scholarly journals Mid-Trimester Scan is better for Detecting Congenital Anomalies: An Experience from Dhulikhel Hospital

2020 ◽  
Vol 18 (1) ◽  
pp. 100-104
Author(s):  
Suman Raj Tamrakar ◽  
Rubina Shrestha
Keyword(s):  
Congenital Anomalies ◽  
Termination Of Pregnancy ◽  
Singleton Pregnancy ◽  
Management Options ◽  
Predictive Values ◽  
New Born ◽  
Elective Delivery ◽  
Valuable Method ◽  
Major Congenital Anomaly ◽  
The Cost

Introduction: Ultrasound is a valuable diagnostic tool for detecting the congenital anomalies in the fetus. Congenital anomalies are detected in 14% of new born. Major anomalies are detected in 2 to 5% of new born. This accounts for 20 % to 30% of total perinatal deaths. Prenatal diagnosis provides variety of management options for the pregnant women ranging from termination of pregnancy, elective delivery or intrauterine manipulation of the anomalies. Aims: To determine the prevalence of the fetal congenital anomalies at 20- 24 weeks ultrasonography. Methods: This is prospective study conducted at Dhulikhel Hospital. Pregnant ladies with singleton pregnancy at 20 to 24 weeks were enrolled for transabdominal ultrasound for detecting congenital anomalies. Results: Of 1027 pregnant ladies screened, anomalies were detected in 31 ladies during mid trimester ultrasound. The overall prevalence of congenital anomalies detected in our study is 3.02% (31 cases), which has sensitivity of 87.8%, specificity of 99.7% and positive predictive values of 93.5%. In our study, mean gestational age during scan was 21+5 weeks of gestation. And 13 pregnant ladies pregnancies were terminated between 20-24 weeks for having major congenital anomaly in fetus. Conclusion: Mid trimester ultrasonography is a valuable method for pregnant ladies to detect the congenital anomalies in fetus. When major anomalies are detected, timely termination of pregnancy have saved the cost and tragedy of losing viable fetus.

scholarly journals Evaluation of StrepBSelectChromogenic Medium and the Fast-Track Diagnostics Group B Streptococcus (GBS) Real-Time PCR Assay Compared to Routine Culture for Detection of GBS during Antepartum Screening

2017 ◽  
Vol 55 (7) ◽  
pp. 2137-2142 ◽  
Author(s):  
Deirdre L. Church ◽  
Heather Baxter ◽  
Tracie Lloyd ◽  
Oscar Larios ◽  
Daniel B. Gregson
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Fast Track ◽  
Group B Streptococcus ◽  
Culture Method ◽  
Predictive Values ◽  
Content Type ◽  
Standard Culture ◽  
Group B ◽  
The Cost

ABSTRACTLife-threatening infection in neonates due to group BStreptococcus(GBS) is preventable by screening of near-term pregnant women and treatment at delivery. A total of 295 vaginal-rectal swabs were collected from women attending antepartum clinics in Calgary, Alberta, Canada. GBS colonization was detected by the standard culture method (Strep B Carrot Broth subcultured to blood agar with a neomycin disk) and compared to recovery with Strep Group B Broth (Dalynn Biologicals) subcultured to StrepBSelectchromogenic medium (CM; Bio-Rad Laboratories) and the Fast-Track Diagnostics GBS real-time PCR (quantitative PCR [qPCR]) assay (Phoenix Airmid Biomedical Corp.) performed with broth-enriched samples and the Abbottm2000sp/m2000rt system. A total of 62/295 (21%) women were colonized with GBS; 58 (19.7%) cases were detected by standard culture, while CM and qPCR each found 61 (20.7%) cases. The qPCR and CM were similar in performance, with sensitivities, specificities, and positive and negative predictive values of 98.4 and 98.4%, 99.6 and 99.6%, 98.4 and 98.4%, and 99.6 and 99.6%, respectively, compared to routine culture. Both qPCR and CM would allow more rapid reporting of routine GBS screening results than standard culture. Although the cost per test was similar for standard culture and CM, the routine use of qPCR would cost approximately four times as much as culture-based detection. Laboratories worldwide should consider implementing one of the newer methods for primary GBS testing, depending on the cost limitations of different health care jurisdictions.

Assessment of Lesions Detected at Mammographic Screening: Performance at First or Repeat Screening in the Florence Programme

1994 ◽  
Vol 1 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Stefano Ciatto ◽  
Marco Rosselli Del Turco ◽  
Daniela Giorgi ◽  
Doralba Morrone ◽  
Sandra Catarzi ◽  
...  
Keyword(s):  
Diagnostic Procedures ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Mammographic Screening ◽  
Surgical Biopsy ◽  
Predictive Values ◽  
Screening Performance ◽  
The Cost ◽  
Benign Biopsy ◽  
Biopsy Rate

To evaluate the assessment criteria and the results achieved in the detection of breast lesions at mammographic screening. Review of cases assessed in the last screening round of Florence city (FC.- first screening round: 29 522 subjects) and Florence district (FD — repeat screening round: 13 268 subjects) programmes. Methods – Referral and biopsy rates, predictive values, and prevalence of cancers detected by screening were determined, as well as the frequency of the diagnostic procedures used at assessment, and their contribution to the final diagnosis according to the mammographic appearance of the suspected lesion. Assessment costs were estimated. Referral rate (FC 4.2%; FD 1.8%), referral positive predictive value (FC 18.7%; FD 28.3%), surgical biopsy rate (FC 0.96%; FD 0.6%), benign/malignant biopsy ratio (FC 0.20; FD 0.13), and prevalence of cancers detected by screening (FC 0.78%; FD 0.5%) were all within the European Community (EC) recommended standards for screening performance. The benign biopsy rate was considerably lower than that of recommended standards. The cost for each subject assessed was 179 000 Italian lire at the first and 116 000 lire at repeat screening. The cost for each subject screened that was attributable to assessment was 7600 lire at the first or 2100 lire at repeat screening. Limited referral rates and costs were achieved and the proportion of cancers detected by screening was high. The number of referrals was further reduced at repeat screening, and assessment had a limited impact on total screening costs. Detail or magnification mammography, palpation, sonography, and fine needle aspiration cytology all contributed to the final diagnosis and should be immediately available at the assessment clinic. The observed benign biopsy rate was particularly low and suggests that EC recommended standards should be modified.

scholarly journals Tetralogy of Fallot in infants less than one year old in the Valencia Region (Spain)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Cavero Carbonell ◽  
L Barrachina Bonet ◽  
T Fernández Rojas ◽  
S Moreno Marro ◽  
L Páramo Rodríguez ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Congenital Anomalies ◽  
Population Based ◽  
Termination Of Pregnancy ◽  
Fetal Anomaly ◽  
Live Births ◽  
Epidemiologic Surveillance ◽  
Increasing Trend ◽  
The Difference ◽  
One Year

Abstract Background Tetralogy of Fallot (TF) is a rare disease characterized by the presence of 4 congenital heart defects (CHD). Objective: to describe the temporal trend and distribution of the TF in the Valencia Region (VR), in less than one year old, during the period 2007-2016. Methods Live births, stillbirths and termination of pregnancy due to fetal anomaly (TOPFA) between 2007-2016 with TF (code Q21.3 of the ICD10-BPA) were selected from the Congenital Anomalies (CA) population-based Registry of VR. The cases were confirmed through the review of clinical documentation. The prevalence of 10000 births with 95% confidence intervals (95%CI) was calculated for the period and for each year, and a descriptive analysis of sociodemographic and clinical variables was made. Results 146 cases were identified (45.2% male, 31.5% female and 23.3% unknown), 89.0% were simple pregnancies and 54.8% were diagnosed prenatally. The overall prevalence of TF was 3.0/10000 births (95%CI: 2.5-3.5), being 2015 the year with the highest prevalence (4.3/10000 births) and 2011 with the lowest (1.8/10000 births). These changes were mainly due to the increase and decrease in the number of TOPFA respectively. 74.7% were live births, 22.6% TOPFA and 2.7% stillbirths. The prevalence in live births was 2.2/10000 births (95%CI: 1.8-2.6) and in TOPFA it was 0.7/10000 births (95%CI: 0.4-0.9), identifying an increasing trend during the period in the last one. 11.0% of live births died during the first year of life. 45.9% of the cases had another CA associated with the TF, being CHD in 52.7% of cases. 66.4% of the mothers were over 30 years of age, being the most frequent those between 30-34 years (30.1%). Conclusions The prevalence obtained in the VR was lower than that of EUROCAT 3.5/10000 births (95%CI: 3.3-3.6) during the same period. EUROCAT has also identified the difference between the prevalence in live births (2.9 (95%CI: 2.8-3.0)) and TOPFA (0.5 (95%CI: 0.5-0.6)), and the increasing trend in the last one. Key messages The prevalence of Tetralogy of Fallot obtained in the VR was lower than that of EUROCAT (European network of population-based registries for the epidemiologic surveillance of congenital anomalies). EUROCAT has also identified the difference between the prevalence of Tetralogy of Fallot in live births and termination of pregnancy due to fetal anomaly, and the increasing trend in the last one.

scholarly journals The syndrome of inappropriate antidiuretic hormone: current and future management options

2010 ◽  
Vol 162 (Suppl1) ◽  
pp. S13-S18 ◽  
Author(s):  
Mark Sherlock ◽  
Chris J Thompson
Keyword(s):  
Antidiuretic Hormone ◽  
Treatment Options ◽  
Fluid Restriction ◽  
Efficacy And Safety ◽  
Electrolyte Abnormality ◽  
Management Options ◽  
Appropriate Treatment ◽  
The Cost ◽  
Underlying Pathophysiology ◽  
Future Management

Hyponatraemia is the commonest electrolyte abnormality, and syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent underlying pathophysiology. Hyponatraemia is associated with significant morbidity and mortality, and as such appropriate treatment is essential. Treatment options for SIADH include fluid restriction, demeclocycline, urea, frusemide and saline infusion, all of which have their limitations. The introduction of the vasopressin-2 receptor antagonists has allowed clinicians to specifically target the underlying pathophysiology of SIADH. Initial studies have shown good efficacy and safety profiles in the treatment of mild to moderate hyponatraemia. However, studies assessing the efficacy and safety of these agents in acute severe symptomatic hyponatraemia are awaited. Furthermore, the cost of these agents at present may limit their use.

Prevalence and Forms of Congenital Anomalies in Twins Born in Pomeranian District During the Period from 1.07.1997 to 31.12.1998

1998 ◽  
Vol 47 (3-4) ◽  
pp. 255-259 ◽  
Author(s):  
T. Zimoń ◽  
M. Walczak ◽  
J. Fydryk ◽  
A. Materna-Kiryluk ◽  
J. Mejnar-towicz ◽  
...  
Keyword(s):  
Congenital Anomalies ◽  
Prevalence Rate ◽  
Congenital Malformations ◽  
Multiple Pregnancy ◽  
Multiple Pregnancies ◽  
Singleton Pregnancy

AbstractThe authors have analysed the frequency and structure of congenital anomalies in children born in the Pomeranian district in the period from 01.07.1997 to 31.12.1998. Among a total of 28.361 births in that area, 748 (2.64%) were affected by congenital anomalies. Among 28.361 births, 620 (2.18%) were from multiple pregnancies. 23 (3.71%) among births from multiple pregnancies were affected by congenital malformations. The prevalence rate of inborn anomalies in births from multiple pregnancy in our area were higher (3.71%) in comparison to births from singleton pregnancy (2.61%). It implies that children born from multiple pregnancy are at higher risk of developing congenital anomalies.

Magnetic Resonance Imaging in the Diagnosis of Glomus Tumours of the Hand

2005 ◽  
Vol 30 (5) ◽  
pp. 535-540 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
A. AL-NAMLA ◽  
A. AL-THUNAYAN ◽  
F. AL-SUBHI ◽  
A. F. EL-SHAYEB
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Senior Author ◽  
Glomus Tumour ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Final Histological Diagnosis ◽  
Sensitivity Specificity ◽  
The Cost ◽  
Negative Imaging

This paper studies the sensitivity, specificity and predictive values of MRI in the diagnosis of glomus tumours of the hand and investigates the final diagnosis and outcome in cases with false positive or negative imaging tests. A total of 42 cases with the clinical diagnosis of a glomus tumour were included in the study. All patients underwent MRI and the results of MRI were correlated with the final histological diagnosis of the excised lesion. MRI had a sensitivity of 90%, a specificity of 50%, a positive predictive value of 97% and a negative predictive value of 20%. The four cases in which the MRI was negative all proved histologically to be glomus tumours. All four tumours were small (2–3 mm in diameter) and the lack of delineation of the lesions by MRI was attributed to their small size. Despite negative MRIs, surgical exploration identified the glomus tumours. Based on the results of the current study and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour.

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