Prediction of severe adverse maternal outcome in women admitted in obstetric ward using physiological and biochemical parameters

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dc.contributor.authorRani, Reenaen_US
dc.contributor.authorMeena, Sunita Baien_US
dc.contributor.authorYadav, C. P.en_US
dc.contributor.authorGoswami, Deeptien_US
dc.contributor.authorTripathi, Revaen_US
dc.contributor.authorRathore, Asmita M.en_US
dc.date.accessioned2020-10-16T07:55:52Z
dc.date.available2020-10-16T07:55:52Z
dc.date.issued2019-05
dc.description.abstractBackground: To study physiological and biochemical parameters to predict serious adverse maternal outcomes and to develop risk score using above parameters.Methods: This prospective study was conducted in 500 high risk pregnant women attending tertiary care teaching hospital. We noted physiological and biochemical parameters as soon as they were available .The primary outcome measures was “severe adverse maternal outcome(SAMO)” in form of one or more among  mortality, near miss morbidity and ICU admissions.Results: Out-off 500 women, severe adverse maternal outcomes were seen in 158 (31.6%) women. Most common cause of near miss maternal morbidity was hypertensive disease of pregnancy (62.7%) followed by major obstetric hemorrhage (18.9%). There were 33(6.6%) ICU admission, 23 (4.6%) maternal death and 153 (30.6%) near miss maternal morbidity. The most common cause of maternal death in our study was obstetric hemorrhage. The significant variables after multivariate analysis [temp, pulse, urine protein] were used  to devise a Maternal early warning score (MEWS) based on physiological parameters at score value of  ≥1/6 was found to have  sensitivity of 70% and specificity of 82% in predicting SAMO with AUROC of 0.76. The significant laboratory parameters after multivariate analysis were blood urea, serum creatinine, serum bilirubin and liver enzymes. The obstetric risk score (Maternal risk prediction score MRPS) which incorporated of these laboratory parameters in addition to physiological parameters has sensitivity of 82% and specificity of 75% with AUROC 0.79 value ≥ 2/18.Conclusions: The addition of laboratotory parameters to physiological variables improves performance of risk score to predict SAMO.en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, Indiaen_US
dc.identifier.affiliationsDepartment of Biostatistics, National Institute of Malaria Research, New Delhi, Indiaen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynecology, Maulana Azad Medical College and associated hospitals, New Delhi, Indiaen_US
dc.identifier.citationRani Reena, Meena Sunita Bai, Yadav C. P., Goswami Deepti, Tripathi Reva, Rathore Asmita M.. Prediction of severe adverse maternal outcome in women admitted in obstetric ward using physiological and biochemical parameters. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 May; 8(5): 2019-2026en_US
dc.identifier.issn2320-1770
dc.identifier.issn2320-1789
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/206719
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber5en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-1770.ijrcog20191960en_US
dc.subjectHigh risk pregnancyen_US
dc.subjectMaternal mortalityen_US
dc.subjectNear miss morbidityen_US
dc.titlePrediction of severe adverse maternal outcome in women admitted in obstetric ward using physiological and biochemical parametersen_US
dc.typeJournal Articleen_US
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