Intertwin estimated fetal weight or crown rump length discordance and adverse perinatal outcome

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Apostolos Kaponis ◽  
Nikolaos Thanatsis ◽  
Vassilis Papadopoulos ◽  
George Decavalas
Keyword(s):  
Perinatal Outcome ◽  
Adverse Outcomes ◽  
Fetal Weight ◽  
Crown Rump Length ◽  
Adverse Perinatal Outcome ◽  
Structural Abnormalities ◽  
Gestational Age At Delivery ◽  
Review Study ◽  
Estimated Fetal Weight ◽  
Threshold Range

AbstractAim:In the current review study, we present recent data regarding the importance of intertwin estimated fetal weight (EFW) and crown rump length (CRL) discordance for the prediction of adverse perinatal outcome both in monochorionic and in dichorionic diamniotic gestations.Results:Twins with significant weight disparity are associated with higher rates of perinatal morbidity and mortality, regardless of gestational age at delivery. However, there is no agreement regarding as to the cut off value above which the perinatal outcome is unfavorably affected and the threshold range from 10 to 30%. On the other hand, CRL discrepancy has proved to be a weak predictor of adverse outcomes, such as fetal or neonatal death in fetuses without chromosomal and structural abnormalities. In clinical practice, decisions about obstetric surveillance of discordant twin gestations, frequency of fetal sonographic monitoring and time of delivery are usually based on amniotic fluid volume and Doppler assessments on a weekly basis.Conclusion:Significant EFW discordance leads to adverse perinatal outcome, although the cut-off value has not yet been estimated. CRL discrepancy is not correlated well with adverse perinatal outcome. However, increased monitoring of women with EFW and CRL discrepancy is suggested.

CORRELATION BETWEEN CEREBROPLACENTAL RATIO AND ADVERSE OUTCOMES IN INTRAUTERINE GROWTH RESTRICTION

2018 ◽  
Vol 8 (3) ◽  
pp. 82-89
Author(s):  
Tran Thao Nguyen Nguyen ◽  
Van Duc Vo ◽  
Ngoc Thanh Cao
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Intrauterine Growth ◽  
Cerebroplacental Ratio ◽  
Gestational Age At Delivery ◽  
The Mean ◽  
Estimated Fetal Weight

Objectives: To identify the values of CPR in intrauterine growth restriction and evaluate the correlation between cerebroplacental ratio and adverse outcomes in intrauterine growth restriction. Material and methods: A prospective study was conducted on 74 cases of intrauterine growth restriction with an estimated fetal weight less than 10th percentile, at Departement of Obstetric and Gynecology of Hue University of Medicine and Pharmacy from 05/2016 – 05/2017. CPR was calculated by PIMCA/PIUA.. The adverse outcomes included gestational age at delivery, methods used to delivery, APGAR score below 7 at 1 minutes and 5 minutes, admission at NICU, perinatal deaths, neonatals deaths. Results: The mean of CPR in group of early IUGR and late IUGR were 0.55 ± 0.14, 1.59 ± 0.69, respectively. The mean of CPR in group IUGR with an estimated fetal weight under the 3th percentile was 1.49 ± 0.76, lower than the mean of CPR in group IUGR with an estimated fetal weight from 3th percentile to 10th percentile. With cut – off at 1, CPR < 1 had the higher prevalence in group of early IUGR, in group IUGR with the estimated fetal weight below the 3th percentile, in group IUGR with hypoamniotic or oligohydramnios. The mean of gestational age at delivery of group IUGR with CPR < 1 and CPR >1 were 37.00 ± 3.18, and 38.59 ± 1.76, respectively. The rate of emergency cesarean section deliveries in the CPR < 1 and CPR > 1 group were 68.75% and 39.65%, respectively (p <0.05). Percentage of neonatal with APGAR ≤ 7 at 1 minute in the group with CPR < 1 and CPR > 1 were 56.25% and 22.41%, respectively. Rate of prenatal death was 12.5 in group IUGR with CPR < 1. Conclusion: There was a strong correlation between CPR and adverse outcomes in intrauterine growth restriction. Key words: intrauterine growth restriction, CPR ratio, middle cerebro artery, umbilical artery

scholarly journals P34.05: Customized standards of estimated fetal weight as predictor of adverse perinatal outcome

2007 ◽  
Vol 30 (4) ◽  
pp. 582-583
Author(s):  
A. Iraola ◽  
E. Eixarch ◽  
E. Meler ◽  
M. Illa ◽  
F. Figueras ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Fetal Weight ◽  
Adverse Perinatal Outcome ◽  
Estimated Fetal Weight

Antithrombin Therapy for Severe Preeclampsia

2000 ◽  
Vol 84 (10) ◽  
pp. 583-590 ◽  
Author(s):  
Masahiro Maki ◽  
Toshihiko Terao ◽  
Tsuyomu Ikenoue ◽  
Kazuo Satoh ◽  
Masao Nakabayashi ◽  
...  
Keyword(s):  
Weight Gain ◽  
Perinatal Outcome ◽  
Controlled Trial ◽  
Severe Preeclampsia ◽  
Fetal Weight ◽  
Low Birth Weight Infants ◽  
Double Blind ◽  
Biophysical Profile ◽  
The Difference ◽  
Estimated Fetal Weight

SummaryA double-blind, randomized, placebo-controlled trial was conducted to evaluate whether treatment with Antithrombin (AT) concentrates improved the clinical and perinatal outcome in patients with severe preeclampsia. Severe preeclamptic patients (24 to 35 weeks of gestation, Gestosis Index (GI) > 6 points) were randomized into two groups: 66 received AT and 67 received placebo. There were no statistical differences in the clinical profiles of the two groups. Study drugs were given intravenously once daily for 7 consecutive days. Maternal symptoms were evaluated from the difference of GI between before and after treatment, and fetal findings were evaluated from the changes of the biophysical profile score and the estimated fetal weight gain. Improvement was significantly greater in the AT group for both the GI (p = 0.020) and the estimated fetal weight gain (p = 0.029). The improvement of coagulation parameters was also evaluated. The D-dimer levels increased significantly in the placebo group (p = 0.026), but did not change in the AT group. Gestation was significantly prolonged (p = 0.007), and the number of low-birth weight infants was significantly smaller (p = 0.011) in the AT group. No adverse events related to AT were observed. It is revealed that AT concentrate therapy for preeclampsia is effective and safe, leading to an improved perinatal outcome.

scholarly journals Serum uric acid as marker of severity of pre-eclampsia

2017 ◽  
Vol 6 (11) ◽  
pp. 4915 ◽  
Author(s):  
Shirish Toshniwal ◽  
Aakriti R. Lamba
Keyword(s):  
Multivariate Regression ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Neonatal Resuscitation ◽  
Resistive Index ◽  
Adverse Outcomes ◽  
Foetal Distress ◽  
High Relative Risk ◽  
Adverse Perinatal Outcome ◽  
Foetal Growth

Background: In pre-eclampsia, there is increased uteroplacental resistance and reduced foetal perfusion due to inadequate invasion of spiral arterioles by trophoblast cells. This causes impaired foetal growth and foetal hypoxia. To assess the usefulness of foetal Doppler in predicting adverse perinatal outcome in preeclampsia.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA - Pulsatility Index (PI) and UA - Resistive Index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI <2SD was taken as abnormal.Results: There were 107 women in the study. Major adverse outcomes 11. Umbilical artery - S/D ratio >2SD (RR 4.46, 95%, CI 1.40-14.17) and RI >2SD (RR 3.36, 95%, CI 1.03-10.61) and MCA RI <2SD (RR 4.46, 95% CI 1.4-14.17) had a high relative risk to predict adverse major perinatal outcome. 39 babies were admitted in neonatal nursery and no parameters could predict them. Though UA - PI >2SD predicted acute foetal distress in labour (RR 2.33, 95% CI 1.21-4.47), there was no association on multivariate regression analysis.Conclusions: This study showed UA-S/D ratio and UA-RI >2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute foetal distress in labour or neonatal nursery admission could not be predicted.

Can Sonographic Fetal Biometry Predict Adverse Perinatal Outcome?

2018 ◽  
Vol 40 (02) ◽  
pp. 230-236 ◽  
Author(s):  
Jutta Pretscher ◽  
Eva Schwenke ◽  
Friederike Baier ◽  
Sven Kehl ◽  
Michael Schneider ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Multivariate Analyses ◽  
Mode Of Delivery ◽  
Adverse Outcomes ◽  
Abdominal Circumference ◽  
Detection Rates ◽  
Fetal Biometry ◽  
Adverse Perinatal Outcome ◽  
Biometric Parameters

Abstract Objective To evaluate the association of sonographic fetal biometry (sonographic head circumference (soHC), sonographic abdominal circumference (soAC), estimated fetal weight (EFW)) with mode of delivery and adverse perinatal outcome. Methods Singleton pregnancies with a gestational age ≥ 37 weeks and an ultrasound examination with complete biometric parameters within 7 days before delivery were retrospectively included. The association between soHC, soAC, EFW and fetal (5-min Apgar < 7, pH < 7.1, neonatal intensive care unit (NICU) admission, shoulder dystocia (ShD)) and maternal (obstetric intervention (OI): caesarean or vaginal operative delivery, obstetric anal sphincter injury syndrome (OASIS), postpartum hemorrhage (pph)) adverse outcomes were analyzed using univariate and multivariate logistic regression analyses. Results 12 396 women were included and 3479 (28.07 %) needed an OI. Multivariate analyses demonstrated significant contributions for the prediction of OI by soHC and soAC, whereas EFW did not reach significance. The highest OR was shown for soHC (1087, p < 0.001). ShD occurred in 73 (0.59 %) of the deliveries. Multivariate analyses showed that significant contributions for the prediction of ShD were provided only by soAC (OR 1460, p = 0.007). For the other maternal and neonatal adverse outcome parameters, no significant association with the biometric measurements could be demonstrated in the multivariate analyses. The overall detection rates for the prediction of adverse perinatal outcome by the different biometric parameters and EFW were poor. Conclusion Obstetric management decisions should not be based solely on measurements of biometric parameters or EFW.

scholarly journals Prediction of adverse effects of preeclampsia

2020 ◽  
Vol 9 (11) ◽  
pp. 4420
Author(s):  
Khushboo Tongaria ◽  
Ashok Kumar ◽  
Simar Kaur
Keyword(s):  
Gestational Age ◽  
Perinatal Outcome ◽  
Adverse Outcome ◽  
Neurological Complication ◽  
Normal Pregnancy ◽  
Adverse Outcomes ◽  
Normal Outcome ◽  
Gestational Age At Delivery ◽  
Study Population ◽  
Lost To Follow Up

Background: To predict the adverse maternal, perinatal and combined (both maternal and perinatal) outcome in preeclampsia by using various clinical and laboratory variables. Methods: Five hundred fifty women diagnosed with preeclampsia were included and twenty-four women were excluded from the study due to exclusion criteria, six women decline to participate, twenty women were lost to follow up, three women withdrew consent, so a total of 497 women were followed up in the study.Results: Mean age of study population was 26.82±4.48 years. Majority of women with preeclampsia delivered vaginally. Forty-five (9.05%) developed neurological complication. Mean gestational age at delivery (weeks) in patients who developed adverse outcome was 34.58±3.74 weeks and in patients with normal outcome is 38.62±1.59 weeks. Mean birth weight of newborns were 2.1±0.73 kg and 1.85±0.61 kg for newborns with adverse outcomes. Majority of perinatal complication was small for gestational age 267 (54.37%) followed by prematurity 262 (53.36%). Total number of adverse perinatal events was six hundred seventy-seven as multiple neonates had more than one perinatal outcome. In combined (both maternal and perinatal) adverse outcome-374 (75%) developed adverse outcome, 123 (25%) developed normal pregnancy outcome.Conclusion: This study found out simple clinical, biochemical tools for monitoring pregnant women and accurately identifying who was at greatest risk of severe complications. By identifying those women at highest risk of adverse maternal outcomes well before that outcome occurs, transportation and treatment can be targeted to those women most in need. This clinical prediction tool found to be an important contributor as it offers the potential to improve health outcomes of women for a condition that is at the root of a large amount of morbidity and mortality in the developing world.

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