Title: The Fetomaternal Outcome in Acute Respiratory Tract Infection in Third Trimester of Pregnancy
Authors: Dr Ajisha D M, Dr Rinku G, Dr Laila B, Dr C.Nirmala
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.109
Abstract
Background: Respiratory diseases in pregnancy gained much attention in the background of H1N1 influenza which has emerged as a killer of pregnant women. According to the confidential review of maternal deaths, 2006-09 Kerala, respiratory diseases form the sixth most common cause of maternal death.
Aim: To analyze then maternal and perinatal outcome of acute lower respiratory tract infection in the third trimester of pregnancy among antenatal women attending a tertiary care hospital of South Kerala
Method: Prospective Cohort Study
Study Setting: Conducted among antenatal women attending SAT hospital Trivandrum. 254 cases diagnosed to have acute lower respiratory tract infection were consecutively recruited as study cohort and an equal number of unexposed groups of similar gestational age as control.
Both groups followed up to find out the fetomaternal outcome.
Results: History of bronchial asthma (p<0.001), passive smoking (p=0.001) and recent history of contact with respiratory infection/ exanthematous fever (p<0.001) are significantly associated with acute lower respiratory tract infection in third trimester of pregnancy. There is increased rate of cesarean section (16.9% vs 26.8%), intrapartum maternal pyrexia (14.6% vs 0.4%), prolonged duration of hospital stay (58.7% vs 17.3%). Fetal distress (25.2% vs 11.4%), MSAF (14.2% vs 7.5%), RDSAB (38.6% vs 13%), increased rate of IBN admission (38.2% vs 14.6%) and increased requirement of ventilator support for babies (7.9% vs 2.4%).
Conclusion: The significant adverse outcomes of acute LRTI in third trimester of pregnancy are increased CS rate, intrapartum maternal pyrexia, MSAF, foetal distress, RDSAB and increased IBN admission. Prompt diagnosis and adequate treatment of acute LRTI including early initiation of antiviral therapy in indicated cases is needed to avoid these adverse outcomes.
Keywords: Acute lower respiratory tract infection, Maternal outcome, perinatal outcome, third trimester of pregnancy, CURB’S Score.
References
- V P Paily, Dr. K. Ambujam, Dr. Betsy Thomas, editors. SECOND REPORT OF CONFIDENTIAL REVIEW OF MATERNAL DEATHS, KERALA. “WHY MOTHERS DIE” KERALA 2006-2009 Observations, Recommendations. Maternal Foetal Medicine Committee, Kerala Federation of Obstetrics &. Gynaecology.2012
- Prevalence of maternal and neonatal infections in a developing country :possible low-cost preventive measures; Urrutia, J J; Sosa, R; Kennell, J H; Klaus, M. In: Symposium on Perinatal Infections, Ciba Foundation, November 27-29, 1979. Perinatal infections. Amsterdam, Excerpta Medica, New York, Elsevier/North Holland, 1980.
- Zhang PJ, Cao B, Zhang S, Wu SN, Li YM, Li XL, Liang LR, Zhu JG, Yang SG, HuK, Zhang HY, Yan XX, Wang C. [Analysis of clinical features among severe orcritical pregnant women in different trimesters with 2009 pandemic H1N1 infection]. Zhonghua Yi XueZaZhi. 2013 Jun 25;93(24):1872-5. Chinese.
- Richey SD, Roberts SW, Ramin KD, et al. Pneumonia complicating pregnancy. Obstet Gynecol 1994;84:525–8
- Schatz M, Dombrowski MP, Wise R, Momirova V, Landon M, Mabie W, et al.Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol 2006;194:120–6.