USE OF SLIDENAFIL CITRATE IN CASES OF INTRAUTERINE GROWTH RESTRICTION AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 23-24
Author(s):  
Anshu Anshu ◽  
Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Intrauterine Growth Restriction ◽  
Randomized Study ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Intrauterine Growth ◽  
Umbilical Artery Doppler ◽  
Doppler Indices ◽  
Antenatal Treatment

Objective: Intrauterine growth restriction (IUGR) is one of the most serious complications of pregnancy. Up to date, there is no evidence of achieving antenatal treatment of IUGR with abnormal placentation. Although, Sildenal citrate has shown promising results, there are no rm conclusion till now. The aim of our study is to evaluate the use of Sildenal citrate in the treatment of IUGR cases associated with impaired placental circulation. Materials And Methods: this was a prospective non-randomized study conducted at JLNMCH, Bhagalpur, Bihar starting from February 2019 to January 2020. The studied population included singleton pregnancy and suffering from IUGR associated with impaired placental circulation. Results: This study included 30 pregnant women. Cases were divided into two groups. The rst group received sildenal citrate and the second control group did not receive sildenal citrate. After 4 weeks after the 1st dose of Sildenal signicant decrease in umbilical artery Doppler indices. There was a statistically signicant difference in the mean birth weight at delivery and neonatal admission to the NICU in sildenal group. Conclusion: sildenale citrate treatment may present a new hope towards better perinatal outcomes for pregnancies complicated by IUGR and impaired placental circulation that may help to decrease neonatal admission to the NICU.

Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen
Keyword(s):  
Pregnant Women ◽  
Shear Wave ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
The Mean ◽  
Adverse Perinatal Outcomes ◽  
Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

scholarly journals Early Uterine and Umbilical Artery Doppler Indices as Predictor for Preeclampsia and Intrauterine Growth Restriction

2021 ◽  
pp. 116-126
Author(s):  
Sara E. Khalil ◽  
Mohammed M. Elnamory ◽  
Mona K. omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Study ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Preeclampsia (PE) is a disorder that causes hypertension and proteinuria after week 20 of pregnancy. Several Uterine Artery (UtAs) Doppler characteristics have been investigated for their ability to predict PE. The purpose of this research is to look into the uterine and umbilical arterial Doppler indices in the early second trimester for the prediction of late preeclampsia or intrauterine growth restriction. Methods: This is a prospective cohort clinical study and was done at Obstetrics and Gynecology department, faculty of medicine Tanta university hospital from January 2020 till April 2021. 150 pregnant women aged from 18 to 30 years old with gestational age from 13 to 16 weeks of pregnancy. Study was done by the same observer by machine MINDRAY DC60 Measurement of fetal biometry (BPD, FL, AC, HC) Gestational age was confirmed with Detection of congenital malformation.    Results: There is a significant difference between the groups regarding uterine and umbilical artery doppler Indices. Uterine RI only yielded significance for predicting IUGR with sensitivity of 62% and specificity of 88%, with Positive predictive value (PPV) 37% and Negative predictive value (NPV) 92%. Umbilical resistance index achieved sensitivity of 56% and specificity of 82%, with PPV 31% and NPV 30% with on statistical significance. Conclusions: Combination of uterine and umbilical artery Doppler study in early pregnancy is one of the best indicator for prediction of preeclampsia and IUGR. Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.

scholarly journals The predictive value of fetal middle cerebral artery/descending aorta ratio doppler parameter in the evaluation of perinatal results of intrauterine growth restriction

2021 ◽  
Vol 18 (4) ◽  
pp. 268-274
Author(s):  
Gokmen Sukgen ◽  
◽  
Omer Kaya ◽  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Control Group ◽  
Predictive Values ◽  
Descending Aorta ◽  
Intrauterine Growth ◽  
Doppler Parameter

Introduction. Although there are various reasons for intrauterine growth restriction (IUGR), the main cause is inadequate utero- placental and feto-placental circulation. Aim. To determine the predictive values of fetal middle cerebral artery/descending aorta (MCA/DA) Doppler parameter in the evaluation of perinatal outcomes in pregnancies with IUGR. Material and methods. 15 with IUGR and 35 normal newborn, who were born at the 34th gestational week or over included into the study. Doppler ultrasonography (US) measurements were performed. The ratio of pulsatility index/resistive index (PI/ RI) from MCA, umbilical artery (Umb), DA was determined. Neonatal characteristics such as Apgar scores, neonatal intensive care unit (NICU) requirement, weight and sex were also recorded. Results. In the IUGR group, mean MCA/DA RI-PI, MCA/UmB RI-PI were 0.88±0.19, 0.86±0.28, 1.22±0.18 and 1.55±0.39, respectively. In the control group, mean MCA/DA RI-PI, MCA/UmB RI-PI were 1.15±0.13, 1.09±0.41, 1.37±0.35 and 1.82±0.44, respectively. There were statistically significant relationship between MCA/DA PI with cord blood pH value and NICU requirement, age with gravida, parity, MCA/UmB RI, MCA/UmB PI; gravida with age and parity; parity with age, gravida, weight, MCA/DA RI, PI ratios. Conclusion. Intrauterine MCA and DA Doppler US parameters of IUGR can be used safely in predicting perinatal outcomes in pregnancies with IUGR over 34 weeks.

Cord Occlusion in Monochorionic Twins with Early Selective Intrauterine Growth Restriction and Abnormal Umbilical Artery Doppler: A Consecutive Series of 90 Cases

2015 ◽  
Vol 39 (3) ◽  
pp. 186-191 ◽  
Author(s):  
Mauro Parra-Cordero ◽  
Mar Bennasar ◽  
José María Martínez ◽  
Elisenda Eixarch ◽  
Ximena Torres ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Consecutive Series ◽  
Type Ii ◽  
Monochorionic Twins ◽  
Intrauterine Growth ◽  
Umbilical Artery Doppler

Objective: To describe perinatal outcomes achieved with cord occlusion (CO) in monochorionic twins with severe selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery Doppler in the IUGR twin (types II and III). Methods: We studied a consecutive series of 90 cases of sIUGR with abnormal Doppler treated with CO of the IUGR fetus. Abnormal Doppler was defined as continuous (type II, n = 41) or intermittent (type III, n = 49) absent/reversed end-diastolic flow. All cases presented at least one of the following severity criteria: gestational age (GA) <22 weeks, inter-twin estimated weight discordance >35%, reversed end-diastolic umbilical artery flow or ductus venosus pulsatility index >95th centile. We prospectively recorded pregnancy course and perinatal outcome. Results: Median GA at surgery was 20.6 weeks and mean duration 22.4 min. Miscarriage (<24 weeks) occurred in 3.3% (3/90) and preterm delivery <32 weeks in 7.1% (6/84) of continuing pregnancies. GA at delivery was 36.4 weeks and neonatal survival of the larger twin was achieved in 93.3%. Conclusion: In a consecutive series studied by an experienced team, CO in monochorionic twins with severe sIUGR type II or III was associated with delivery >32 weeks in 92.9% and neonatal survival of the normal twin in 93.3% of pregnancies.

scholarly journals Diagnostic Value of Fetal Thymus Size in Intrauterine Growth Restriction

2021 ◽  
pp. 43-50
Author(s):  
Mohamed Mosaad Elshishiny ◽  
Mohamed Mohsen Elnamoury ◽  
Ayman Abd Elaziz Aldorf ◽  
Essmat Hamdy AboZeid
Keyword(s):  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Control Group ◽  
Fetal Thymus ◽  
Intrauterine Growth ◽  
Doppler Study ◽  
Significant Difference ◽  
Adverse Perinatal Outcomes ◽  
Thymus Size

Background: Changes in thymus size and histopathology have been observed both in animal models of intrauterine growth restriction (IUGR). The aim of the present study was to evaluate the size of the fetal thymus by sonography in pregnancies with IUGR and to search for a possible relationship between a fetal thymus size and adverse perinatal outcomes. Methods: This prospective observational study was carried out on 100 participants who were divided into two groups. Group A: Study group which include 50 patients with IUGR. Group B: Control group which Include 50 normal patients with appropriate gestational age. All patients were subjected to: History taking: (Personal, Obstetric History, Maternal Medical History) and trans-abdominal ultrasound. Results: IUGR group show statistically significant decrease in the estimate of fetal weight (EFW) compared to the control group (P<0.05). Doppler study of umbilical artery shows significant increase of (pulsatility index (PI), resistance index (RI) and systolic/diastolic (S/D) in IUGR group when compared to control group. Doppler study of middle cerebral artery (MCA) shows significant increase in (RI, SD) in IUGR group when compared to control group while PI doesn’t show significant difference between two groups.  Thymus size decrease in IUGR group when compared to the control group. IUGR group had low survival and lower APGR Score when compared to the control group. Correlation between thymus size with the studied doppler parameters and pregnancy outcome in the current study. Umbilical Doppler RI, PI and SD showed statistically significance in this study (P<0.05) and this means that the blood flow in the umbilical arterial (UA) is important for the fetus. As regard the MCA RI and SD Doppler, they show statistically significance in this study (P<0.05) while the MCA PI Doppler did not show any statistically significance in this study (P>0.05). Conclusions: IUGR is associated with small thymus and small fetal thymus may be an early indicator of adverse perinatal outcomes in pregnancies complicated by IUGR.

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