Susan Thomas

Abstract

Background: Intrauterine growth restriction (IUGR) complicates 7-15% of pregnancies and is associated with adverse perinatal outcomes. The primary goal of antenatal care is the early detection of such conditions. Doppler studies in fetus are used to predict the morbidity in IUGR. Studies show that cerebroplacental ratio is a better predictor of IUGR babies and adverse perinatal outcome. In this study we compare perinatal outcomes of IUGR babies with a normal CPR and an abnormal CPR. Materials and Methods: This prospective cohort study was carried out in the Department of Obstetrics and Gynaecology, Amala Institute of Medical Sciences, Thrissur, from January 2018 to June 2019. The study included 170 antenatal mothers diagnosed IUGR sonologically or are at risk of IUGR. CPR was calculated from Doppler parameters as ratio of MCA PI and Umbilical artery PI. CPR more than 1.08 was considered normal. Perinatal outcomes were compared between normal and abnormal CPR group. Results: The incidence of abnormal CPR was found to be 39.4%. An abnormal CPR was associated with an increase in rate of emergency ceaserean rate for fetal distress (76.12%) and 64.18% had an APGAR of Conclusion: In patients with IUGR, cerebroplacental ratio is a useful marker in prediction of adverse perinatal outcome. Integrating CPR into routine Doppler studies in clinical practice will help better identify fetuses at risk.   Keywords: IUGR, Cerebroplacental ratio, Doppler, Neonatal outcome.

View Article

Abstract

Introduction: Corona virus disease 2019 (COVID-19) has changed all our lives in a significant way. Despite the fact that pregnant women were placed in the ‘vulnerable group’, antenatal care services have been affected by the pandemic. We are conducting the study to find the impact of COVID-19 on antenatal care and its impact on maternal and perinatal outcomes and thereby giving us an insight on how to improve our provision of care. Objectives: 1. To find the effect of COVID-19 on obstetric care delivery in non-covid and covid patients. 2. To assess the maternal and perinatal outcome in Covid positive patients. Materials and Methods: This is a descriptive study conducted at Amala Institute of Medical Sciences, Thrissur, Kerala during the period of April 2020 to December 2020. All pregnant women who delivered here during the period were taken in the study. Data was collected through pre prepared questionnaire by direct or telephonic conversation. Results: Total deliveries were 919 with response rate of 85.6%. During pandemic, approximately 54% of women missed their ANC visit due to fear of Covid. Absence of partner during visits, delivery and postnatal period was a cause for nervousness for 56.40% of mothers. Telemedicine was used by 52% of subjects and was found effective. Conclusion: Antenatal care is essential but challenging during COVID-19 pandemic. A protocol based approach is needed which is cost-effective and easy.   Keywords: Antenatal care, Pregnancy, Telemedicine, COVID- 19.

View Article