Postnatal Complications Research Articles

Intrauterine Thoracoamniotic Shunting of Fetal Hydrothorax with the Somatex Intrauterine Shunt: Intrauterine Course and Postnatal Outcome.

(1) Background: Severe fetal hydrothorax can be treated by intrauterine thoracoamniotic shunting (TAS). The aim of this study was to assess perinatal outcome and complication rates of TAS with a novel Somatex intrauterine shunt. (2) Methods: This is a single-center retrospective study of all fetuses with hydrothorax treated with TAS using a Somatex shunt between 2014 and 2020. (3) Results: A total of 39 fetuses were included in the study. Mean gestational age at first intervention was 27.4 weeks (range 19–33). Of these, 51% (n = 20) of fetuses had fetal hydrops, which resolved in 65% (13/20) before delivery. The live birth rate was 97% (n = 38), and 74% (n = 29) survived the neonatal period. The rate of postnatal pulmonary complications was high, with 88% of neonates requiring any kind of ventilatory support. There were 23% (n = 9) genetic abnormalities (trisomy 21 and Noonan syndrome). (4) Conclusions: TAS with a Somatex shunt has a high technical success rate, leading to high neonatal survival rates. Pregnancy and neonatal outcome is comparable to TAS for fetal hydrothorax using different shunt types.

Impact of Prenatal Exposure to Smoking on Child Health.

Prenatal exposure to tobacco smoke remains common, through active smoking and/or passive environmental exposure, and is linked to adverse childhood outcomes. Not only have high-quality studies and meta-analyses demonstrated increased risks of prenatal as well as postnatal complications, but adverse child outcomes are well described. In utero exposure to tobacco smoke has been associated with congenital anomalies, infant and teenager overweight and obesity, and neuropsychiatric sequelae. In addition, certain childhood malignancies have been linked to paternal smoking during pregnancy. In this chapter, adverse childhood outcomes related to intrauterine exposure to electronic cigarettes and marijuana are described.

Effects of Misoprostol on Induction of Labour in Patients with Hypertensive Disorders of Pregnancy: A Meta-Analysis.

Objective Hypertensive disorders of pregnancy (HDP) can cause serious prenatal and postnatal complications and is a threat to maternal and fetal health. To offer guidance for clinical decisions, we systematically reviewed the effects of misoprostol on induction of labour in HDP patients. Methods PubMed, Web of Science, Embase, CNKI, and Wanfang databases were searched for relevant literature from 2010 to 2020. Subsequently, a meta-analysis was performed to compare the effective rate of induction of labour and reducing postpartum hemorrhage (PPH) between the intervention group (n = 544, misoprostol) and the control group (n = 543, oxytocin). Results A total of 10 studies with 1087 patients were included. The 10 studies compared the effective rate of induction of labour between the two groups and confirmed that the effective rate in the intervention group was significantly higher than that in the control group (OR = 4.37; 95% CI: 2.73, 7.00). Seven studies compared PPH between the groups and showed that it was significantly reduced in the intervention group compared to the control group (SMD = −1.32; 95% CI: −2.05, −0.59; P < 0.0001). Conclusion Misoprostol has a high effective rate of induction of labour in HDP patients and is an effective uterotonic agent in reducing PPH. This meta-analysis provides clinicians with meaningful information to help them make evidence-based decisions.

Can fetal magnetic resonance imaging aid prognosis in gastroschisis: A multicenter study.

To assess the contribution and impact of fetal magnetic resonance imaging (MRI) in managing fetal gastroschisis. We conducted an observational retrospective study of gastroschisis patients at three fetal medicine centers from 2008 to 2019. The primary endpoint was the number of cases in which the MRI provided relevant information related to gastroschisis. A total of 189 patients were included, and our study group included 38 patients who underwent MRI. For the eight patients with suspected gastroschisis, MRI confirmed the diagnosis. In six cases, it provided additional relevant information (spiral turn, intestine ischemia, and bowel size discrepancy). For the 17 patients with ultrasound signs of additional gastrointestinal anomalies, MRI detected one case of unidentified complex gastroschisis on sonography. For the 13 patients undergoing routine MRI, no significant information was obtained. One termination of pregnancy and one fetoscopy were performed a few days after the MRI results. There was no subsequent follow-up or additional bowel complications to support management. Although MRI did not change the management of pregnancies complicated by fetal gastroschisis, patients presenting with fetal gastroschisis with intraabdominal bowel dilatation could benefit from MRI to allow for more precise prenatal counseling to predict postnatal intestinal complications before birth.

Maternal cannabis use during pregnancy and maternal and neonatal outcomes: A retrospective cohort study.

To examine the relationship between reported prenatal cannabis use and neonatal and maternal outcomes and whether the legalisation of cannabis in Canada affected the rates of reported use or the association with maternal and neonatal outcomes. Population-based retrospective cohort study. Routinely collected data in a real-world setting. All women in the Canadian province of Nova Scotia with singleton births between 1 January 2004 and 30 June 2021. The association between cannabis use and maternal and neonatal outcomes was examined using generalised linear models with inverse probability weighting. Maternal and neonatal outcomes in the peripartum and postpartum period. Rates of reported cannabis use in pregnancy increased from 1.3% to 7.5% over the study period with no appreciable change in slope after legalisation in 2018. Infants of mothers reporting cannabis use in pregnancy were more likely to have major anomalies and a 5-minute Apgar score ≤7, require neonatal intensive care unit admission, and had lower birthweight, head circumference and birth length than infants of mothers not reporting cannabis use. These associations did not differ before and after legalisation. Reported cannabis use during pregnancy is associated with early postnatal complications and reduced fetal growth, even after taking into account a range of confounding factors. Rates of reported cannabis use during pregnancy increased over the past 5years in Nova Scotia with no apparent additional effect of legalisation.

Abstract 80: A case of familial growth hormone deficiency

Here by presenting, a case of familial short stature where in 2 siblings presented with failure to gain height. Similar history was present in maternal uncle. They had no history of peri/ intra / post-natal complications. They had normal developmental milestones and had normal scholastic performance. On examination there were no other syndromic features. Height was - 6 SDS and weight was below 5 centiles. Upper to lower segment ratio was preserved. SMR was Prepubertal. Systemic examination was unremarkable. On evaluation, IGF 1 levels were low. Dynamic pituitary testing for growth hormone deficiency failed to stimulate growth hormone. Pituitary Imaging with contrast MRI showed hypoplastic pituitary. In view of both siblings having short stature and similar history in maternal uncle, a whole exome sequencing was done, which showed homozygous mutation for Growth hormone releasing hormone receptor, Exon 3, c.214G>T (p. Glu72Ter). Thus, the diagnosis was confirmed as isolated growth hormone deficiency type 4.

Abstract 81: A case report of elevated TSH, elevated T3 and low T4 levels and mutation in SLCA5A gene: A diagnostic dilemma

Background: Iodide transport defect (ITD) is one of the causes of thyroid dyshormonogenesis. It is an uncommon disorder which is mediated by NIS mutations. They present with hypothyroidism and goitre due to the absence of active transport of iodide into the thyroid gland. The clinical presentation of patients with ITD due to different mutations of NIS gene has been described: including T354P, G395R, Q267E, and G543E mutations.Case Report: A 10-year-old boy born out of non – consanguineous marriage, with no antenatal, postnatal complications presented with history of goitre for 7 years. The child had a history of ADHD, average scholastic performance, and history of weight gain of 4-5 kilograms over past 2 months. Mother was diagnosed to have hypothyroidism during pregnancy. His Thyroid profile showed FT4 – 0.413 ng/dL, FT3 – 6.06 pg/mL, TSH – 12.75 mIU/mL and USG neck showed mild thyromegaly. A genetic analysis was done which revealed a homozygous mutation on Exon 7 in SLC5A5 gene. Child was started on Levothyroxine supplementation.Conclusion: The clinical picture is suggestive of hypothyroidism with elevated free T3 levels. This genetic mutation needs to be followed up in the global data base to ascertain its significance in future.

Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial

BackgroundAvailable research on the contribution of traditional midwifery to safe motherhood focuses on retraining and redefining traditional midwives, assuming cultural prominence of Western ways. Our objective was to test if supporting traditional midwives on their own terms increases cultural safety (respect of Indigenous traditions) without worsening maternal health outcomes.MethodsPragmatic parallel-group cluster-randomised controlled non-inferiority trial in four municipalities in Guerrero State, southern Mexico, with Nahua, Na savi, Me’phaa and Nancue ñomndaa Indigenous groups. The study included all pregnant women in 80 communities and 30 traditional midwives in 40 intervention communities. Between July 2015 and April 2017, traditional midwives and their apprentices received a monthly stipend and support from a trained intercultural broker, and local official health personnel attended a workshop for improving attitudes towards traditional midwifery. Forty communities in two control municipalities continued with usual health services. Trained Indigenous female interviewers administered a baseline and follow-up household survey, interviewing all women who reported pregnancy or childbirth in all involved municipalities since January 2016. Primary outcomes included childbirth and neonatal complications, perinatal deaths, and postnatal complications, and secondary outcomes were traditional childbirth (at home, in vertical position, with traditional midwife and family), access and experience in Western healthcare, food intake, reduction of heavy work, and cost of health care.ResultsAmong 872 completed pregnancies, women in intervention communities had lower rates of primary outcomes (perinatal deaths or childbirth or neonatal complications) (RD -0.06 95%CI − 0.09 to − 0.02) and reported more traditional childbirths (RD 0.10 95%CI 0.02 to 0.18). Among institutional childbirths, women from intervention communities reported more traditional management of placenta (RD 0.34 95%CI 0.21 to 0.48) but also more non-traditional cold-water baths (RD 0.10 95%CI 0.02 to 0.19). Among home-based childbirths, women from intervention communities had fewer postpartum complications (RD -0.12 95%CI − 0.27 to 0.01).ConclusionsSupporting traditional midwifery increased culturally safe childbirth without worsening health outcomes. The fixed population size restricted our confidence for inference of non-inferiority for mortality outcomes. Traditional midwifery could contribute to safer birth among Indigenous communities if, instead of attempting to replace traditional practices, health authorities promoted intercultural dialogue.Trial registrationRetrospectively registered ISRCTN12397283. Trial status: concluded.

Profile of Children suspected of ASD in a Tertiary Care Centre

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition seen in children during their early develop-mental phase where children lack in achieving age-appropriate skills or they are unable to meet the social demands due to limited capacities. It is characterised by impairments in social communication, interaction and presence of restrictive, repetitive interests/behaviours. Prevalence of ASD has increased in recent times which warrants for early identification and intervention. *The word Autism is used in this study to denote Autism Spectrum Disorders. Aim: To study the profile of children less than 5yrs of age specifically brought for suspicion of ASD by parents. Methodology: This is a cross sectional descriptive study conducted at Child Psychiatry Department of Asha Hospital for 1year with children less than 5yrs of age. 44 children with suspicion of ASD, brought by parents were evaluated through clinical inter-view using DSM-5, psychological tests- Developmental screening test, CARS-2(Childhood Autism Rating Scale), M-CHAT and CBCL. Results: Most children were between 3-5yrs of age (68.18%), were predominantly males (72.73%), 47.73% had significant prena-tal factors, 22.73% of mothers had preterm delivery, 27.27% had postnatal complications, 36.36% of children had Delayed mile-stones and 59.09% speech delay. The symptoms presented were, ‘poor/no’ response to name (90.90%), poor Eye-Eye contact (95.46%), poor socialisation (97.73%), stereotypic behaviour (81.18%) and sensory issues (52.27%). ADHD (54.54%) &amp; intel-lectual disability (95.45%) were the common psychiatric comorbidity.18.18% children had mild autism and 15.90% children were at a risk of autism. Conclusions: The symptoms presented by parents for suspicion of autism were depicted to be either mild or risk of ASD on screening

Value of fetal abdominal subcutaneous tissue thickness via ultrasound in prediction of birth weight

Background: Multiple interactions between maternal, foetal, and placental effects impact the development of the foetus. Numerous aspects of perinatology need that the foetal development rate correspond with its age. Abnormal foetal development can lead to prenatal and postnatal complications and is associated with an increase in infant morbidity and mortality, given that foetal weight is one of the most influential factors influencing newborn survival. The goal of this study was to evaluate the accuracy of fetal abdominal subcutaneous tissue thickness (FASTT) measured by ultrasonography at term and correlate it with the actual birth weight (BW) recorded at the time of delivery. Methods: This study prospective observational study was carried out on 60 singleton pregnant ladies and normal viable ongoing pregnancies at 37-39th week. Women underwent the following procedures: history taking, abdominal examination, abdominal ultrasonographic examinations (at 37-39 weeks), and follow-up after delivery for the recording of the post-natal fetal weight. Results: The mean resistive index was 0.61±0.01 among the participants while the mean FASTT was 6.8± 1.8 mm. Cut-off value of FASTT for large babies obtained by using ROC curve was 4.55 mm. Sensitivity for FASTT >4.5 mm for gestational age babies is 91.7% and specificity is 65.4%. There was statistically significant positive correlation between FASTT and weight at birth in grams. There were 44% had vaginal delivery and 56% had caesarean delivery. There were 14% had preterm labor. The mean weight at birth was 3227±642.7 g among the participants. Conclusions: The relationship between FASTT and BW is favourable. 4.55 mm was the FASTT cutoff threshold for large newborns. The sensitivity and specificity for FASTT >4.5 mm in newborns of gestational age are 91.7% and 65.4%, respectively. In addition to other well-established birth weight indicators, FASTT can be used to predict newborns who are big for their gestational age.

Rising Trends of Cesarean Section in Bangladesh: Associated Factors and Long-Term Complications on Health of Mother and Children

Background: With taking into consideration of the high cesarean section (CS) rate, the objectives of this study were to ascertain factors associated with and point out metamorphose complications with high CS rates in Bangladesh. Subjects and Method: A cross-sectional study accounted for data collection from rural (196) and urban (241) women who gave birth to babies between 2005 and 2018 in Chattogram, Bangladesh. The study subjects were selected by using a systematic random sampling technique and the sample size was determined by using web-based Raosoft software. The delivery modes were dependent variables whereas influential factors and complications related to delivery were independent variables. The data were collected through face-to-face interviews using a pre-structured question­naire. The height and weight of the participants were measured by using a stadiometer and weighing machine respectively. Data analysis was done by using regression analysis. Results: The results divulged that mingling of relative influence and doctor’s profit-making tendency, obstetric factors, and demand from a family with higher socioeconomic status contributed to the recent increased cesarean rate in urban areas (41.5%). The distended abdomen in mothers (OR= 5.11, 95% CI= 2.98 to 8.76) was strongly associated with CS (p&lt; 0.05), and back pain, and urinary incontinence were about one and half times higher in CS mothers. However, miscarriage and pelvic organ prolapse were associated with decreased risks of CS. Postnatal complications include cold fever (OR= 11.95, 95% CI= 7.02 to 20.35), and pneumonia (OR= 5.79; 95% CI= 2.71 to 12.36) were highly prevalent in children with cesarean delivery. Conclusion: Cesarean section has become alarmingly increased in urban rather than rural areas of Bangladesh in recent decays. Awareness-raising, doctor commitment, government policy, and strict monitoring of private health facilities are needed to control high rates of cesarean delivery. Keywords: cesarean delivery; vaginal delivery; demographic factors; obstetric factors; postpartum complications. Correspondence: Md. Altaf Hossain, Department of Animal Resources Science, Sunchon National University, Suncheon, Jeollanam-do, South Korea. Telephone: +8201098532108; Email: altaf@cvasu.ac.bd Journal of Maternal and Child Health (2022), 07(05): 532-542 https://doi.org/10.26911/thejmch.2022.07.05.04

Analysis of extrauterine growth retardation and related risk factors in 132 premature infants.

Objectives:To understand the incidence and related risk factors of extrauterine growth retardation (EUGR) in preterm infants.Methods:The clinical data of 132 premature infants hospitalized in the neonatal ward of Maternity and Child Health Care of Zaozhuang from July 2019 to June 2020 were collected. Children were divided into groups according to their birth gestational age (<32 weeks, 32~35 weeks and >35 weeks) and birth weight (<1-500 g, 1,500~2,500 g and >2,500 g). Treatment during hospitalization and follow-up after discharge were investigated by retrospective analysis. Incidence of EUGR in premature infants at discharge and the related risk factors leading to this complication, demonstrated by logistic multivariate regression analysis, were summarized.Results:When evaluated according to weight, length and head circumference, incidence of EUGR at discharge in premature infants were 36.36%, 41.67% and 21.97% respectively. Smaller gestational age and lower birth weight significantly correlated with higher incidence of EUGR at discharge (P<0.05). Logistic regression analysis showed that small gestational age, low birth weight, intrauterine growth retardation, late first intestinal feeding, digestive system complications and respiratory system complications were independent risk factors for EUGR in premature infants discharged from hospital (P<0.05).Conclusions:The incidence of EUGR in premature infants at discharge is relatively high. Strengthening perinatal health care for pregnant women, reducing the incidence of intrauterine growth retardation and preterm birth, giving intestinal feeding as soon as possible after birth, and actively participating in preventing and treating postnatal complications are effective ways to reduce the incidence of EUGR at discharge.

Fetal Ovarian Cysts: Prenatal Diagnosis Using Ultrasound and MRI, Management and Postnatal Outcome-Our Centers Experience.

The present study provides our clinical experience regarding the imaging diagnosis, management and postnatal outcome of neonates prenatally suspected of having developed ovarian cysts. This multicenter observational study included patients diagnosed prenatally with fetal ovarian cysts and follow-up in the postnatal period. Descriptive statistics were used to render the information regarding the prenatal imaging aspect of the fetal pelvic masses using ultrasound and/or MRI, prenatal surveillance and postnatal neonate’s immediate outcome, indications leading to surgery and pathologic aspect. The inclusion criteria were fulfilled by 21 patients. The mean gestational age at the time of initial diagnosis was 31.28 weeks of gestation (WG). Only five out of 21 cysts regressed completely during pregnancy without postnatal complications. In addition, 11 out of 21 infant’s required surgical treatment in the first two weeks after birth, mainly for ovarian torsion. Five out of 21 neonates were referred to postnatal follow-up clinically and by ultrasound, but three out of five cases required emergency surgical treatment for acute complications. Ultrasound plays a major role in the diagnostic of fetal ovarian cyst. From our experience, MRI does not bring supplementary data or change the management. Spontaneous resolution of fetal ovarian cysts is to be expected but the ovarian mass could lead to serious complications, if resolution does not occur in due time.

Puerperal Complications in a Tertiary Hospital

Postnatal period is considered as an important part in reproductive life of women. Even though the antenatal phase and labour are utmost important, puerperal phase of pregnancy cannot be overlooked. Puerperal complication can sometime lead to diabilities for lifelong of women. For the prevention of postnatal complication, antenatal prepadareness is needed. The objective of this study was to find out the incidence of puerperal complications and associated risk factors. This is a retrospective, descriptive study conducted at Tribhuvan University Teaching Hospital, Department of Obstetrics and Gynaecology from April 2019 to March 2020. The cases of puerperal complications were noted from the record book from ward. The individual files were collected from record section. Data was collected from record files and analysed. Total number of deliveries were 4932 in one year. Out of which, 84 cases (1.7%) were admitted due to various puerperal complications. Majority of the women admitted with puerperal complications were between 21-29 years, 59.5%. Sixty-four percent (n=54) were primipara and 35.7%(n=30) were multipara. Seventy-six (90.5%) were term deliveries, 6(7%) were preterm and 2(2.4%) were post term deliveries. Sixty-two (74%) had emergency cesarean section as mode of delivery. Major indication of emergency cesarean section was fetal distress (29.8%, n=25). Surgical site infection (53/84,63%) was the commonest puerperal complication followed by puerperal sepsis (8/84,9.5%). Fifty- three cases of surgical site infection (SSI) were observed in patients who had undergone emergency cesarean section. Associated medical condition like hypertension, diabeties, anemia, obesity was seen in 33.5% (n=33) of the cases. Surgical Site Infection is the most common puerperal complication and commonly seen in women who had undergone emergency cesarean section.

Neutrophil-lymphocyte Ratio as a Bio- Inflammatory Prognostic Marker of Fetomaternal Outcomes of Preeclampsia: A Narrative Review

Background: Preeclampsia &amp; its related problems have potential contribution to maternal mortality &amp; morbidity. Early diagnosis &amp; appropriate management of preeclampsia can prevent antenatal, intranatal &amp; postnatal complications associated with preeclampsia. The neutrophil to lymphocyte ratio (NLR) which is derived from a complete blood count &amp; dedifferentiation, is a straightforward inflammatory index (1). Pre-existing studies have shown that NLR is indicator of Preeclampsia.&#x0D; Objective of this Narrative Review: In this we summarized the evidence regarding the clinical utility of NLR in preeclampsia &amp; its related complications.&#x0D; Methods: A comprehensive systematic search from PubMed, Embase, Cochrane Library, VIP database for relevant literature. Sensitivity, specificity &amp; other measures of accuracy of NLR for the diagnosis of PE were pooled.

Does meconium contaminated amniotic fluid affect intestinal wall thickness and functional outcome in patients with anterior abdominal wall defects?

Background:Gastroschisis (GS) and omphalocele (OC) are congenital abdominal wall defects, the main difference between is the direct exposure of intestinal loops in amniotic fluid in children with a GS. This leads to a reduced primary closure rate and a higher number of intraoperative abnormalities and post-operative complications.Aims and Objectives:We analysed abdominal wall defect patients over an 11-year period, aiming to assess the influence of meconium-contaminated amniotic fluid. This study has different objectives to show the consequence of functional outcome of abdominal wall defects (AWD) children in reliance to colour of amniotic fluid, to assess the effect of reduced bowel exposure time to meconium contaminated amniotic fluid on edematous inflammatory thickening of the bowel loops, to show an positively influence in the number of primary AWD closures, to demonstrate a reduced incidence of post-natal complications and to verify a better outcome of OC children because of failing exposure to amniotic fluid.Methods:A retrospective, observational case–control design was used to compare GS (n = 36) and OC (n = 18) children. Physical data, colour of amniotic fluid, pre- and perinatal problems, operative complications and surgical technique, post-operative complications, duration of intensive care unit (ICU) stay, mechanical ventilation, parenteral nutrition, commencement of oral feeding and total hospital stay were collected. Data were analysed with descriptive methods, t-test and non-parametric tests such as Wilcoxon and Kruskal–Wallis were performed in addition to the analysis of variance, including post hoc testing accepting a confidence interval of 95% (P < 0.05) by using IBM SPSS software, version 23 (IBM, Illinois, USA).Results:Rate of meconium-contaminated amniotic fluid is significantly higher in GS compared to OC (P < 0.001), delivery problems such as congenital infections are also significantly higher (P < 0.001), this yields in significantly more bowel loops anomalies and problems during surgery (P < 0.036) but had no significant influence on primary abdominal wall closures rate (P = 0.523). The post-surgical outcome of OC was significantly better as compared to GS. Within the GS, those with swollen intestines had significantly longer ICU stays (P = 0.045) due to extended mechanical ventilation (P = 0.007), parenteral nutrition (P = 0.011) and delayed initiation of oral feeding (P < 0.001. Same results were found for the duration of ICU stay (P = 0.008), mechanical ventilation (P = 0.006), parenteral nutrition (P = 0.011) and delayed initiation of oral feeding (P < 0.001) in secondary closures as compared to primary abdominal wall closures in the GS group.Conclusions:Worsen functional short-term outcome of GS children was directly addicted to meconium contamination of amniotic fluid due to swollen intestines and because of this more post-surgical problem including significantly extended hospital stays were observed.

Maternal and Fetal Outcome of Prelabor Rupture of Membranes at Term. Prom) - a trial of 24 hours of expectant management.

Objective: To find out the maternal and fetal outcome of 24 hours of expectant management. Design: Prospective descriptive study. Settings: Labor room of obstetrics and Gynae unit I, services hospital Lahore. Subjects: Participants were 100 women presenting with prelabor rupture of membranes at term. 50 nullipara and 50 multipara with cephalic presentation and no contraindication to vaginal delivery. Methods: All the participants of the study group were subjected to conservative management for 24 hours under antibiotic cover of Inj. cefataxime followed by induction if labor did not start spontaneously in 24 hours or if signs of chorioamnionitis developed at any stage. Data was collected on a Performa, which was then entered on database IV and analyzed in percentages on spss statistical package. Results: The magnitude of PROM in Gynae unit I services hospital in the year 2002 was 7.008%. 84% patients went into spontaneous labor, 2% patients developed signs of chorioamnionitis, and 14% patient did not enter into spontaneous labor after 24 hours of PROM. 94% patients with PROM delivered vaginally total of 6 c/s were carried out, 2% c/s due to fetal distress, 2% for failed induction and 2% for fetal distress after induction. Postnatal complications included chorioamnionitis 2%, PPH 7%, puerperal pyrexia 4%, wound infection 3%, and DVT in 1% patients. Neonatal complications included admission to ICU in 8% babies and neonatal infection in 1%. There was no fetal mortality. Conclusion: Conservative approach did not negatively affect fetal maternal outcomes.

Early Identification and Prevention of Postnatal Complications among the Postnatal Mothers by Using the ‘Postnatal Care Bundle’

Background: Postnatal period initiates immediately after the birth of a baby. The terms puerperium period is commonly used to refer to the first 6 weeks after delivery of baby. A postnatal care bundle used during this period and it will help to significantly improve patient outcomes.&#x0D; Objective: To develop, test and pilot of Postnatal Care Bundle (PNCB) and to assess conventional postnatal care among the postnatal mothers and to evaluate the effectivity of Postnatal Care Bundle (PNCB) for early identification and prevention of postpartum complications among the postnatal mothers and to assess the satisfaction level of staff nurses after implementation of Postnatal Care Bundle and conventional postnatal care for early identification and prevention of postnatal complications among the postnatal mothers.&#x0D; Methodology: The interventional analytical and true experimental research design approach will be used and the sample use for the postnatal mothers including the full term normal delivery, caesarean section will be and the random sampling use and sample size is 185 in each group i.e. control and experimental group. One group will be received conventional postnatal care and other group will be on postnatal care bundle. The outcome includes that postnatal care bundle help to early identification and prevention of postnatal complications among the postnatal mothers.&#x0D; Conclusion: PNCB will be effective in quality care of postnatal period.

Influence of the degree of bacteriuria on perinatal results for asymptomatic urinary tract infection

The objective: to conduct a comparative analysis of the outcomes of pregnancy, childbirth and the postpartum period in women with varying degrees of asymptomatic bacteriuria (AB) and to assess its role in the development of perinatal complications. Materials and methods. To identify the features of the course of childbirth and the postpartum period in BB, a comprehensive clinical study of 182 pregnant women was carried out, divided into 3 groups. Group I (main) included 85 pregnant women with asymptomatic bacteriuria &gt;105 CFU/ml («severe» bacteriuria), group II included 52 pregnant women with АB 102–104 CFU/ml («moderate» bacteriuria) who did not receive treatment. Group III (control) consisted of 45 pregnant women without urinary tract infection. Statistical analysis of the research results was carried out using computer processing of the data obtained using the «Excell-5.0» and «Statistica» programs. Results. The age of the surveyed ranged from 16 to 42 years, while the average age was the same in the studied groups. In the first group it was 27.2±0.63 years, in the second group – 26.2±0.75 years, in the third (control) – 26.7±0.42 years. Premature birth was observed significantly more often in АB. Thus, pregnancy against the background of asymptomatic infection urinary tract ended in premature birth in 10.6% and 11.5% of observations in women of groups I and II, which did not exceed the general population indicator, however, in comparison with healthy patients, it increased in 4.8 and 5 times, respectively (p&lt;0.05). Conclusion.The results of our study showed that АB affects the development of preterm labor, premature rupture of membranes, increases the frequency of pathological births, caesarean sections and pyoinflammatory diseases in the postpartum period. In pregnant women with asymptomatic infection urinary tract, regardless of the severity of bacteriuria, it is advisable to use antibiotic therapy to reduce intranatal and postnatal complications, reduce the severity and duration of recurrent infection urinary tract and reduce purulent-inflammatory diseases of puerperium.

Awareness of Postpartum Complications and Utilization of Preventive Measures Among Patients at Tagbilaran Maternity And Children’s Hospital, Tagbilaran City, Bohol

The postpartum period, also known as puerperium and the “fourth trimester,” refers to the time after delivery when maternal physiologic changes related to pregnancy return to the nonpregnant state. In addition, to the physiologic changes and medical issues that may arise during this period, healthcare providers should be aware of the psychological needs of the postpartum mother and be sensitive to cultural differences surrounding childbirth, which may involve eating foods and restricting certain activities. This study aimed to assess the level of awareness of postpartum complications and utilization of preventive measures among patients, which hoped to come up with appropriate recommendations. Through a quantitative method, 50 randomly selected postpartum mothers were interviewed. The results revealed that they were moderately aware of the postpartum complications and moderately utilized preventive measures to prevent postnatal complications. Furthermore, it also revealed a significant correlation between the mothers’ level of awareness of postpartum complications and their level of utilization of preventive measures. The results implied the need to amplify and simplify information dissemination in the context of postpartum complications and preventive measures. It is recommended that there is a need to increase pregnant mothers’ level of awareness of postpartum complications as well as the utilization of preventive measures.