Comparison of umbilical artery Doppler and non-stress test in assessment of fetal well-being in gestational diabetes mellitus: A prospective cohort study.
Electron Physician. 2017 Dec;9(12):6087-6093
Authors: Niromanesh S, Shirazi M, Eftekhariyazdi M, Mortazavi F
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies.
Objective: We aimed to compare the non-stress test (NST) and umbilical artery (UA) Doppler assessments for evaluation of the adverse perinatal outcomes in GDM.
Methods: We conducted a prospective cohort study on 50 pregnant women with GDM in Jame Zanan Hospital, Tehran, Iran, from Oct 2014 to Sep 2015. A convenient sampling method was used for patient recruitment. Inclusion criteria were women with GDM, singleton pregnancies, and gestational age>32 weeks who had neither medical conditions nor fetal anomalies. Adverse perinatal outcomes were defined as Apgar scores at 1-min and 5-min <7, hypoglycemia (blood glucose <45 mg/dl), neonatal acidosis (PH<7.2), hypocalcemia (Ca<8 mg/dl), admission to the NICU for more than 24 hours, and perinatal death. Statistical analyses were performed with SPSS version 16 using Chi-square, Fisher's exact test, and independent-samples t-test. The significance level was considered at 0.05.
Results: Totally, 22% and 12% of women had an abnormal UA Doppler and a non-reactive NST respectively. Poor outcomes were detected in 13 women. The most frequent poor outcomes were hypoglycemia (n=9), Apgar 1-min <7 (n=8), neonate admitted in NICU (n=6), and respiratory distress syndrome (n=6). Poor outcome was more prevalent in women with non-reactive NST (p<0.001), abnormal UA Doppler (p=0.033), and those with infant birth weight >4000 gram (p=0.033). Sensitivity and specificity of the NST in predicting different poor outcomes were 76.9% and 97.3% respectively. Sensitivity and specificity of UA Doppler in predicting different poor outcomes were 30.8% and 94.6% respectively.
Conclusion: NST is a better predictor of adverse perinatal outcomes in GDM patients.
PMID: 29560164 [PubMed]
Maternal-fetal Rhesus (Rh) factor incompatibility in Arar, northern Saudi Arabia.
Electron Physician. 2017 Dec;9(12):5908-5913
Authors: Aljuhaysh RM, El-Fetoh NMA, Alanazi MI, Albaqawi AS, Alanazi WM, Alanazi NS, Alanazi RM, Alanazi AM, Alnemer EM, Alenezi RA, Alabdullatif TK, Alanazi RA, Alanazi SS, Alsultan KS, Alanazi IM, Alsunayni DS
Background and aim: Rh isoimmunization still contributes to the neonatal morbidity and mortality due to non-immunization, under-immunization, and in rare cases, false Rh typing. The main objective of this study was to determine the prevalence of Rh incompatibility, mothers' knowledge about Rh incompatibility, mothers' knowledge about anti-D immunoglobulin and to show the pregnancy outcome of Rh negative mothers.
Methods: A cross-sectional study was carried out at the Maternity and Children Hospital in Arar city from November 2016 to May 2017. All pregnant mothers attending the Maternity and Children Hospital for pregnancy follow up or delivery, during the study period were studied. Data were collected by means of personal interview with the sampled population using a researcher-made questionnaire covering the needed data. Data were analyzed by SPSS version 16, using descriptive statistics and Chi-Square test.
Results: Of the studied mothers, 23% were Rh negative. Only 38% of the studied mothers had knowledge about Rh incompatibility, 68.5% had knowledge about anti-D and 51% had knowledge about time of administration of anti D. Considering pregnancy outcome; 55% of the delivered babies needed incubation after delivery, 23.3% of those babies were born to Rh negative mothers. However, 6.7% of the incubated children died after incubation (47.8% of them belong to Rh negative mothers).
Conclusion: About a quarter of the mothers in the studied population were Rh negative. Mothers had a low level of knowledge about Rh incompatibility and anti-D immunoglobulin and its administration. Health education sittings are needed to increase public awareness about this important issue.
PMID: 29560141 [PubMed]
Low birth weight and macrosomia in Tigray, Northern Ethiopia: who are the mothers at risk?
BMC Pediatr. 2017 Jun 12;17(1):144
Authors: Mengesha HG, Wuneh AD, Weldearegawi B, Selvakumar DL
BACKGROUND: Infant birth weight, which is classified into low birth weight, normal birth weight and macrosomia, is associated with short and long-term health consequences, such as neonatal mortality and chronic disease in life. Macrosomia and low birth weight are double burden problems in developing counties, such as Ethiopia, but the paucity of evidence has made it difficult to assess the extent of this situation. As a result there has been inconsistency in the reported prevalence of low birth weight and macrosomia in Ethiopia. This study aimed to determine the incidence and predictors of low birth weight and macrosomia in Tigray, Northern Ethiopia.
METHOD: We conducted a cross-sectional survey among a cohort of 1152 neonates delivered in Tigray Region at randomly selected hospitals between April and July 2014. We used the birth weight category described previously as an outcome variable. Data were collected using structured questionnaire by midwives. We entered and analyzed data using STATA™ Version 11.0. Data were described using a frequency, percentage, relative risk ratio, and 95% confidence interval. Multinomial logistic regression was conducted to identify independent predictors of low birth weight and macrosomia.
RESULT: In this study, we found a 10.5% and 6.68% incidence of low birth weight and macrosomia, respectively. Seventy (57.8%) of all low birth weight neonates were term births. The predictors for low birth weight were: early marriage (<18 year) (RRR: 0.59, CI: 0.35-0.97); rural residence (RRR: 0.53, CI: 0.32-0.9); prematurity (RRR: 15.4, CI: 9.18-25.9); no antenatal follow-up (RRR: 6.78, CI: 2.39-19.25); and female sex (RRR: 1.77, CI: 1.13-2.77). Predictors for macrosomia were: female gender (RRR: 0.58, CI: 0.35-0.9); high body mass index (RRR: 5.0, CI: 1.56-16); post-maturity (RRR: 2.23, CI: 1.06-4.6); and no maternal complication (RRR: 0.46, CI: 0.27-0.8).
CONCLUSION: In this study, we found gestational age and gender of the neonate to be common risk factors for both low birth weight and macrosomia. Strengthening antenatal follow up, prevention of pre and post maturity, controlling body mass index, and improving socioeconomic status of mothers are recommendations to prevent the double burden (low birth weight and macrosomia) and associated short and long-term consequences.
PMID: 28606178 [PubMed - indexed for MEDLINE]