Maternal and fetal factors observed with late preterm births

Backround: Although neonatal morbidity and mortality rates are fallen in recent decades, the prevalence of preterm deliveries has increased especially late preterm births. Late preterm deliveries are at increased risk of various neonatal complications compared to term deliveries.This study was carried out to identify the maternal characteristics and co-morbidites found with late preterm births and feto-maternal outcome in terms of indication of delivery, route of delivery, Apgar score and NICU admissions.Methods: A retrospective study was conducted in a tertiary care teaching hospital of Indian armed forces between Jan 2011 to Dec 2012 where 248 late preterm deliveries were analysed.Results: 56% women had spontaneous late preterm births and 44% women were induced. 23% of patients had history of 1 or more prior abortion and 13% patients had previous fetal deaths among the patients had late preterm delivery. Common maternal morbidities in mother delivering late preterm were hypertensive disorders of pregnancy (20.6%), anaemia (14.5%) and preterm premature rupture of membrane (13.7%). 4.8% newborns had Apgar ≤ 7 and 10% newborns required NICU admissions.Conclusion: Higher incidences of hypertensive disorders of pregnancy, anaemia and preterm premature rupture of membrane were found with late preterm birth and 10% of newborns required NICU care.

Evaluation of fetomaternal outcome in pregnancies complicated by heart disease: our experience at a tertiary care centre

Background: Heart disease is an important cause of indirect maternal deaths accounting for 20% of all cases, complicating approximately 1% of all pregnancies. During pregnancy, increased cardiac demands potentially increase morbidity and mortality in women with underlying heart disease. This study illustrates the fetomaternal outcome in pregnancies complicated by heart disease.Methods: This study is a prospective observational study which was carried out from December 2013 to August 2015 at a tertiary care teaching hospital of armed forces India. A total of forty four pregnant women with heart disease were attended during the study period. Various parameters were used to measure maternal outcome like preterm labour, cesarean delivery, congestive cardiac failure, maternal mortality, while fetal outcome was measured in terms of low birth weight, prematurity, intrauterine growth restriction, perinatal mortality and intrauterine death.Results: A total of 7545 pregnant women delivered during the study period, of which 94 were patients with heart disease giving a prevalence of 1.2%. Acquired valvular heart lesions were found in 61 patients (64.9%) with mitral valve being the commonest valve affected in 69 patients (73.4%), others were congenital. Of the group, 89 patients were in NYHA class I and 05 in NYHA class II. Majority, 44 patients (46.8%) delivered vaginally while 31 patients (33%) underwent a cesarean delivery and 30 babies (31.9%) were low birth weight. There was no neonatal mortality. Maternal mortality was low (1.1%), while 43 (45.7%) had obstetric complications.Conclusions: Multidisciplinary team approach involving obstetrician, neonatologist, cardiologist and anesthesiologist led to the favorable outcome in our study. Key determinant of adverse fetomaternal outcome was the poor functional class of NYHA