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Rates and Standardization
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
Infant mortality rates can be used to make comparisons across geographic regions and to measure progress over time. Of course, as a single number, an infant mortality rate can only capture one dimension of what is really a multidimensional situation. To get a broader perspective, we could simultaneously look at other rates – even other rates related to infants – such as the perinatal mortality rate. The perinatal mortality rate is defined by the CDC as the number of infant deaths under age 7 days plus fetal deaths at 28 weeks of gestation or more, divided by the total number of live births. Figure 3.3 displays global perinatal mortality rates in the year 2000 [85]. Note the considerable variability across the world. This variability could be studied to improve perinatal mortality, providing what might be called a “natural experiment”.
Hypertensive Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
The risk of maternal death is around 1–2% in the developed world and up to 10% in developing countries. An estimated 50,000 women die each year worldwide having had an eclamptic convulsion. Perinatal mortality is 6–12% in the developed world and up to 25% in developing countries. Other complications are similar and possibly more severe than severe pre-eclampsia cases (maternal—abruption 7–10%, DIC 7–11%, HELLP 10–15%, pulmonary edema 3–5%, renal failure 5–9%, aspiration pneumonia 2–3%, cardiopulmonary arrest 2–5%; perinatal—PTB 50%) [94].
DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Mortality rates:Maternal mortality rates are reported every 3 years.Maternal mortality rate is the number of maternal deaths while pregnant or within 42 days of abortion or delivery, not from accidental or incidental causes, per 100 000 births.Stillbirth mortality rate is the number of stillbirths after 24 weeks' gestation per 1000 total births.Neonatal mortality rate is the number of deaths of all liveborn infants within the first 28 days per 1000 live births.Perinatal mortality rate is the number of stillbirths and first-week neonatal deaths per 1000 total births.
The effectiveness of small heterodimer partner and FGF 19 levels in prediction of perinatal morbidity in intrahepatic cholestasis of pregnancy
Published in Journal of Obstetrics and Gynaecology, 2022
Mehmet Bayram, Kader Irak, Sami Cifci, Ali Riza Koksal, Cemal Kazezoglu, Zuat Acar, Halil Onur Ozarı, Huseyin Alkim
Low birth weight and preterm delivery are more common in pregnant women having ICP compared to normal pregnant women (Jiang et al. 2018; Li et al. 2018). Preterm delivery is an important cause of perinatal mortality and morbidity (Jiang et al. 2018; Ovadia et al. 2019). In our study, also, preterm delivery, low birth weight and need for neonatal ICU were found to be higher in the ICP group. In addition, we found that all three parameters (preterm delivery, low birth weight and neonatal ICU requirement) correlated with serum SHP level. No such correlation was found with the TBA level or with the FGF19 level. ROC analysis showed that an SHP level above 1995 ng/L has 53.8% sensitivity and 77.8% specificity for predicting the need for neonatal ICU. According to our results, serum SHP level may be useful in predicting possible foetal complications and the need for neonatal ICU in patients having ICP.
Neonatal birth fractures: a retrospective tertiary maternity hospital review
Published in Journal of Obstetrics and Gynaecology, 2020
Andreas Rehm, Prakash Promod, Amanda Ogilvy-Stuart
The health service in England consists of 152 acute NHS trusts with 167 birth centres. There were 679,106 live births in England in 2017 with one in 50 pregnant women giving birth at home. Outcomes of maternity services in the UK currently do not include data on neonatal fractures and other neonatal injuries. In the 2013–2015 inspection period, the CQC classed 7% of maternity services as inadequate and 41% as ‘requiring improvements’ with the majority of issues being related to midwife access and continuity of care (Inspection Framework: NHS Acute Hospitals 2017; National Review of Maternity Services 2017). The complexity of pregnancies is increasing (e.g. maternal diabetes, obesity) but perinatal mortality reduced from 8.6 per 1000 deliveries in 2003 to 6 per 1000 deliveries in 2013 (4722 perinatal deaths: 3286 stillbirths, 1436 neonatal deaths). Maternal mortality reduced from 14 deaths to 9 deaths per 100,000 maternities during the same period. The Hospital Episode Statistics (HES) database recorded an increase in delivery complications in England of 7.38% (95,252) between 2010 and 2014 (National Review of Maternity Services 2017) and in its 2018 report, The Royal College of Midwifes (RCM) raised concern that the NHS England has an estimated shortage of 3500 full-time midwifes which has remained unchanged since 2016 (State of Maternity Services Report England 2018).
Evaluation of obstetric outcomes and prognostic significance of graft function in kidney transplant recipient pregnancies
Published in Hypertension in Pregnancy, 2020
Riza Madazlı, Didem Kaymak, Verda Alpay, Hakan Erenel, M. Tamer Dincer, Nurhan Seyahi
The obstetric outcomes of kidney transplant recipient pregnancies are illustrated in Table 2. The mean gestational age at delivery was 33.1 ± 5.4 weeks and mean birth weight was 2051 ± 1083 g. in the study group. Deliveries ≤37 and ≤34 gestational weeks were detected in 71.9% and 40.6% of the pregnancies, respectively. The incidences of fetal growth restriction, preeclampsia, gestational diabetes, maternal anemia, and urinary infection during pregnancy of the study population were 18.8%, 34.4%, 6.3%, 31.3%, and 3.1%, respectively. Cesarean delivery rate for live-born pregnancies was 85.7% in which 25.9% were due to fetal distress. Incidences of 5-min Apgar score<7, cord pH <7.20 and neonatal intensive care unit admission for live-born babies in the study group were 50%, 25%, and 46.4%, respectively. There were four stillbirths (12.5%) occurred at 22, 22, 23, and 25 weeks of gestation in pregnancies with kidney transplantation. There was 1 neonatal death (3.1%) delivered at 26 weeks of gestation and died due to prematurity. The perinatal mortality rate in our study population was 15.6% (5/32) and live birth rate was 87.5% (28/32). The incidence of composite adverse obstetric outcomes was 43.8% (14/32). There was no maternal mortality and congenital anomaly in the newborns.