Perinatal Outcome in Term Pregnancies with Isolated Oligohydroamnios

Objective: To evaluate the frequency of adversative perinatal outcome in pregnancies with oligohydramnios isolation at term. Study Design: Case series Place and Duration of Study: Department of Obstetrics & Gynecology, Sadiq Abbasi Hospital Bahawalpur from 1st January 2021 to 30th June 2021. Methodology: Two hundred women with term pregnancy 37+0 to 41+6 weeks, pregnancy with isolated oligohydramnios, active phase of labour were included. CTG and obstetrical ultrasound for biophysical profile were done. Patient’s labour was monitored closely and followed till delivery. Results: Majority of the patients 87 (43.5%) were between 20-25 years with mean age was 28.43±4.27 years. Seventy six (38%) were between para 1-2, 83 (41.5%) were para 3-4, while 41 (20.5%) were para >4. Perinatal outcome reveals that APGAR score <6 at 1 minute was calculated in 21 (10.5%) and <7 at 5 minutes in 17 (8.5%) which is not very significant. Conclusion: Oligohydramnios Isolation was not related with adversative perinatal consequences. Keywords: Isolated oligohydramnios, Perinatal outcome, Amniotic fluid index, Term pregnancy, APGAR score

Study of mode of delivery and fetal outcome in pregnancies with oligohydramnios

Background: The significance of amniotic fluid volume as a marker of fetal status is an ongoing turn of events. Oligohydramnios causes adverse fetal outcomes like meconium-stained liquor, meconium aspiration syndrome, fetal heart rate abnormalities, poor APGAR scores, fetal growth restriction and fetal prematurity. It is associated with maternal hypertension, infections, and placental insufficiency. It causes maternal complication because of increased incidence of induction of labour and operative intervention.Methods: Hundred cases of oligohydramnios were included in our study conducted at the Navodaya medical research, hospital and research centre, during a period of two years after obtaining the informed consent of patients and institutional ethical clearance. All gravidas were included with a gestational age greater than 28 weeks with singleton pregnancies with oligohydramnios. Associated fetal and maternal risk factors were observed. The amniotic fluid index (AFI) was measured by ultrasound. The nonstress test, the fetal biophysical profile and the Doppler study were carried out to evaluate the fetal condition. Then we have observed for delivery and fetal outcome.Results: Incidence of oligohydramnios was 2.85% in our study. The 53% of cases had LSCS while 47% had normal delivery. Fetal distress was the commonest indication for LSCS. Poor neonatal APGAR score was 16.9% in LSCS while 36% in vaginal delivery.Conclusions: From the above study, the caesarean delivery seems to be a safer mode of delivery than vaginal delivery because it is associated with a good perinatal outcome.

Spontaneous pneumothorax in a pregnant woman with COVID-19: a case report

Numerous symptoms and complications of COVID-19 include pneumothorax as a rare but potentially-lethal condition. The present case report involved a pregnant woman with COVID-19 presenting with pneumothorax. A 30-year-old pregnant woman with COVID-19 and a gestational age of 32 weeks presented to our hospital with dyspnea, coughs and fever. The rales initially heard in both lungs continued to be heard only in the left lung after 24 hours. Pneumothorax was confirmed through radiology. The emergency cesarean section performed to avoid the potential detrimental effects of the infection on the fetus caused no breathing episodes in the biophysical profile. The patient recovered postpartum without complications and both the mother and the newborn were discharged 12 days later. Spontaneous pneumothorax is a rare complication in COVID-19 pregnant patients that can emerge at any stage of the disease.

New Trends in Precision Medicine: A Pilot Study of Pure Light Scattering Analysis as a Useful Tool for Non-Small Cell Lung Cancer (NSCLC) Diagnosis

Background: To date, in personalized medicine approaches, single-cell analyses such as circulating tumour cells (CTC) are able to reveal small structural cell modifications, and therefore can retrieve several biophysical cell properties, such as the cell dimension, the dimensional relationship between the nucleus and the cytoplasm and the optical density of cellular sub-compartments. On this basis, we present in this study a new morphological measurement approach for the detection of vital CTC from pleural washing in individual non-small cell lung cancer (NSCLC) patients. Materials and methods: After a diagnosis of pulmonary malignancy, pleural washing was collected from nine NSCLC patients. The collected samples were processed with a density gradient separation process. Light scattering analysis was performed on a single cell. The results of this analysis were used to obtain the cell’s biophysical pattern and, later on, as basis for Machine Learning (ML) on unknown samples. Results: Morphological single-cell analysis followed by ML show a predictive picture for an NSCLC patient, screening that it is possible to distinguish CTC from other cells. Moreover, we find that the proposed measurement approach was fast, reliable, label-free, identifying and count CTC in a biological fluid. Conclusions: Our findings demonstrate that CTC Biophysical Profile by Pure Light Scattering in NSCLC could be used as a promising diagnostic candidate in NSCLC patients.

Analysis of the prevalence of obstetric and gynecological diseases in a large goat breeding enterprise

The purpose is to analyze the prevalence of obstetric and gynecological pathologies in a large dairy goat enterprise. Method. Analysis of data from veterinary registers of the enterprise, as well as histological examination of fetal membranes and determination of the biophysical profile of newborn goats were carried out. Results. The results obtained showed different distribution of obstetric and gynecological diseases among the Alpine goats in the conditions of a large industrial enterprise during the year. The results obtained showed that the general level of obstetric-gynecological diseases of goats by months of the year made up from 2.7 % to 100 % of the number of calves taken place with the most favourable conditions for obstetric-gynecological pathologies being June, July and September – 7.8 %, 4.1 % and 2.7 % respectively. A significant increase in the proportion of stillborn goats from their total number to 26.8 % and 26.3 % was observed in August and November, respectively. In winter and late autumn, there is a marked increase in retention of placenta, up to 8–10 %. In late spring and summer there is a seasonal decrease. The average number of goats in calving at this farm is 1.8 ± 0.43 goats with fluctuations by months of the year from 1.4 in January to 2.9 in August. The conducted histological and fetal membrane studies and determination of the biophysical profile of goats' calves showed a wide spread of fetoplacental insufficiency and changes in the placenta structure in the Alpine breed goats in the conditions of a large enterprise. Scientific novelty. The analysis of spread of obstetric-gynecological diseases of the Alpine breed goats in the conditions of the big enterprise has been carried out; the wide spread of fet-placental insufficiency among the uterine population has been confirmed by histological studies and the estimation of the biophysical profile of newborn baby goats.

Modified biophysical profile and perinatal outcome in high risk pregnancies

Background: Aim and objective of current investigation was to evaluate perinatal outcome in high risk pregnancy with modified biophysical profile and also evaluate the efficacy of MBPP.Methods: Type of study was observational study, 100 patient fulfilling inclusion criteria were included in study. All women were subjected to modified biophysical profile comprises amniotic fluid index and non stress test. NST was performed with cardiotocogram, real time ultrasound scanning was performed. Perinatal outcome assessed in terms of admission to NICU, low birth weight, foetal distress, low APGAR score, neonatal mortality.Results: Out of 100 cases, 55 cases had reactive NST and 45 had non reactive NST. AFI was normal in 79 cases 21 cases had abnormal AFI. Diagnostic power was maximum seen with NST i.e. 76.36% (61.90% for AFI and 71.64% for combined MBPP) it indicates that NST is a good predictor to diagnose a compromised foetus.Conclusions: This study shows that pregnancy with high risk factors are associated with more chances of intrapartum complications perinatal morbidity and mortality , if MBPP was abnormal or any one parameter was abnormal, chances of perinatal morbidity were high.

Short-Term Effects of Dexamethasone versus Betamethasone on Ultrasonic Measures of Fetal Well-Being: Cohort from a Blinded, Randomized Trial

<b><i>Introduction:</i></b> Maternal corticosteroid administration for anticipated preterm birth is common; however, the corticosteroid effect on fetal ultrasound and cardiotocograph (CTG) remains contested. This study aimed to evaluate short-term ultrasound and CTG impact of (a) dexamethasone versus betamethasone (b) pooled corticosteroid effect. <b><i>Methods:</i></b> Substudy of blinded randomized trial of dexamethasone versus betamethasone (given &#x3c;34 weeks). Umbilical artery (UA), middle cerebral artery (MCA), ductus venosus (DV), and uterine artery Doppler, myocardial performance index (MPI), biophysical profile (BPP), and CTG measured pre-corticosteroid then 1, 2, 4, and 7 days post-corticosteroid. <b><i>Results:</i></b> Of 47 fetuses (39 singleton; 4 dichorionic, diamniotic twins; and 4 monochorionic, diamniotic twins) in the February 2012–2013 period, 24 received dexamethasone and 23 betamethasone at average gestation 29.8 ± 2.9 weeks. Thirteen pregnancies (30%) had pre-corticosteroid fetal concerns (estimated weight &#x3c;10th centile and/or abnormal UA/MCA Doppler). Few significant differences were seen post-corticosteroid: DV pulsatility index and right MPI initially decreased 15–20%, and average BPP decreased slightly on days 1–2. There were no major differential effects of dexamethasone versus betamethasone. <b><i>Discussion/Conclusion:</i></b> No substantive post-corticosteroid effects were seen for most ultrasound/CTG measures in fetuses with heightened preterm birth risk but predominantly normal pre-corticosteroid measures. Clinically, this suggests avoiding overreliance on individual measures for delivery decisions post-corticosteroid; equally, multiple/marked ultrasound changes suggest true pathology and not corticosteroid effect.