Prediction Of Perinatal Outcome Research Articles

Correlation Between Fetal Ductus Venosus Doppler and Amniotic Fluid Index in Prediction of Perinatal Outcome in Preeclamptic Pregnancies

Correlation Between Fetal Ductus Venosus Doppler and Amniotic Fluid Index in Prediction of Perinatal Outcome in Preeclamptic Pregnancies

Role of admission test by Cardiotocography (CTG) as a predictor of perinatal outcome: A prospective study

Background: Routine and continuous electronic monitoring of foetal heart rate (FHR) in labour has become an established obstetric practice. In this study we aim to evaluate if the admission Cardiotocography (CTG) can be used as a predictor in detecting foetal hypoxia at the time of admission in labour and to correlate the results of the admission CTG with the perinatal outcome. Material & Method: Total of 100 patients admitted in the labour room with singleton live pregnancy after 37 weeks of gestation were included in this prospective observational study. Foetal heart tracing was recorded at the time of admission to labor room, for a period of 20 minutes and evaluated using standard procedure. Result: One hundred patients were recruited. The admission CTG were ‘reactive’ in 67, equivocal in 21, and ‘ominous’ in 12 women. Occurrence of foetal distress, meconium stained liquor and neonatal intensive care unit (NICU) admission was significantly more frequent among patients with ominous test results compared with equivocal or reactive test results on admission. Incidence of vaginal delivery was more common when the test was reactive. Conclusion: It is simple and easy test and an effective screening test to identify group of women with greater risk of Intrapartum foetal hypoxia and prevents unnecessary delay in intervention.

The Relationship between Amniotic Fluid Index (AFI) & Single Largest Vertical Pocket and Perinatal Outcome in Late Severe Preeclampsia

Backgound: the amniotic fluid is a clear fluid that surrounds the fetus, and produced in part by the amniotic cells, maternal blood during the first trimester of pregnancy and fetal urine and lung fluid during the second trimester of pregnancy. It serves as a cushion to the fetus allowing musculoskeletal development and protecting it from trauma. It also maintains temperature and has a minimal nutritive function. Evaluation of AFV through ultrasound measurement is an essential part in tests of fetal well-being (BPP), by measuring the AFI or the MVP. Objective: the aim of this study was to evaluate both AFI and single deepest pocket in patients with late severe preeclampsia, and to correlate both markers with different parameters of fetal outcome. Patients and Methods: the study was a prospective controlled study involving 100 women with severe preeclampsia >34w managed at Al Hussein University Hospital and Al Arish General Hospital with the following inclusion criteria, pregnant patients, age 18- 40 years old, with variable parity and a singleton living fetus >34 weeks gestation, and with severe preeclampsia. Results: the neonatal outcomes regarding meconium is more with AFI group than MVP group while the neonatal outcome regarding NICU, RDS & Neonatal death in both groups were similar with no evidence of a statistical difference between both techniques. Conclusion: we concluded that AFI had more significant statistical relationship with perinatal outcome, hence AFI appeared to be a better predictor of perinatal outcome in preeclamptics in late severe preeclampsia.

Study of 24 weeks antenatal visit as predictor of perinatal outcome

Study of 24 weeks antenatal visit as predictor of perinatal outcome

Hyperuricemia as a Predictor of Perinatal Outcomes in Pregnancy Induced Hypertension

Hyperuricemia as a Predictor of Perinatal Outcomes in Pregnancy Induced Hypertension

Fetal Doppler Parameters at Term in Pregnancies Affected by Gestational Diabetes: Role in the Prediction of Perinatal Outcomes.

The timing of delivery for women affected by gestational diabetes (GDM) is still controversial. Good clinical practice often suggests offering induction of labor at term in order to reduce the complications associated with this condition, while recent evidence supports expectant management. Fetal Doppler parameters represent a validated tool for testing fetal well-being at term and can select pregnancies that need increased surveillance. The aim of the present study was to evaluate the role of fetal Doppler parameters at term for the prediction of pregnancy outcomes in patients affected by GDM. Prospective cohort study in a single center. Evaluation of umbilical artery (UA) PI, middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR) and umbilical-to-cerebral ratio (UCR) at > 37 weeks of gestation in singleton, morphologically normal pregnancies affected by GDM, was performed in order to estimate the association between ultrasound measurements at term and perinatal outcome. Regression linear analysis was used to estimate the association between fetal Doppler parameters and neonatal pH, neonatal Apgar score, neonatal weight and a composite adverse outcome. The receiver operating characteristic (ROC) curve was used to estimate the possible predictive value of the above association. Our results on 130 women showed MCA PI to be the best predictor of perinatal outcomes in terms of low Apgar score at the 1st minute (p = 0.00), pH (p = 0.02) and composite adverse outcome (p = 0.05). UCR showed a significant correlation with neonatal pH (p = 0.02). No significant correlations for UA PI and CPR MoMs have been demonstrated in our population. However, the small sample size is a limitation of the study. Evaluation of MCA Doppler and eventually UCR at term can be a useful tool to discriminate pregnancies affected by GDM that can benefit from IOL before 41 weeks in order to reduce complications related to this condition.

The Reliability of the Cerebroplacental Ratio in the Prediction of Perinatal Outcome in IUGR Babies

The Reliability of the Cerebroplacental Ratio in the Prediction of Perinatal Outcome in IUGR Babies

Human Development Index (HDI) of the maternal country of origin as a predictor of perinatal outcomes - a longitudinal study conducted in Spain

BackgroundIn an era of worldwide population displacement, recent studies have identified strong associations between social situations and perinatal outcomes among immigrants. Little is known about the effect of maternal social background on pregnancy outcomes. The Human Development Index (HDI) assesses the following dimensions of human development: life expectancy, education level and income. The objective of our study was to determine if maternal HDI may be used to identify women at increased odds of poor pregnancy outcomes.MethodsWe conducted a longitudinal population-based study in a tertiary centre in Madrid, Spain. The outcome variables were maternal and perinatal/antenatal mortality, preeclampsia (PE), low birth weight (LBW), gestational diabetes mellitus (GDM), preterm delivery (PTD) before 37 and 34 gestational weeks, abnormal cardiotocography (CTG) during delivery, C-section (CS) due to abnormal CTG, pH < 7.10 at birth, Apgar at 5 min ≤ 7, and resuscitation type ≥3. We performed multivariate logistic regression analyses adjusted for potential confounding variables to evaluate the associations between maternal HDI and perinatal outcomes.ResultsIn total, 38,719 singleton infants who were born in our maternity ward between 2010 and 2016 and had perinatal outcome data available were included in this study. The neonates of women from medium/low HDI countries had significantly lower odds of low birth weight (LBW) than their very high HDI country counterparts (OR 0.63, 95% CI 0.55–0.72). However, the odds of PTD before 37 gestational weeks and PE were higher in the medium/low HDI group than the very high HDI group (OR 1.26, 95% CI 1.04–1.53; OR 1.35, 95% CI 1.02–1.79, respectively). Poorer neonatal outcomes were identified in the medium/low HDI group than the very high HDI group, including greater odds of abnormal CTG, CS due to abnormal CTG and Apgar 2 ≤ 7 (p < 0.05).ConclusionsOur findings suggest that the infants of mothers from medium/low HDI had lower odds of LBW but higher odds of PTD, PE and poor neonatal outcomes. These results support the hypothesis that maternal HDI can be used to understand the impact of maternal origin on pregnancy outcomes. Further studies are needed to confirm its validity.

P20.07: Abdominal circumference growth velocity and cerebroplacental ratio as predictors of perinatal outcome in small‐for‐gestational‐age fetuses

P20.07: Abdominal circumference growth velocity and cerebroplacental ratio as predictors of perinatal outcome in small‐for‐gestational‐age fetuses

OP21.09: Fetal Dopplers for prediction of perinatal outcomes in pregnancies complicated by gestational diabetes mellitus

OP21.09: Fetal Dopplers for prediction of perinatal outcomes in pregnancies complicated by gestational diabetes mellitus

Role of Colour Doppler in the Prediction of Perinatal Outcome in Intrauterine Growth RestrictionsRole of Colour Doppler in the Prediction of Perinatal Outcome in Intrauterine Growth Restrictions

Role of Colour Doppler in the Prediction of Perinatal Outcome in Intrauterine Growth RestrictionsRole of Colour Doppler in the Prediction of Perinatal Outcome in Intrauterine Growth Restrictions

Predictors of perinatal outcomes and economic costs for late-term induction of labour

ObjectiveWe aimed to predict the perinatal outcomes and costs of health services following labour induction for late-term pregnancies. Materials and methodsWe conducted a cohort study of 245 women who underwent labour induction during their 41st week of gestation. The cervical condition was assessed upon admission using the Bishop score and ultrasound cervical length measurements. We estimated the direct costs of labour induction, and a predictive model for perinatal outcomes was constructed using the decision tree analysis algorithm and a logit model. ResultsA very unfavourable Bishop score at admission (Bishop score <2) (OR, 3.43 [95% CI, 1.77–6.59]), and a history of previous caesarean section (OR, 7.72 [95% CI, 2.43–24.43]) or previous vaginal delivery (OR, 0.24 [95% CI, 0.09–0.58]) were the only variables with predictive capacity for caesarean section in our model. The mean cost of labour induction was €3465.56 (95% confidence interval [CI], 3339.53–3591.58). Unfavourable Bishop scores upon admission and no history of previous deliveries significantly increased the cost of labour induction. Both of these criteria significantly predicted the likelihood of a caesarean section in the decision tree analysis. ConclusionThe cost of labour induction mostly depends on the likelihood of successful trial of labour. Combined use of the Bishop score and previous vaginal or caesarean deliveries improves the ability to predict the likelihood of a caesarean section and the economic costs associated with labour induction for late-term pregnancies. This information is useful for patient counselling.

Umbilical Artery Doppler as the Signature Vessel and Predictor of Perinatal Outcome in IUGR

Umbilical Artery Doppler as the Signature Vessel and Predictor of Perinatal Outcome in IUGR

Platelet Count in First Trimester of Pregnancy as a Predictor of Perinatal Outcome.

AIM:To rule out maternal and pregnancy factors that may contribute to platelet count (PLT) changes in the first trimester of gestation and examine if there is any association between its levels and adverse perinatal outcome.METHODS:The study population included all patients from the first-trimester visit between 2013-2015 with pregnancy results. Linear multiple regression was constructed to rule out variables that may have a significant contribution to PLT. For each adverse outcome at birth, multiple logistic regression analysis was implemented to estimate the PLT effect.RESULTS:PLT was measured in 6092 patients. There was the significant contribution on PLT in the first trimester from maternal weight, the presence of rheumatologic disease, BHCG levels and MPV. There was a significant association between PLT and abnormal cardiotocography at delivery (OR 1.004; IC95% 1.001 to 1.007) and C-Section due to abnormal CTG (OR 1.005; IC95% 1.002 to 1.008). When adjusted for factors that interact with PLT there was also a significant association with pH at birth < 7.10 and gestational diabetes.CONCLUSIONS:Maternal and pregnancy factors can poorly predict relevant changes in PLT at the first trimester of gestation. PLT at first trimester of pregnancy might predict adverse perinatal outcome in combination with other markers.

Perinatal Death and Associated Factors in Wolaita Sodo Referral Hospital, Southern Ethiopia: a Facility Based Cross-Sectional Study

Abstract Background: Birth is a critical time for the mother and fetus. In Ethiopia rates of new born morbidity and mortality are among the highest in the world. Even though many African mothers including Ethiopian are ending up in perinatal mortality, little was investigated to identify the associated factors. Methodology: A facility based retrospective cross-sectional study was conducted in July, 2015 in Wolaita Sodo University teaching and referral Hospital by collecting data through record review of all women who gave birth at the hospital within the past one year preceding the survey. Systematic sampling technique was used to select 300 subjects. Epidata version 1.4.4.0 and SPSS version 20 were used to enter and analyze data respectively. Proportions and means were used to describe the study population by explanatory variables whereas; Bivariate and multivariable logistic regression were used to identify the candidate and predictor variables respectively. All statistical tests were considered significant at α<0.05. Result: Among the 300 mothers who delivered their index child at Wolaita Sodo University teaching and referral hospital, 52 (17.3%) of them had a dead perinatal outcome. Antenatal care visit, obstructed labor, referral from other health facility, cord prolapse, preeclampsia and birth weight were identified as predictors of perinatal outcome. Conclusion: Perinatal death among the study participants was high, which seeks a due attention. Appropriate antenatal care supported with ultrasound examination, improving obstetrics care, early diagnosis and appropriate management of severely asphyxiated fetus at the time of delivery could reduce the prevalence. Hence, making health facilities (those which can provide comprehensive services) accessible to clients could reduce perinatal death attributable to referral related causes. Besides, health facilities have to give due attention on strengthening improvement of ante-natal care service and the use of partograph.

Doppler Triple-vessel Wave Pattern as a Screening Method for Prediction of Perinatal Outcome in Pregnancy-induced Hypertension

Doppler Triple-vessel Wave Pattern as a Screening Method for Prediction of Perinatal Outcome in Pregnancy-induced Hypertension

Search for early markers of gestational diabetes mellitus–comparison of first and third trimester levels of adropin, copeptin and vitamin D in prediction of perinatal outcomes

Search for early markers of gestational diabetes mellitus–comparison of first and third trimester levels of adropin, copeptin and vitamin D in prediction of perinatal outcomes

Middle Cerebral Artery Peak Systolic Velocity as a Predictor of Perinatal Outcome in Fetal Growth Restriction

Middle Cerebral Artery Peak Systolic Velocity as a Predictor of Perinatal Outcome in Fetal Growth Restriction

Possible role of asymmetric dimethylarginine (ADMA) in prediction of perinatal outcome in preeclampsia and fetal growth retardation related to preeclampsia

Objective: The objective of this study is to investigate maternal serum and neonatal umbilical cord asymmetric dimethylarginine (ADMA) levels in prediction of perinatal prognosis in pregnancies with preeclampsia (PE) and fetal intrauterine growth retardation (IUGR) accompanying PE (PE + IUGR).Methods: Maternal serum ADMA (msADMA) and neonatal umbilical cord ADMA (ucADMA) levels were studied from 34 patients with PE, 25 patients with PE + IUGR, and 30 healthy pregnant controls in this prospective case–control study. Umbilical artery Doppler indices of fetuses, birth weights, Apgar scores, umbilical artery pH measurements of neonates, and admissions to neonatal intensive care unit (NICU) were recorded.Results: Median msADMA was significantly higher in PE and PE + IUGR groups (p = 0.024 and p = 0.011, respectively), and ucADMA was significantly higher in PE and PE + IUGR groups than the control group (p = 0.029 and p = 0.018, respectively). Median msADMA and ucADMA levels were significantly higher in the PE + IUGR group than the PE group (p = 0.019 and 0.021, respectively). ucADMA levels did not correlate with fetal umbilical arterial blood flow neither in the PE nor in the PE + IUGR group (p = 0.518 and p = 0.892, respectively). None was related with neonatal umbilical artery pH or NICU admission rates.Conclusions: msADMA and ucADMA correlated with severity of PE. msADMA and ucADMA failed to predict perinatal outcome in patients with PE and PE + IUGR.

Prediction of perinatal outcome in preeclampsia using middle cerebral artery and umbilical artery pulsatility and resistance indices

ABSTRACTObjective: In preeclampsia, changes in fetal hemodynamics can be detected 2–3 weeks earlier than any changes in cardiotocogram. Thus, these Doppler changes can be used to predict perinatal outcome. The present study is planned to assess the accuracy of the middle cerebral artery to umbilical artery (UA) pulsatility index (PI) and resistance index (RI) in predicting adverse perinatal outcome in pregnancies complicated by preeclampsia. Methods: Total of 115 and 108 pregnant women were included in preeclampsia and control group, respectively. Weekly Doppler study was done in both groups starting from 30 weeks till 36 weeks or delivery, whichever is later. Results: Mean gestational age at delivery was 250 ± 13 and 273 ± 8 days, respectively, in preeclampsia and control group (p < 0.01). Thirty-four babies in preeclampsia group had been admitted to nursery; out of which three died (p < 0.01). On receiver operating characteristic analysis, MCA /UmA PI ratio and MCA /UmA RI ratio had sensitivity of 9% and 9.7% and specificity of 98% and 96.6%, respectively, for predicting adverse perinatal outcome. Conclusion: Doppler indices of MCA and Um A are significantly abnormal in preeclampsia. But on diagnostic statistical analysis they have good specificity but low sensitivity for detecting adverse perinatal outcome.