History Of Intrauterine Death Research Articles

Case 1: Intramuscular Hematoma in a Neonate in the Nursery

A very preterm (29 2/7 weeks) male infant with a birthweight of 998 g is delivered by lower segment cesarean delivery (for transverse presentation with spontaneous leaking). The mother is a 25-year-old gravida 2 woman with no history of consanguinity. There is a history of intrauterine death in a previous pregnancy (at 6 months of gestation) 2 years prior. The neonate does not cry after birth. The Apgar scores are 2 and 5 at 1 and 5 minutes, respectively. The neonate undergoes intubation and is transferred to the nursery for further management in view of ongoing poor respiratory efforts. Clinical evaluation suggests multiple bruises over the left forearm, left leg, and right leg at birth. Early rescue (bovine) surfactant is administered 45 minutes after birth, ventilator settings are gradually lowered, and the neonate undergoes extubation and receives nasal continuous positive airway pressure (CPAP) 24 hours after birth. The neonate is given nothing by mouth for 24 hours, after which orogastric feeding is initiated (20 mL/kg per day) and then increased as per protocol. Treatment with caffeine (intravenous loading followed by oral) and vitamin A (injectable 5,000 IU alternate days, 3 days a week) is initiated. Respiratory distress worsens 72 hours after birth, requiring increased CPAP support. Radiologic evaluation suggests infiltrates in both the lung fields, and treatment with antibiotics (piperacillin and tazobactam with amikacin) is initiated. Respiratory distress gradually improves, antibiotics are stopped after 10 days, and the neonate is weaned to room air on day 12 after birth. The neonate regains his birthweight on day 18 after birth. The neonate is breathing room air with no respiratory distress and receiving full gavage feeds (180 mL/kg per day) till day 21, when he has 4 …

Maternal and Fetal Outcome of Pregnant Women with Diabetes

Background: Gestational diabetes mellitus (GDM) poses an important public health problem because it not only affects the maternal and fetal outcome, but these women with their fetuses are also at an increased risk of developing diabetes and related complications later in their life. Objective: The study was conducted to determine the maternal and fetal outcomes of diabetic v/s normoglycemic pregnancies Material & method: This was a retrospective analytical record based study conducted in a tertiary level hospital on 100 pregnant women over a period of one year. Information regarding maternal fetal and labor outcome parameters was recorded and compared in diabetic and normoglycemic pregnancies Results: In this study, patients with obesity, history of diabetes in the family, spontaneous abortions, history of intrauterine death and gestational diabetes in previous pregnancy had a greater incidence of GDM in current pregnancy (p<0.05). Hypertension, polyhydromnios, macrosomia, fetopelvic disproportion and cesarean sections were more (p<0.001) among diabetic pregnancies. Hypoglycemia, hyper-bilirubinemia, congenital anomalies were also observed to be more among diabetic pregnancies - suggesting an adverse effect of hyperglycemia in utero Conclusion: Diabetes during pregnancy is associated with higher maternal and fetal morbidity and pregnancy provides an opportunity to the clinician to control the disease process and inculcate healthy lifestyle practices in these patients.