Fetal Outcomes In Women Research Articles

Effects of Ursodeoxycholic Acid Treatment for Intrahepatic Cholestasis of Pregnancy on Maternal and Fetal Outcomes.

Intrahepatic cholestasis of pregnancy (ICP) appears in the second or third trimester of pregnancy and is characterized by pruritus and elevated blood bile acid (BA) levels. Complications from these symptoms may include preterm birth, fetal distress, or stillbirth. Although the precise causes of ICP are unknown, genetic, hormonal, and environmental variables may be involved. First-line treatment for ICP is ursodeoxycholic acid (UDCA), which improves bile flow and consequently lowers BA levels and pruritus. The objective of this study is to investigate the impact of UDCAtherapy on maternal and fetal outcomes in women with ICP. This was a prospective observational study of 123 pregnant women with ICP, aged between 20 and 45 years who were diagnosed clinically (pruritus) supported by abnormal laboratory results including elevated serum BA levels, and abnormalities in liver function tests, over the course of three years, from July 2021 to June 2024. Every patient received UDCA, commencing at 10-15 mg/kg/day and being titrated according to clinical guidelines. Maternal and fetal outcomes were tracked for the duration of the pregnancy, with data being collected at baseline (15 ± 1 weeks) and every two weeks until delivery. The mean age of the study participants was 29.6 ± 5.4 years, with the youngest patient being 20 years and the oldest being 45 years. Most womenwere multipara 65.9%, and the mean BMI was 27.8 ± 3.5 kg/m ². The mean time of gestational age at ICPdiagnosis was 31.2 ± 2.7 weeks, and the time of gestational age at delivery was 37.1 ± 2.4 weeks. On average, the serum BA level at diagnosis was 23.5 ± 8.1 µmol/L. In the majority of ICP patients with good fetal outcomes, UDCA not only normalizes serum BA levels but also reduces maternal symptoms. In addition to addressing patient response variability to this therapy and optimizing dissemination procedures, the researchers expect that the results of this study will support the continued use of UDCA as first-line treatment for ICP, at least until more evidence becomes available.

Increased prevalence of negative pregnancy and fetal outcomes in women with primary adrenal insufficiency. A systematic review and meta-analysis.

Maternal primary adrenal insufficiency (PAI) during pregnancy, due to either Addison disease (AD) or congenital adrenal hyperplasia (CAH), is rare. Only few studies have examined the subsequent important outcomes of maternal glucocorticoid and mineralocorticoid deficiencies during pregnancy upon the fetus and the neonate. Therefore, this systematic review and meta-analysis evaluated the impact of these deficiencies, with data from PubMed/Medline, Cochrane/CENTRAL, and Google Scholar. A total of 31 studies were included for qualitative analysis and 11 for quantitative analysis. Studies examining the prevalence of spontaneous abortion, preterm birth, the occurrence of small for gestational age (SGA) neonates, as well as the neonatal birth weight were included. The systematic review revealed a substantial number of spontaneous abortions, preterm births and SGA neonates in pregnant women with PAI. The meta-analysis showed a mean spontaneous abortion prevalence of 18%, 18% and 17% in women with PAI, AD or CAH, respectively. The mean preterm birth prevalence was 11% when women with AD or CAH were analyzed together, and 13% and 9% in women with AD or CAH, respectively, when these women were analyzed separately. The mean prevalence of SGA neonates was 8% when women with AD or CAH were analyzed together, and 5% and 10% in women with AD or CAH, respectively, when these women were analyzed separately. The mean fetal birth weight was within normalcy in all women with PAI, as well as in women with AD or CAH. In conclusion the executed systematic review of 31 studies followed by a meta-analysis of 11 studies in pregnant women with PAI has shown a greater prevalence of pregnancies with negative outcome (spontaneous abortion, preterm birth) and of negative fetal outcome (SGA) in women with either AD or CAH, as compared to control pregnant women.

Prevalence of Meconium Stained Amniotic Fluid and Predictors for Poor Fetal Outcomes Among Women Delivering at Bugando Medical Centre Mwanza Tanzania

<i>Background:</i> Meconium stained amniotic fluid occurs in up to 20% of all deliveries and is reported to vary in different settings across the world. Babies delivered by these women are at high risk of low score and meconium aspiration syndrome. Limited studies have reported on the predictors for poor fetal outcomes in women presenting with meconium stained amniotic fluid. <i>Methods:</i> This was a cross sectional study involving 209 pregnant women with meconium stained amniotic fluid. Semi structured questionnaire was used for data collection. Data were analyzed using STATA version 12. <i>Results: </i>A total of 1202 women delivered during the study period from December 2017 to February 2018. Amongst, 209 (17.4%) women had meconium stained amniotic fluid. Of the 209 babies, 35 (16.7%) had low score, 41 (19.6%) were admitted due to meconium aspiration syndrome and 3 (1.4%) died due to meconium aspiration syndrome related complications. Predictors for poor fetal outcomes were found to be Thick meconium (Grade III), Meconium as a new event during labor monitoring and null parity. <i>Conclusion:</i> The prevalence of meconium stained amniotic fluid at Bugando Medical Centre was found to be 17.4%. Thick meconium, development of meconium as a new event and nullparous were found to predict for poor fetal outcomes. Immediate interventions are recommended for those with the identified predictors for poor fetal outcome.

#1616 Pregnancy and fetal outcome in women with Alport syndrome

Abstract Background and Aims Pregnancy in patients with CKD is associated with maternal and fetal risks. The data about pregnancy outcome in Alport syndrome (AS) is limited. The aim was to evaluate the fetal and maternal pregnancy outcome in women with AS. Method One center retrospective study included 88 women with AS (86 with COL4A5, 2 with COL4A4 variants). Data at conception (age, arterial hypertension (HP), proteinuria (Pr), GFR), course of pregnancy (HP, Pr, GFR, pre-eclampsia (PE)), delivery (preterm (PD): < 37 weeks; early preterm (EPD): < 34 weeks), fetus characteristics (intrauterine fetal growth restriction (IUGR): L < 2 z-score for gestational age; small for gestational age (SGA): m < 2 z-score (SGA)) were obtained from medical charts and a cross-sectional survey. Results Information of 88 women, 133 term pregnancies (2 in 25 pts, 3 in 2 pts) were analyzed. Only 16 (q = 0,18) from 85 (q = 0,96) women with hematuria had diagnosis of AS before pregnancy; one of them had HP, 13 pts had Pr. HP, Pr, decreased GFR were revealed in 11 (q = 0,13), 27 (q = 0,2) and 9 (q = 0,06) pregnant, respectively. PE occurred in 8 cases (q = 0,06); PD was seen in 24 (q = 0,18) and EPD in 1 (q = 0,01) cases; cesarean section was performed in 8 cases (q = 0,07). IUGR and SGA were recorded in 8 (q = 0,06) and 11 (q = 0,08) neonates, respectively; 6 babies (q = 0,05) required a neonatal intensive care unit stay. Pr was the risk factor for PE (CI 14,86 ± 0,85, p < 0,001), PD (CI 6,267 ± 0,49; p < 0,001), IUGR (CI 14,86 ± 0,85, p < 0,001), SGA (CI 8,93 ± 0,67, p < 0,001). Conclusion The risk of pre-eclampsia and slowing of fetal growth in women with AS and normal kidney function appears comparable to that in the general population. But AS should be considered as a potential risk factor for preterm delivery. Proteinuria is associated with unfavorable pregnancy and fetal outcome in AS.

#2740 Pregnancy outcomes in patients with IgA nephropathy and the impact of pregnancy on the renal disease

Abstract Background and Aims IgA nephropathy (IgAN), the predominant primary glomerulonephritis in adults,, frequently affects women in childbearing age. There is a dearth of information about the impact of pregnancy on the outcome in IgAN especially in the Indian population where it is known to have an aggressive disease phenotype. This retrospective cohort study examines pregnancy outcomes in women with biopsy-proven IgAN and the impact on renal outcome. Method In a retrospective cohort study, we assessed the medical records of women in child bearing age (18-40 years) diagnosed with biopsy proven primary IgAN from 2012-2022. Patients with end stage kidney disease (ESKD) at the time of biopsy and/or at time of conception and those who had undergone kidney transplantation were excluded. Maternal (pre-eclampsia, relapse, renal disease progression, etc.) and fetal outcomes (neonatal death, preterm delivery, intra-uterine growth retardation-IUGR, etc.) were recorded. Relapse was defined as increase in proteinuria to ≥1 g/day during pregnancy and renal disease progression as >40% sustained decline in eGFR and/or ESKD. Results Of 75 women assessed, 25 were lost to follow up. 34 did not conceive after biopsy. 20 pregnancies were documented in 14 patients. Three (15%) were medically terminated, 7 (35%) resulted in spontaneous abortions, and 10 (50%) culminated in live births. There was one neonatal death. 6/20(30%) pregnancies occurred while the patient was on ACEi/ARBs of which 5 pregnancies resulted in live births. 7/10 (70%) births were premature, 5 being moderate preterm (34-37 weeks) and 2 late preterm (32-34 weeks). IUGR below the 5th percentile affected 7/10(70%) of births. The mode of delivery was evenly split between vaginal (5, 50%) and Caesarian (5, 50%). From a maternal perspective, preeclampsia affected 3/10 (30%) patients. 5/10(50%) patients who delivered had a relapse during pregnancy with 2 developing nephrotic range proteinuria. 4 of them receiving steroids during pregnancy. All relapsed patients had persistent proteinuria >1 g/day postpartum. In 2 (20%) pregnancies, relapse developed during immediate post-partum period. In 4 patients, eGFR decreased by > 40 percent compared to their baseline (at biopsy) following the pregnancy. Conclusion Pregnancy is associated with adverse maternal and fetal outcomes in women with IgA nephropathy. eGFR, estimated glomerular filtration rate. IUGR, Intra-uterine growth restriction (based on birth weight percentile, adjusted for gender and gestational age). *Serum creatine of one patient during pregnancy is not available, analysis is done using values of other 9 patients. **Urine Protein of one patient is not available at the latest follow-up, analysis is done using values of 9 other patients.

Insulin Use During Gestational and Pre-existing Diabetes in Pregnancy: A Systematic Review of Study Design.

Insulin is the first-line pharmacologic therapy for women with diabetes in pregnancy. However, conducting well-designed randomized clinical trials (RCTs) and achieving recommended glycemic targets remains a challenge for this unique population. This systematic literature review (SLR) aimed to understand the evidence for insulin use in pregnancy and the outcome metrics most often used to characterize its effect on glycemic, maternal and fetal outcomes in gestational diabetes mellitus (GDM) and in pregnant women with diabetes. An SLR was conducted using electronic databases in Medline, EMBASE via Ovid platform, evidence-based medicine reviews (2010-2020) and conference proceedings (2018-2019). Studies were included if they assessed the effect of insulin treatment on glycemic, maternal or fetal outcomes in women with diabetes in pregnancy. Studies on any type of diabetes other than gestational or pre-existing diabetes as well as non-human studies were excluded. In women diagnosed with GDM or pre-existing diabetes, most studies compared treatment of insulin with metformin (n = 35) followed by diet along with lifestyle intervention (n = 24) and glibenclamide (n = 12). Most studies reporting on glycemic outcomes compared insulin with metformin (n = 22) and glibenclamide (n = 4). Fasting blood glucose was the most reported clinical outcome of interest. Among the studies reporting maternal outcomes, method of delivery and delivery complications were most commonly reported. Large for gestational age, stillbirth and perinatal mortality were the most common fetal outcomes reported. This SLR included a total of 108 clinical trials and observational studies with diverse populations and treatment arms. Outcomes varied across the studies, and a lack of consistent outcome measures to manage diabetes in pregnant women was observed. This elucidates a need for global consensus on study design and standardized clinical, maternal and fetal outcomes metrics.

Impact of COVID-19 on pregnancy and fetal outcomes in women with multiple sclerosis

Background: In the general population, maternal COVID-19 is associated with worse maternal and fetal outcomes. Two previous studies have assessed COVID-19 clinical outcomes in pregnant women with multiple sclerosis (MS), but there are no data about maternal and fetal outcomes. Objectives: In this multicenter study, we aimed to assess maternal and fetal outcomes in pregnant women with MS and COVID-19 infection. Methods: We recruited pregnant patients with MS who contracted COVID-19 and were followed up in Italian and Turkish Centers, during 2020–2022. A control group was extracted from a previous Italian cohort. Associations between group (COVID-19 or healthy patients) and clinical outcomes (maternal complications, fetal malformations, and spontaneous abortion) were investigated with a weighted logistic regression where propensity score–based inverse probability of treatment weighting (IPTW) approach was applied for adjusting for difference in baseline confounders. Results: In the multivariable analysis, COVID-19 during pregnancy was associated with a higher risk of maternal complications (odd ratio (OR) = 2.12; 95% confidence interval (CI) = 1.32–3.48; p = 0.002), while it was not associated with higher risk of spontaneous abortion and fetal malformations. Conclusion: Our data indicate that COVID-19 during pregnancy increases the risk of maternal complications, while it seems to have no significant impact on fetal outcomes.

Fetal Outcome in Women of Pre-Eclampsia

Background: Pre-eclampsia, a serious condition characterized by high blood pressure in pregnant women, presents significant health risks for both the mother and fetus. This study aimed to assess the impact of pre-eclampsia on fetal outcomes in the Pakistani population, recognizing the condition's high prevalence and its role in maternal and neonatal morbidity and mortality. Objective: To evaluate the fetal outcome in women with pre-eclampsia in the Pakistani population. Methods: This descriptive case series was conducted at the Department of Obstetrics and Gynaecology, University College of Medicine and Dentistry Lahore, from January to June 2023. A total of 93 patients were enrolled to study the effects of pre-eclampsia on mothers and fetuses. Results: Among the 93 patients, the mean age was 37.59±6.37 years. The age distribution predominantly included women aged 31-35 years, followed by those in the 36-40 and 41-45 age groups. Severe pre-eclampsia was observed in 69.9% of patients, while 30.1% had mild pre-eclampsia. The fetal outcomes were as follows: 65.5% good, 12.9% stillbirth, and 21.5% neonatal death, with an insignificant P-value. Conclusion: The study concluded that the high prevalence of pre-eclampsia in the community is alarming, significantly increasing the risk of adverse outcomes for infant health and well-being. There is a critical need to educate women about the signs and symptoms of pre-eclampsia.

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.

MATERNAL AND FETAL OUTCOMES IN WOMEN RECEIVING URSODEOXYCHOLEIC ACID (UDCA) AS TREATMENT FOR INTRAHEPATIC CHOLESTASIS OF PREGNANCY (IHCP), A SINGLE CENTER EXPERIENCE: ARE WE DOING ENOUGH?

Intrahepatic cholestasis of pregnancy (IHCP) is a common type of hormonally driven cholestasis in the late second or early third trimester of pregnancy. It's a reversible condition and has a genetic predisposition. This study aimed to analyze the maternal and fetal outcomes of women being treated with Ursodeoxycholic acid (UDCA) for IHCP. Seventy-five pregnant women with IHCP were included in this observational cross-sectional study, with a study duration of one year. SPSS software version 24.0 was used to analyze the data collected by the investigating officer. Laboratory and clinical parameters were assessed at presentation and after treatment. Results showed that 92% of pregnant women with IHCP had significantly raised serum bile acid levels. However, UDCA treatment caused complete resolution of itching in 57.7% of patients, reduced to mild in 40.4%, and moderate itching in 1.9% of patients. Mean Alkaline Phosphatase and ALT levels significantly decreased after UDCA treatment, with p-values of 0.001 and 0.004, respectively. The dose of UDCA required ranged from 10-25 mg/kg/day. A positive family history of IHCP was found in 36.5% of patients, while 33% had a history of IHCP in previous pregnancies, and 16% had twin pregnancies. The incidence of early delivery was high at 98%, with a mean gestational age of 36.4 weeks. Among these early deliveries, 8% had vaginal delivery, and 92% had C-sections. The indications of delivery were intractable itching and no improvement in LFTS in 15%, PROM and fetal distress in 21%, failed induction in 31%, previous cesarean in 23%, and other reasons in 10%. The study found that 99% of babies had good APGAR scores and no morbidity. However, 1% mortality was reported due to severe IHCP in the mother. In conclusion, UDCA treatment significantly improved physical and laboratory parameters and effectively treated IHCP. Early delivery had better maternal and fetal outcomes.

Practice of Cervical Cerclage at a University Teaching Hospital in Southern Nigeria

Background: Although the aetiology of preterm deliveries is largely unknown, it is said to be multifactorial and cervical insufficiency has been implicated. Hence, cervical cerclage is a necessary and common prophylactic obstetric procedure for preventing prematurity and associated recurrent second trimester miscarriages. Objectives: To evaluate the pattern, indications, and fetal outcome of cervical cerclage. Methodology: This was a retrospective study of 50 women who had cervical cerclage insertion at the University of Port Harcourt Teaching Hospital between January 1, 2021, and December 31, 2022. Data was obtained from the ward registers, theatre records, and case notes of the women, and entered into a structured proforma. Data analysis was done with SPSS version 25, and results are presented as frequency tables and charts. Results: The mean age of the patients was 35 ± 2.07 years. The mean of number of previous miscarriages was 2.46 ± 2.07, 56.8% were multiparous and 50% had a previous manual vacuum aspiration. Majority 35 (70%) of the women had prophylactic cerclage, 10 (20%) had cerclage following in-vitro fertilization and embryo transfer pregnancy, while 5(10%) had rescue cerclage. Most 29 (58%) of the prophylactic cervical cerclage insertion were done between 11-15 weeks, with MacDonald technique being the most common technique practiced. Of these, only 18 (36%) carried the pregnancy up to 36 weeks of gestation. Conclusion: Many of cervical cerclage procedures were performed for prophylaxis and resulted in improved fetal outcomes in women who had previously experienced mid-trimester losses or preterm delivery.

Impact of experiencing multiple vulnerabilities on fetal growth and complications in women with hyperglycemia in pregnancy

BackgroundIn women with hyperglycemia in pregnancy living in France, psychosocial deprivation is associated with both earlier and greater exposure to the condition, as well as poorer maternofetal prognosis. We explored the impact of this and two other socioeconomic vulnerability indicators—food insecurity and poor language proficiency—on adherence to prenatal care and maternal and fetal outcomes.MethodsIn a socially deprived suburb of Paris, we selected women who delivered between 01/01/2012 and 31/12/2018 and received care (nurse, dietician, diabetologist evaluation, advice, regular follow-up to adjust insulin doses if requested) for hyperglycemia in pregnancy. We analyzed the associations between individual psychosocial deprivation, food insecurity, French language proficiency (variables assessed by individual questionnaires) and fetal growth (main outcome), as well as other core maternal and fetal outcomes.ResultsAmong the 1,168 women included (multiethnic cohort, 19.3% of whom were Europeans), 56%, 17.9%, and 27.5% had psychosocial deprivation, food insecurity, and poor French language proficiency, respectively. Forty-three percent were prescribed insulin therapy. Women with more than one vulnerability had more consultations for diabetes. The rates for small (SGA), appropriate (AGA), and large-for-gestational-age (LGA) infant were 11.4%, 76.5% and 12.2%, respectively. These rates were similar in women with and without psychosocial deprivation, and in those with and without food insecurity. Interestingly, women with poor French language proficiency had a higher odds ratio of delivering a small- or large-for-gestational age infant than those with good proficiency.ConclusionWe found similar pregnancy outcomes for women with hyperglycemia in pregnancy living in France, irrespective of whether or not they had psychosocial deprivation or food insecurity. Optimized single-center care with specialized follow-up could contribute to reduce inequalities in maternal and fetal outcomes in women with hyperglycemia in pregnancy.

Statement of Retraction: Maternal and fetal outcome in women with gestational hypertension in comparison to gestational proteinuria: A 3-year observational study

Statement of Retraction: Maternal and fetal outcome in women with gestational hypertension in comparison to gestational proteinuria: A 3-year observational study

To study the maternal and fetal outcome in women presenting with jaundice in pregnancy: A prospective observational study

To study the maternal and fetal outcome in women presenting with jaundice in pregnancy: A prospective observational study

RETRACTED ARTICLE: Maternal and fetal outcome in women with antiphospholipid syndrome: a three-year observational study

RETRACTED ARTICLE: Maternal and fetal outcome in women with antiphospholipid syndrome: a three-year observational study

Maternal and fetal outcomes in women undergoing induction of labor with low dose vaginal misoprostol.

To determine Maternal and Fetal outcome in women undergoing induction of labour with low dose misoprostol. A cross-sectional study was carried out to determine the efficacy of Misoprostol for induction of labor (IOL) in MTI, Lady Reading Hospital (LRH), Peshawar from 21st January to 31st December 2021. All pregnant women with singleton pregnancy and cephalic presentation admitted for Induction of Labor were included in the study. Maternal and Fetal outcome was noted. Induction of labor was started with 25 micrograms of Misoprostol, repeated every six hours depending on Bishop Score. Three hundred and thirty-seven women were included in this study. The majority of females (76%) were in 18-35 years age group. In 92.3% of females, the Bishop score was less than six. The maximum number of females (33.5%) delivered after eight hours of IOL. Sixty-six (66.46%) of females had gestational age of 37-40 weeks. Premature rupture of membranes was the most common indication (32.9%). Three doses of misoprostol were required in 31.2% of females. Only 5.6% of females required six doses of misoprostol for induction. With Misoprostol 85.1% of females delivered spontaneously, 2.37% required forceps delivery, 1.7% required vacuum delivery, and 10.68% delivered by Caesarean Section. APGAR score was 8 /10 in 84% of neonates at birth. Eighty-seven %(87.8%) of neonates did not require NICU admission. Misoprostol is a safe medicine to be used to induce labor in females. It can help shorten the duration of labor, with good fetomaternal outcome.

Prediction of complications of pre-eclampsia using the fullPIERS high risk predictive model.

To determine the predicted probability percentage of complications in women with pre-eclampsia using the Pre-eclampsia Integrated Estimate of Risk (fullPIERS) model within the first 24 h after admission and assess the model's predictive value for complications of pre-eclampsia. This was a prospective cohort study in which the fullPIERS model was applied to 256 pregnant women with pre-eclampsia within the first 24 h after admission. These women were then followed for 48 h to 7 days for maternal and fetal complications. Reciever operating characteristics (ROC) curves were generated to assess the performance of the fullPIERS model for adverse outcomes of pre-eclampsia. Of the 256 women enrolled in the study, 101 women (39.5%) developed maternal complications, 120 women (46.9%) developed fetal complications, and 159 women (62.1%) developed both. With an area under the ROC curve of 0.843 (95% confidence interval 0.789-0.897), the fullPIERS model had good discriminating ability to predict complications at any time point between 48 h and 7 days after admission. The sensitivity and specificity of the model at a ≥5.9% cut-off value for predicting adverse maternal outcomes were 60% and 97%, respectively; they were 44% and 96%, respectively, for predicting combined fetomaternal complications with a cut-off value of 4.9%. The fullPIERS model performs reasonably well in predicting adverse maternal and fetal outcomes in women with pre-eclampsia.

Feto-Maternal Outcome of Moderate Anaemia in Term Pregnancy at DMCH

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion & 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 & had folic acid ..

Pattern of Suicidal Deaths in Cases Coming to a Tertiary Center in Bangladesh

Background: Anaemia is a major public health problem throughout the world especially in developing countries and it is the most common nutritional deficiency disorder in the world. High prevalence of anaemia among pregnant women persists despite the availability of effective and low-cost interventions for prevention and treatment. Objective: The aim of this study was to evaluate the adverse maternal and fetal outcome in women diagnosed with moderate anaemia at term pregnancy. Methods: This Descriptive type of observational cross-sectional study was conducted in the department of Obstetrics & Gynaecology, Dhaka Medical College Hospital; from 16th September 2021 to 15th March 2022. Samples were collected by purposive sampling. Sample size was 96. Detailed demographic data were collected from the hospital case records in structured data collection form. History, clinical examination, and investigations were done meticulously. Then all information were collected in data collection sheet. Data processing work consist of registration schedules, editing computerization, preparation of dummy table, analyzing and matching of data by number of SPSS version 24. Results: This study was attempted to observe the feto-maternal outcome of moderate anaemia. Among 96 study patients, majority (37.5%) were between 21-25 years age group. There was rural predominance with 66.56%. Socio-demographic data showed that 45.8% came from lower class and 40.6% from lower middle class. Majority patients (59.28%) were housewives. According to level of education, 42.64% had only school education followed by 37.44% had no education. Among the patients, 89.6% were Muslims and 9.4% were Hindus. Among the 53 multiparous women, 21 patients (39.62%) had no history of fetal loss, 16 patients (30.18%) had history of previous abortion & 5 (9.43%) had previous ectopic pregnancies. According to the type of anaemia 81.12% had normocytic normochromic anaemia, 79.04% had Iron deficiency, 8.32 & had folic acid def

#4109 THE IMPACT OF IMPLEMENTING AN INNOVATIVE OBSTETRIC NEPHROLOGY SERVICE ON MATERNAL AND FETAL OUTCOMES IN WOMEN AT RISK OF PR-AKI

Abstract Background and Aims Pregnancy Related Acute kidney injury (PR-AKI) is a global health problem with substantial maternal and fetal morbidity and mortality. Late referral, and late diagnosis of women with risks of PR-AKI represent the major barriers for curtailment of this ugly trend, particularly in the developing world. Our past experience per se revealed striking maternal and fetal mortality of women with PR-AKI. Great strides are strongly needed to save maternal and fetal lives. This study assessed the impact of implementing an innovative obstetric nephrology service (ONS) and healthcare program on maternal and fetal outcomes in women at risk of PR-AKI. Method An innovative interdisciplinary obstetric nephrology clinic was established in 2020 to improve the quality of care for pregnant women at risk of PR-AKI. The service was staffed by both nephrologists and obstetricians. Women who presented to the clinic were stratified into low, moderate, and high-risk groups. A risk stratification-based care program was adopted. Very high-risk women were admitted to the maternal care unit. The study compared the outcomes of ONS-treated women who completed their follow up (n = 43) versus two groups of conventionally treated women (n = 40) and women presented before service (n = 40). Results Although they had greater pre-existing risks, ONS-treated women had no reported maternal or fetal mortality compared to women in the conventionally treated group (11.8% and 51.5% respectively), and to women presented before service (22.5% and 45% respectively). Progression to end-stage renal disease was significantly less in ONS-treated women compared to both conventionally treated and those treated before service (3% versus 13.2% and 37.5% respectively). Conclusion Easily feasible Obstetric nephrology service implementation and adoption of early referral program and diagnosis policies were associated with better maternal and fetal survival as well as better renal outcomes. Provision of parallel services is strongly recommended to decrease the magnitude of PR-AKI.