scholarly journals A retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetry

2019 ◽  
Vol 8 (12) ◽  
pp. 2736
Author(s):  
Kedar N. Ganla ◽  
Rana A. Choudhary ◽  
Kavita N. Desai ◽  
Santoshi B. Kadam ◽  
Krutika Arunachalam
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Morbidity And Mortality ◽  
Sildenafil Citrate ◽  
Common Finding ◽  
Interventional Study ◽  
Intrauterine Growth

Background: Intrauterine growth restriction (IUGR) is one of the major reasons for neonatal morbidity and mortality. Oligohydramnios is a common finding in IUGR. In majority of these cases diminished utero-placental blood flow is observed. However, in spite of this understanding and identification of high-risk patients, the management options are limited. Sildenafil citrate, a phosphodiesterase type-5 inhibitor improves utero-placental perfusion.Methods: We present a retrospective interventional study involving 50 adult pregnant women diagnosed with early-onset IUGR (n=38) and oligohydramnios (n=12). Vaginal sildenafil citrate 25 mg t.i.d. was started from the day of diagnosis till delivery. Primary efficacy endpoints included changes in Doppler parameters i.e., amniotic fluid index (AFI), uterine artery (UA)- pulsatility index (PI), resistance index (RI) and systolic diastolic ratio (S/D ratio). Secondary endpoints included live birth, birth weight, Apgar score at birth, neonatal survival to hospital discharge and adverse maternal side effects.Results: There was a statistically significant improvement in UA-PI, RI and S/D ratios (p<0.0001) in all cases. In oligohydramnios cases, treatment showed a statistical significant increase in AFI score (2.86±1.33 cm). The mean birth weight on delivery was 2200 gm with good Apgar scores. No major adverse effects were reported by women using sildenafil citrate vaginally.Conclusions: Sildenafil citrate, by increasing utero-placental perfusion, improves uterine artery Doppler patterns, AFI, fetal weight and overall better neonatal survival rates by reducing neonatal morbidity and mortality. Sildenafil citrate may hold a promising treatment strategy for management of IUGR and oligohydramnios.

scholarly journals Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Health And Disease ◽  
Neonatal Problems

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.

Intrauterine growth retardation (upavishataka garbhavyapad) and it’s ayurved and modern management – review of literatures.

2020 ◽  
Vol 8 (02) ◽  
Author(s):  
Snehal Snehal
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Intrauterine Growth Retardation ◽  
Modern Science ◽  
Neonatal Morbidity ◽  
Signs And Symptoms ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Basic Principles ◽  
Intrauterine Growth

According to modern science , intrauterine Growth Restriction (IUGR) is an important causes of fetal and neonatal morbidity and mortality.    In IUGR development and maturity of foetus delayed or impaired . Fetal growth restriction is said to be present in those babies whose birth weight is below the 10th percentile of the average for the gestational age. Growth restriction can occure in preterm , term, or post term babies.(1)  Placental insufficiency or utero placental insufficiency is most imp. Cause of intrauterine growth restriction.    The signs and   symptoms of IUGR and Upavishtaka are same .In Ayurveda Upavishtak is described under Garbhavyapads.In ayurvedic literature , there are many natural formulations ,various drugs have been described  for treatment is based upon basic principles such as rasa , guna ,veerya,vipak of drugs.Hence to study the consept of IUGR (upavishtaka) according to modern and Ayurveda; this topic has been selected for study.

First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

2004 ◽  
Vol 191 (6) ◽  
pp. S22
Author(s):  
Lorraine Dugoff ◽  
John Hobbins ◽  
Vincent Faber ◽  
Fergal Malone ◽  
Michael Belfort ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
First Trimester ◽  
Growth Restriction ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth

scholarly journals Physical activity during pregnancy and fetal outcomes: a case-control study

2010 ◽  
Vol 44 (1) ◽  
pp. 90-101 ◽  
Author(s):  
Monica Yuri Takito ◽  
Maria Helena D'Aquino Benício
Keyword(s):  
Physical Activity ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Case Control Study ◽  
Growth Restriction ◽  
P Value ◽  
Intrauterine Growth ◽  
Control Study

OBJECTIVE: To investigate the relationship between physical activity during the second trimester pregnancy and low birth weight, preterm birth, and intrauterine growth restriction. METHODS: Case-control study including 273 low birth weight newborns and 546 controls carried out in the city of São Paulo, Southeastern Brazil, in 2005. Low birth weight cases were grouped into two subsamples: preterm birth (n=117) and intrauterine growth restriction (n=134), with their related controls. Information was collected by means of interviews with mothers shortly after birth and transcription of medical records. Data were analyzed using conditional multiple and hierarchical logistic regression. RESULTS: Light physical activity for over 7 hours per day was shown to be protective against low birth weight (adjusted OR=0.61; 95% CI 0.39-0.94) with a dose-response relationship (p-value for trend=0.026). A similar trend was found for intrauterine growth restriction (adjusted OR=0.51; 95% CI 0.26-0.97). Homemaking activities were associated as a protective factor for both low birth weight and preterm birth (p-value for trend=0.013 and 0.035, respectively). Leisure-time walking was found to be protective against preterm birth. CONCLUSIONS: Mild physical activity during the second trimester of pregnancy such as walking has an independent protective effect on low birth weight, preterm birth, and intrauterine growth restriction.

Civil unrest linked to intrauterine growth restriction in western Kenya

2014 ◽  
Vol 5 (5) ◽  
pp. 370-373
Author(s):  
E. Dybjer ◽  
J. Linvik ◽  
P. M. Nilsson
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Epidemiological Data ◽  
Control Area ◽  
Growth Restriction ◽  
Western Kenya ◽  
Civil Unrest ◽  
Intrauterine Growth ◽  
Control Hospital ◽  
Mount Elgon

Risk factors associated with intrauterine growth restriction (IUGR) have previously been identified, but few studies have described the relationship between IUGR and maternal stress caused by exposure to civil unrest. Here, we investigate this relationship during the Mount Elgon crisis in western Kenya between 2006 and 2008, following a period of violence. Birth weight data were compared between three hospitals in an exposed area, Mount Elgon (n=570), and one hospital in a control area, Kimilili (n=530). In a sub-analysis, the most stress exposed hospital, Bungoma West (n=211), was compared with the control hospital in Kimilili. Adjustments were made for offspring sex, gestational age and parity. The difference in mean birth weight between the most stress-exposed hospital (Bungoma West) and the control hospital (Kimilili) was 91 g after full adjustment (P=0.041). In conclusion, epidemiological data suggest a significant relationship between exposure to civil unrest and IUGR causing lower birth weight.

scholarly journals Prediction of Intrauterine Growth Restriction in High Pulsatility Index of Uterine Artery

2017 ◽  
Vol 22 (2) ◽  
pp. 1-6
Author(s):  
Nidhi Sharma ◽  
Sunayana Srinivasan ◽  
Krishnamurthy Jayashree ◽  
Kulasekaran Nadhamuni ◽  
Meenakshi Subbiah ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Intrauterine Growth

scholarly journals UTERINE ARTERY DOPPLER INDICES AS PREDICTIVE MEASURES FOR THE PRE-ECLAMPSIA AND INTRAUTERINE GROWTH RESTRICTION

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
MN Rashid ◽  
M Kari ◽  
R Rashid ◽  
MA Rana ◽  
A Amjad ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Cross Sectional Survey ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth ◽  
Pregnant Females ◽  
Doppler Indices

Preeclampsia and Intrauterine growth restriction (IUGR) remains as the important causes for the neonatal and maternal complications leading to even death in some cases. Uterine artery Doppler USG can be done transvaginally or trans abdominal and performed in the 1st or 2nd trimester of the pregnancy to detect these complications Doppler waveform suggested the high vascular resistance to blood flow. In our present study, we conclude uterine artery Doppler indices as prognostic procedure for the preeclampsia and intrauterine growth restriction. A cross-sectional survey design with convenient sampling technique was used. Mixture of standardized and self-modified structured questionnaire was undertaken to determine the indices of pre eclampsia and IUGR by uterine artery. The data was collected from Bahria International Hospital, Lahore during the period of 9 months. This study was included 162 pregnant females with identification of the main uterine artery on a longitudinal scan lateral to the uterus.  Initial diastolic notch of right and left side of the uterine artery waveforms was recorded. At every antenatal checkup, urine was tested for protein and blood pressure readings were taken to identify preeclampsia. Further analysis was done dividing patients as normotensive and those patients developing hypertension after 30 weeks of gestation. After delivery neonates observed for IUGR by head circumference and body weight. The study was concluded that from the total sample size of 162 pregnant females who undergoes uterine artery Doppler, 34% females shows diastolic notch and almost all of these later diagnosed with preeclampsia and 19.8% deliver babies with IUGR. So, based on the study, we have concluded that uterine artery Doppler is helpful to provide diagnosis of preeclampsia and IUGR in early pregnancy.

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