Online ISSN: 2515-8260

Keywords : gestational age


MORPHOMETRIC STUDY OF CAUDATE AND QUADRATE LOBES OF THE FETAL LIVER

Dipin Kumar Yadav; Manisha Nakhate; Sunita Bharti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1847-1855

Background: Liver is largest gland of the body, situated in the right upper quadrant of the abdominal cavity. It occupies whole of the right hypochondrium greater part of epigastrium and extend into the left hypochondrium reaching up to the left lateral line. Liver is divided into right and left lobe by attachment of falciform ligament anteriorly and superiorly; by the fissure for the ligamentum teres inferiorly and by the fissure for the ligamentum venosum posteriorly.The caudate lobe is situated between the ligamentum venosum, porta hepatis and the groove for the inferior vena cava. Whereas the quadrate lobe is situated between ligamentum teres hepatis, fossa for gallbladder and porta hepatis. The caudate lobe is also known as the posterior hepatic segment.
Objective: This study aimsto correlate the length and width of the caudate and quadrate lobes of the liver with the Gestational age (GA) of the fetus.
Methods: This study was conducted on 131 formalin-fixed fetuses with the gestational age ranging from 12 to 36 weeks in the Department of Anatomy D Y Patil medical college in the collaboration with the OBGY Department of D Y Patil Hospital, Nerul, Navi Mumbai. Caudate and quadrate lobes of the liver were dissected and measurements of length, width, and circumference were taken with the help of vernier caliper, measuring scale, and thread. 
Results: In this study, the length of the caudate lobe and the width of the caudate lobe was 10.62±3.22 mm and 6.945±2.391 mm respectively after calculating mean and standard deviation. The length and width of quadrate lobe was 14.775±4.636 mm and 7.555±2.763 mm respectively. The circumference of caudate and quadrate lobes were 40.886±11.647 mm and 48.74±14.008 mm respectively for the total sample size. Calculation of the length, width, and circumference of the caudate and quadrate lobe was found to be statistically significant with the gestational age of fetuses.
Conclusion: From this study we can conclude that there is a significant correlation between the length, width and circumference of the caudate and quadrate lobe with the gestational age.

Birth Weight And Gestational Age: A Clinical Descriptive Study

Dr. Narendra Krishnarajapete Siddashetty; Dr. Srinivas Pagadpally

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1195-1199

Birth weight has been universally used as a measure of intrauterine growth, largely because of relative ease of its measurement and of its correlation with gestation.3. Weight is the most widely used single clinical indicator of growth. Fetal weight is the one single clinical factor of greatest interest to the neonatal pediatrician. All the singleton live born babies born in the hospital were examined with in 48 hours of birth. Gestational age was calculated by enquiring into 1st day of mothers last menstrual period and will be subsequently confirmed by New Ballard Score. Babies were weighed naked immediately after birth on lever actuated weighing scales to the nearest 50 g. The weighing machine was checked periodically by known standard weights. In the derived normogram based on birth weight and gestational age it was observed that there is a linear relationship of the birth weight with increasing gestational age. The birth weight increased linearly with the increasing gestational age upto 39 weeks, after which it started declining.

A Study On The Relation Of Head Circumference And Chest Circumference With Gestational Age

Dr. Narendra Krishnarajapete Siddashetty; Dr. Srinivas Pagadpally

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 1188-1194

At birth HC is larger than ChC by about 2.5cm. By 6-12mnths of age, both are equal. After1st year of life, ChC tends to be larger by 2.5cm. By the age of 5 years, it is more or less 5cm greater in size than the HC. In undernourished Indian children, it may not equal to HC even by the end of the 2nd year. All the singleton live born babies born in the hospital were examined within 48 hours of birth. Gestational age was calculated by enquiring into 1st day of mothers last menstrual period and will be subsequently confirmed by New Ballard Score. If any disparity of more than 2 weeks between gestational age by enquiring LMP and by NBS, were excluded from the study. Their gestational ages ranged from 29 to 42 weeks. The mean head circumference of the babies analyzed was 33.64 cm, with the standard deviation of 1.40 cm. It was found that HC was correlated well with the gestational age. It gave a correlation coefficient “r” value of 0.680 (p<0.0001). The mean chest circumference of the babies analyzed was 31.85 cm, with the standard deviation of 2.19 cm. It was found that chest circumference was correlated well with the gestational age. It gave a highest correlation coefficient “r” value of 0.763 (p<0.0001).

FOETAL KIDNEY LENGTH IN 3RD TRIMESTER OF PREGNANCY AND ITS CORRELATION WITH GESTATIONAL AGE USING ULTRASONOGRAHY

DR. AISHWARYA K SHRIVASTAVA; DR. MANISHA LADDAD; DR. NITIN S KSHIRSAGAR

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5105-5129

Background: The cornerstone of the obstetrician's capacity to successfully manage prenatal care is essential to prenatal testing and successful planning for appropriate treatment or intervention. [1] Menstrual irregularities, lactational amenorrhea, oral contraceptive failure, bleeding in the first trimester, and delayed conception may further affect the ability to accurately calculate GA from the date of LMP. When an early termination is required as soon as the foetus reaches maturity, such as in the case of pre-eclampsia, severe intrauterine growth retardation (IUGR), diabetes, placenta praevia, an accurate GA is crucial. Accurate GA estimation is also required when specific tests, including as chorionic villus sampling, amniotic fluid and serum testing, and foetal therapy planning, must be carried out. [2] Estimating gestational age from an early measurement of crown rump length in first trimester is accurate, however we are often faced with patients who seek late prenatal care and who have no information about their last menstrual period or when conception occurred. The parameters used in second and third trimester are BPD, HC, AC, FL and combination of them. Foetal kidney length shows no significant change with any underlying medical condition. Therefore, its length can be used as an additional measurement of foetal growth. This measurement is easy to take and can therefore be easily used for dating pregnancies after 20 weeks of gestation, particularly when measurements of biparietal diameter and head circumference are difficult.
Methodology: 120 ANC cases in the 3rd trimester attending OPD in tertiary care center after obtaining written informed consent with fairly reliable LMP and documented dating scan have been included in this study. Sonography was carried out, mean kidney length was obtained along with other parameters like BPD, HC, AC, FL. Pearson’s correlation coefficient was calculated between gestational age and renal length as well as between gestational age and other foetal biometric indices.

EFFECT OF ANEMIA IN PREGNANCY ON NEONATAL BIRTH WEIGHT AND GESTATIONAL AGE AT DELIVERY

Dr. Ramya.S, Dr. Pagadpally Srinivas

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 7426-7433

BACKGROUND: Anemia is the world's most common nutritional deficiency disorder. Maternal anaemia has become one of the world's major health concerns and it is linked to negative maternal and foetal outcomes such as Maternal and perinatal mortality rates, premature birth, low birth weight, and certain anomalies have all increased.
OBJECTIVE: This study was conducted to determine the effect of maternal anemia with new born’s birth weight, and gestational age at delivery.
METHODOLOGY: This was an observational clinical study involving 200 pregnant women and their newborn. Every singleton live birth baby born was examined. The hemoglobin for 100 anemic mother and hemoglobin of 100 non anemic mother was considered and it was correlated with neonatal outcomes such as gestational age at birth and birth weight.
Results: The majority of the anemic mothers were from the lower class. Non anemic mothers were from lower middle class. Preterm births accounted for 25% in total, in which 17% preterm birth were born to anemic mothers. and low birth weights accounted for 45% in total in which 38% were born to anemic mother.
CONCLUSION: According to WHO data from 2018, anaemia in pregnancy affects 65-75% of pregnant women in India. Preterm births are 12.1% and low birth weights are 17.8% among babies born to anaemic mothers. In future, With the help of national health programme we should aim in reduction of incidence of anemia in pregnancy and their detrimental effect on new born.

SONOGRAPHIC ASSESMENT OF GESTATIONAL AGE BY THE FETAL KIDNEY LENGTH AND VOLUME AFTER 18 WEEKS OF GESTATION IN LOCAL POPULATION

DR. MADAN MOHAN BABU, DR. SURESH A DR. ABHISEK SAHA

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 286-294

Obstetric care begins with determining gestational age, which has the least variability in early pregnancy. This current study was planned to provide an overview of fetal kidney length and volume as a useful adjunct parameter for better determination of gestational age.
MATERIALS AND METHODS
Normal singleton pregnancies from 18–40 weeks of gestational age, referred to the department of Radio-diagnosis and Imaging at VIMS & RC, Bangalore. Fill PC-PNDT [Prenatal Diagnostic Technique] form i.e Obstetric ultrasonography were performed using Affinity 50 G pro ultrasound scanner using a 3.5 MHz convex probe. Images were recorded in the system as DICOM.
RESULT
Out of 200 patients who presented themselves for routine obstetric ultrasound scan within the period of study, 150 patients met the inclusion criteria [18th week of gestation to term] and were selected for the study while patients were excluded from the study for the following reasons; for not remembering their LMP, fetus with IUGR, 10 patients presented with oligohydramnios, poly-cystic renal dilated renal pelvis. It correlates strongly with gestational age while the relationships between right and left kidney lengths with gestational age were established. However no correlation of gestational age with volume. Fetal kidney length increases with increase in FGA and shows excellent intra and inters class correlation coefficient which suggests good agreement and reproducibility of measurements. 

Estimation of gestational age of fetus with the help of fetal fibular length: By real time ultrasonography

Dr. Manisha Kumari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2045-2049

Introduction: The ultrasound is a sound wave beyond the audible range of frequency. Clinical application of ultrasound in obstetrics was introduced and popularized by Donald & Glasgow in 1958, the advantage being that the ultrasound is a noninvasive technique causing minimum discomfort to the patient and practically no side effect on the fetus.
Materials and Methods: In present study an analysis will also be made of the variation in the gestational period, associated with the fibular length and socioeconomic, physical and medical factors recorded from obstetric and gynecological records. The patients included in this study were of 13 weeks to 40 weeks of fetal gestational age as diagnosed during the antenatal examination by gynecologist. The present study was conducted in the Department of Anatomy, in coordination with the Department of Radiodiagnosis, LLRM Medical College, Meerut, in pregnant women a during 2ndand 3rd trimester. Ultrasonographic measurement of fibular length was done in Radio diagnosis Department of LLRM Medical College, Meerut.
Results: At the 14 weeks of the gestation the mean calculated fibula length was 15.7mm and at 20 weeks was 29.33 mm. The mean fetal fibular length of 51.92 mm was recorded at the age of 30 weeks of gestation whereas the same was 74.51mm at 40 weeks of gestation.
Conclusions: Dating of fetus by fetal fibular length is more accurate than the other fetal parameters and it was found more predictive than other fetal parameters.

Clinical Study of Neonates Born to Mothers with Hypertensive Disorders of Pregnancy (HDP)

Gajula Ravi, Janardhan Reddy Pulluru, Suraboina Satishkumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10414-10423

Background:Globally, hypertensive disorders of pregnancy (HDP) are one of the major
causes of perinatal and maternal morbidity and mortality. These disorders are
characterized by increase in blood pressure (BP) which may be present before or
appear for the first time during pregnancy after 20 weeks with or without proteinuria
or evidence of multiorgan involvement and have been classified into preeclampsia (PE)
and eclampsia syndrome, chronic hypertension (CH), PE superimposed on CH, and
gestational hypertension. The HDP may complicate 5%–10% of all the pregnancies
with the prevalence of 6.9%–7.9% in India. Studies have shown that HDP accounts for
around 16% of 2.6 million stillbirths and 15% of perinatal deaths globally. Higher rates
of adverse perinatal outcome such as preterm delivery, low birth weight, birth asphyxia,
stillbirth, and early death have been reported worldwide in women having
HDP.Prematurity and preterm birth are documented as the most common cause of
perinatal death in Indian women with HDP. The present study was conducted with the
aim to know the type of hypertension affecting the pregnant women and perinatal
outcome.Aims and objectives:To determine the outcome of neonates born to mothers
with Hypertensive Disorders of pregnancy in comparison with neonatal outcome in
babies born to normotensive mothers.
Materials and Methods: A comparative case control study will be performed on
Neonates fitting into inclusion criteria from JAN 2019 to Jun 2020 and a
prestructuralperforma will be used to obtain detailed History taking, Clinical
examination .The comparison will be done between two groups. The study group, which
will include neonates born to mothers with either gestational hypertension,
preeclampsia or eclampsia. The control group, which will include all babies born to
normotensive mothers, matched forgestation with the study group during the study
period.
Results: The results showed that the primary and the secondary outcomes in the study
group was significantly poorer compared to control group. There was significantly high
rate of death among the neonates born in the study group (p< 0.05).Also there was
higher rate of meconium stained amniotic fluid (16%), more requirement of surfactant
(14%) and more requirement of NICU admission (31%) among the study group. There
was also higher rate of IUGR (20%) as well as higher rates of Low birth weights among
study group.

Role of fetal renal length measurements in estimation of gestational age

Dr S.Swetha Reddy, Dr M. Laxmi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10340-10349

Introduction: For the management of obstetric cases, it is very important to know the
EDD. But in our set up most of the women do not know the date of LMP and hence it is
difficult to predict the EDD. Therefore, ultrasound examination plays an important role
in determining the EDD.
Aims: To formulate the ideal length of fetal kidney to the corresponding gestational age
and to study of echo pattern of fetal kidney and its correlation with pregnancy outcome.
Materials and methods: 200 pregnant women with known LMP were taken for the
study. Gestational age by LMP was calculated and it ranged from 20 weeks to 40 weeks.
All the cases were subjected to ultrasound examination. Besides other information
through USG, special emphasis was made to calculate USG gestational age by
conventional method of measuring BPD. FL. AC. At the same time the renal length and
renal medullary echo pattern was examined in all the cases. The cases were grouped
according to the gestational age by LMP and mean renal length was calculated for each
gestational age group.
Results: It was observed that there was a wide variation in renal length for the
gestational age group of 20-30 weeks. This variation narrowed down from the 30-40
weeks of gestational age group. There was a definite correlation between the renal
length with the gestational age by LMP. It was found that USG with standard
parameters gave ± 3 weeks difference form LMP EDD, whereas the EDD calculated by
renal length gave a difference of ± 2 weeks. The prediction interval was narrowed from
±3 weeks to ± 2 weeks when renal length was used instead of the standard USG
parameters i.e., there was ± 1 week difference between EDD by renal length and EDD
by USG.
Conclusion: Examination of fetal renal medullary echo pattern helps us in identifying
high risk pregnancy associated with intrauterine growth restriction and helps us in
management decisions.

CHARACTERISTICS OF HEMOSTASIS DEPENDING ON HEMORRHAGIC AND ISCHEMIC BRAIN DAMAGE IN PREMATURE NEWBORNS

MadjidovaYakutkhon Nabievna; AkhmedovaZiyodaShakhabiddinovna .; AzimovaNodira Mirvasitovna; NasirovaDilfuzaShavkatovna .; KhalilovaAliyeEmirasanovna .; AmritdinovaFarangizShakhabiddinovna .; BakhramovMakmudjonSaydullo ugli .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1130-1133

In this article, some indicators of the hemogram in premature newborns are studied. The analysis and comparison of the obtained indicators in children with hemorrhagic and ischemic lesions of the central nervous system was carried out. Small distinctive features were revealed in intraventricular hemorrhage and cerebral ischemia

The Use Of Abdominal Aorta Length In The Fetuses’ After 34 Weeks Of Gestation For Calculating Gestation Age Among Primigravida Healthy Women

Dr Najlaa Hanoon; Dr Wisam Akram

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 139-149

Aim of the stud; To verify the correlation between abdominal Aorta Length in the fetus and gestational in weeks between 34- 40 weeks
Type of study; Case Control
Methods; a healthy pregnant women were chosen who’s age between 15-40 years all are primigravida and conceived within 3 months of marriage. They were between 34- 40 weeks in gestation. Their last menstrual period was know and recorded in addition all were scheduled for ultrasound examination for measurement of the abdominal aorta length, femoral length and biparietal diameter.
Result; a highly significant correlation was found between abdominal aorta and biparietal diameter and femoral length . In addition a highly significant correlation was found between gestational age calculated by their LMP and abdominal aorta. In addition a highly significant correlation was found between gestational age and abdominal aorta length. A non linear exponential equation was constructed with lowest mean of sum of squares=1, and coefficient of correlation= 0.97 between abdominal aorta length and gestational age in weeks. From this equation a reference table built which contains value for the abdominal aorta between 34- 40 weeks for 1,2.5,5,10,90,95, and 99 centiles. After the building of this table further 35 women were taken for assessment of this table. Only 2 were miss calculated, the Kappa Cohen coefficient=0.93
Conclusion; a table by which the gestational age can be calculated between 34-40 weeks by measuring the abdominal aorta. However under no circumstances this table may be used apart from assessment applications. Further studies are required to verify its accuracy