Sonographic Assessment of the Fetal Heart Circumference as a Predictor of the Gestational Age

Introduction: Ultrasound is a non-invasive imaging modality, safe for both the mother and the fetus, which uses a high frequency sound to generate images of body tissues and organs. It has been widely used for fetal evaluation and dating. Purpose: To determine normative values of fetal heart circumference (FHC) as a predictor of the gestational age (GA) in black population and compare it to those of the Caucasian population. Material and Methods: A prospective cross-sectional study was carried at the University of Maiduguri Teaching Hospital (UMTH), Nigeria. 324 women with a singleton pregnancy between 12-40 weeks, who conceived naturally, were scanned using a 2D ultrasound machine with a 3.5 MHz curvilinear probe. Two fetal heart diametersat right angle to each other were taken at the level of the four-heart chamber view, during diastole. Results: There is a strong positive linear correlation between the FHC and the GA (r2= 0.964, p<0.001). The equation of GA prediction is Y=0.246X + 5.06 (where y=GA, X=FHC). FHC weekly growth rate is 3.81mm. FHC is more accurate between 12-20 weeks GA and its accuracy decreases as the pregnancy progresses. There is a strong correlation between FHC and biparietal diameter (BPD) (r2=0.959), HC(r2=0.946) and FL (r2= 0.962). Conclusion: The study has derived a nomogram of FHC as a predictor of the GA in Nigerian population and has shown that the FHC is a good predictor of GA especially in the early second trimester. Also, there was a statistically significant difference between the FHC in our study population (blacks) and those of the Caucasian population.

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Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

10.33798/ajmas2019/00265. ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-18

Author(s):

Chijioke Okeudo ◽

B.U. Ezem

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Cross Sectional Study ◽

Fluid Volume ◽

Singleton Pregnancy ◽

Cross Sectional ◽

South Eastern ◽

Amniotic Fluid Volume ◽

The Mean ◽

Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

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Reference values for fetal heart rate in cattle in the first trimester of pregnancy

Acta Veterinaria Hungarica ◽

10.1556/004.2019.028 ◽

2019 ◽

Vol 67 (2) ◽

pp. 274-281

Author(s):

Lea Lénárt ◽

Marcel Taverne ◽

Peter Wolleswinkel ◽

Zoltán Gubik ◽

László Molnár ◽

...

Keyword(s):

Heart Rate ◽

Fetal Heart Rate ◽

Fetal Heart ◽

First Trimester ◽

Reference Curve ◽

Singleton Pregnancy ◽

Array Transducer ◽

Significant Difference ◽

Bovine Fetuses ◽

First Trimester Of Pregnancy

The aim of this study was to create a fetal heart rate (FHR) reference curve for singleton bovine fetuses in the first trimester of gestation and to determine its possible relationship with the outcome of pregnancy. Forty-eight Holstein-Friesian cows with one fetus and five cows with twins were used. Fetal heart beatings were recorded on videotape during transrectal scanning with a 5 and/or 7.5 MHz linear array transducer on a weekly basis between Days 40 and 95 of gestation. FHR was calculated by averaging the results of five counts of the same record by the same observer. For singleton pregnancies, a reference curve was created using the mean, the standard deviation (SD) and the 5th and 95th percentiles. The FHR increased from Days 40–46 (173 beats/min) to Days 61–67 (183 beats/min). After a peak, the FHR decreased slowly until Days 89–95 (175 beats/min), while the SD increased. There was no significant difference between singleton and twin fetuses. in the aborted and lost fetuses in twin gestation due to fetal reduction, both bradycardia and tachycardia were detected compared to the singleton pregnancy reference curve.

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Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0342 ◽

2020 ◽

Vol 48 (2) ◽

pp. 144-152

Author(s):

Mariana Biancardi ◽

Renato Augusto Moreira de Sa

Keyword(s):

Strain Rate ◽

Gestational Age ◽

Speckle Tracking ◽

Age Groups ◽

Cross Sectional Study ◽

Observer Agreement ◽

Cross Sectional ◽

Strain And Strain Rate ◽

Significant Difference ◽

Myocardial Fibers

AbstractObjectiveTo analyze the behavior of fetal longitudinal myocardial fibers assessed by speckle tracking (STE) after fetal viability.MethodsA cross-sectional study was performed in 156 women with normal singleton pregnancies from 22 to 31 weeks of gestation. Strain (S) and strain rate (SR) values were measured in both ventricles during the fetal cardiac cycle. The population was divided into five gestational age groups based on 2-week intervals. The correlations of maternal variables with the S and SR variables and intra-observer analysis were performed.ResultsThere was a significant difference in the S and SR values of the left ventricle (LV) among the gestational age groups (P = 0.007). Significantly higher S and SR values were observed in early age groups demonstrating reductions in LV S and SR values at 26 weeks, followed by stabilization. For the right ventricle (RV), there was no significant difference between gestational age groups. Significant intra-observer agreement was observed for S values of the RV (P = 0.008) and LV (P = 0.0004) and SR values of the RV (P = 0.0001) and LV (P = 0.015).ConclusionDecreases in the S and SR values of the LV occurred after 26 weeks, followed by stabilization. No significant difference was observed in the S or SR value of the RV among the gestational age groups, and no significant association of any maternal variable evaluated with S and SR values was observed. Significant intra-observer agreement was obtained among the results.

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Structural and Functional Changes in Maternal Heart during Pregnancy: An Echocardiographic Study

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0038-1624065 ◽

2017 ◽

Vol 02 (04) ◽

pp. 072-076

Author(s):

Sunanda Kasula ◽

Sumalatha Beeram ◽

Ramakrishna Janapati ◽

Indrani Garre

Keyword(s):

Blood Pressure ◽

Gestational Age ◽

Systolic Function ◽

Interventricular Septum ◽

Clinical History ◽

Left Ventricular ◽

Two Dimensional ◽

Cross Sectional ◽

Functional Changes ◽

Significant Difference

Abstract Background Pregnancy is associated with profound physiologic alterations in the maternal cardiovascular system. This study aimed to investigate maternal cardiac performance during normal pregnancy by two-dimensional echocardiography parameters and various functional and structural alterations. Methods This was a cross-sectional study of 100 normal pregnant women who attended the antenatal clinic, and all participants had clinical history, physical examination, and 12-lead electrocardiogram. Two-dimensional, M-mode, and Doppler echocardiography was done. Echocardiographic parameters were compared with normal age-matched controls from previously published studies. Results The mean age of the study group was 23.35 ± 3.05 years, mean systolic blood pressure was 110.5 ± 8.69 mm Hg, and mean diastolic blood pressure was 71.6 ± 6.77 mm Hg. There was an increase in left atrial (LA) diameter, left ventricular end diastolic diameter, and interventricular septum (IVS) thickness as gestational age advanced. There was a gradual decrease in E-wave velocity, and E/A ratio increased during the second trimester and decreased during the third trimester. The E-wave deceleration time increased with gestational age There was no statistically significant difference between IVS thickness and E/A ratio (p = 1.000). Conclusion Cardiac chamber dimensions, LV wall thickness, and LA size, most indices of systolic function although within normal range, were significantly higher in pregnant Asian Indian women than in the controls. This study shows that the subtle reduction in myocardial compliance appears as an adaptive response to changes of preload, afterload, and LV geometry.

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Extended-Interval Gentamicin Dosing in Achieving Therapeutic Concentrations in Malaysian Neonates

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-20.2.119 ◽

2015 ◽

Vol 20 (2) ◽

pp. 119-127

Author(s):

Yee Shan Low ◽

Sin Li Tan ◽

Angeline SL Wan

Keyword(s):

Body Weight ◽

Gestational Age ◽

Trough Concentration ◽

Elimination Rate ◽

Dose Interval ◽

Pharmacokinetic Analysis ◽

Pharmacokinetic Parameters ◽

Creatinine Concentration ◽

Cross Sectional ◽

Significant Difference

OBJECTIVE: To evaluate the usefulness of extended-interval gentamicin dosing practiced in neonatal intensive care unit (NICU) and special care nursery (SCN) of a Malaysian hospital. METHODS: Cross-sectional observational study with pharmacokinetic analysis of all patients aged ≤28 days who received gentamicin treatment in NICU/SCN. Subjects received dosing according to a regimen modified from an Australian-based pediatric guideline. During a study period of 3 months, subjects were evaluated for gestational age, body weight, serum creatinine concentration, gentamicin dose/interval, serum peak and trough concentrations, and pharmacokinetic parameters. Descriptive percentages were used to determine the overall dosing accuracy, while analysis of variance (ANOVA) was conducted to compare the accuracy rates among different gestational ages. Pharmacokinetic profile among different gestational age and body weight groups were compared by using ANOVA. RESULTS: Of the 113 subjects included, 82.3% (n = 93) achieved therapeutic concentrations at the first drug-monitoring assessment. There was no significant difference found between the percentage of term neonates who achieved therapeutic concentrations and the premature group (87.1% vs. 74.4%), p = 0.085. A total of 112 subjects (99.1%) achieved desired therapeutic trough concentration of <2 mg/L. Mean gentamicin peak concentration was 8.52 mg/L (95% confidence interval [Cl], 8.13–8.90 mg/L) and trough concentration was 0.54 mg/L (95% CI, 0.48–0.60 mg/L). Mean volume of distribution, half-life, and elimination rate were 0.65 L/kg (95% CI, 0.62–0.68 L/kg), 6.96 hours (95% CI, 6.52–7.40 hours), and 0.11 hour−1 (95% CI, 0.10–0.11 hour−1), respectively. CONCLUSION: The larger percentage of subjects attaining therapeutic range with extended-interval gentamicin dosing suggests that this regimen is appropriate and can be safely used among Malaysian neonates.

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Transverse cerebellar diameter: a reliable predictor of gestational age

African Health Sciences ◽

10.4314/ahs.v20i4.51 ◽

2020 ◽

Vol 20 (4) ◽

pp. 1927-32

Author(s):

Sanjay Mishra ◽

Surajit Ghatak ◽

Pratibha Singh ◽

Dushyant Agrawal ◽

Pawan Garg

Keyword(s):

Gestational Age ◽

Indian Population ◽

Cross Sectional Study ◽

Abdominal Circumference ◽

Sectional Study ◽

Ethnic Population ◽

Cross Sectional ◽

Femur Length ◽

Biparietal Diameter ◽

Significant Difference

Objectives: To determine accuracy of transverse cerebellar diameter (TCD) measurement in the prediction of gestational age (GA) in normal fetuses; to develop reference chart for TCD according to GA in Indian population. Design: A retrospective cross-sectional study. Method: Ultrasonographic measurements in 300 singleton pregnant women included biparietal diameter (cm), head circum- ference (cm), abdominal circumference (cm), femur length (cm) and transverse cerebellar diameter (cm). Reference chart with mean TCD for corresponding gestational age (GA) in weeks was developed. Results: Statistically significant relationship found between TCD and gestational age (R2=0.92, p=0.0006). Regression for- mulae based on TCD with other parameter can be used to predict gestational age of foetus. When TCD is compared with findings in other studies in different ethnic population, it is found that there is significant difference exists. Conclusion: In normally developing fetuses the TCD has linear correlation with advancing gestational age. A separate refer- ence chart is required for every different population because ethnicity, nutrition and environmental factors can have impact on normal TCD values. This will help to avoid misinterpretation of data to determine gestational age. Keywords: Transverse cerebellar diameter; ultrasonography; gestational age.

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Difference in The Incidence Severe Preeclampsia and Eclampsia between Maternal Age 20-34 Years and >34 Years in dr. Soebandi Hospital Jember

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v3i2.5065 ◽

2017 ◽

Vol 3 (2) ◽

pp. 18

Author(s):

Muhammad Fakhri Ali ◽

Yonas Hadisubroto ◽

Jauhar Firdaus

Keyword(s):

Data Analysis ◽

Mortality Rate ◽

Maternal Mortality ◽

Gestational Age ◽

Maternal Age ◽

Advanced Maternal Age ◽

Severe Preeclampsia ◽

Cross Sectional ◽

Maternal Mortality Rate ◽

Significant Difference

Maternal Mortality Rate (MMR) in Indonesia is still high. The maternal mortality rate continues to rise due to hypertension, one of which is caused by pre-eclampsia and eclampsia. Many factors cause preeclampsia, including advanced maternal age. The purpose of this study was to determine the effect of advanced maternal age during pregnancy with severe preeclampsia and eclampsia in RSD dr. Soebandi Jember. This study used cross sectional approach using 264 samples were divided into two groups, there are pregnant women aged 20-34 years and >34 years. The results of data analysis using Chi Square for severe preeclampsia and obtained p = 0.015 and OR = 2.494, which means there is a significant difference in comparison severe preeclampsia between gestational age of 20-34 years and >34 years. At the age of 20-34 years from 216 samples found 28 people suffering from severe preeclampsia (12.9%). Whereas at the age of mother> 34 years of 48 people found 13 people (27.1%) suffered severe preeclampsia Results of data analysis obtained eclampsia using Fisher and p = 0.554, which means there are no significant differences in comparison eclampsia between gestational age of 20-34 years and >34 years. At the age of 20-34 years from 216 samples found 3 people suffering from eclampsia (1.38%). While at mother age> 34 years from 48 people found 1 person (2.08%) suffered eclampsia.

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Normal interpupillary, inner canthal distance and outer canthal distance in a normal population of Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.288 ◽

2019 ◽

Vol 35 (1) ◽

Author(s):

Nausheen Hayat ◽

Saba Alkhairy ◽

Alyscia Cheema ◽

Muneeb Ehsan ◽

Muhammad Athar Khan

Keyword(s):

Normal Population ◽

Age Groups ◽

Geographical Location ◽

Normative Values ◽

Anthropometric Measures ◽

Cross Sectional ◽

Pakistani Population ◽

Mean Values ◽

Significant Difference ◽

The Mean

Objective: This study was conducted to quantify the normal indices of anthropometric measures related to ophthalmology including Interpupillary distance (IPD), Inner canthal distance (ICD), Outer canthal distance (OCD) in a normal, healthy Pakistani population. Methods: This is a cross sectional study. Total 500 patients were chosen randomly but 499 were included in this study. Patients were selected randomly in an outpatient department of Jinnah Post Graduate Medical Centre Karachi, over the period of five months. IPD, ICD & OCD all measurements were taken with the help of plastic rule by only one researcher to minimize chances of error as much as possible. IPD was reconfirmed from auto refractometer while ICD and OCD readings were taken twice by occluding one eye of researcher to reduce error. Participants were divided into four categories on basis of: Age, Gender, ethnicity and geographical location. Patients were further categorized on basis of Ethnicity to Urdu Speaking, Sindhi, Punjabi, Pathan, and others. Moreover, four age groups were drawn ranging from 15-24 years, 25-44 years, 45-64 years and 65 years and greater. Results: Our study comprised a total of 499 patents of which 272(54.5%) were males, and 227(45.5%) were females. The mean age of the participants was 39.3 ± 14.5 years. The mean values for the IPD, ICD and OCD in mm were 61.8 ± 6.2, 30.9 ± 2.9 and 85.2 ± 6.6 respectively. A statistically significant difference was observed between IPD, ICD and OCD Indices among male and female study participants (p<0.001, p=0.043, p<0.001). While comparing the IPD, ICD and OCD indices amongst the different ethnic groups, we found no statistically significant difference (p=0.09. p=0.28, p=0.06). Overall, there was no correlation between the age and other variables i.e. IPD, ICD, OCD, (r = 0.07, p = 0.085), (r = 0.005, p = 0.906), (r = -0.08, p = 0.058). Conclusion: This work has recommended normative values of IPD, ICD and OCD in Pakistani population on the basis different variables including gender, age, and ethnicity. How to cite this:Hayat N, Alkhairy S, Cheema A, Ehsan M, Khan MA. Normal interpupillary, inner canthal distance and outer canthal distance in a normal population of Pakistan. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.288 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Scintigraphic evaluation of cheek teeth in clinically sound horses

Veterinary Record ◽

10.1136/vr.105459 ◽

2019 ◽

Vol 185 (15) ◽

pp. 481-481 ◽

Cited By ~ 1

Author(s):

Marcin Szulakowski ◽

Mahmoud Mageed ◽

Tim Steinberg ◽

Karsten Winter ◽

Kerstin Gerlach

Keyword(s):

Diagnostic Imaging ◽

Imaging Modality ◽

Age Groups ◽

Age Effect ◽

Reference Region ◽

Mandibular Ramus ◽

Cross Sectional ◽

Significant Difference ◽

Dental Diseases ◽

Radioisotope Uptake

Dental disorders are one of the top-ranking clinical domains in equine practice. Scintigraphy has emerged as a useful diagnostic imaging modality for equine dental diseases. There is a paucity of the normal scintigraphic uptake and its correlation with age. This prospective, cross-sectional, descriptive and pilot-designed study aimed to describe the radioisotope uptake (RU) patterns of the reserved crown and periodontal bone of the maxillary and mandibular cheek teeth (CT) in clinically sound horses and to evaluate the age effect on RU. For this purpose, 60 horses that underwent a bone scintigraphy for reason unrelated to head were included and divided equally into four age groups. Regions of interests (ROIs) were positioned around alveolar and periodontal bone of each maxillary and mandibular CT including their reserve crown, and a reference ROI positioned at the mandibular ramus. The count per pixel of each ROI was measured using a dedicated software and the RU ratio relative to the reference region was calculated. The results showed that the maxillary and mandibular CT had a standard RU pattern, where it increased from rostral to caudal, and peaked in the middle of dental arcades and decreased slightly towards the last CT. The maxillary CT had a higher RU compared with the mandibular CT, and there was no significant difference in the maxillary and mandibular CT uptake between age groups. This information may aid veterinarians evaluating potentially abnormal dental scintigraphy.

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Prevalence of Lower Back Pain in Pregnant Women with Pre-Eclampsia

10.53350/pjmhs211592773 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2773-2776

Author(s):

Parveen Shafi ◽

Rahim Khan ◽

Tariq Ahmad ◽

Syed Alam Zeb ◽

Ahsan Sajjad

Keyword(s):

Back Pain ◽

Pregnant Women ◽

Lower Back Pain ◽

Gestational Age ◽

Domestic Work ◽

Cross Sectional ◽

Lower Back ◽

Group I ◽

Significant Difference ◽

Group Ii

Objective: The aim of this study is to determine the prevalence of lower back pain in pregnant women with pre-eclampsia. Study Design: Cross sectional study Place and Duration: Mardan Medical Complex/BKMC, Tahseel Headquarter Hospital, Takht Bhai Mardan, Swabi Medical Complex /GKMC, from October 2019 to October 2021. Methods: Total 160 pregnant women were presented in this study. Patients were aged between 18-45 years. Detailed demographics of enrolled cases age, body mass index, gestational age, and residency and education status were calculated after taking informed written consent. Patients were divided into two groups. Group I had 80 patients with pre-eclampsia and group II had 80 patients with normotensive. Gravidity among both groups was assessed. Symptoms and prevalence of lower back pain among both groups were assessed and compared. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients in group I was 27.09±5.66 years with mean gestational age 33.14±7.41 weeks while in group II mean age was 26.55±8.26 years with mean gestational age 32.47±8.33 weeks. Thirty seven patients (46.3%) in group I was primigravida and 40 (50%) in group II was primigravida. Thirty nine patients (48.8%) had urban residency in group I and in group II thirty seven (46.3%) cases were from urban area. Frequency of literacy among both groups were 42 (52.5%) and 44 (55%). Prevalence of lower back pain in group I was 55 (68.8%) higher as compared to group II 53 (66.3%) with no any significant difference. Domestic work was the most common cause among both groups followed by social work (Job), lifting of heavy object and medication pain. Conclusion: We concluded in this study the prevalence of lower back pain among pregnant women was significantly high among both pre-eclampsia and normotensive cases. Most common causes of lower back among women was domestic work. Health professionals must be proactive in diagnosing LBP and providing proper management due to the enormous impact of it on the quality of life. Keywords: Pregnant Women, Low Back Pain, Prevalence, Symptoms, causes.

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