarean section outcomes: a retrospective analysis.

Pregnant individuals have faced unique challenges during the COVID-19 pandemic, necessitating a closer examination of maternal and fetal health outcomes. Investigate the morbidity and mortality associated with SARS-CoV-2 infection among pregnant individuals, considering vaccination status and variant strains. Retrospective cohort. Tertiary state hospital. Patients who underwent cesarean sections were categorized into three periods: pre-vaccination (before 31 August 2021), early post-vaccination (from September 2021), and late post-vaccination (aligned with 70% immunization coverage by 2 September 2021). Data collected included demographic information (age, gravidity, parity count, gestational age, newborn APGAR scores), cesarean section indications, chronic diseases, vaccination status, vaccine type and doses, SARS-CoV-2 variant status, ICU admission, and mortality due to COVID-19. ICU admission and mortality rates, focusing on the impact of SARS-CoV-2 infection and vaccination status. 297 COVID PCR-positive symptomatic patients who underwent cesarean sections. In the pre-vaccination group, there were 13 mortalities (8.1%) compared to 9 (6.6%) post-vaccination (P=.610). Maternal ARDS was seen in 46.2% of pre-vaccination mortalities versus 11.1% post-vaccination (P=.045). COVID-19 delta variant patients had higher ICU admission (80%) and mortality rates (40%). Rates of COVID-19 PCR-positive cesarean sections, ICU admissions, and mortality declined significantly in early (P=.021, P=.004, P=.009), respectively and late post-vaccination periods (P<.001, P<.001, P=.0019), respectively. Vaccinated patients had no ICU admissions or mortality. Vaccination against COVID-19 is crucial for pregnant individuals as it significantly reduces the risk of severe illness. While vaccines offer substantial protection, the pandemic's acute phase might be waning, yet COVID-19 remains a global threat, particularly in regions with limited vaccine access. Continued vigilance and proactive measures are essential to mitigate ongoing risks and the emergence of new variant strains. Retrospective observational design and the single-center setting, which may affect the generalizability of the findings.

Risk factors and birth outcomes of preterm birth subtypes: a case-control study of singleton natural pregnancy

ObjectiveThe objective of the study was to identify the risk factors correlated with spontaneous preterm birth (SPTB) and iatrogenic preterm birth (IPTB), as well as to compare the pregnancy outcomes...

The impact of COVID-19 infections on pregnancy outcomes in women

BackgroundGiven that viral infections can increase the risk of adverse pregnancy outcomes, such as spontaneous miscarriage, preterm premature rupture of membranes, and preterm birth, the effects of COVID-19, a novel emerging coronavirus disease rapidly spreading globally, on pregnancy outcomes have garnered significant attention.MethodsWe conducted a review of studies related to pregnant women infected with SARS-CoV-2 over the past five years (December 2019 to April 2023), utilizing search engines such as PubMed, Web of Science, and the China National Knowledge Infrastructure (CNKI). This study was registered with PROSPERO with ID: CRD42024540849.ResultsA total of 218 articles were screened, with 15 studies meeting the inclusion criteria for this research, including 12 cohort studies, one cross-sectional study, one case-control study, and one case series. Six studies found that the preterm birth rate was higher in the infected group compared to the control group; five studies showed that the cesarean section rate was higher in the infected group; three studies found that the APGAR scores of newborns were higher in the control group than in the infected group; three studies indicated that the mortality rate of newborns in the infected group was higher than that in the control group.ConclusionsOur retrospective review suggests that compared to pregnant women not infected with SARS-CoV-2, those diagnosed with COVID-19 are more likely to experience adverse outcomes such as preterm birth, cesarean delivery, and low birth weight in newborns.

Comparative analysis of Apgar scores in newborns: the impact of anesthesia methods during cesarean delivery

Analgesia during caesarean section has a protective property regarding the condition of mother and child. Anesthesia methods should minimize harm to the newborn. The main problem after general anesthesia is respiratory distress syndrome.The objective: to evaluate the impact of the use of different types of anesthesia (general anesthesia or spinal anesthesia) during cesarean section on the health of newborns.Materials and methods. 120 full-term pregnant women who underwent planned cesarean section were included in the study. The study participants are divided into groups: I group – 70 pregnant women who underwent a cesarean section under general anesthesia; Group II – 50 patients with spinal anesthesia during cesarean section.The duration of labor and the time of induction of anesthesia were carefully recorded. To assess the health of the newborn the Apgar score was used 1, 5 and 10 minutes after delivery.Results. The study found that the method of delivery affects the neonatal Apgar score. Shorter time from anesthesia to birth (within 5 min) and delivery through the uterus (more than 120 s) led to a decrease in Apgar scores by 1 min.At the same time, it was established that the assessment of newborns at birth according to the Apgar scale at the level of 4–6 points after 5 and 10 minutes was lower during childbirth with general anesthesia compared to the assessment of newborns who were born with the use of spinal anesthesia, and at the assessment of 7–10 points – greater after 5 min and 10 min in newborns who were born in childbirth with spinal anesthesia than in babies who were born in childbirth under usual general anesthesia.Conclusions. The results of the study demonstrate that the methods of anesthesia during cesarean section improve the health of the mother and the child. Health care providers can improve prenatal care and outcomes with this knowledge. Spinal anesthesia improves the condition of the newborn, as determined by the Apgar score at three intervals.

Hydrotherapy in Pain Management in Pregnant Women: A Meta-Analysis of Randomized Clinical Trials.

Background: the benefits of water are significant during the birth process. Improved maternal experience of labor, less use of epidurals, better pain management, shorter labor, and a greater sense of control are observed during the birth process. Objective: This report aims to determine the benefits of hydrotherapy in clinical childbirth approaches and its applicability in pain control. Methods: A meta-analysis of randomized clinical trials selected from various databases with no publication date limits was conducted, comparing groups that did not use hydrotherapy with groups that did during labor. Results: Seven articles met the inclusion criteria, with five articles using hot water immersion and two using hot water shower as hydrotherapy treatments. This study identified 840 participants, with the intervention groups including 417 term pregnant women and the control groups including 423 pregnant women. The effect size of hydrotherapy on pain was calculated using the visual analog scale in five articles and analgesic use in the other two articles. Hydrotherapy significantly reduced pain during labor with a mean difference of -0.97 (95% CI: -1.91 to -0.03; I2 = 97.32%, p < 0.001). The duration of the first stage of labor was not significantly affected, with a mean difference of -0.17 h (95% CI: -0.55 to 0.21; I2 = 56.75%, p = 0.059). Additionally, hydrotherapy did not significantly impact the newborns' Apgar scores at 5 min, with a mean difference of 0.18 (95% CI: -0.48 to 0.85; I2 = 2.15%, p = 0.939). Conclusions: Hydrotherapy is beneficial for pain control in the first stage of labor and does not increase its duration or negatively affect the Apgar score of newborns.

Association of preeclampsia, placental pathology, and maternal-fetal features with gestational hypertension before and after 34 weeks of pregnancy

Objective: Evaluating the preeclampsia, placental pathology, maternal and fetal features in women with gestational hypertension (GH) at varying gestational ages. Methods: A series of maternal, fetal, placental pathological, and neonatal variables were prospectively evaluated and compared between two 30-tuple groups of eligible pregnant women with early GH before 34 weeks' gestation and those with late GH after 34 weeks' gestation. Results: Proteinuria and preeclampsia were more prevalent in the early GH group compared with the late GH group (80% vs 20%, P:0.001). The maternal high blood pressure and proteinuria were significantly associated with the early GH and preeclampsia (p&lt;0.05). The percentage of syncytial knots significantly increased as preeclampsia progressed (P&lt;0.05). A significant positive correlation existed between the early GH and the percentage of newborns admitted to NICU, the length of hospitalization, and the levels of the doppler indexes of umbilical and uterine arteries (p&lt;0.05); the newborn Apgar scores were also lower in the early GH group (p&lt;0.05). The mortality rate of newborns born to early hypertensive mothers (13.30%) was insignificantly higher than those delivered by the late hypertensive mothers (3.30%, p:0.16). Conclusion: Maternal high blood pressure and proteinuria may be predicting risk factors for the early GH and/or preeclampsia. The placentas of women with early GH were partially different from those with GH after 34 weeks' gestation. Higher rates of maternal and fetal pregnancy-related complications in the early GH group may be indicative of the different effects of GH and preeclampsia on pregnancy outcomes depending on the gestational age.

The Interplay of Anemia and Cardiovascular Disease in Pregnant Women and APGAR Scores of their Newborn: A Retrospective Study in Pregnant Women

Objectives: The implications of maternal anemia extend beyond the immediate physiological consequences; moreover, the consequences of maternal anemia are not limited to the mother alone. It may lead to low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores. It, further, adds up to higher incidence of morbidity rates in neonates. The objective of the study is to assess the prevalence and severity of anemia during pregnancy, to establish a correlation between maternal hemoglobin (Hb) levels and APGAR scores in newborns, and determine the association between cardiovascular disease and severity of anemia. Materials and Methods: A retrospective study was conducted at a private medical college in Bareilly from March 2022 to March 2023. The study focused on pregnant females aged 15–49 years who were admitted and delivered within the facilities of the private medical college during this period. Pregnant females with pre-existing chronic conditions affecting Hb levels were excluded from the study. A total of 130 subjects were included in the study, and their Hb levels and APGAR scores at 1 min were considered for analysis. Results: The results show a spearmen rank correlation coefficient (r) = 0.575 between maternal Hb levels and APGAR scores at 1 min, indicating a significant positive relationship (P &lt; 0.05). Infants born to mothers with moderate anemia exhibited the highest prevalence of low APGAR scores (&lt;4), highlighting the potential impact of maternal anemia on immediate neonatal well-being. No significant association was found between cardiovascular diseases in pregnancy and severity of anemia. Conclusion: The findings indicate that the optimization of maternal Hb levels is a critical intervention to ensure a healthier start for the neonate. This study provides a crucial foundation for evidence-based practices in maternal healthcare and neonatal well-being. Focus on improving maternal Hb provides multifaceted benefits both in mothers and neonates.

Enoxaparin sodium combined with magnesium sulfate in the treatment of severe preeclampsia.

To observe the treatment of severe preeclampsia in newborns with enoxaparin sodium combined with magnesium sulfate. A retrospective analysis was conducted on the clinical data of 80 patients with severe preeclampsia admitted to Hefei Second People's Hospital, China from January 2019 to December 2020. Treatment records showed that 40 cases received magnesium sulfate treatment (single group), and 40 cases received enoxaparin sodium combined with magnesium sulfate treatment (combination group). Levels of D-dimer, soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PLGF), Apgar scores of newborns delivered before and after treatment were compared. Gestation weeks and incidence of adverse reactions were analyzed. After treatment, levels of D-dimer, sfit-1 and adverse reactions in the combination group were significantly lower than those in the single group (P<0.05), and the level of PLGF, newborn Apgar score and length of gestation were significantly higher than those in the single group (P<0.05). Compared to magnesium sulfate alone, the combination of enoxaparin sodium and magnesium sulfate in the treatment of pregnant women with severe preeclampsia can more effectively regulate the cytokine level of patients, improve pregnancy outcome, and improve neonatal Apgar score. The incidence of adverse reactions is low, making it a safe and efficient treatment modality.

ANALYSIS OF RISK FACTORS FOR THE INCIDENT OF EARLY ONWARD NEONATAL SEPSIS REVIEWED FROM THE APGAR SCORES AND WEIGHT AT BIRTH AT KUDUNGGA HOSPITAL

Neonatal sepsis is one of the most common causes of death in neonates.. The aim of this study was to analyze the relationship between early onset neonatal sepsis in terms of the score. APGAR and birth weight infants. The research design used was correlational analytic with a cross sectional time approach with a total sample of 52 respondents. The sampling method in this study used the Accidental Sampling technique. Data were collected using medical record data .Test the analysis using the Chi Square Test. The APGAR score in newborns is known to be mostly in the APGAR score category 7-10 (no asphyxia) (73.1%). Almost all of the birth weights of newborns were found to be in the birth weight category ≥2500 grams (77%). The incidence of early-onset neonatal sepsis in newborns is known to be mostly in the category of no early-onset neonatal sepsis (69.2%).

COVID-19 in pregnant women: description of a possible case of COVID-19-linked HELLP-like syndrome

New evidence suggests that Sars-CoV2 infection during pregnancy may result in complications such as hypertension, nephropathy, thrombocytopenia, and liver damage. A pre-eclampsia-like syndrome has also been proposed in pregnant women with severe SARS-CoV-2 infection, which meets the pre-eclampsia criteria but resolves without delivery, with improvement in respiratory symptoms. 31-year-old, second pregnancy, in Emergency Room for PROM (premature rupture of membranes), has Sars-CoV2 infection and has not been vaccinated. Normal examinations and mild hypertension were present upon admission, but no treatment was administered. Vaginal Leukocytic Delivery 12 hours after admission, newborn Apgar score 9/10, weight 3.250 kg. At 20 hours after delivery, epigastric pain VAS 8-9 for 20 minutes, systolic/diastolic hypertension peak, increase in transaminases, LDH, ALP, Bilirubin, Dimer, platelet and fibrinogen drop. Neurological and respiratory objectivity were negative, and renal indices were within normal limits, so nifedipine 30mgx2/day + methyldopa 500 mgx2/day was started. Abdominal ultrasound revealed a thin perihepatic fluid stratum. A prophilaxis of dexamethasone 12mg twice a day and magnesium sulfate was introduced. At 32 hours after delivery, the laboratory detected an increase in transaminases, LDH, and worsening of thrombocytopenia. The patient is always eupnoic, and the diuresis is adequate. Blood tests improved gradually after 56 hours postpartum. Methyldopa and steroids are escalating. On day 7, discharge with normalized platelet and bilirubin counts and a decreasing trend in transaminases, LDH, and PAL. At the one-week follow-up, liver enzymes and coagulation were completely normal, and blood pressure was well controlled with methyldopa. We conclude that the simultaneous presence of the two diseases could have had a synergistic or opportunistic effect, resulting in severe clinical manifestations via interaction with the Renin-Angiotensin-Aldosterone system.

Correlation of Apgar Score and Umbilical Artery pH in Full-Term Newborns Delivered by Cesarean Section Due to Decreased Fetal Heart Rate

Correlation of Apgar Score and Umbilical Artery pH in Full-Term Newborns Delivered by Cesarean Section Due to Decreased Fetal Heart Rate

The effect of slow-release vaginal dinoprostone on maternal and fetal oxidative stress in term pregnancies complicated by oligohydramnios: Prospective cohort study.

To evaluate changes in oxidant status using thiol/disulfide homeostasis in mothers and fetuses after induction of labor with slow-release vaginal dinoprostone inserts. A total of 70 pregnant women were divided into two groups. Thirty-five women in whom labor was induced with slow-release vaginal dinoprostone inserts (10 mg of prostaglandin E2, group A) were compared before and after the administration. The other 35 women, who were followed up spontaneously during labor (group B), were included as a control group. Both groups were diagnosed with isolated oligohydramnios without signs of placental insufficiency. The thiol/disulfide homeostasis parameters were calculated before medical induction and after removal of the insert at the beginning of the active phase of labor. Maternal and cord blood values were measured in both groups. Although the balance shifted to the antioxidant side after the slow-release vaginal dinoprostone insert was applied, there was no significant difference in maternal oxidative load compared to the pre-application status (5.32 ± 014/5.16 ± 0.15, p = 0.491). Despite the shift toward the antioxidant side, maternal antioxidants were still significantly lower in the group that received slow-release vaginal dinoprostone at the beginning of the active phase of labor than in the control group (295.98 ± 13.03/346.47 ± 12.04, respectively, p = 0.009). There was no statistically significant difference in terms of oxidative balance or newborn Apgar score ( p > 0.05). Induction of labor with slow-release vaginal dinoprostone inserts in pregnancies with isolated oligohydramnios does not cause further oxidative stress and is safe for both mothers and neonates in terms of oxidant load by thiol/disulfide homeostasis.

Investigating the Relationship Between COVID-19 Stress in Pregnant Women and Mode of Delivery, APGAR Score, and Anthropometric Indices of Newborns

Background The COVID-19 pandemic led to a wave of anxiety and stress in all segments of society, especially among pregnant women. Stress poses a significant health concern for pregnant women, potentially impacting maternal and fetal well-being. Aim This study aims to explore the relationship between COVID-19 stress in pregnant women and the mode of delivery, APGAR score, and anthropometric indices of newborns. Methods A cross-sectional study was conducted in 2021, employing a survey method on 195 pregnant women who sought delivery at 22 Bahman Hospital in Khaf. Data collection involved the use of the standard COVID Stress Scale (CSS). SPSS-22 software was utilized for the analysis, employing Pearson correlation coefficient and multiple linear regression tests at a significance level of 0.05. Results Pregnant women who underwent cesarean sections exhibited significantly higher levels of COVID-19-related stress compared to those who had natural deliveries (p&lt;0.001). A significant negative correlation was observed between the APGAR scores in the first and fifth minutes and the anthropometric indices (weight, length, and head circumference) of newborns concerning COVID-19 stress (p&lt;0.001). Moreover, maternal stress emerged as a predictor for the type of delivery, APGAR scores, length, and head circumference of newborns (p&lt;0.001). Conclusion The study underscores the adverse impact of COVID-19 stress on maternal pregnancy outcomes, particularly leading to elevated cesarean section rates. The substantial influence of this stress on the APGAR score and anthropometric indices of newborns highlights the significance of implementing screening, counseling, and stress reduction education for pregnant women during the COVID-19 pandemic and beyond.

Fondaparinux Results in Similar Pregnancy Outcomes with Lower Adverse Reaction Rates Compared to Low Molecular Weight Heparin in Chinese Recurrent Miscarriage Women.

Fondaparinux inhibits thrombin generation by inactivating factor Xa, which has the potential to treat recurrent miscarriage (RM). However, more clinical evidence is required to support its application in Chinese women with RM. This research aimed to compare the live birth rate, gestational weeks at delivery, birth weight, Apgar score of newborns, and adverse reaction rates between fondaparinux and low molecular weight heparin (LMWH) in Chinese women with RM. Totally, 132 women with RM treated with fondaparinux or LMWH were included in this retrospective study. According to the corresponding treatment, women with RM were divided into the fondaparinux cohort (N = 45) and LMWH cohort (N = 87). The live birth rate was 68.9% in the fondaparinux cohort and 56.3% in the LMWH cohort, which was not different between the two cohorts (P = 0.161). Multivariable logistics regression analysis suggested that only previous miscarriage times (≥ 4 times vs. < 4 times) were independently related to a lower possibility of live birth in women with RM (odds ratio = 0.431, P = 0.036). It was also observed that gestational weeks at delivery (38.1 ± 1.4 vs. 37.7 ± 1.7 weeks) (P = 0.258), birth weight (2,923.7 ± 355.0 vs. 2,807.8 ± 334.0 g) (P = 0.144), and Apgar score of newborns (9.8 ± 0.5 vs. 9.6 ± 0.8) (P = 0.175) were not different between the fondaparinux cohort and LMWH cohort. Inspiringly, the total adverse reaction rate was reduced in the fondaparinux cohort vs. the LMWH cohort (20.0% vs. 37.9%) (P = 0.036). Fondaparinux results in similar pregnancy outcomes with lower adverse reaction rates compared to LMWH in Chinese women with RM.

A Randomized Comparative Study to Evaluate the Efficacy of Dexmedetomidine used as an Adjuvant to Isobaric 1% 2-Chloroprocaine in Parturients Undergoing Elective Lower Segment Cesarean Section under Subarachnoid Block

Background and Aims: Preservative-free 1% 2-chloroprocaine (2-CP) is an amino-ester local anesthetic (LA), suitable for short duration daycare or ambulatory surgeries. Dexmedetomidine as an adjuvant may enhance the efficacy of LA. Our study aimed to evaluate the analgesic efficacy and safety of intrathecal dexmedetomidine as an adjuvant to 1% 2-CP in parturients undergoing elective lower segment cesarean section (LSCS). Material and Methods: After obtaining approval from the Institutional Ethics Committee and informed written consent, 100 term parturients aged 18–35 years, belonging to American Society of Anesthesiologists (ASA) physical status II, undergoing elective LSCS were randomly allocated into two groups. Group CD received 1% preservative-free 2-CP 3 ml (30 mg) +0.5 ml dexmedetomidine (5 µg) diluted in (normal saline) NS, while Group C (n = 50) received 1% preservative-free 2-CP 3 ml (30 mg) +0.5 ml NS. Among the various parameters noted, duration of sensory block was the primary outcome measure while the onset of sensory block, highest dermatomal level achieved, time to achieve highest dermatomal level, time to two-segment regression, onset and duration of motor block, duration of analgesia, Visual Analog Scale (VAS) score, Apgar score, hemodynamic changes, and side effects were secondary outcome measures. Results: Both groups were comparable with respect to demographic profile, onset of sensory block, onset and duration of motor block. The duration of sensory block (100.12 ± 15.41 versus 71.68 ± 4.68 min) (&lt;0.0001) as well as the duration of analgesia (113.08 ± 13.74 versus 81.60 ± 8.28 min) (&lt;0.0001) were significantly prolonged in Group CD compared to Group C. Apgar score of newborns, hemodynamic parameters, and adverse effects were comparable in two groups. Conclusion: Intrathecal dexmedetomidine (5 µg) as an adjuvant to preservative-free 1% 2-CP results in a prolonged duration of both sensory block and analgesia for LSCS without affecting motor block characteristics.

Feto-Maternal Outcome of Labour with Epidural Analgesia

Introduction: Epidural anesthesia along with an experienced anaesthetist, a dedicated obstetrician and a trained midwife has ability to convert the painful and extensively stressful labour labour event into a less stressful event. The purpose of this study was to compare feto-maternal outcome of labour with epidural analgesia to those without epidural analgesia.&#x0D; Methodology: The prospective, comparative and interventional study was conducted among primigravida with full term pregnancy admitted to maternity ward. Study group were given epidural analgesia which was compared with control group who did not give any labour analgesia. Maternal and foetal outcome were assessed.&#x0D; Results: Difference in mean duration of first stage and second stage of labour was statistically non-significant between two groups (p&gt;0.05). Before the analgesia (basal) mean VAS was 8.45 and 8.32 in women who received epidural anesthesia and cases who didn’t receive epidural anesthesia respectively. The mean VAS was significantly less in women who received epidural anesthesia (p&lt;0.001).&#x0D; Conclusion: Use of epidural analgesia during the later stage of labour, when cervical dilatation was more than 4 cm, provides better analgesic effect with minimal side effect and almost equivalent duration of labour. Epidural analgesia doesn’t unnecessarily increase operative delivery rate and had no adverse effect on APGAR score of newborns.

Effect of Supplemental Oxygen on Apgar Score of Newborns in Pregnant Women Undergone Cesarean Section with Spinal Anesthesia

Background: In obstetrics, there have been discussions and changes in procedures surrounding the provision of extra oxygen during cesarean sections performed under spinal anesthesia. Despite its recognized benefits in maintaining maternal cerebral oxygenation, concerns persist about its impact on neonatal health, especially regarding newborn oxygen saturation levels. This gap in understanding the direct effects on immediate neonatal outcomes, particularly Apgar scores, underscores the need for further research. This study aimed to determine the effectiveness of supplement on Apgar scores at one and five minutes post-delivery in newborns of mothers undergoing cesarean sections with spinal anesthesia. Methodology: Through randomized sampling, 100 patients from two hospitals in Iraq were included in this interventional trial. Following approval for research and establishment of inclusion and exclusion criteria, the researcher gathered patient sociodemographic information and average score. The sample is divided into two groups: (50) participants as a study group and (50) participants considered as a control group. With a significance threshold 0.05, the gathered data were examined using descriptive and inferential statistics in Statistical Package for the Social Sciences software version 22. Results: The results demonstrated that the most represented age group in both study and control groups was 25-30 years, and the least represented was 35-40 years. The highest BMI category was 'overweight' in both groups, while 'obese' was the least common. Regarding birth weights, the study group had a higher percentage of normal birth weights than the control group. In APGAR scores after 5 minutes, a significantly higher percentage of newborns in the study group had reassuring scores (7 to 10) compared to the control group. Furthermore, a relevant difference in outcomes was shown by a significant link between the study group and the impact of O2 supplement on APGAR score at (p-value. 0). Sociodemographic factors such as age, education level, occupation, BMI, and gestational age showed no significant correlation with APGAR scores, underscoring the complexity of these factors' influence on neonatal outcomes. Conclusion: The study found that supplemental oxygen positively affects newborns' APGAR scores during Cesarean sections with spinal anesthesia, with the study group showing better scores than the control group. It suggests that improving prenatal care, training in neonatal care, ensuring medical equipment availability, and enhancing obstetric research and education are vital for better neonatal and maternal care in Iraq, ultimately leading to improved health outcomes for mothers and newborns.

Pre-eclampsia among Pregnant Women Admitted to the Department of Obstetrics and Gynaecology of a Tertiary Care Centre.

Pre-eclampsia is a pregnancy-related hypertensive disorder with maternal and neonatal complications. Many studies are done regarding the prevalence of pre-eclampsia in Nepal but ascertaining the maternal risk factors and fetal outcomes are important. The aim of this study was to find out the prevalence of pre-eclampsia among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care centre. A descriptive cross-sectional study was conducted among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care hospital from 13 July 2023 to 29 September 2023 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. Point estimate was calculated at a 95% Confidence Interval. Among 5065 patient, pre-eclampsia was seen in 44 (0.87%) (0.61-1.13, 95% Confidence Interval). A total of 16 (36.36%) cases of pre-eclampsia were in the age group 25-29 years and 30 (68.18%) of them were nulliparous. A total of 38 (86.36%) of the newborns of the pre-eclamptic cases had low birth weight. The APGAR score of newborns at the 1 minute after birth was 26 (59.09%) followed by the newborns who needed re-evaluation 16 (36.36%). The APGAR score recorded at 5 minutes showed maximum newborns with normal APGAR score 40 (90.90%). The prevalence of pre-eclampsia among pregnant women was found to be lower than other studies done in similar settings. maternity; Nepal; pre-eclampsia; prevalence.