Pushpalakshmi, R (2022) A Prospective Observational study of Maternal Risk Factors and Perinatal Outcome in Fetal Growth Restriction at Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: "Every fetus has its own growth potential and its own growth rate” JAMES M TANNER. Fetal growth restriction undoubtedly remains the most challenging areas of research for obstetricians today. It is a major contributor of perinatal morbidity and mortality and has been described as etiologically responsible of about a 50% of perinatal deaths occurring preterm and 20% at term. despite of marked progress made over the past two decades in both diagnostic procedures and management strategies, the question of what causes fetal growth restriction remains unanswered still in 30-40% of all cases of FGR. There are so many causes contributing to FGR–Maternal, fetal and placental causes. AIMS AND OBJECTIVES: 1. To study maternal risk factors and perinatal outcome in fetal growth restriction. 2. To correlate with perinatal morbidity and mortality associated with fetal growth restriction. 3. To study outcome of labour in fetal growth restrictions. METHODOLOGY: This study was conducted in Institute of Obstetrics and Gynaecology, Egmore, a Tertiary care teaching hospital for a period of one year. The study population consisted of 100 women with singleton pregnancies who gave birth to neonates with birth weight less than the 10th percentile. {include from methods inclusion criteris, exclusion criteria}. It’s a prospective observational study Carried out in all pregnant women admitted as IUGR between 28-40 weeks of gestation. RESULTS: Incidence of FGR was 9.8% in present study. The incidence of FGR according to national perinatal database was 9.65% among neonates. Majority of mothers were in 26-35 years age group (59%) similar to Satyavrathan and singh A [et al.]. The rate of FGR in developing countries is six times higher comparing to developed countries. hypertensive disorders of pregnancy (64%), idiopathic causes (24%), hypothyroid, diabetes, APLA were noted in FGR mothers similar to sharma [et al.] and satyavarthan [et al.] ◙ Cesarean mode of delivery remains the primary one. 24% of cases delivered vaginally comparing to 32% as in Seal [et al.] imminent eclampsia, HELLP syndrome and eclampsia accounted for IMMEDIATE TERMINATION. The most common indication of termination was fetal distress (29%), severe oligohydramnios (40%), doppler changes which is observed in Rajarajeswari [et al.] study. ◙ FGR diagnosed between 32-34 weeks majority as with Seal [et al.] in Lekshmi [et al.], 60% of the FGR born to the mothers < 37 weeks and 29% < 32 weeks, while in ours 44% in 35-37 weeks and 32% were born in 30-35 weeks. CONCLUSION: High risk factors for FGR should be evaluated in all the pregnancies. Accurate diagnosis can be obtained through monitoring using serial growth charts, DFMC, FHR monitoring by using CTG and the doppler studies of uterine, umbilical, MCA, CPR. Cesarean section remains the primary mode of delivery. Correction of maternal risk factors and timely delivery optimise the fetal outcome. The diagnosis of uteroplacental insufficiency causing FGR identifies the group of fetus prone for perinatal complications. Abnormal Doppler associated significantly with earlier FGR detection, shorter decision delivery interval, longer NICU stay.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221916883 |
| Uncontrolled Keywords: | Maternal Risk Factors, Perinatal Outcome, Fetal Growth Restriction, Tertiary Care Hospital, Prospective Observational study. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Apr 2022 07:44 |
| Last Modified: | 29 Nov 2023 03:11 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19315 |
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