POST-PARTUM SUB-CLINICAL ENDOMETRITIS- ALTERATION IN UTERINE HAEMODYNAMICS, INFLAMMATORY MARKERS ON TREATMENT WITH MODIFIED ESTRUS SYNCHRONIZATION PROTOCOLS IN DAIRY COWS

Forty-one dairy cows (n=41) were enrolled to envisage the changes in uterine haemodynamics during sub-clinical endometritis (SCE) and its treatment with modified estrus synchronization protocols at 8 weeks post-partum. Trans-rectal Doppler sonography of both the middle uterine arteries (MUAs) was carried out for assessment of uterine perfusion whereas serum inflammatory markers i.e. IL-6 and C-RP were measured at 8 weeks post-partum and estrus (induced or spontaneous). Modified estrus synchronization protocols (MG6G and MG6GP) were used to adjudge their efficacy in post-partum dairy cows diagnosed with SCE and reproductive parameters were recorded. As a part of result, Doppler indices of both the MUAs at estrus i.e. TAMEAN, TAMAX, Blood flow volume-TAMEAN and TAMAX and diameter of MUA, were significantly lower (P<0.05) after application of MG6G and MG6GP protocols in SCEP as compared to SCEP control cows. Similarly, the IL-6, C-RP concentrations and PMNCs proportion (%) were significantly higher (P<0.05) in SCEP control as compared to cows treated with MG6G and MG6GP protocols. Moreover, on the day of estrus, the uterine haemodynamics, concentration of serum inflammatory markers and PMNCs proportion (%) in treated cows was at par with SCE negative control (SCEN) cows. In terms of reproductive performance, days open were recorded to be significantly lower (P<0.01) in treated and SCEN group as compared to SCEP control cows. In conclusion, sub-clinical endometritis led higher uterine perfusion, release of proinflammatory cytokines and PMNCs proportion which happened to plummet the post-partum reproductive performance was successfully managed with modified estrus synchronization protocols.

Features of regional blood flow after endoscopic myomectomy

The state of regional blood flow in 65 patients before and after endoscopic myomectomy was studied using modem methods such as Doppler examination and color Doppler sonography. It was determined that blood flow velocity indeces obtained during the Doppler examination of myoma vessels and uterine arteries allow to estimate the morphological structure of myomas uninvasively and can be used to define the indications for conservative endoscopic surgical procedures in patients with myoma uteri. Doppler monitoring of regional blood flow during postoperative period makes it possible to evaluate the effectiveness of surgical treatment previously performed.

Diagnostic role of uterine artery dopplerometry in the first trimester of pregnancy

A Doppler sonographic examination of blood flow in the left and right uterine arteries was carried out in women in the first trimester of pregnancy. Systolic- diastolic ratio (S/D) andpulsative index (PI) were assessed in 71 women with physiological course of pregnancy and in 49 women with threatened abortion. The investigation revealed clear connection of the uterine blood flow lateralization and corpus luteum localization. These interrelations are characterized differently in case of physiological pregnancy and threatened abortion. The new approach to the evaluation of uterine blood flow gives an ability ofpreclinical diagnostics of threatened abortion.

Hemodynamical parameters in functional system "motherplacenta-fetus" in women had higher levels of alpha-fetoprotein (AFP) and horionic gonadotropin (HG) in 11 trimester of pregnancy

Haemodinamic parameters in the functional system mother-placenta-fetus in 49 women with elevated mildtrimester maternal serum AFP (2MoM) and in 38 women with elevated maternal serum hCG (2MoM) were studed. The control group included 32 women with normal mildtnmester serum AFP and hCG. Indexes of impedance to flow in the uterine arteries were significantly higher in patients with elevated MSAFP or MShCG comparing with women of the control group, beginning from 28 weeks of pregnancy. There was a significant association between the maternal serum AFP levels and indexes of impedance to flow in the uterine artery, umbilical artery and fetal aorta during pregnancy. In patients with abnormal (more then 95th centile) uterine arteries Resistance Index at 2024 weeks, abnormal dynamic of MSAFP and MShCC levels from 16 until 24 weeks was observed. We suppose that unexplained elevated mildtri mester maternal serum AFP and hCC сaп be associated with disturbed utero-placental circulation.

Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

Leiomyomas, also termed as fibroids, are benign smooth, muscle neoplasms seen in 70–80% of women by the age of 50 years. Uterine artery embolization (UAE) is a minimally invasive procedure that involves cessation of vascular supply to the fibroids, by infusion of gelatinous microspheres into the uterine arteries. Pyomyoma is a suppurative leiomyoma, secondary to infection of necrotic tissue. It is an infrequent complication of uterine artery embolization (UAE). Pyomyoma can lead to sepsis, peritonitis, and respiratory distress syndrome resulting in high morbidity and mortality. Due to its rarity, high suspicion is crucial in the diagnosis, and prompt treatment is recommended to reduce mortality. Ultrasound, computed tomography, and magnetic resonance imaging assist in diagnosis. We present a case of a 44-year-old woman with ruptured pyomyoma, following an UAE intervention. The patient was treated with total abdominal hysterectomy and salpingo-oophorectomy along with peritoneal irrigation and drainage.

Ovarian and uterine two-dimensional and Doppler ultrasonographic changes in the feline peri-estrus period

Objectives The aim of this study was to evaluate two-dimensional and Doppler ultrasonographic changes of the ovary and uterus during estrus and the early post-estrus period in domestic cats. Methods Two-dimensional and Doppler ultrasonographic evaluations of the ovaries and uterus were performed in seven queens on days 1, 3 and 5 of estrus, and 5 days after estrus (AE5). Results On day 1, 5.4 ± 0.5 follicles of 2.1 ± 0.1 mm were detected progressively increasing in number and size up to day 5 and then decreased on AE5 ( P <0.05). A maximum follicular diameter of 4.1 ± 0.1 mm was achieved on day 5. Both during and after estrus, the uterus was generally hypoechoic compared with the surrounding tissues and delineated by a thin hyperechoic line corresponding to the serosa. In some animals, the uterine layers were distinguished during and after estrus. The blood flow waveforms of the intraovarian and uterine arteries were characterized by a systolic peak and diastolic flow extending throughout the remainder of the cardiac cycle to the next systole. In the uterine artery waveforms, the early diastolic notch was mild or absent during most estrous observations. The resistance index of the intraovarian arteries decreased up to day 5, and then increased on AE5 ( P <0.05). The resistance index of the uterine arteries was lower during estrus than in the post-estrus period ( P <0.05). Conclusions and relevance It is concluded that in the domestic cat, follicular number and diameter as well as ovarian and uterine blood flow changed during and immediately after estrus. Doppler ultrasound proved suitable to evaluate the hemodynamic changes involved in the cyclic remodeling of ovarian and uterine tissues that occurs during and after follicular growth in domestic cats.

The Effect of Pregnancy-Induced Hypertension on Uteroplacental Vasculature Hemodynamic Changes and Pregnancy Outcome

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. Pregnancy induced hypertension can cause growth retardation of fetus. Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome. Materials and Methods: The study was carried out at tertiary care hospital of nawab shah for the period of 06 months at Department of Radiology in association with Department of Gyne and Obs. Total 106 participants were selected for the study and all females were pregnant with 1st or 2nd trimester gestational record and medical history was taken from all participants and co-morbidities was also evaluated. Blood pressure was checked from all participants from their right arm in lying position and Ultrasound test was repeated as per requirement through color Doppler ultrasound machine and Data was analyzed by using statistical software SPSS. 24.00 version. Results: After collection of research data from all participants, the entire data was assembled for the analysis. Participants were divided into various age groups as 26 were in 18-21yeras, 34 in 22-25years, 21 in 26-29years and only 07 were from 34-37years. 26 participants were belongs to 1st trimester, 34 among 2nd trimester and 21 in third trimester. PI was also noted with three different readings 32 in Umbilical artery, 21 in middle cerebral artery and 37 in uterine artery. RI was also noted among different arteries 41 in umbilical, 36 in middle cerebral and 39 in uterine arteries. S/D was also noted, 33 in umbilical artery, 49 in middle cerebral artery and 30 in uterine arteries. Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

Uterine Artery Pulsatility Index as a Pre-eclampsia Predictor in the 3 Trimesters in Women with Singleton Pregnancies

Objective To evaluate the mean uterine artery pulsatility index (UtAPI) in each trimester of pregnancy as a predictor of early or late pre-eclampsia (PE) in Colombian pregnant women. Methods The UtAPI was measured in singleton pregnancies in each trimester. Uterine artery pulsatility index as predictor of PE was evaluated by odds ratio (OR), receiver operating characteristic (ROC) curves, and Kaplan-Meier diagram. Results Analysis in the 1st and 3rd trimester showed that abnormal UtAPI was associated with early PE (OR: 5.99: 95% confidence interval [CI]: 1.64–21.13; and OR: 10.32; 95%CI: 2.75–42.49, respectively). Sensitivity and specificity were 71.4 and 79.6%, respectively, for developing PE (area under the curve [AUC]: 0.922). The Kaplan-Meier curve showed that a UtAPI of 0.76 (95%CI: 0.58–1.0) in the 1st trimester was associated with early PE, and a UtAPI of 0.73 (95%CI: 0.55–0.97) in the 3rd trimester was associated with late PE. Conclusion Uterine arteries proved to be a useful predictor tool in the 1st and 3rd trimesters for early PE and in the 3rd trimester for late PE in a pregnant population with high prevalence of PE.

Algorithm for the diagnosis and treatment of primary placental dysfunction in pregnant women of risk groups

Research objective: to evaluate the effectiveness of diagnosis and complex therapy of placental dysfunction (PD) in early stages of gestation.Materials and methods. We examined 110 pregnant women with risk for the primary PD. Exclusion criteria were multiple pregnancies, anomalies of fetal development and internal genital organs of the mother, pregnancy resulting from assisted reproductive technologies.The diagnosis of PD was established in 56 women (group I) based on the assessing the state of extraembryonic structures and blood flow in the spiral and uterine arteries at 12–13 weeks of gestation. The rest of the patients (54 women) entered the control group without PD (group II).Results. All pregnant women with verified PD at 12–13 weeks were prescribed complex drug treatment, which included micronized progesterone, venotonic Normoven, Magnicum, and Artihol. As a result of treatment, already at 22–24 weeks of gestation, the average value of blood flow (resistance index) in the uterine and spiral arteries did not differ significantly in the groups. There was no significant difference in fetometry and placentometry indices at 35–36 weeks of gestation. Complications of the gestational period in patients in the study groups were also almost the same.Conclusions. History of hormonal disorders and miscarriage, clinical signs of miscarriage in early gestation, abnormal embryo placement, extragenital pathology, and genital tract infections are risk factors for PD. Determination of the state of extraembryonic structures at 7–8 weeks of pregnancy (ovum volume, blood flow in the corpus luteum) and at 12–13 weeks (chorion volume, vascularization index, blood flow in the spiral and uterine arteries) can serve as a verification criterion for the PD development. Complex drug therapy, which began from the early stages of gestation (micronized progesterone, Normoven, Magnicum, Artihol) has established itself as an effective method of treating primary PD in pregnant of risk groups.