Doppler Ultrasonographic Assessment of Maternal and Foetal Blood Flow in Canine Pregnancy and Its Application in the Critical Management of Gestation#

Background: Doppler ultrasonographic assessment of maternal and foetal blood flow/perfusion has become an indispensable diagnostic tool in veterinary obstetrics. Periodic Doppler examination of critical canine pregnancies to interpret vascular information such as blood velocity, flow direction/pattern and vascular pathologies would ensure safety of dam and survival chances of conceptuses.Methods: The present study included twenty apparently healthy bitches of different breeds presented at University Veterinary Hospital, Thrissur, Kerala for the management of breeding and pregnancy. Doppler examinations were conducted from fourth week of pregnancy at 10 d interval to evaluate blood flow in uteroplacental artery (UPA), umbilical artery (Uma) and foetal abdominal aorta by measuring pulsatility (PI) and resistive indices (RI). Result: Throughout the study the UPA showed biphasic wave. Up to 40 days of gestation the UPA showed diastolic notch and from 41-50 days it disappeared completely. The PI and RI decreased significantly at 5 per cent level between each 10 d interval. Similarly, the PI and RI of Uma decreased significantly at 5 per cent level between each 10 d interval. The PI of foetal abdominal aorta increased significantly at 5 per cent level from £ 30 d to 31-40 d of gestation and thereafter it decreased significantly up to whelping. During early pregnancy the diastolic wave form was absent for Uma and abdominal aorta although at later stages both these vessels showed biphasic wave forms. The study also included the early diagnosis of two abnormal pregnancies, viz., a complete foetal resorption in a Labrador bitch and an incomplete abortion in a Rottweiler bitch by Doppler ultrasound. The incomplete abortion was critically managed and the bitch whelped five healthy puppies fourteen days from the date of the incomplete abortion of three puppies. Thus, the study demonstrated the potential applicability of Doppler Ultrasound in the management of normal and abnormal pregnancies and predicting survival chances of neonates after whelping.

AYURVEDIC MANAGEMENT OF UPAVISHTAKA GARBHA DUE TO PIH AN INTEGRATED APPROACH - A SINGLE CASE STUDY

At present era it is observed that the incidence of normal pregnancy and delivery has been diminished. In childbirth weight is one of the most important factors affecting neonatal mortality and morbidity. Pregnan-cy induced hypertension is a global complication, approximately 10-17% of pregnancies are affected, and IUGR is one among the complications of PIH. In Ayurveda Samhithas, various Garbhavyapat are de-scribed and one among those are Upavishtaka Garbha. Acharya Charaka stated, as if bleeding per vagina or other types of discharges occur in pregnant woman, then the foetus will not grow properly in the uterus, and Acharyas mentioned many Chikitsas for the same. If IUGR is occurred due to PIH then most of the Chikitsas are to reduce PIH and to increase the weight of the baby. Hence can enlighten the treatment pro-cedures in medical practice. Here is a single case study which reduces the PIH and promote the Foetal weight with Ksheerabasti with Gokshura and Yashtimadhu. Here both the drugs are having Vasodilatation property which reduces the hypertension in pregnant lady and increases the foetal blood flow. Ksheera is having Balya property which in turns the foetal growth, which gave significant action in the PIH and IUGR.

Efficacy and safety of metformin for the treatment of gestational diabetes: a new approach to the problem

Historically, the following two methods were used to treat gestational diabetes mellitus: non-medical life-style interventions (diet and increased physical activity) and insulin treatment when other interventions were not effective. The possibility of alternative types of treatment such as oral anti-diabetic drugs has been the source of debate in recent years. Metformin is an oral anti-diabetic drug that reduces insulin resistance, which is common during gestation and is considered one of the main pathways of glucose metabolism alteration during pregnancy. The main concern is that metformin can cross the placenta and is found unchanged in foetal blood. This is the reason why oral anti-diabetic drugs are contraindicated during pregnancy in many countries, including Russia (according to the 2012 Russian recommendations for gestational diabetes treatment). In recent years, many studies investigating the safety and efficacy of metformin for maternal and foetal health have been published. We will review recent randomized clinical trials and discuss new international clinical recommendations (FIGO, 2015) and new opportunities for gestational diabetes mellitus treatment.

Prostaglandin E2 Labour Induction with Intravaginal (Minprostin) versus Intracervical (Prepidil) Administration at Term: Randomized Study of Maternal and Neonatal Outcome and Patient’s Perception Using the Osgood Semantic Differential Scales

Aim. To compare the efficacy, safety, and patient’s perception of two prostaglandin E2 application methods for induction of labour.Method. Above 36th weeks of gestation, all women, who were admitted to hospital for induction of labour, were prospectively randomised to intravaginal 1 mg or intracervical 0.5 mg irrespective of cervical Bishop score. The main outcome variables were induction-to-delivery interval, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, rate of vaginal delivery, and patient’s perception using semantic differential questionnaire.Results. Thirty-nine patients were enrolled in this study. There was no statistical significant difference between the two groups in regard to perceptions of induction. The median induction delivery time using intravaginal versus intracervical administration was 29.9 versus 12.8 hours, respectively (P=0.04). No statistically difference between the groups was detected in regard to parity, gestation age, cervical Bishop score, number of foetal blood samples, PDA rate, rate of oxytocin augmentation, and mode of birth.Summary. Irrespective of the cervical Bishop Score, intracervical gel had a shorter induction delivery time without impingement on the women’s perception of induction.