Article Type : Protocol
Title : Comparative study to assess the placental weight and fetal outcome in normal mothers and anemic mothers during intranatal period in selected hospitals
Authors : Ms Lalhriatpuii
Abstract : Introduction: The most common hematological condition that may occur during pregnancy is anemia. It is a decrease in the blood's oxygen carrying ability – a reduction in the number of red blood cells (RBC) or a low hemoglobin concentration. Objectives: - 1) To assess the placental weight in normal mothers and anaemic mothers. 2)To assess the foetal outcome in normal mothers and anaemic mothers. 3)To compare the placental weight and foetal outcome in normal and anaemic mothers. Methodology- It is an academic hospital-based study and it will be conducted among 60 mothers with normal and anaemic from AVBRH respectively. An observational checklist will be used to collect the data. Ethics approval was obtained from IEC, DMIMS (DMIMS(DU)/IEC/Dec - 2019/ 8638). The conclusion will be drawn from the results and will be published in peer reviewed journal. Expected Results: The study will enhance the knowledge regarding the need and importance of proper diet among the women especially during pregnancy. Findings will also improve the importance of MCH programme which are organized by the Government of India regarding the prevention of anaemia.
Introduction : The most common hematological condition that may occur during pregnancy is anemia. It is a decrease in the blood's oxygen carrying ability – a reduction in the number of red blood cells (RBC), a low hemoglobin concentration, a mixture of both1. Maternal anemia may affect placenta and fetal outcome, if the placenta has affected by anemia, there will be an impact on the growth and development of the fetus, as the placenta is an important developing organ that provides nutrients and oxygen to the fetus and allows the fetus to pass waste products to the blood of the mother. Neonates may get pathological conditions like, birth asphyxia, prematurity, IUGR, low birth weight and also the placenta varies in its measures that includes its weight, morphometry, number of cotyledons and its thickness. So, a good placenta and fetal outcome is highly depends on the health of the mother2. BACKGROUND OF THE STUDY The placenta (Greek, plakuos = flat cake) called Gross anatomical appearance on the basis of these organs. The placenta is a mateno-fetal organ that starts to develop at blastocyst implantation, and is delivered at birth with the fetus. It provides energy, gas exchange, waste elimination, a source of hematopoietic stem cells, endocrine and immune support for the growth of the fetus during that 9 month span3. The placenta serves as a filtering mechanism, transferring oxygen and nutrients from the body of the mother to the baby and removing carbon dioxide and waste materials from the baby into the body of the mother. The placenta also plays a major role in the development of hormones and releases hormones into the maternal and fetal circulations to influence pregnancy, metabolism, fetal growth and parturition. Earlier in developing countries women frequently become anemic during pregnancy due to rising demand for iron and vitamins. Fetuses face premature delivery, low birth weight due to lack of oxygen supply to placenta and fetus4. Much like the other essential organs of the body, the placenta is subjected to various defects and diseases. Specific clinical conditions such as anemia, diabetes, hypertension and others have a harmful impact on placenta which sometimes leads to morphological changes. This can The health of the fetus is severely impaired, and even life. Some researchers noted that the placenta has substantial functional reserve capacity; it can fix any harm sustained with considerable ease. It has also its own compensatory mechanisms that help to reduce the ill effects of tissue damage as well as adverse maternal conditions such as anaemia. Placenta provides the most reliable record of an infant's prenatal experience. It undergoes numerous changes in weight, length, structure, shape and function over the gestation to sustain prenatal life5.
Method : It is an academic hospital-based study and it will be conducted among 60 mothers with normal and anaemic from AVBRH respectively. An observational checklist will be used to collect the data. INCLUSION CRITERIA: ? Normal mothers both primigravida and multipara with good obstetric history. ? Mothers with anaemia. ? Mothers who are willing to participate in the study. ? Mothers who are present at the time of the study ? Mothers who can speak and understand Hindi and English. EXCLUSION CRITERIA: ? High risk mother other than anaemia. ? Mothers who are not present at the time of the study. ? Mothers delivering baby by LSCS. SAMPLE SIZE The sample size for this study is 60 RANDOMIZATION All the participants will be assigned randomly by sequentially numbered system. INTERVENTIONS The aim of the study will be explained to all the participants, the placenta and the feotal outcome of 30 anemic mothers just after the delivery will be assessed by using observational checklist. Likewise, another 30 groups with normal mothers will be assessed and the placenta and fetal outcome in normal mothers and anemic mothers will be compared. DATA MANAGEMENT AND MONITORING The demographic data will be will be recorded. The placental weight and the fetal outcome will be assessed by using observational checklist and it will be compare the placental weight and foetal outcome in normal and anaemic mothers. STATISTICAL ANALYSIS SPSS software will be used for statistical analysis. ETHICS AND DISSEMINATION This study is approved by the Institutional Ethics Committee of DMIMS (DMIMS(DU)/IEC/Dec - 2019/ 8638). Proper information about the study will be given to all the participant and they will be requested to go through the consent form and sign on it if they agree to participate. EXPECTED OUTCOMES/RESULTS This study is planned to assess the placental weight and the fetal outcome in normal and anaemic mothers. The assessment will be done by using observational checklist.
Discussion : The placental weight in anemic mother is expected to be lower as compared to the placental weight of normal healthy mother. Also, the fetal outcome is expected to be much better in normal healthy mother as compared to anemic mother. The researcher wants to be certain on the weight difference and results in fetal outcome among the study group of normal mother and anemic mother. This study will help the researcher in identifying whether there is such expected difference among the study comparison group and will help in taking required intervention among the study group. A study was conducted on A Comparative Study to Assess the Relationship of Placental Weight and Fetal Outcome among Normal and Anemic mothers in Tertiary Care Hospital Karad. In this study the researcher wanted to assess and compare placental weight and fetal outcome with selected demographic variables in both the selected group. The researcher used Purposive sampling technique and the sample consists of 62 anemic mothers and 62 normal mothers. The result of the study shows that increase in placental weight is directly proportional to the fetal weight and that anemic mothers tend to have lower placental weight and smaller baby as compared to normal mothers. Baliga et al conducted a study on estimation of malondialdehyde levels in serum and saliva of children affected with sickle cell anemia 7. There are studies reported on Infant and Child nutrition in this region 8,9. Also a number of ongoing studies are reported by Khatib et al on early childhood development programs in low middle-income countries10-12.
Conclusion :
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