Reference values for Ductus Venosus pulsatility index between 11 and 13 + 6 weeks of Gestation: A Single-center Observational Study in a Tertiary Care Hospital

Author(s):  
Somayeh Haji Ahmadi ◽  
Alireza Rezaei Adariani ◽  
Ehsan Amini

Abstract BackgroundThe ductus venosus pulsatility index(DVPI) has been evolved as an important marker of the first trimester screening sonography. The aim of this study is to define a reference for ductus venosus pulsatility index at 11–13 +6 weeks of gestation.MethodsIn this cross sectional observational study, 415 women with singleton pregnancies and crown lump length(CRL) between 45 and 84 mm were included. Exclusion criteria were abnormal biochemical screening results, presence of fetal structural malformation or chromosomal abnormalities such as thickened nuchal fold, abnormal perinatal outcomes, and newborns with a chromosomal abnormality. Transabdominal U/S was performed in all participants by an expert radiologist in obstetric sonography. CRL, nuchal translucency(NT), and blood flow indices of ductus venosus (DV) in each fetus were measured. The collected data were analyzed by IBM SPSS software version 20. Linear regression was performed to demonstrate the association between CRL DVPI. Further, 5th, 50th, and 95th percentiles of DV blood flow indices were calculated for each gestational age.ResultThe mean value of DVPI ranged from 1.05 at CRL 42mm to 1.3 at CRL 82mm. DVPI and CRL did not show any significant linear association (Regression coefficient B=0.001, R2=0.003, P=0.31)Conclusion: We defined means and ranges of DVPI, while determining the 5th, 50th, and 95th percentiles of DVPI for each CRL at our institution which were approximately similar to previous studies.

Author(s):  
Paras V. Dobariya ◽  
Parul T. Shah ◽  
Hina K. Ganatra

Background: Fetal, Neonatal and Maternal complications associated with pregnancy beyond 40 weeks have always been underestimated. However emerging evidence demonstrates that the incidence of complications increases after 40 weeks of gestation. The present study conducted to find out the fetomaternal outcome of such prolonged pregnancy.Methods: A prospective cross sectional study of 84 patients with uncomplicated prolonged pregnancy fulfilling the inclusion and exclusion criteria and admitted in department of obstetrics and gynecology at a tertiary care hospital. The aim of the study was to know fetomaternal outcome in pregnancy beyond 40 weeks in consideration of spontaneous and induced labour.Results: Out of 84 patients, 58 (69.05%) were in the age group of 20-30 years, 44 (52.38%) were between 41-42 weeks of gestation according to their LMP and 38(45.24%) were between 40-41 weeks of gestation. In 27 (32.14%) patients mode of delivery was caesarean section, in whom most common indication being fetal distress in 48.15% followed by failure to progress in 22.22%. In present study perinatal morbidity like IUFD, neonatal asphyxia, MAS, RDS were 4.76%, 9.52%, 7.14% and 3.57% respectively. Maternal morbidity like prolonged labor, PPH, fever, wound infection were 10.71%, 5.95%, 3.57% and 3.57% respectively.Conclusions: With Regular antenatal check-up, incidence of postdate pregnancy can be decreased and it is important because of definite risk to fetus as pregnancy continuing beyond 40 weeks of gestation is associated with increased perinatal morbidity and mortality especially those who do not come for regular antenatal check-up. Confirmation of diagnosis of exact term of pregnancy is very important as many patients don’t have regular menstrual history and LMP. Diagnosis can be confirmed by first trimester ultrasound which is most important non-invasive method and readily available.


Author(s):  
Srinivasa B. ◽  
Basavaraj C. Kotinatot

Background: The aim of this study is to evaluate the pattern and rational use of antibiotics in post-operative caesarean section (CS) inpatients in tertiary care teaching hospital, BIMS Belagavi.Methods: This cross sectional prospective observational study was conducted from December 2019 to February 2020, prior permission from institutional ethics committee was taken. Detailed data of post-operative caesarean section (CS) inpatients including age, diagnosis, line of management, complications and any adverse effects if occurred during the study was collected and entered in a specially designed proforma and MS word excel and analyzed by descriptive statistics like percentage.Results: Total 100 post-operative caesarean section inpatients were involved in the study. Most common indication for C-section was cephalopelvic disproportion. Average no of antibiotics per prescription was 3.32. Most commonly prescribed antibiotic was cefotaxime (27.71%) followed by gentamycin (25.90%) and metronidazole (24.59%). Majority (90%) of patients who admitted for ≤3 days (66%) had received combination antibiotic i.e., cefotaxime, metronidazole and gentamycin. IV fluids (21.21%) and analgesics (13.13%) were most frequently prescribed concomitant drugs. Majority (97.8%) of patients received parenteral preparation. 306 antibiotics (92.17%) used were from national model list of essential medicines (NLEM) and 332 antibiotics (100%). used were by generic name. Polypharmacy was 7.92.Conclusions: Cefotaxime was the most frequently prescribed antibiotic. Most of the antibiotics prescribed was rationally from NLEM and were by generic name.


2019 ◽  
Vol 10 (5) ◽  
pp. 524 ◽  
Author(s):  
Reetu Agarwal ◽  
Loknandani Sharma ◽  
Ajay Chopra ◽  
Debdeep Mitra ◽  
Neerja Saraswat

2020 ◽  
pp. 26-28
Author(s):  
Jayanta Saha ◽  
Kuntal Bhattacharyya ◽  
Shravan Kumar ◽  
Debarshi Jana

INTRODUCTION Metabolic syndrome is a constellation of several cardiovascular risk factors, and is defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria (2001) or the International Diabetes Federation (IDF) criteria (2005). 1, 2The prevalence of metabolic syndrome varies between 24.6 - 41% in different parts of Indian subcontinent and based on different criteria for metabolic syndrome. OBJECTIVES To assess epicardial adipose tissue (EAT) thickness by echocardiography in patients with metabolic syndrome, and find out if there is any association between EAT thickness and different cardiovascular risk factors. MATERIALS AND METHODS This cross-sectional observational study was conducted in a tertiary care hospital in India among patients attending the Medicine and Cardiology out-patient department (OPD) during the study period of six months from May 2018 to October 2018. Patients satisfying the diagnostic criteria of metabolic syndrome as per the IDF criteria (2005) were included in the study, as there are separate cut off points for waist circumference for South Asian population. Design: Cross-sectional observational study. Setting: Single centre study in a tertiary care teaching hospital. Participants: Initially 450 patients with metabolic syndrome as per International Diabetes Federation (IDF) criteria (2005) were screened. Patients having age above 65 years, deranged liver/renal function, ischemic heart disease, heart failure, malignancy, pregnancy, ascitis, poor echo window, history of endocrine disorders like Cushing Syndrome, glucocorticoid use, having any acute illness and those not giving consent were excluded. Final sample size was 397. For defining the normal EAT thickness in this geographic region, 50 age and gender matched healthy volunteers without any conventional cardiovascular risk factors (except age in some cases) acted as controls. Study period was six months. RESULT The mean value of EAT thickness in the control group was 2.97 (± 0.86) mm, hence the upper reference limit of EAT thickness in this study was taken as more than mean + 2SD, i.e. 4.69mm. Mean EAT thickness in patients suffering from metabolic syndrome was 5.48 ± 0.83 mm, which was significantly increased compared to controls. Taking 4.69mm as cut off, it was seen that 311 (78.34%) patients had increased EAT thickness >4.69mm. CONCLUSION Further studies with larger sample size and longitudinal design are required to establish the ability of EAT thickness to predict cardiovascular risk.


Author(s):  
Noor Jahan ◽  
Swastika Singh Chandel ◽  
Deepak Chopra ◽  
Arshiya Khan ◽  
Razia Khatoon

Background: Syphilis is a sexually transmitted disease caused by bacteria named Treponema palladium, subsp. pallidum. Nearly 1.36 million pregnant women are known to be affected by syphilis in the developing countries. When left untreated syphilis during pregnancy can result in adverse fetal outcomes such as spontaneous abortion and stillbirth. Objective of the study was present study was done to evaluate the seroprevalence of syphilis among pregnant females attending Antenatal Clinic (ANC).Methods: A hospital based cross-sectional study was done over a period of six months from January to June 2019. A total of 132 pregnant females were included in the study who attended Antenatal Clinic for routine checkup whose blood samples were sent to Microbiology Laboratory for screening for syphilis by Rapid Plasma Reagin (RPR) test.Results: Out of 132 samples of pregnant females screened for syphilis, none of the sample was found reactive for syphilis by RPR test. Maximum patients (57.6%) belonged to age group 20-25 years followed by (27.3%) of 26-30 years. 30.3% patients belonged to urban areas and 69.7% patients belonged to rural areas. Majority of patients (80.3%) belonged to first trimester, followed by (18.9%) patients to second trimester and (0.8%) patients to third trimester. 78.8% patients were from lower socio-economic class followed by 12.9% patients from middle class and 8.3% patients from upper class.Conclusions: Although zero percent syphilis prevalence was observed in this study, it is recommended that free screening for syphilis should be offered to all pregnant females visiting Antenatal Clinic.


Author(s):  
Sharmin Khan ◽  
Ram N. Maiti ◽  
Sekhar Mandal

Background: Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases and is the single most important risk factor for stroke. Despite different guidelines for management of hypertension like Joint National Committee, British Hypertension Society, National Institute for Health and Care Excellence; there are still the clouds of controversy. The objective of the study was to evaluate the prescribing pattern of antihypertensive drugs among the patients attending medicine outpatient department of a tertiary care teaching hospitalMethods: A cross-sectional, observational study was conducted in our hospital over a period of six months. Relevant information was collected from medical records of 209 hypertensive patients fulfilling inclusion criteria. The collected data were sorted and analyzed.Results: Out of 209 patients, maximum were of age group of 45-65 years (55.02%). 115 (55.02%) were male and 94 (44.97%) were female. Diabetes mellitus (24.4%) was the most common associated disease with hypertension. Most of the patients had received single antihypertensive drugs (49.28%). Among the monotherapy category calcium channel blocker (82.78%) was the most commonly prescribed antihypertensive drug class followed by angiotensin receptor blocker (36.36%). Amlodipine (81.82%) was the most common among calcium channel blockers. The most frequent fixed drug combination prescribed consisted of amlodipine and atenolol. Most of the drugs were prescribed in generic name (90.9%).Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines.


Author(s):  
ASHWANI UMMAT ◽  
RANJODH JEET SINGH ◽  
SONIA KOCHHAR

Objective: The objective of the study is to analyze the prescription pattern of drugs for osteoarthritis (OA) in a north Indian medical college collaborated with a tertiary care hospital. Methods: An observational study was conducted on 300 patients diagnosed with OA in the department of orthopedics in collaboration with the department of pharmacology, and thus, prescription was collected as in a cross-sectional manner for 6 months and the same were analyzed in the Department of Orthopedics in tertiary care hospital collaborated with medical college. Results: The average age of patients participating in this present study was 56.46±7.4 years with affected age group of 46-60 years. 60 % of females were affected by osteoarthritis outnumbering male (40 %) patients in this present study. The most commonly involved joint was knee joint (87.33 %) in patients diagnosed with osteoarthritis followed by back (6.67 %) and hip joint (6%). The combination therapy (90 %) outweighed monotherapy (10 %) with preferred route of drug administration as oral route (90 %) followed by topical route (10 %). The average number of drugs prescribed for patients of osteoarthritis was 2.62±0.76. This present study concludes that NSAIDs (45.8%) were prescribed most commonly. However, the drug paracetamol was lesser prescribed and other drugs such as Diclofenac (27.22 %) and acetaminophen (34.44 %) most of all followed by Nimesulide (16.67 %), ibuprofen (13.33 %) and Rofecoxib/valdecoxib (8.33 %) were prescribed. Conclusion: This present study concludes that NSAIDs were most commonly prescribed as p-drugs while paracetamol was undermined prescribed.


Author(s):  
Nuno Montenegro ◽  
Alexandra Matias

ABSTRACT Ductus venosus (DV) is a tiny vessel with a central role in fetal circulation both in singletons and multiples. In the present review we detail the contribution of DV evaluation in twin pregnancies in the first trimeter of pregnancy. The higher prevalence of abnormal A-wave in fetuses with abnormal karyotype and/or cardiac defects made DV evaluation a useful marker for the screening of chromosomal abnormalities and fetal cardiac anomalies. In dichorionic (DC) pregnancies, DV blood flow assessment reproduces the role of NT in the screening for aneuploidies, just as in singleton pregnancies. In monochorionic (MC) twin pregnancies, the Doppler assessment of DV blood flow improves the detection of those at higher risk of developing twin-to-twin transfusion syndrome or growth discrepancy later in pregnancy. As for singletons, DV should be systematically evaluated in all first trimester scans for a more performant screening in multiples. How to cite this article Matias A, Montenegro N. Improving our Knowledge in Twins: The Role of Ductus Venosus in the First Trimester. Donald School J Ultrasound Obstet Gynecol 2013;7(4):409-414.


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