Keywords : perinatal outcome
Umbilical Cord Thickness, Cross Sectional Area and Coiling Index by Second Trimester Ultrasonography as Predictors of Perinatal Outcome
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 4, Pages 566-589
Present study was carried out to determine the fetomaternal outcome in relation to cord indices (Umbilical Cord Thickness, Cross Sectional Area and Coiling Index ) measured during the second trimester (18-24 weeks) ultrasonography.
Material & Methods: It was a prospective observational study conducted between JULY 1ST, 2021 TO JUNE 30th, 2022 at Department of Obstetrics and Gynecology, Gauhati Medical College and Hospital, Guwahati. During the study period, we included 500 consecutive women eligible to participate in the study.
Results: The mean age was found to be 25.57 with a SD of 3.174, the minimum age being 19 years and maximum age was 34 years. In the study, 6(1.2%) participants, 464(92.8%) participants and 30(6%) participants were <10th percentile (hypocoiled), 10th to 90th percentile (normocoiled) and >90th percentile (hypercoiled) of coiling index. In the study, 35(7%) participants, 429(85.8%) participants and 36(7.2%) participants were <10th percentile,10th to 90th percentile and >90th percentile of cross sectional area. In the study, 30(6%), 447(89.4%) and 23(4.6%) were <10th percentile,10th to 90th percentile and >90th percentile of cord thickness. Abnormal cord indices are significantly associated with meconium stained liquor, LBW/IUGR, Low APGAR scores, increased NICU admissions, neonatal death, congenital anomalies and even intra-uterine fetal demise.
Conclusion: It has been concluded that abnormal cord indices are very strongly associated with adverse perinatal outcome and maternal complications. Hence, USG in the second trimester has a very potential value in screening these adversities
Doppler study in second and third trimester in high risk pregnancy and perinatal outcome
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 962-975
In order to screen for defective placentation and related consequences such pre-eclampsia, intrauterine growth restriction, and infant death, doppler examination of the placental circulation is crucial.
Methods: From August 2021 to July 2022, the study was carried out in the Department of Obstetrics & Gynecology, Owaisi Hospital and Research Centre, Hyderabad, Telangana, India. Prospective observational study conducted in a hospital involving 100 patients.
Results: Any gestational age after 32 weeks where REDV is detected should warrant consideration for an urgent delivery. Guidelines from the Society for Maternal-Fetal Medicine, which suggest intensive fetal monitoring of these fetuses and continuing expectant treatment until 32 weeks as long as fetal monitoring is still reassuring, support this.
Conclusion: Doppler velocimetry can be a valuable addition to standard antepartum surveillance procedures in patients with IUGR fetuses. If other antepartum surveillance tests are reassuring, an abnormal Doppler should not necessitate an obstetric intervention. When an aberrant Doppler finding is discovered, the obstetrician is made aware of the potential problems, and the delivery should be scheduled at a tertiary care center with good neonatal facilities.
Study the association between maternal Body Mass Index (BMI) and obstetric & perinatal outcome in singleton pregnancies
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 1621-1627
High BMI is associated with an increased risk of preeclampsia, gestational hypertension, macrosomia, induction of labour, caesarean deliveries and poor perinatal outcomes.Low BMI has been shown to be associated with an increased risk of preterm deliveries, low birth weight and anemia and a decreased risk of preeclampsia, gestational diabetes, obstetric intervention and postpartum haemorrhage. Aim & Objective: 1. To assess correlation between maternal Body Mass Index (BMI) and perinatal outcome. Methods: Study design: Prospective observational Study. Study setting: Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Mumbai (NWMH), (Tertiary Health Centre). Study population: patients who delivered / underwent completion of pregnancy at the institute such cases were included in the study. Sample size: 100 Results: The highest number of patients belonged to the age group of 23-28 yr (61%%), followed closely by the age group of 29-35 yr (33%). Patient between age group 18-22 yr was only 6%. LSCS was performed in 48%, out of which Emergency LSCS constituted 40% & Elective LSCS constituted 8%. P-value for LSCS was 0.001 & for Emergency LSCS was 0.003 suggesting these are more common in BMI Group III & IV. Instrumental Deliveries were performed in 4% of patients out of which Forceps applied in 2% & Vacuum extraction done in 2% patients. Out of 90 patients, in 7 (7.78%) patients second stage of labour was prolonged. Meconium-stained liquor was found more commonly in BMI Group III with P-value for 0.028. Total of 25 patients were diagnosed to be suffering from gestational hypertension. 5 (20%) of them had postpartum haemorrhage & Blood Transfusion was needed in 3 (12%) them. Foetal Distress was found to be the most common complications affecting 18% of patients who participated in this study. P-value for Foetal Distress is 0.011 suggesting significant association being more common in BMI Group IV. Neonatal complications respiratory distress syndrome & Meconium Aspiration Syndrome were found in 4 % & 3% babies without any significant association in any of the BMI group. Conclusion: Vaginal Delivery was the most common obstetric outcome, Neonatal outcome was Live Birth among all the patients.
A study of perinatal outcome in isolated oligohydramnios in a tertiary care hospital
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3467-3480
Aim and Background: To investigate the perinatal outcome at a tertiary care institution in isolated oligohydramnios. In Isolated Oligohydramnios, to Understand the Perinatal Outcome. compare the maternal and perinatal outcomes between isolated oligohydramnios and pregnancies where the amniotic fluid volume (AFI) is within a normal range (AFI5cm). to learn how frequently isolated oligohydramnios occur.
Methods: Patients were the subjects of a prospective case-control research on the perinatal outcome in isolated oligohydramnios with AFI 5 cm.
Results: In this study, 100 cases of isolated oligohydramnios were diagnosed through clinical examination and ultrasonography in the third trimester. These cases were compared to 100 controls, who had normal AFI and were matched for age, parity, and gestational age. The two groups did not significantly differ in terms of parity, gestational age, or maternal age.
Conclusions: Most of the participants in our study were in the 20 to 30 year age range. The case group's mean age was 23.84 years, while the control group's was 24.26 years. Primi and Multi mothers were up 69% and 31% of the case group, respectively. Primi and Multi mothers made up 66% and 34%, respectively, of the control group.
“A STUDY ON ROLE OF UMBILICAL ARTRERY DOPPLER IN FETUSES WITH INTRAUTERINE GROWTH RESTRICTION”
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 4929-4939
Background:Intrauterine Growth Restriction (IUGR) is a term used to describe the condition
of a foetus whose size or growth is subnormal.” A foetus is growth restricted if its weight is
less than tenth percentile of its gestational age”. IUGR is associated with increased mortality
and morbidity which possibly may extend into adult life as compared to foetuses and newborns
presenting with characteristics of normal growth.
AIM: To evaluate the usefulness of umbilical artery Doppler indices as predictors in antepartum
surveillance in clinically suspected cases of intra uterine growth
restriction.MATERIALS & METHODSStudy Design: Institutional prospective
Observational study.Study area: The study was done in the Dept. of. in a Medical
college.Study Period:1 year.Study population:Women who presented to antenatal
OPD/IPD with clinical symptoms and risk factors and laboratory data of IUGR meeting the
mentioned inclusion criteria.Sample size: A total of 100 women were included in the
study.Sampling method: Simple Random sampling method
Study of Hypertensive Disorders of Pregnancy by Comparision of Spot Urine Protein/Creatinine Ratio and 24hours Urinary Protein toDiagnose Proteinuria
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 10022-10032
Background:The aim is to compare the spot urine protein/creatinine ratio with 24hour
urinary protein in hypertensive disorders of pregnancy.
Materials and Methods: A prospective correlational study was conducted on 100
hypertensive pregnantwomen during the study period. The objective of the study was to
know if a spot protein/creatinine ratio would provide an accurate quantification of
proteinuria and whether it can replace the use of the 24 hours urine protein in
preeclamptic women. Ethical clearance and informed consent were obtained. Urine
samples were collected for visual dipstick, spot urine P/C ratio and 24hours urinary
protein estimation.
Results: A fair degree of correlation existed between the two variables with r =
0.842with a highly significant p value <0.01 when all the observations were considered.
The correlation at lower level of proteinuria was less r = 0.72 compared to higher levels
of proteinuria,but is statistically significant. The area under the ROC curve - 0.739
(95% CI: 0.628, 0.849) with p value < 0.01 (significant). The optimal cut off point was
0.5, which yielded a sensitivity of 92% and specificity - 66%. Even though the results
were known to clinicians the values were not taken for clinical decision, only by the
ratio alone. However the 24 hour urine protein values were considered for the patient
management. The perinatal outcome in women with higher levels of proteinuria were
poor with increased incidences of IUGR, prematurity, low birth weight and the need for
NICU care was increased in such babies.
Conclusion: The present study indicates that this method for quantification of
proteinuria, when properly interpreted, can provide valuable information, that for
clinical purposes is a satisfactory substitute for the determination of protein excretion in
a 24 hour collection.