Background: Accurate estimation of fetal weight is of paramount importance in the management of labour and delivery.Methods: This was a cross sectional study conducted over a period of 6 months in a tertiary care teaching hospital. All singleton term mothers with cephalic presentation and intact membranes with ultrasound examination done within a week were included in the study. IUFD, multiple gestation, malpresentation, diagnosed oligohydramnios or polyhydramnios, pelvic and or abdominal masses, and current weight more than 80 Kgs were excluded from the study. Expected fetal weight was estimated by clinical method (Johnson's formula), which was compared with Ultrasound weight estimation (Hadlock method) and actual birth weight. Results:The estimated mean birth weight by clinical method was 3492.75±393.16g, by Ultrasound was 3230.02±407.22g and actual mean birth weight was 3236.32±472.87g. The estimated birth weight by ultrasonographic method showed slightly stronger positive correlation (r=0.54; p<0.001) with actual birth weight as compared to the clinical method (r=0.44; p<0.001). The error of estimation of weight by clinical method showed significant negative correlation (r=-0.24; p=0.01) with gestational age, however ultrasonographic method did not show significant correlation (r= +0.045; p=0.64). The sensitivity and specificity of clinical method and ultrasonographic method for identifying fetal birth weight above 3500 gm was 69.23; 65.67% and 46.15; 80.60%, respectively. Conclusions:Ultrasound was more reliable method to establish fetal weight at term and more consistent in various period of gestations. Clinical method can be reliably used to screen large babies in centers where ultrasound has limited availability.
Profile of blood glucose, calcium, phosphorus and magnesium was studied during peri -parturient period <italic>i.e.</italic> on day 10 antepartum/ day of prolapse, day of parturition and day 10 postpartum in 12 normal pregnant buffaloes and 12 buffaloes with antepartum cervico vaginal prolapse during the last month of gestation. The blood glucose, serum calcium, phosphorus and magnesium concentration (mg/dl) in normal pregnant buffaloes were 62.13±1.01, 8.75±0.2, 6.04±0.12 and 1.7±0.10 on day 10 antepartum, 57.39±1.13, 8.30±0.25, 5.59±0.16 and 1.95±0.09 on day of parturition and 59.69±1.22, 6.69±0.23, 4.89±0.07 and 2.08±0.14 at day 10 postpartum respectively, where as, the corresponding values in buffaloes with antepartum cervicovaginal prolapse were 53.66±1.39, 3.99±0.11, 2.88±0.08 and 2.7±0.1 on the day of prolapse; 52.15±1.03, 6.77±0.29, 4.72±0.12 and 2.12±0.08 on the day of parturition; 57.63±1.28, 5.40±0.22, 4.29±0.14 and 1.89±0.14 on day 10 postpartum. The blood glucose, calcium and phosphorus concentration was significantly lower (p< 0.05) in buffaloes with antepartum cervico -vaginal prolapse as compared to normal pregnant buffaloes whereas, on day 10 antepartum/ day of prolapse the serum magnesium concentration was significantly higher in buffaloes with antepartum prolapse as compared to normal pregnant buffaloes.
Sabita Pathak, third year Resident,5 Meeta Thapa, second year Resident,6 Basanta Sharma, fi rst year Resident, Department of Obstetrics and Gynaecology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal AbstractThe management of ovarian teratoma in normal condition is well established but in rare giant tumour (diameter over 15 cm) management approaches such as laparoscopy or laparotomy are controversial and may be therapeutically challenging for surgeons. Laparotomic resection is the preferred method for the en-block mass removal, adequate abdominal cavity irrigation, and avoidance of accidental mass rupture during management of giant ovarian teratoma.Here we discuss a case of a 43 year old multiparous lady suffering from a huge ovarian tumour of size 40 cm, admitted in Nepal Medical College Teaching Hospital on 15th May 2013. This patient underwent laparotomy on 21st May 2013 and left sided huge multiloculated ovarian cystic teratoma was removed en-bloc with no complications.
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