A primigravida presented to us at 32 weeks of gestation with vomiting, myalgia and jaundice. On examination she had icterus, she was dehydrated, uterus was corresponding to dates and the fetal heart rate was good. On evaluation, all the investigations were normal except mild unconjugated hyperbilirubinaemia and hypoglycaemia. Based on the above findings we derived at a diagnosis of Gilbert syndrome. Dehydration due to vomiting aggravated her jaundice. On correcting her dehydration jaundice resolved, patient improved symptomatically and was discharged two days later. She was later admitted at term and underwent emergency caesarian section in view of fetal distress. Mother and baby were fine postoperatively and was discharged on the fifth postoperative day Gilbert syndrome is rare in obstetric practice. Virtually all patients have decreased activity of Uridine diphosphate glucuronosyl transferase (UDPGT). The case is reported due to its rarity.
Background: Meconium staining of amniotic fluid has long been regarded as a sign of fetal distress and fetal asphyxia. Although exact cause is unknown, meconium is thought to be passed from fetal gastro-intestinal tract as a response to hypoxia, mesenteric vasoconstriction induced gut hyper peristalsis, vagal stimulation and normal physiologic function of a mature fetus. Overall frequency has ranged from 5 to 24.6%. Present study is undertaken to detect incidence, mode of delivery, fetal heart rate variability and neonatal outcome in neonates born through MSAF. The objective of the study was to maternal risk factors, mode of delivery and perinatal outcome in labors complicated with meconium stained amniotic fluid.Methods: This is a cross sectional study done at Government Medical College, Thrissur on term, singleton pregnancies complicated with meconium stained amniotic fluid satisfying the inclusion criteria. Patients detailed history, gestational age, per abdominal examination, per speculum and per vaginal examination, admission tests including intrapartum cardiotocography (CTG) was recorded in a predesigned proforma.Results: The age of the patients varied between above 19 and 30 years. Majority of the study population were 69.3% Primi gravidas. Out of 130 cases, 56.2% were grade 2 meconium stained liquor, 30.7% were grade 3 meconium stained and 13.1% were grade 1 meconium stained. Association between neonatal complications in relation to grades of meconium was found to be statistically significant (p = 0.001). NICU admission was 24.7% in grade 2 meconium group. Hypoxic Ischemic encephalopathy was high in grade 3 meconium group, 45%. Majority of babies born through grade 1 meconium were asymptomatic and 10% of babies in grade 3 meconium groups were asymptomatic. Meconium aspiration syndrome, Respiratory distress were more in babies born through deliveries complicated with grade 3 meconium.Conclusions: The study indicated meconium stained amniotic fluid during labour increases the prevalence of abnormal intrapartum CTG, Caesarean section, lower Apgar score, increased duration of NICU and hospital stay, poor perinatal outcome and non-significant difference in incidence of lower birth weight in babies.
<p>Local content insertion enabled single frequency networks (SFN) for TV broadcast is a topic of considerable research interest. The SFN broadcast system is not ideally suited for localized content, but it offers enormous spatial diversity and power gain advantages. Orthogonal Frequency Division Multiple Access (OFDMA) allows reserving a fraction of available subcarriers for broadcasting local content. However, a user in the transition region from one local service area (LSA) to another experiences high co-channel interference (CCI). This work explores the possibility of using a `buffer zone' based on universal frequency reuse schemes. In such systems, the power allocation to each content is varied to reduce the CCI-dominated region in the LSA boundary. Simulation results show that depending on the threshold signal-to-interference plus noise (SINR) ratio selected, the proposed buffer architectures increase the percentage of users served by the SFN compared to the scheme where such a buffer is absent. Moreover, the proposed method is spectrally efficient compared to an orthogonal allocation of local content across the LSAs.</p>
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