scholarly journals Fetal Liver Size, Hepatic Artery Doppler Study in Late Intra Uterine Growth Restriction

Author(s):  
Ali Farag Ali ◽  
Mohamed Mohsen El Namori ◽  
Ahmed El Sayed El Halwagy ◽  
Magdy Hassan Hussein Balaha

Background: Intrauterine growth restriction (IUGR) is a condition in which the fetus does not reach its growth potential. It is well known that a fetus affected with late IUGR has smaller abdominal size.  The aim of the study is to evaluate the fetal liver size, fetal hepatic artery blood flow and other fetal vascular Doppler indices in cases of late IUGR. Methods: This observational analytical, cross-sectional study was carried out on 100 pregnant women at or above 32 weeks. Participants were divided into two groups: Group 1 (study group): 50 pregnant women as study group who were affected with IUGR. Group 2 (control group): 50 normally pregnant women as control group. Results: There was no statistically significant correlation between fetal weight and liver length. There was a positive highly statistically significant correlation between symphysial fundal height and the estimated fetal weight by ultrasound in cases of IUGR. There was a statistically significant decrease in the liver size in IUGR compared to the normal group. There was a statistically significant reduced hepatic arterial Doppler indices. Conclusions: Reduced liver size and hepatic arterial Doppler indices (PI, RI) can be valid diagnostic methods in IUGR. SFH, in fetuses suffering from IUGR when compared to normal cases, was correlated with EFW.

Author(s):  
Fatin Shallal Farhan ◽  
Ban Hadi Hameed ◽  
Muna Abdulghani Zghair

Objective: The effectiveness of progesterone in the prevention of threatened preterm labor has been established for many years, but the preferable route, dose, and duration of treatment are until now under the evaluation of researches. The aim of this study was to determine the effect of rectal progesterone on Doppler indices of the uterine arteries in pregnant women with threatened preterm delivery.Methods: A prospective case–control study was conducted at the obstetric ward and the Outpatients Department of Al-Yarmouk Teaching Hospital in Baghdad for the period of 1 year from April 1, 2017, to April 1, 2018. 100 women were enrolled in the study, 50 of them were pregnant women with a diagnosis of preterm labor assigned as a study group and the other 50 were apparently healthy pregnant women of the same gestational age assigned as a control group. Doppler study of uterine arteries was done to all participants, and the results were compared for both groups. The patients with preterm labor received nifedipine tocolysis initially until contractions subsided and Doppler study had been repeated for those women after 1 week of rectal progesterone therapy.Results: The study group had a significantly higher resistance index (RI) than the control group (0.58 vs. 0.52) as p<0.05, in spite of the pulsatility index (PI) being higher for the study group compared to the control group (0.78 vs. 0.77) but this difference was not statistically significant. The RI before the therapy (0.58) was significantly higher than the index after therapy (0.52), and the PI was again significantly higher before therapy (0.78) than after therapy (0.71) as p<0.05. During the follow-up period, 3 (6.5%), 4 (8.7), and 39 (84.8%) patients delivered within 1 week, after 1 week, and at term, respectively.Conclusion: Rectal progesterone can arrest threatened preterm labor, and this effect is possible in part explained by its action on uterine arteries.


2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.


2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.


2015 ◽  
Vol 96 (1) ◽  
pp. 5-9 ◽  
Author(s):  
K V Voronin ◽  
A M Alale ◽  
I I Alale ◽  
R M Banakhevich

Aim. Prevention of purulent and septic complications in females after planned caesarean section.Methods. Out of 60 pregnant women, who underwent comprehensive examination during the trial, 35 (58.3%) were included in the study group and were delivered off by planned cesarean section; 25 (41.7%) pregnant women, included in the control group, were delivered off by urgent cesarean section. Considering the goal of the study, bacteriology of vaginal discharge, amniotic fluid and placental tissues, DNA detection of vaginal discharge bacterial flora before and after treatment (using «Femoflor-16» test system) according to classification by M.N. Boldyreva (2010), uterine cavity aspirate cytology according to classification by M.A. Kupert (2003), sonography of the uterus and uterine adnexa on the 4-5 day after the surgery according to classification of A.P. Milovanov were added to the training program for pregnant women. In the study group, pregnant patients with severe anaerobic vaginal dysbiosis at the 36-38 weeks of gestation were administered causal treatment of severe anaerobic vaginal dysbiosis, pregnant patients of the control group were not treated if severe anaerobic vaginal dysbiosis was diagnosed.Results. Performed correction of vaginal microbiota in the study group has significantly improved the course of postoperative period, reduced the incidence of uterine subinvolution, signs of chorioamnionitis as a manifestation of ascending infection compared to the control group. Postpartum endometritis has developed in 1 (2.8%) patient of the study group and in 5 (20.0%) cases in the control group. Offered method for preparing the patients with vaginal dysbiosis to cesarean section reduced the risk for postpartum endometritis by 6.8 times.Conclusion. Strategy of preparation for planned Caesarean section should include vaginal discharge bacteriology and treatment of severe anaerobic vaginal dysbiosis, which reduces the risk for postpartum endometritis by 6.8 times.


Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chenchen Liu ◽  
Puying Wei ◽  
Jun Li

Abstract Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Ilknur Col Madendag ◽  
Mefkure Eraslan Sahin ◽  
Yusuf Madendag ◽  
Erdem Sahin ◽  
Mustafa Bertan Demir ◽  
...  

Aim. The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. Methods. A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26+0 and 30+0 weeks of gestation and delivered singletons between 37+0 and 41+6 weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) < 7 mg/dl (n = 80), (2) Hb 7–9.9 mg/dl (n = 320), (3) Hb 10–10.9 mg/dl (n = 1300), and (4) Hb > 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. Results. The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m2, nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 ± 80 g in the severe anemia group, 3050 ± 100 g in the moderate anemia group, 3350 ± 310 g in the mild anemia group, and 3400 ± 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). Conclusion. The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight.


Author(s):  
Gul Nihal Buyuk ◽  
Z.Asli Oskovi-Kaplan ◽  
Aysegul Oksuzoglu ◽  
H.Levent Keskin

Abstract Objectives The aim of our study was to analyze the mean platelet volume levels as a potential marker of altered placentation in intrauterine growth restriction (IUGR) cases. Methods A total of 126 term singleton pregnant women with IUGR fetuses and 345 healthy pregnant controls were recruited and compared. Results The mean platelet volume was significantly higher in the IUGR group (10.8±0.9 fl) than the control group (9.9±1.1 fl) (p=0.03). The mean hemoglobin was lower in IUGR group (11.3 (8.3–14.5) g/dl) than the control group (11.9 (8.2–13.0) g/dl) (p=0.04). The optimal cut-off MPV for prediction of IUGR was ≥10.55 fl, with a sensitivity of 59% and a specificity of 75%. Conclusion Increased MPV levels in term pregnant women may be particularly helpful for discrimination and prediction of high-risk fetuses when IUGR is suspected.


2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen

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.


2014 ◽  
Vol 4 (1) ◽  
pp. 15-20
Author(s):  
Ohida Sultanaa ◽  
Nasim Jahan ◽  
Nayma Sultana ◽  
Farzana Mahmudad ◽  
Tazdik G Chowdhurye

Objective: To measure the distribution of TPO-Ab positivity and to observe the effect of thyroid peroxidase positivity on thyroid function during first trimester in normal pregnancy. Method: A cross sectional among 120 subjects were taken in this study and divided into control and study groups. Control group (Group A) consisted of 60 healthy non pregnant women age ranged between 20 to 35 years. Study group (Group B) consisted of 60 normal pregnant women of same age range. Group B was further subdivided into group B1 and group B2according to the level of TPO-Ab. Group B1 consisted of TPO-Ab positive pregnant women and group B2 consisted of TPO- Ab negative pregnant women. Control group was selected from personal contacts and study group from Out Patient Department (OPD) of Obstetrics and Gynecology of Sir Salimullah Medical College and Mitford Hospital. For assessment of thyroid function, serum free thyroxine (FT4), thyroid stimulating hormone (TSH) were measured. Serum FT4, TSH were measured by Enzyme link immunosorbant (ELISA) method. Again, serum TPO-Ab of total study population and hCG of all the pregnant women were measured. Serum TPO-Ab by Micro particle Enzyme Immunoassay (MEIA) method and hCG was estimated by ELISA. Statistical analysis was done by SPSS version 17. Results: In this study, serum FT4 and was significantly (P<0.001) higher and TSH level was significantly (P<0.001) lower in normal pregnant women during 1st trimester in comparison to those of non pregnant women. Again, 18% of pregnant women showed TPO-Ab positivity. However, serum FT4 level was significantly (P<0.001) lower whereas, TSH level was significantly (p<0.001) higher in TPO-Ab positive pregnant women in comparison to those of TPO-Ab negative pregnant women. Conclusion: TPO-Ab positivity increases during 1st trimester of normal pregnancy which decreases the hyper functional state of thyroid hormones. So, thyroid screening should be done routinely during pregnancy. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21160 Update Dent. Coll. j: 2014; 4 (1): 15-20


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