Breed-specific ecobiometry and ultrasound factors predictive of fetal maturity in healthy English Bulldog bitches subjected to elective cesarean section

The aims of the current study are to build an equation to predict gestational age (GA) and to compare ultrasound parameters indicative of delivery in healthy English Bulldog bitches subjected to elective cesarean section. Sixteen pregnant female dogs were included in the study. Inner chorionic cavity (ICCDD) and biparietal (BPD) diameters were measured at 30 and 50 days after artificial insemination, respectively, to estimate GA at embryonic and fetal stages. BPD, heart rate (HR), and intestinal peristalsis were measured at 48 h, 24 h, and 6 hours before delivery to compare fetal development. ICCD and BPD values were subjected to linear regression and parameters predictive of elective cesarean section were compared through Student’s t-test before delivery. The number of conceptuses did not influence pregnancy duration. Both ICCD and BPD were significantly correlated to GA; their formulas presented accuracy of ± 1 and ± 2 days, respectively, in comparison to that of progesterone dosage. Based on the comparative ultrasound assessment, BPD has significantly increased from 48 h to 6 h before delivery (≥3 cm), regardless of the number of pups, whereas HR has significantly decreased within 6 h before delivery (HR <200 bpm). There was not statistically significant difference in parameter “intestinal peristalsis” among measurement times. The current study is pioneer in highlighting that measuring ICCD and BPD in the formula is a useful tool to predict GA in the herein investigated breed and that fetal parameters such as BPD and HR are fetal maturity predictors.

Gestation-Based Viability–Difficult Decisions with Far-Reaching Consequences

Most clinicians rely on outcome data based on completed weeks of gestational of fetal maturity for antenatal and postnatal counseling, especially for preterm infants born at the margins of viability. Contemporary estimation of gestational maturity, based on ultrasounds, relies on the use of first-trimester scans, which offer an accuracy of ±3–7 days, and depend on the timing of the scans and the measurements used in the calculations. Most published literature on the outcomes of babies born prematurely have reported on short- and long-term outcomes based on completed gestational weeks of fetal maturity at birth. These outcome data change significantly from one week to the next, especially around the margin of gestational viability. With a change in approach solely from decisions based on survival, to disability-free survival and long-term functional outcomes, the complexity of the parental and care provider’s decision-making in the perinatal and postnatal period for babies born at less than 25 weeks gestation remains challenging. While sustaining life following birth at the margins of viability remains our priority—identifying and mitigating risks associated with extremely preterm birth begins in the perinatal period. The challenge of supporting the normal maturation of these babies postnatally has far-reaching consequences and depends on our ability to sustain life while optimizing growth, nutrition, and the repair of organs compromised by the consequences of preterm birth. This article aims to explore the ethical and medical complexities of contemporary decision-making in the perinatal and postnatal periods. We identify gaps in our current knowledge of this topic and suggest areas for future research, while offering a perspective for future collaborative decision-making and care for babies born at the margins of viability.

Usefulness of Maternal and Fetal Parameters for the Prediction of Parturition Date in Dogs

An accurate parturition timing is of key importance for breeders and veterinarians in order to give professional assistance to parturition in dogs. However, pregnancy length calculated from the breeding date has a wide variability. Different parameters and formulas have been described and calculated, as well as their accuracy which is affected by various factors: stage of pregnancy, litter and maternal size. Therefore, the selection of the most appropriate parameter panel poses the challenge of weighing their influences and impact on the overall accuracy. The aim of this review is to analyze the parameters useful for parturition timing, especially their accuracy, and to propose the addition of fetal maturity and criteria for its evaluation to detect readiness for parturition. Parameters, as described in literature, are classified as: (i) maternal parameters, (ii) fetal parameters, (iii) ultrasonographic assessment of maternal and fetal heart rate and blood flow, (iv) parameters indicating fetal maturity. A focus on recently described parameters—such as fetal gastrointestinal motility and fetal lung development detected by quantitative ultrasound—is reported. Currently, the most accurate way to predict parturition day is represented by a prepartum progesterone drop, but the identification of a panel of ultrasonographic parameters combining their significance and their accuracy throughout pregnancy is still needed.

Correlation of ultrasound placental diameter & thickness with gestational age

Background & Objectives: Estimation of fetal maturity is common in obstetric practice especially when the women do not keep accurate menstrual records. An accurate establishment of expected date of delivery is fundamental to the management of both high risk and normal pregnancies. The objective of this study was to determine the placental diameter (PD), placental thickness (PT) and to establish a correlation between PD, PT and gestational age. Methods: This is an observational cross-sectional study that examines by means of ultrasonography the correlation between placental diameter and thickness with gestational age in Enugu, South East, Nigeria. Results: A total of 400 healthy subjects were recruited in 3rd trimester of pregnancy having fulfilled the inclusion criteria. PD and PT in this study did not correlate with parity. There is a linear increase of gestational age and placental thickness and diameter. These increases heighten between 38th week gestation and 40 weeks’ gestation. 205.0±1.4, 43.00±0.0 to 215.0±1.4, 46.00±2.8 respectively. Conclusion: Placental thickness and Placental diameter can be used to predict gestational age. It is therefore advised to use PT & PD in ultrasound obstetric assessment especially when Last menstrual period (LMP) is not clear. doi: https://doi.org/10.12669/pjms.36.5.1938 How to cite this:Njeze NR, Ogbochukwu JO, Chinawa JM. Correlation of ultrasound placental diameter & thickness with gestational age. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1938 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.

Fetal birth weight, a challenge to the mother and simplest marker for fetal maturity: a study in new rural hospital setup

Background: The birth weight is an important factor which the obstetricians have to give due importance when contemplating elective induction of labor before 40 completed weeks. It is a single most important determinant for survival, growth and development of infant. It reflects the health status of the mother during adolescence and pregnancy and also the quality of antenatal care. It is well known that there is a co-relation between weight of the fetus and the length of the gestation and other various factors. This study looks into the various factors influencing the fetal birth weight and length of gestation and what is its relative importance to the viability of developmental chances of premature infants and also infants born at term. Objective was to study the effect of various maternal factors like maternal age, parity, maternal weight, gestational age on fetal birth weight.Methods: 176 participants with term pregnancies were studied under three independent variables viz gestational age, maternal age and maternal weight that had effect on the fetal birth weight in two groups - primipara and multipara and reported by statistical analysis.Results: The independent variables gestational age and maternal weight showed a statistically significant correlation (p <0.05) with fetal birth weight in both the groups. Whereas the variable maternal age didn’t have any statistically significant effect (p >0.05) on the fetal birth weight in the study.Conclusions: Primipara had more pronounced correlation with fetal birth weight than multipara in the variable gestational age. The maternal weight affected fetal birth weight equally in both the groups. And maternal age had no effect on fetal birth weight in either groups.

Evaluation of pulmonary maturity in bovine neonates: analysis of amniotic fluid

ABSTRACT: Considering the representativeness of dairy cattle in our country, the concern about the mortality rates of the animals increases each time. Regarding to calf mortality, the Respiratory Distress Syndrome (RDS) has an important relevance during the neonatal period, and it is present in immature lungs. The amniotic fluid is in direct contact with the fetus, and it is able to offer evidence about his maturity. The aim of this study was to standardize the characteristics of the amniotic fluid, color, aspect, viscosity, quantification of lamellar body and surfactant evaluation by the Clements test and cytology, of term-born, mature and healthy calves. There were used 50 Black and White Holstein calves, which mothers were observed at calving in order to collect the amniotic fluid by puncture in the moment of exposure of the fetal membrane through the vaginal canal. Most amniotic fluid had a clear and hazy appearance due to varying degrees of viscosity and the presence or absence of clots. The Clements test could be adapted to the bovine species by the modification consisting in the addition of 3mL of amniotic fluid and 1mL of 95% ethanol. The methodology of the lamellar body count by the automated particle counter is not applicable for the bovine because of the small size of their lamellar body. The Nile Blue staining is unsatisfactory on predicting fetal maturity on the bovine species, different from cytology using Hematoxylin-Shorr stain. The presence of orange cells, increase in large amounts at the end of pregnancy. The cell stained orange counting, cells which are found in great amounts at the end of pregnancy. The present study stablished new parameters for evaluation of fetal and pulmonary maturity in the bovine species.

Induction and Augmentation of Labor

Certain maternal and fetal conditions require induction of labor for the safety and well-being of either the mother or baby. Similarly, once fetal maturity has been reached, elective induction of labor remains an option for delivery timing and patient request. A thorough understanding of the physiologic mechanisms of labor onset and maintenance has allowed obstetrical providers to induce labor from the quiescent state and augment spontaneous labor in the latent or prolonged state. The goal of labor induction and augmentation is the successful and expedited delivery of the neonate in a manner that is safe to both the mother and the infant. Positive maternal outcomes include a shortened admission to onset of labor time, shortened first stage of labor, successful vaginal delivery, and avoidance of intraamniotic infection or postpartum hemorrhage. Positive fetal outcomes include absence of meconium amniotic fluid staining, regular newborn nursery admission, and hospital discharge with the mother. In this review, we outline the various mechanical, chemical, and natural methods of labor induction and augmentation, including a detailed assessment of the risks and benefits of each method for both the mother and baby. This review contains 7 figures, 4 tables, and 33 references. Key Words: amniotomy, augmentation of labor, cervical ripening, induction of labor, oxytocin, membrane sweeping, nipple stimulation, prostaglandins, transcervical balloon catheter