Abstract

Purpose: To determine long-term outcome of infants with isolated or multiple soft markers but no structural or chromosomal abnormalities.

Methods: A retrospective study of 78 pregnant women who were referred for amniocentesis and found to have soft markers including echogenic intracardiac focus/foci (EIF), echogenic bowel (EB), unilateral or bilateral choroid plexus cysts, (UCPCs or BCPCs) mild pyelectasis and single umbilical artery but no structural anomalies and outcomes of the liveborns with a 4- to 9-year follow-up was conducted.

Results: Among 28 fetuses with EIF, allergic asthma and epilepsy were diagnosed in two liveborns. We followed up nine pregnancies with EB, epilepsy was present in one case. Allergic asthma was detected in both UCPCs and BCPCs, whereas epilepsy and attention-deficit/hyperactivity disorder (ADHD) were diagnosed in two liveborns with BCPCs. Twelve liveborns with multiple soft markers were evaluated; no pathology was detected in most of them except one case of allergic asthma, one case of hearing impairment and one case of ADHD.

Conclusions: This study shows longer-term favorable outcomes of the liveborns with isolated or multiple soft markers without any aneuploidy and may provide insight into this debated point.

Abstract

Background: The umbilical cord is the lifeline of the foetus as it supplies water, nutrients, and oxygen. Protection of these blood vessels is needed and provided by Wharton’s Jelly, amniotic fluid and the helical pattern, or coiling, of the umbilical cord vessels.

Aim: To establish the relationship between antenatal umbilical cord coiling index (aUCI) measured at 18–20 weeks along with level II USG and adverse perinatal outcomes.
Methods A cross-sectional study was conducted on 408 antenatal women, enrolled at the time of fetal anatomic survey, and their cord coiling index (aUCI) was measured, and its association with perinatal outcomes was observed. Umbilical coiling index was classified as Hypocoiled if UCI \10th percentile, hypercoiled [90th percentile, normocoiled between 10th and 90th percentile.

Results: 408 antenatal women were enrolled for the study. Mean aUCI was 0.43 ± 0.30 (normocoiled group),0.18 ± 0.4 (hypocoiled), and 0.53 ± 0.05 (hypercoiled group). The average gestational age at delivery in hypocoiled group was 36.8 ± 2.34 weeks, and it was shorter than 38.3 ± 1.82 weeks of the normocoiled group and 38.9 ± 1.72 weeks of the hypercoiled group. Mean birth weight observed was 2055 ± 744 (hypocoiled group), 3049 ± 564 (hypercoiled), and 3102 ± 564 (normocoiled) p\0.001. Preterm births 52 (59%) and low birth weight 76 (69%) were significantly associated with hypocoiling. Conclusion Abnormal umbilical cord coiling index, detected at the fetal ultrasound anatomic survey in the second trimester (18–20 weeks), can be used potentially as a screening or as a predictive tool for adverse antenatal or perinatal events.

Abstract

Background: There is no consensus about the better intravenous drug between Hydralazine and Labetalol to control hypertension in cases of severe hypertension in pregnancy. Both drugs have their own advantages and disadvantages.

Methods: This is a prospective randomized controlled trial comparing the efficacy and safety of intravenous Labetalol versus Hydralazine for management of severe hypertension in pregnancy. A total of 152 eligible subjects were randomised in two groups consisting 76 subjects each by envelope method. Both the groups were comparable with respect to systolic, diastolic and mean arterial blood pressure at admission. One group received Labetalol and the other Hydralazine. The number of drug doses, the time taken to achieve target blood pressure and side-effects were noted.

Results: With a single dose, Labetalol (81.5%) was able to achieve target blood pressure in a significantly higher number of cases as compared to Hydralazine (69.5%). Labetalol could help in achieving the target blood pressure faster than Hydralazine. The incidence of maternal adverse effects was comparable between the groups. Fetal outcome was comparable in both groups.

Conclusion: Hydralazine and Labetalol both were found to be equally efficacious in reducing blood pressure in cases of severe hypertension in pregnancy. Labetalol achieved the target blood pressure faster than Hydralazine. The adverse effects of both the drugs were comparable.

Abstract

Background: Preeclampsia is a heterogeneous disorder prevalent in 3–10% of pregnant women globally. The etiology is multifactorial. There is a initial stage of endothelial dysfunction and placental ischemia (Stage 1); this leads to maternal syndrome of hypertension, edema, and proteinuria (Stage 2). Drugs acting on immunomodulatory, anti-inflammatory, antioxidant and proresolving pathways can minimize the complications of preeclampsia. The therapeutic effect of aspirin is based on acetyl group and salicylate group. Both components have independent therapeutic effects on anti-inflammatory pathway and proresolving pathway.

Aims and Objectives: This study was designed to assess the effectiveness and safety of aspirin in prevention and treatment of symptoms and complications of preeclampsia in women at high risk of preeclampsia.

Methods: This is a prospective experimental study to evaluate the effectiveness of aspirin versus placebo in the prevention of maternal syndrome of preeclampsia in women with high risk of preeclampsia (G1 = 97, G2 = 92). Patients with age C 34, chronic hypertension, multiple pregnancies, gestational diabetes, and high pulsatility index of uterine artery were enrolled between 12 and 20 weeks of gestation and prescribed 75 mg aspirin daily till 34 weeks of gestation. Control group was not prescribed aspirin.

Observations and Results: There was a reduction in relative risk of preeclampsia in aspirin group as compared with control group. There was no significant increase in the number of cases of abruption placenta, preterm delivery, neonatal intraventricular hemorrhage, patent ductus arteriosus, and postpartum hemorrhage following aspirin therapy.

Conclusion: In patients with high mean pulsatility index of uterine arteries, low dose aspirin can be a useful intervention. Uterine artery Doppler is a simple and noninvasive test which can be used safely for the prediction of preeclampsia. Aspirin is safe, economical, and easily available commercially.

Abstract

Objective(s) We aimed at evaluating the predictive value of amniotic fluid index <= 5 on perinatal outcome in terms of effect on cardiotocography, mode of delivery, meconium in liquor, birth weight, fetal distress, APGAR score at birth and neonatal admission to ICU.

Method(s) This is a prospective study of 308 antenatal women admitted to labor ward of MIMS during February 2014–December 2015 with gestational ages between 34 and 41 weeks. All women enrolled were subjected to history taking, examination, AFI estimation and compared between those with AFI <=5 from rest.

Results The non-reactive CTG, cesarean section rate due to fetal distress, low birth weight, APGAR score < 7 and NICU admission were significantly high among those with oligoamnios than the control group.

Conclusion Oligoamnios has a significant correlation with adverse perinatal outcome.

Abstract

Objective: Study was planned to know vitamin D status in mothers and their newborns and effect of vitamin D deficiency on pregnancy outcome.

Study design: Two hundred consecutive pregnant women with singleton pregnancy admitted to the labor ward of a tertiary care center were recruited for the study. Maternal and cord blood samples were taken and analyzed for 25(OH) D level. Maternal and fetal outcomes were studied.

Results: High prevalence of hypovitaminosis D was found among pregnant women. Eighty-six percentage had vitamin D deficiency, 9.5% had insufficiency, and only 4.5% had sufficient vitamin D level. Women with preeclampsia had statistically significant vitamin D deficiency and insufficiency as compared to patients who had normal blood pressure levels (p = 0.04). Cesarean section rate was significantly higher in patients with vitamin D deficiency and insufficiency compared to sufficient group (p = 0.004). Cord blood 25(OH) D levels strongly correlated with maternal serum 25 (OH) D levels (p = 0.001, correlation coefficient r = 0.84).

Conclusions: This study showed a very high prevalence of hypovitaminosis D among pregnant women and excellent correlation between maternal and fetal 25(OH) D levels. Hypovitaminosis D was associated with preeclampsia, increased Cesarean rate, and low birth weight babies.

Abstract

Background: A number of screening techniques have been developed to reduce the incidence of cervical cancer, most common of which is conventional Pap smear (CPS) being overtaken by liquid-based cytology (LBC) in most of the developed countries. There are a number of studies with conflicting results, and no method has been shown superior in terms of all parameters. LBC was introduced in our hospital in 2014, and we planned to do a study and compare results of the two techniques. This study aims to compare the two methods in terms of sensitivity, specificity, positive predictive value and negative predictive value, turnover time, cost-effectiveness, sample adequacy. This study has been done in 100 women with unhealthy cervix to increase the output.

Method: This was a prospective observational study. A total of 100 women fulfilling the inclusion criteria were subjected to screening test. In first 50 cases, first conventional Pap smear was taken and then LBC, and in remaining 50 cases, first LBC and then conventional Pap smear were taken; this was done to remove bias.

Results: The number of unsatisfactory slides was reduced with LBC, and turnover time was less for LBC. The detection of ASCUS was increased with LBC, but the detection of higher-grade lesions (HSIL and SCC) was equal with both tests.

Conclusion: The superiority of LBC with respect to reduction in the number of unsatisfactory slides and less turnover time is being offset with increased detection of low-grade lesions subjecting women to further testing increasing the cost of programme and anxiety among women. It is difficult to say that it can completely replace conventional Pap smear in low-resource settings.

Abstract

Objective: Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.
Design Prospective comparative study.

Setting: Obstetrics and Gynecology department in Kamala Nehru Memorial Hospital Allahabad.

Patient(s): On the basis of inclusion and exclusion criteria, 100 patients of PCOS were selected for study and assigned randomly in two groups to receive either metformin (1500 mg/day) (group M) or N acetylcysteine (1800 mg/day) (group N) for 24 weeks.

Intervention(s): Metabolic parameter and hormonal profile were determined before and after the treatment.

Main Outcome Measure(s): Metabolic parameters, fasting glucose, fasting insulin and testosterone changes.

Result(s): Forty-five patients of both groups were ultimately evaluated. There was a significant improvement of body mass index, waist circumference and waist–hip ratio in group N, but there was no significant difference found in weight reduction among two groups. The biochemical marker of insulin resistance like fasting insulin, fasting glucose/insulin ratio improved significantly in group N. Greater reduction of total testosterone was observed in group N.

Conclusion(S): Better improvement of metabolic and hormonal profile was observed in N acetylcysteine group. Because of its less side effect comparing to metformin, NAC can be used as a substitute for insulin-sensitizing agent in treatment of PCOS.

Abstract

Aims and objectives: To assess the outcome of minimally invasive paravaginal repair of symptomatic cystocele and to correlate postoperative outcome with preoperative presentation. The primary outcome was the anatomical outcome measured by postoperative physical examination and the functional outcome was assessed by subjective symptoms and questionnaires. The secondary outcomes were perioperative and postoperative complications.

Materials and methods: In this longitudinal prospective observational study, 44 women underwent laparoscopic or robotic paravaginal cystocele repair from January 2016 to July 2016 and they were followed up to 1 year after surgery in a tertiary advanced laparoscopic center. All patients had a symptomatic lateral cystocele C grade 2 according to Baden–Walker classification. Other coexisting defects like apical cystocele or combined defects were corrected concomitantly. The anatomical outcome was measured by physical examination and functional outcome was assessed by questionnaires—Pelvic Organ Prolapse Distress Inventory 6 and Urinary Distress Inventory 6 preoperatively and during postoperative follow-up.

Results: All 44 patients were followed up to 12 months after surgery. The anatomical cure rate for cystocele was 97.7%. There were no major complications. All subjective symptoms and quality of life scores improved significantly during postoperative follow-up. The anatomical recurrence rate in our study was 2.3%.

Conclusion: Minimally invasive paravaginal repair of cystocele is an effective advanced laparoscopic procedure. It can be concomitantly performed with other surgical procedures to correct coexisting defects. The anatomical and functional results were outstanding with minimum perioperative morbidity and encouraging long-term outcome.

Abstract

Introduction Abnormal uterine bleeding (AUB) is the commonest menstrual problem during perimenopause. The International Federation of Gynaecology and Obstetrics working group on menstrual disorders has developed a classification system (PALM–COEIN) for causes of the AUB in non-gravid women. The present study was conducted with the aim to study the two components of this system in clinical practice in general and to establish a clinico-pathological correlation of AUB with context of PALM component in particular.

Materials and Methods Two hundred and thirty-six perimenopausal women (aged 40 years and above till 1 year beyond menopause) admitted with complaints of abnormal uterine bleeding were studied. After thorough history and examination, a clinical diagnosis was made as per PALM– COEIN classification. Relative contribution of various causes of PALM (structural) and COEIN (functional) components was analysed. After all indicated investigations, endometrial sampling and hysterectomy specimen were assessed by histology. A clinicopathological correlation was analysed statistically.

Result PALM and COEIN components contributed almost equally for AUB when assessed clinically. On the other hand, the histological examination revealed significantly more cases of PALM (structural or anatomical) component of AUB, i.e. 50.23 versus 63.98 % (p B 0.05) The difference was mainly attributed to the detection of more cases of AUB-M (malignancy and hyperplasia) in highly significant proportions (p B .01) and coexistent cases of AUB-A;L. AUB-L was the commonest (41.1 %) aetiology overall.

Conclusion The PALM–COEIN classification system should take into account both the clinical and histopathological diagnoses in women having AUB around perimenopause as the two diagnostic modalities are complementary to each other and clinical impression should be placed into proper perspective of this classification in order to optimise outcome.

Abstract

Background The advent of effective chemotherapeutic agents for ovarian carcinoma has made radical abdominopelvic radiation redundant. Nevertheless, palliative pelvic Aimsradiotherapy still has a role in palliating local symptoms. However, its effect on progression-free survival (PFS) may be debated.

Aims To study the outcome of fractionated palliative pelvic radiotherapy in relapsed ovarian cancers in terms of symptom control and PFS.

Methods Twenty-three patients of ovarian cancers, heavily pretreated with chemotherapy and with recurrent or residual pelvic masses, were planned for palliative pelvic radiotherapy to the dose of 46–50 Gy in 23–25 fractions in 4.5–5 weeks. Symptom control and outcomes have been analyzed.

Results Post-radiotherapy, abdominal pain was controlled in 15 out of 17 patients (88.2 %), bleeding per vaginum in all 5 patients and vaginal discharge stopped in 4 out of 5 patients (80 %). On follow-up, of 23 patients, 17 (74 %) had progressive disease post-radiation, and median time to disease progression was 10 months (range 1–49). On univariate analysis, increased PFS was observed in patients who received radiation late in their course of disease, those with serous histology, and with lesser disease bulk in pelvis (<=2 cm) prior to radiation initiation.

Conclusion Fractionated palliative pelvic radiotherapy is an efficient method for symptom palliation in relapsed ovarian cancers. Patients who are heavily pretreated with chemotherapy and have a small-volume pelvic disease may show a prolonged PFS with addition of pelvic radiotherapy. Indications of radiotherapy, however, need to be defined.

Abstract

Objective To study the effect of GnRh agonist administration prior to estrogen–progesterone preparation of the endometrium on the implantation rate in frozen–thawed embryo transfer (FET) cycles in infertile patients treated with IVF/ICSI.

Design Prospective controlled study.

Setting Private center in Alexandria, Egypt.

Patients Patients undergoing frozen–thawed embryo transfer FET.

Intervention(s) Patients were divided into two groups, A and B. Group A patients consisted of 110 patients (110 cycles) who received daily subcutaneous injections of 0.1 mg of the GnRh agonist triptorelin starting from the mid-luteal phase of the cycle preceding the actual FET cycle. The dose was reduced to 0.05 mg from the second day of the cycle when daily oral estradiol valerate 6 mg was also started. Daily vaginal supplementation of micronized progesterone 400 mg b.d. was started after 12 days when the GnRh agonist was also stopped. Frozen–thawed embryos were transferred on day ? 1 of their chronological age and when the endometrium reached 12 mm in thickness. Group B consisted of 100 patients (100 cycles) who started daily estradiol valerate 6 mg administration from the second day of the FET cycle and followed the same regimen but without prior treatment with triptorelin.

Main Outcome Measures Implantation and pregnancy rates were compared among the two groups.

Results There was a significant increase in implantation rate in the GnRh agonist group (group A) compared to the estrogen and progesterone only group (group B) (44.1 vs. 21.1 %; P = 0.002*). The pregnancy rate was also significantly higher in group A compared to group B (65.5 vs. 42 %, P = 0.013*).

Conclusions GnRh agonist administration during endometrial preparation for FET increases the implantation and pregnancy rates.

Abstract

Introduction We conducted a randomized, double-blinded,placebo-controlled study, to evaluate the effect of dehy-droepiandrosterone (DHEA), on diminished ovarianreserve (DOR).

Materials and Methods Twenty patients with DORreceived DHEA (oral 25 mg three times a day). Post-sup-plementation 12 weeks, D2/3 age-specific follicle-stimu-lating hormone (FSH), anti-mullerian hormone (AMH)levels, and antral follicle count (AFC), were repeated toevaluate response. Spontaneous pregnancy rates and regu-larization of menstrual cycles were also studied as sec-ondary outcome.

Results Predominant risk factors were age[35 years(28 %) and poor responders to ovarian stimulation (23 %).There was significant improvement of AMH levels(1.15±1.49 vs. 1.53±1.62) found before and aftersupplementation in the DHEA group. When the AMHvalues between DHEA and placebo group were compared,pre- and post-supplementation, no significant differencewas found. There was decrease in FSH levels and increasein AFC value post-supplementation in both DHEA andplacebo groups which was not statically significant. DHEAsupplementation benefited clinically, as evidenced by the improvement in the menstrual abnormality spontaneousconception in two cases each.

Conclusions A significant improvement in AMH levelspre- and post-supplementation of DHEA was noted. Thesame was not seen for FSH and AFC values.

Abstract

Introduction: Vaginal birth after caesarean section (VBAC) has been historically studied to be a standard and a safe procedure with good successful results.
Aims This study was conducted to determine changes in pattern of VBAC by the same author over a period of 10 years.

Results: Data for 1 year between 2005–2006 and 2014–2015 were compared, and successful VBAC was found to be 74.46% in 2005–2006 period compared to only 34.42% in 2014–2015. Neonatal mortality and maternal morbidity were, however, much higher 10 years ago.

Conclusions: It was concluded that better diagnostic techniques, awareness of patients and medico legal fear have led to safer health of mother and child and lesser incidence of VBAC over the last 10 years.

Abstract

Objectives: To test the application of a clinical definition of life-threatening complications in pregnancy and determine the level of near miss maternal morbidity and mortality.

Methods: A prospective observational study was conducted in the obstetrics and gynaecology department, NRS Medical College, Kolkata, India, to identify life-threatening complications using a modification of the Mantel’s criteria. The main outcome measures were validity of identification criteria, main causes and incidence of lifethreatening complications in pregnancy, maternal near miss: case fatality rates, morbidity–mortality index and use rate of effective interventions.

Results: In total, 177 maternal near miss and 23 maternal deaths were identified in the screened 4400 women. The incidence of near miss was 4.02%. Main causes of maternal mortality were hypertensive disorders (43%) and renal failure (21%). Main causes of near miss were hypertensive disorders (55%), ectopic pregnancy (19%). Near miss mortality index was 7.7:1.

Conclusions: A high proportion of women with lifethreatening complications and all women who died were referred from peripheral hospitals. This signals that there may have been important failures in the referral system relating to maternal care and there is a need for further investigation.

Abstract

Background: Solitary kidney may be congenital or as a result of nephrectomy. There is a lot of literature available on quality of life in these patients, but there is limited data on pregnancy outcome.

Objectives: To study pregnancy outcome in patients with solitary kidney either congenital or due to nephrectomy.

Materials and Methods: Study Design This is a retrospective observational study conducted at tertiary health center in Ahmedabad, from 2011 to 2014. Sample Size There were 164 patients of solitary kidney, out of which two patients had congenital solitary kidney and the remaining had solitary kidney due to nephrectomy. Among 164 patients, 96 (58.53 %) patients had completed family, 37 (22.56 %) patients did not try for pregnancy, 15 (9.14 %) patients have conceived, 12 (7.3 %) were lost to follow up and 4 (2.43 %) patients were infertile. Method Patients in reproductive age group (20–40 years), with solitary kidney either congenital or due to nephrectomy, were included. Maternal and fetal outcome was studied, and patients were followed up till 2 years postpartum. Exclusion Criteria Patients with solitary kidney due to post-renal transplant were excluded.

Results: There were 15 (9.14 %) patients who had conceived, out of which 11 (73.33) patients delivered and 4 (26.67 %) patients had spontaneous abortion. Two patients developed gestational hypertension and one had preeclampsia. On follow-up, all babies were normal and none of them had delayed developmental milestones.

Conclusion: Preconceptional counseling should be done in these patients regarding risk of developing preeclampsia during pregnancy and preterm delivery. These patients can have good pregnancy outcome with close monitoring during antenatal period.

Abstract

Objective: The objective of the study was to assess the fetal outcome after receiving intrauterine transfusion (IUT) in Rh- isoimmunized pregnancy in a tertiary care center.

Study Design: This was a retrospective observational descriptive study in which all Rh-negative gravidas with isoimmunization warranting IUTs (40 patients) were analyzed during the period from January 1, 2010 to October 31, 2015. Primary outcome variables were fetal outcomes and procedural-related factors.

Results: Forty pregnancies (13—hydropic, 27—non-hydropic) required 74 IUTs. IUT was performed at gestational age of 15.4–33 weeks when indicated. The amount of blood transfused ranged from 4 to 110 ml. There were two sudden intrauterine fetal deaths during the procedure,four post-procedure intrauterine fetal deaths in fetuses with severe hydrops, and three neonatal deaths. The overall survival rate was found to be 77.5%.

Conclusion: IUT was found to be an effective therapy in correcting anemia in fetuses of Rh isoimmunized mothers. Early diagnosis of fetal anemia and intrauterine blood transfusion by an experienced fetal medicine specialist is very important for the perinatal outcome.

Abstract

Background: In modern obstetrical practice, incidence of induction of labour is on rise for varied maternal and foetal indications. Ultrasound can help obstetricians in counselling patients before induction of labour and explain the probability of successful induction.

Objectives: To study the role of foetal head–perineum distance in predicting successful vaginal delivery and to correlate with other parameters such as cervical length and Bishop score.

Design: This study is a prospective case–control study in a tertiary care teaching hospital.

Population: There were 250 term patients between 37 and 40? weeks with singleton cephalic presentation with no contraindications for vaginal delivery.
Methods Prior to induction of labour, transperineal ultrasound was performed to measure foetal head–perineum distance. Simultaneously, cervical length was performed using transvaginal ultrasound probe. Bishop score was determined at the same time by clinical examination.

Main Outcome: Measures Outcome of induction was considered successful when it resulted in vaginal delivery. It was considered to be a failure if patient did not get into active phase of labour or an operative intervention had to be performed because of non-progress of labour in active phase of labour. Cases were excluded if caesarean delivery had to be performed in the event of foetal distress.

Results: It was observed that as the transperineal foetal head–perineum distance decreased, the rate of vaginal delivery increased. Similarly, when foetal head–perineum distance increased, the rate of caesarean delivery increased. At a cut-off B 5.5 cm, foetal head–perineum distance had a maximum predictability (sensitivity 97%, specificity 88.1%).

Conclusion: Transperineal foetal head–distance measured by ultrasound can be used as an important tool to predict vaginal delivery before induction of labour.

Abstract

Background: Pregnancy outcomes might be affected by unintended pregnancy such as preeclampsia, preterm birth, cesarean section and low birth weight. The aim of the present study is to assess the association between unintended pregnancy and pregnancy outcomes.

Methods: This was a cross-sectional study conducted in 103 hospitals in Tehran, Iran, in July 2015. The data were collected by trained midwives. The interested independent variable was unintended pregnancy and also preeclampsia, weight gain during pregnancy, preterm birth, cesarean section and low birth weight were considered as interested outcomes, and the association of unintended pregnancy and interested outcomes were assessed.

Results: Out of 5152 cases, 1021 (19.82%) cases were unintended pregnancy. There was no significant relationship between unintended pregnancy and low birth weight (adjusted OR 0.67, 95% CI 0.403–1.13, P = 0.138), the risk of preterm birth (adjusted OR 1.15, 95% CI 0.850–1.57, P = 0.351) and preeclampsia (adjusted OR 1.21, 95% CI 0.846–1.75, P = 0.289). The results of multiple linear regression model showed that the mean difference between two groups was 0.70 kg, and weight gain mean in unintended pregnant women significantly was lower than unintended pregnant women (mean difference = 0.70, 95% CI 0.14–1.26 kg, P = 0.014).

Multiple logistic regression showed that after adjusting confounders, there was a significant relationship between unintended pregnancy and cesarean section, and the adjusted odds of cesarean section in unintended pregnant women was 1.32 times of intended pregnant women (95% CI 1.07–1.63, P = 0.009).

Conclusion: We found higher risk of cesarean section and inappropriate weight gain during pregnancy as adverse outcomes of unintended pregnancy in adjusted model.

Abstract

Objectives: To evaluate the cerebroplacental ratio which is the ratio of pulsatility index of fetal middle cerebral and umbilical arteries, in normal and high-risk pregnancies during 30–36 weeks of gestation.

Methods: In this study, we included 70 patients, who were scanned for Doppler parameters of Middle cerebral artery and Umbilical artery pulsatility index ratio of fetus, between 30 and 36 weeks, and then were followed till delivery. Thirty-five patients with normal pregnancy and 35 patients with high-risk pregnancy were included. Perinatal outcome was evaluated in relation to indices ratio.

Results: There was cerebroplacental ratio of\1.00 in eight cases of the study group in comparison with the control group in which there is no case of < 1.00 value. It was associated with poor perinatal outcome in terms of need for lower segment cesarean section for fetal distress, Apgar < 8 at 5 min, and admission to nursery.

Conclusion: Cerebroplacental ratio is highly sensitive in diagnosing hemodynamically compromised fetuses and very useful for the prediction of adverse perinatal outcome in these fetuses.