Section Of Obstetrics Research Articles

Lesions of the prepuce and penis in rams: A retrospective study

In the ovine reproductive management, a thorough breeding soundness evaluation including specific inspection of the male genital tract represents a valuable tool for assessing the reproductive potential of a selected subject and for diagnosing genital disorders. During examination, accurate inspection on penis and prepuce is necessary, since conditions affecting these structures may hamper regular coitus. Records from 1270 males undergoing breeding soundness evaluation (n = 1232) or admitted for genital disorders to the Section of Obstetrics and Gynaecology (n = 38) of the Department of Veterinary Medicine, were collected, and lesions of penis and prepuce were therefore classified. The data collected revealed that 47/1270 rams examined presented lesions of the penis and prepuce. The most frequent condition was urolithiasis accounting for over 2% of the cases, followed by lack of the urethral process (0.39% incidence), lack of the glans penis and hypospadias (0.23% cases). Moreover, most of the conditions (40%) were observed in animals less than 2 years old, suggesting the importance of a careful breeding soundness evaluation in animals at young age.

DEGUM Recommendations on Diagnostic Puncture in Prenatal Medicine.

Diagnostic puncture (amniocentesis, chorionic villus sampling, and fetal blood sampling) is an essential part of prenatal diagnostics and the only established and sufficiently scientifically evaluated possibility of diagnosing genetic diseases from pregnancy-specific cells. The number of diagnostic punctures in Germany, as in other countries, has fallen significantly. This is largely due to the introduction of first-trimester screening with further detailed ultrasound examination of the fetus and the analysis of cf-DNA (cell-free DNA) from maternal blood (noninvasive prenatal test - NIPT). On the other hand, knowledge about the incidence and appearance of genetic diseases has increased. The development of modern molecular genetic techniques (microarray and exome analysis) makes a differentiated investigation of these diseases increasingly possible. The requirements for education and counseling regarding these complex correlations have thus increased. The studies performed in recent years make it clear that diagnostic puncture performed in expert centers is associated with a low risk of complications. In particular, the procedure-related miscarriage risk hardly differs from the background risk for spontaneous abortion. In 2013, the Section of Gynecology and Obstetrics of the German Society for Ultrasound in Medicine (DEGUM) published recommendations on diagnostic puncture in prenatal medicine 1. The developments described above and new findings in recent years make it necessary to revise and reformulate these recommendations. The aim of this review is to compile important and current facts regarding prenatal medical puncture (including technique, complications, genetic examinations). It is intended to provide basic, comprehensive, and up-to-date information on diagnostic puncture in prenatal medicine. It replaces the publication from 2013 1.

Maternal and Neonatal Prognosis of Childbirth Among 14 to 19 Years Teenage Girls at the Ordre De Malte Hospital of Djougou, Benin

<i>Introduction</i>: Despite advances in clinical care, teenage childbirth is still feared both medically and socially. Because of their immature bodies, teenage girls are more prone to complications during pregnancy and delivery. Objective: This study aimed to investigate maternal and neonatal prognosis of childbirth among 14 to 19 years teenage girls at the Ordre de Malte hospital of Djougou (HZ-OMD) in 2021.<i> Method</i>: For descriptive and analytical purposes, we conducted a prospective study in the gynecology and obstetrics section of the Ordre de Malte hospital of Djougou (HZ-OMD), from January 1 to May 31, 2021 (5 months). The study population consisted of all parturients admitted into the gynecology and obstetrics section of the HZ-OMD throughout the study period. Data were collected through a face-to-face interview using a pre-designed and tested questionnaire, as well as through physical checkup. Pearson's chi-square and Fisher's exact tests have been used as appropriate to determine correlation between variables. <i>Result</i>: A total of 240 participants were included in this study. The teenage girls childbirths rate in the HZ-OMD was 18.3%. Deliveries were vaginal (63.7%) and vaginal (36.3%). The dystocia noted during vaginal delivery were mechanical (15.2%) and dynamic (11%). High blood pressure was found in 28.6% and was complicated by eclampsia in 16.4% of cases. No maternal deaths were recorded. Preterm births and low birthweight represented 21% and 33.33% of these births respectively. Acute fetal distress was noted in 13.75%. The neonatal mortality rate was 106 per 1000 live births. Irregular fetal heart rate and a generally narrowed pelvis were associated 5.14 and 5.86 times respectively with the risk of delivering through cesarean section (p=0.001; p=0.033). Fifth minute Apgar <7, a criteria of fetal morbidity, was significantly associated with low birthweight (p=0.01), preterm delivery (p=0.021), and acute fetal distress (p 0.001). Newborns were 5 times more likely to die when they are of low birthweight (p=0.001). <i>Conclusion</i>: Teenage girls’ childbirth presents huge risks due to the immaturity of their bodies and the poor follow-up of their pregnancies in our settings.

Retracted: The Effect of Skin-to-Skin Contact on Postoperative Depression and Physical Recovery of Parturients after Cesarean Section in Obstetrics and Gynecology Department.

[This retracts the article DOI: 10.1155/2022/9927805.].

Rectal diclofenac; an effective modality for pain relief after vaginal birth

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; Vaginal delivery (VD) is the safest delivery option for the mother and is associated with quick recovery and minimal maternal morbidity and mortality. However, one of the commonest fears among women about VD is pain. This study aims to assess the effectiveness of diclofenac suppositories (per rectum) compared to the intramuscular diclofenac for the pain relief in females after VD.&lt;br /&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective comparative was study conducted at the Emergency Section (labor room) of Obstetrics &amp;amp; Gynecology Department in one of the tertiary care teaching hospitals of Lahore, Pakistan. A total of 182 female patients undergoing VD were selected and further divided into group A and group B. Group A was administered rectal analgesia in the form of rectal suppositories (100 mg) immediately after perineal tear (first and second degree only) repair and repeated after 6 hours. While group B received one injection of intramuscular diclofenac, immediately after perineal tear repair. The pain score was measured on a graphical score using Graphic Rating Scale, immediately at rest, during movement, and during urination. The pain score was reassessed after 6 hours with the same parameters and compared between both groups.&lt;br /&gt;&lt;strong&gt;Results:&lt;/strong&gt; The overall pain score was significantly lower immediately (p = 0.004) and 6 hours (p = 0.002) after VD in group A at rest, during movement, and during urination as compared to group B.&lt;br /&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The use of rectal diclofenac suppositories is a simpler and more effective and acceptable method of reducing the pain experienced by the women following perineal trauma after vaginal childbirth.&lt;/p&gt;

How is functionning the Ethical Review Board « Comité d'Ethique Pour La Recherche En Obstétrique Et Gynécologie » (CEROG) ?

IntroductionThe French College of Gynecology and Obstetrics (CNGOF) has created an Ethical Review Board called the CEROG that aim to ensure the research projects are in conformity with the regulation and the laws, as well as to allow their publication in international scientific journals. The aim of this work was to analyze the work of this committee through the application received and to review the ethical procedures required by type of research project. MethodsWe conducted a national retrospective study of all applications from 2018 to 2021 received by the CEROG Ethical Review Board. Each application must contain a verification of conformity with the MR004 regulation, a submission form and an information form to the patients involved. At reception, the documents are anonymized and then addressed to the members of one of the two independent sections (Obstetric and Prenatal diagnosis or Gynecology and Assisted Reproductive Therapy). ResultsTwo hundred and sixty applications were received, including 52% in the Gynecology section and 48% in the Obstetrics’ section. Only 10% (14/136) and 8% (10/124) were disapproved, respectively. In total, 35% of the applications to the Gynecology section leaded to publications in scientific journals but only 23% did so in the Obstetrics section. Most publications (60.8%) were in low impact factors journals (rank D and E). ConclusionThe Ethical Review Board CEROG is essential to ensure the conformity of the research projects with French regulations and allow fast publication in international journals.

The Effect of Skin-to-Skin Contact on Postoperative Depression and Physical Recovery of Parturients after Cesarean Section in Obstetrics and Gynecology Department.

The effect of skin-to-skin contact (SSC) on postpartum depression and physical rehabilitation of cesarean section women was explored. 280 parturients undergoing cesarean section were selected and were rolled into two groups randomly. The parturients in the control group (Con group, 140 cases) received routine care, and those in the experimental group (Exp group, 140 cases) received SSC on the basis of routine care. The postpartum depression and physical recovery of parturients in two groups were compared. It was found that, in the Exp group, the number of pregnant women with no or with very mild depression was much more 85% vs. 55%), the number of women with adequate lactation was more (53 cases vs. 27 cases), the first lactation time (FLT) was dramatically shorter (41.25 ± 4.81 h vs. 58.43 ± 5.43 h), the breastfeeding success rate (BFSR) and breastfeeding rate (BFR) were obvious higher, the days for uterine involution was much shorter (6.96 ± 1.13 days vs. 9.47 ± 1.75 days), the descent of uterine fundus 24 hours after delivery (24 h-DUF) was obviously larger (3.17 ± 0.26 mm vs. 1.56 ± 0.43 mm), the duration of lochia (DOL) was remarkably shorter (33.21 ± 5.32 days vs. 25.32 ± 3.54 days), and the Visual Analogue Scale (VAS) score was lower (4.88 ± 0.32 points vs. 3.41 ± 0.53 points), showing statistical differences for all above indicators (P < 0.05). It suggested that SSC could effectively relieve the postpartum depression of uterine parturients, promote the lactation, increase the BFR, facilitate uterine involution, and alleviate chronic uterine inflammation and postpartum pain, showing high clinical application and promotion value.

Quality Requirements for gynecological ultrasound examinations of DEGUM level II - Recommendations of the Sections/Working Groups Gynecology and Obstetrics of DEGUM, ÖGUM and SGUM.

Gynecological sonography is the central and most frequently used technical examination method used by gynecologists. Its focus is on the clarification of masses of the uterus and the adnexa, fertility diagnosis, clarification of bleeding disorders and chronic and acute pelvic problems, pelvic floor and incontinence diagnosis as well as the differential diagnosis of disturbed early pregnancy. The indication for diagnostic and therapeutic interventions, preoperative planning and postoperative controls are largely based on the findings of gynecological sonography. These examinations are particularly dependent on the experience of the examiner.Based on the proven multi-stage concept of obstetric diagnostics, gynecological sonography should primarily be performed by an experienced and specialized examiner in patients for whom the initial gynecological examinations have not yet led to a sufficient assessment of the findings. So that the expert status required for this has an objective basis, the Gynecology and Obstetrics Section of DEGUM in cooperation with ÖGUM and SGUM implemented the option of acquiring DEGUM Level II for gynecological sonography. The effectiveness of the care in the multi-level concept depends on the quality of the ultrasound examination at level I. Quality requirements for the basic examination and the differentiation between the basic and further examination have therefore already been defined by DEGUM/ÖGUM. The present work is intended to set out quality requirements for gynecological sonography of DEGUM level II and for the correspondingly certified gynecologists.Common pathologies from gynecological sonography and requirements for imaging and documentation are described.

Cesarean section in modern obstetrics – necessity of popular tendention? (Literature rewiev)

The article is devoted to the review of scientific publications, which are devoted the problem of cesarean section (CS) in modern obstetrics. Cesarean section is the birth of a fetus through an incision in the anterior abdominal wall. It is one of the most common operations in the world. Initially, the operation is intended to improve the perinatal outcomes. The incidence of abdominal delivery is increasing in all countries, sometimes reaching 80 %. The article presents research data related not only to the medical indications for CS. Literary sources which describe the psychological motivations of women in labor to choose the method of delivery are presented. Today, in addition to the medical indications for CS, the social and economic aspects play a significant role to choose the mode of delivery. The system of health care organization, its methods of financing, the level of medical care in modern conditions contribute to increasing the frequency of CS. The current data on the potential consequences of the increase of CS rate for the further development of the newborn (carbohydrate metabolism disorders, nervous development) and the mother (the risk of maternal mortality, bleeding, infectious complications, postpartum depression) are analyzed. The modern method of analysis and comparison of the frequency and structure of cesarean section – Robson scale, which, in addition to numerous demographic indicators, provides information about the possible reserves to reduce the frequency of abdominal delivery, in particular, vaginal delivery after previous CS and labor induction in nulliparous women is presented.

Obstetrics and birth: effects of experiences and gender bias on student test scores

Objectives: Paramedic education requires all students have the experience of attending childbirth. Obstetric (OB) experiences are limited for students in hospitals and even more so in the field. Gender bias may exist in hospital OB rotations for paramedic students but research on this is limited. This study is intended to examine whether a sex bias exists in field or hospital placements and if that bias correlates to OB test scores. Methods: Using data from Fisdap, numbers of OB experiences were analysed and compared to individual student sex and experience type (hospital clinical, field or skills laboratory). The number of experiences were compared to that student's score on the OB section of the Fisdap paramedic readiness examinations version 3 (PRE3) or version 4 (PRE4). Results: Of 12 090 paramedic students, male (n=5625) and female (n=2682) students who took the PRE3 had equal average scores of 0.76 and male (n=2498) and female (n=1285) students who took the PRE4 had average scores of 0.77 and 0.79 respectively. Students who took the PRE3 saw a mean of 4.32 births, a majority of which were in hospital (3.68); there was minimal difference in experiences between male and female students in field or skills laboratory settings, but women saw more births in hospital settings (3.92) than men (3.43). Students who took the PRE4 saw a mean of 4.54 births, a majority of which were in hospital (3.8) and there was minimal difference in experiences between male and female students in field or laboratory settings but women students saw more births in hospital (4.06) than men (3.54). Conclusions There is no correlation between the number of OB emergency encounters by paramedic students and their OB test scores. However, a potential gender bias exists as female students tend to have more labour and birth experiences in hospital settings than their male counterparts, while number of experiences in lab and field settings were similar.

Effect of Postoperative Adverse Events on Hospitalization Expenditures and Length of Stay Among Surgery Patients in Taiwan: A Nationwide Population-Based Case-Control Study.

Background: The current study sought to determine the incidence of postoperative adverse events (AEs) based on data from the 2006 Taiwan National Health Insurance Research Database (NHIRD).Methods: This retrospective case-control study included patients who experienced postoperative AEs in 387 hospitals throughout Taiwan in 2006. The independent variable was the presence or absence of 10 possible postoperative AEs, as identified by patient safety indicators (PSIs).Results: A total of 17,517 postoperative AEs were identified during the study year. PSI incidence ranged from 0.1/1,000 admissions (obstetric trauma-cesarean section) to 132.6/1,000 admissions (obstetric trauma with instrument). Length of stay (LOS) associated with postoperative AEs ranged from 0.10 days (obstetric trauma with instrument) to 14.06 days (postoperative respiratory failure). Total hospitalization expenditures (THEs) ranged from 363.7 New Taiwan Dollars (obstetric trauma without instrument) to 263,732 NTD (postoperative respiratory failure). Compared to patients without AEs, we determined that the THEs were 2.13 times in cases of postoperative AE and LOS was 1.72 times higher.Conclusions: AEs that occur during hospitalization have a major impact on THEs and LOS.

Histomorphometric Variations of the Placenta in Normal and Hypertensive Pregnancies

Background: Pregnancy-induced hypertension is a leading cause of deleterious changes in the placenta resulting in decreased blood supply towards the placenta. The objective of the current study was to analyze the histo-morphometric variations in the placenta of women with or without known pregnancy-induced hypertension.&#x0D; Methods: Cross-sectional study was carried out in the Gynecology and obstetrics section of Nazeer Hussain Medical Complex, Hyderabad in collaboration with Isra University, Hyderabad from March 2019 to August 2019. A total of 100 placentae were selected and divided into two groups (control and study groups) based on the presence or absence of hypertension in pregnancy. The observations of the control group placenta were compared with the study group placentas. All placentae were observed for morphometric and histological changes. SPSS ver. 22 was used to analyze the collected data.&#x0D; Results: There was an increase in the mean weight of placentae among the control group as compared to the group having known hypertension cases and the difference was statistically significant (p-value &lt;0.05). The fetoplacental weight ratio was increased among the hypertension group when compared to the statistically insignificant control group (p-value &lt;0.05). Various gross (infarction, calcification) and histological changes (hyalinised villi, intervillous hemorrhage, decreased villous vascularity) were observed in the placentae of the hypertensive group as compared to the normal group.&#x0D; Conclusion: The findings of the study concluded that Preeclampsia/PIH poses harmful and serious histo-morphometric variations in the placental tissues that affect fetal outcome.

Obstetric and Perinatal Outcomes in Women ≥40 Years of Age: A Retrospective Study About 421 Cases in Mahdia

OBJECTIVES: All this study is aimed to evaluate obstetrical and neonatal outcomes among women age 40 years and older.STUDY DESIGN: Among 9962 women who delivered in Mahdia’s hospital between January 2015 and December 2016, 421 women (4.22%) were 40 years old or older at the time of delivery. Our retrospective study included 421 pregnant women aged more than 40 years and 421 controls aged 18-39, stratified to parity. Data were analyzed using Pearson’s χ22 test.RESULTS: The mean age of the case group was 41.32 years and that for the control group was 31.25 years. Preeclampsia and diabetes were the most common pathologies (p=0.01), the mode of delivery was marked by a high rate of cesarean section. The rate of instrumental extractions was not influenced by age. The rate of neonatal admission and 10-minute Apgar Scores&lt;7 were significantly higher in the older group (p&lt;0.05). The rate of abruption placenta, placenta previa, postpartum hemorrhage, and stillbirth were increased in mothers over 40 years but there was no difference statically. CONCLUSION: Based on findings, maternal age over 40 years is associated with a high rate of obstetrical, medical complications and cesarean section deliveries. Better pregnancy monitoring helps to improve this risky situation.

XII International Congress of Physicians. SECTION OF Obstetrics AND FEMALE DISEASES

The section was headed by prof. A. M. Makeev and prof. V.O.Snegirev, members of the organizing committee: prof. A.P. Gubarev, acad. A. Ya. Krassovsky, prof. I.P. Lazarevich, prof. A. Ya. Lebedev, parts, teacher I. M. Lvov, prof. D.O. Ott prof. G.E. Rein, prof. K.O. Slavyansky, Dr. V.V. Sutugin, prof. N.O. Tolochinov, prof. N.N. Phenomenov, prof. P.I. Yasinsky, prof. I. V. Yastrebov.

Abstract 13510: Impact of Adverse Pregnancy Outcomes on Indication for Lipid Therapy in Women

Introduction: Lifetime risk for cardiovascular disease (CVD) is higher in women who experience adverse pregnancy outcomes (APOs) including pre-eclampsia, preterm birth, gestational hypertension, and gestational diabetes. APOs are risk-enhancing factors for atherosclerotic cardiovascular disease (ASCVD) in contemporary cholesterol guidelines. Hypothesis: History of APOs impacts consideration for lipid therapy in a significant proportion of women with borderline to intermediate CVD risk . Methods: A single center retrospective chart review of new patients who presented to the University of Florida Women’s Heart Health Clinic between July 2017 - July 2019 was performed. New female patients were routinely screened for pregnancy history with an obstetrics questionnaire, and cardiovascular history and lipid profiles were collected where available. Patients were stratified by age and calculated 10-yr risk of a cardiovascular event using the ACC/AHA Pooled Cohort Equation. APO history within age and risk categories in addition to pregnancy history documentation in electronic health records were then assessed. Results: Of the 182 new patients who presented to the University of Florida Women’s Heart Health Clinic between July 2017 - July 2019, average age was 49 years old and 71.3% were Caucasian. 25% of the study population had history of APO, and of patients with history of APO, only 55% had documented lipid profiles, 46% had pregnancy history documented in the obstetrics section of the electronic health record, and 17% had pregnancy history documented in their past medical history section. For patients aged 40-75 y/o with borderline-intermediate 10-yr CV event risk, risk-enhancing factors influenced consideration of potential statin therapy, with 20% of patients in the intermediate risk group having history of APO. Conclusions: Pregnancy history impacts potential statin therapy in a significant percentage of women aged 40-75 y/o with borderline-intermediate 10-yr ASCVD risk. However, APOs are often under-recognized and poorly documented as non-traditional CVD risk factors in women. Efforts to improve recognition of APOs in clinical practice should be promoted to improve CVD risk reduction efforts, particularly in young women.

A Comparative Study on effect of the Sedative Drugs (Tramadol and Fentanyl) on the Intraoperative Agitation in patients with Cesarean section (C/S) using ASA assessment in Baghdad Educational Hospital

Many of serious events such as severe injuries from falling out of the bed, self-extubation, hemorrhage as well as even removal of catheters that arise due to agitation. A postanesthetic phenomenon that advances in the initial phase of general anesthesia recovery can able to describe as agitation which characterized by potential violent behavior, disorientation and confusion. Additionally, it may cause medical staff injuries. This study was intended to assess and compare the sedative effect of the tramadol and fentanyl in prevention of agitation postoperatively for patients under went for cesarean section (C/S). The current study commenced in the obstetric and cesarean section department/Baghdad Teaching Hospital/Medical City/Baghdad-Iraq. The study involved fifty (50) pregnant females-their age ranged (20–45) years underwent cesarean section (C/S) under general anesthesia. The patients were distributed equally into (2) two groups; group (A): were received Fentanyl (50mcg), while second group(B) were received Tramadol (100mg). Patients were pre-medicated with metoclopramide (10mg), ranitidine (50mg) as well as dexamethasone (8mg) intravenously. The maintenance of anasethseia was inducing by oxygen 100% sevoflurane 2%, the umbilical cord of neonate was clamped. The sedative drugs (tramadol and fantanyl) were administrated to group (A) and group (B) respectively. Based on Sedation-Agitation scale, of fifty (50) pregnant females. Fentanyl and tramadol produced significant calm and cooperative (grade 4) in thirty-nine (39) females, but both drugs did not produce significant sedative effect (grade 3) in the females. In tramadol group, three (3) females were anxious and agitated and three (3) females were developed agitation. Fentanyl and tramadol were effective in prevention of agitation, but fentanyl, as compared with tramadol may have a greater beneficial effect for reducing the agitation postoperatively.

A survey of practice of rapid sequence induction for caesarean section in England

BackgroundIn view of newer techniques of preoxygenation and laryngoscopy and recent obstetric guidelines concerning the management of difficult intubation, we aimed to evaluate the current practice of rapid sequence induction for caesarean section in England. MethodsIn 2017, 316 questionnaire surveys were posted to all 158 hospitals with caesarean section capabilities in England. At each hospital, one questionnaire was to be completed by the obstetric anaesthetic consultant lead and one by an anaesthetic trainee. Differences in responses between consultants and trainees, regardless of their place of work, were compared for all data using the chi-square and the Fisher’s exact tests. ResultsOne-hundred-and-eighty complete questionnaires were returned, with an overall response rate of 57%, 98 (54%) from obstetric anaesthetic consultant leads and 82 (45.6%) from trainees). Both head up (57%) and ramped (56%) were the preferred positions for preoxygenation. Less than half of respondents (43%) preoxygenated until the surgeon was scrubbed. Cricoid pressure was used by almost all respondents (98%). Thiopentone (67%) was the most commonly chosen anaesthetic induction agent and most respondents (82%) supported a change to the use of propofol. Suxamethonium (92%) was the neuromuscular blocker of choice but more than half the respondents (52%) supported a change to rocuronium. In the event of a failed intubation, the rescue supraglottic airway device of choice was the i-gel® (65%). ConclusionsOur survey demonstrated the significant variation in the practice of rapid sequence induction for caesarean section in obstetrics in the United Kingdom.

Neonatal acute kidney injury: recording rate, course, and outcome: one center experience

Background: Neonates, and particularly preterm newborns, are at increased risk for acute kidney injury (AKI) due to immature kidney function. While specific criteria have been defined for AKI in this particular population, this diagnosis is frequently overlooked, and consequently, is often not recorded in patients’ medical files. AKI-associated short- and long-term morbidity and mortality underline the importance of this diagnosisObjective: To assess the recording rate of AKI in the neonatal intensive care unit (NICU), and to identify clinical features that may promote awareness to this condition.Study design: The database of one medical center was searched for serum creatinine values above 1 mg% among all the newborns (more than 48 hours old) who were hospitalized in the neonatal intensive care unit (NICU) during the years 2010–2015, and who underwent at least two blood tests during their hospitalization. The files of patients who met acute kidney injury (AKI) diagnostic criteria were searched for AKI diagnosis, maternal, fetal, and postnatal course and outcome.Results: Of 59 newborns who met AKI criteria, 51 (86%) were preterm and 8 term newborns. The respective mean gestational weeks at birth were: 28 ± 3 and 38.5 ± 1, and mean birth weights: 1002 ± 57 and 3157 ± 375 grams. Mortality rates were 14/51 (27%) versus 1/8 (12.5%). Of the 44 survivors, AKI was recorded in the medical files of 9/37 (24%) preterm versus 5/7 (71%) term-newborns. AKI associated with twin pregnancy in preterm neonates: 22 (43%) versus 1 (12.5%) in term-newborn. Unexpected high frequencies of maternal obstetrical problems and cesarean section delivery: 62.5 and 78%, respectively, along with persistently depressed 5-min Apgar 6.6 ± 3.5 were found in term newborns with AKI. Congenital anomalies of the urinary tract (CAKUT) were suspected prenatally on fetal ultrasound in 3 (6%) and 1 (12.5%) of the respective groups, a 10-fold higher rate than that observed in the general population. AKI recurred in 18 (35%) of the preterm and none of the term neonates. Mild AKI episodes (Stage 1–2) occurred in 30/37 (81%) by contrast to severe events (Stage 3) in 4/7 (57%) preterm and term survivors, respectively. Ventilation duration associated significantly with AKI recurrence, and sepsis with mortality: OR 1.25 (95%CI = 1.09–1.43) (p < .001) and OR = 4.65 (95%CI = 1.26–17.2) (p = .014), respectively.Conclusions: We demonstrated underreporting of AKI, particularly among preterm newborns, a population at high risk of developing recurrent episodes. Our data suggest different clinical profiles of AKI among preterm and term neonates: with later onset, milder but recurrent episodes in the former. Increased alertness for AKI diagnosis is needed for neonates with prolonged respiratory support, treated with diuretics and after sepsis. Newborns suspected of CAKUT (Congenital Anomalies of Kidneys and Urinary Tract) as per fetal ultrasound might need closer observation for AKI occurrence.

English

Anesthetic management of preeclamptic patients remains a challenge. Although general anesthesia can be used safely in pre-eclamptic women, it is fraught with greater maternal morbidity and mortality. The added risks associated with general anesthesia include airway difficulties due to edema (often aggravated by tracheal intubation) and the pressure response to laryngoscope and intubation. However, several studies support the use of spinal anesthesia as first choice reasoning less post-operative morbidity and mortality. To compare maternal outcome among preeclamptic women after caesarian delivery under general and spinal anesthesia in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Hospital based retrospective comparative cross sectional study was used to compare maternal outcomes. All preeclamptic mothers that underwent Caesarian Section in Obstetrics and Gynecology Ward, Tikur Anbessa Specialized Hospital from October 2014 to October 2016 was included in the study. Data collection was carried out by using structured questionnaire. Data entry and analysis was done on SPSS version 20. Independent sample T-test and logistic regression was conducted to compare the outcome in both groups of spinal and general anesthesia, 95% confidence interval (CI) and p value &lt; 0.05 is set as cut off point for statistical significance. The mean age of study subjects were 28.18 years and SD= &plusmn; 4.66 years, the median age is 28 years (IQR: 25-30 years). Majority 152 (91%) of the cesarean sections (C/S) was emergency C/S and the rest 15 (9%) were elective C/S. 78 (46.7%) of parturient operated under general anesthesia, and 89 (53.3%) were operated under spinal anesthesia. None of the mothers developed post-op complication, and none of the maternal death were documented until discharge from the hospital in both groups of parturient. The present finding shows that statistically significant higher intra operative blood pressure and pulse rate was observed among GA group when compared with SA group. In conclusion, SA is safer than GA in terms of stable intra operative vital signs among preeclamptic women. Key words: Preeclampsia, caesarean section, general anesthesia, spinal anesthesia, Ethiopia.

Maternal factors associated with low birth weight: a case control study in rural Kerala

Background: Low birth weight (LBW) continues to remain a major public health problem worldwide. There are numerous factors contributing to LBW both maternal and foetal. The maternal risk factors are biologically and socially interrelated. The mortality of low birth weight can be reduced if the maternal risk factors are detected early and managed by simple techniques. This study was conducted to study the maternal risk factors associated with low birth weight. Methods: A retrospective record based case control study was conducted. Retrospective data collection was done using registers from medical record section of Obstetrics and Gynaecology department. After applying exclusion criteria and checking for completeness of records, we selected 60 cases and 124 matched controls. Data was entered in Microsoft excel and analyzed using SPSS version 16. Students ‘t’ test, chi-square test and odds ratio were used to find out the factors associated with low birth weight. Results: In the present study, 60 cases and 124 controls were studied. Mean age of mothers in the case group was 24.4±4.7 yrs. and in the control group was 24.8±4.42 yrs. Mean weight of the cases was 62.5±6.89 kg and of the controls was 65.04±7.16 kg. A total of 35% of the cases and 20% of the controls suffered from pregnancy related diseases. Conclusions: Maternal factors like Socio-economic status, weight, haemoglobin and parity were significantly associated with LBW. Maternal diseases like hypertension, diabetes can result in LBW baby.