Background: Transverse Cerebellar Diameter (TCD) serves as a reliable predictor of gestational age in foetus and is a standard against which aberrations in other foetal parameters can be compared, especially when the GA cannot be determined by the date of last menstrual period or early pregnancy scan, TCD is one foetal parameter that has remained consistently superior in predicting gestational age in both singleton and twin gestation. Aim of the study was to assess and evaluate the effectiveness of transverse cerebellar diameter by using ultrasonography for determining the gestational age of the foetus.Methods: A cross-sectional study was done in 100 uncomplicated pregnant patients between the 15th week of gestation to term referred from routine antenatal clinic in outpatient and in-patient department of Obstetrics and Gynecology department of Vinayaka Mission Krupananda Variyar medical college and hospital, Salem during study period April 2015-March 2016. TCD is obtained in the axial plane in the cerebellar view i.e. with a slight rotation of the transducer approximately 30° from the conventional thalamic plane where the biparietal diameter is measured using the cavum septi pellucidi, third ventricle and thalami as landmarks.Results: The correlation of transcerebellar diameter (TCD) with that of BPD (bi-parietal diameter) had shown a perfect positive correlation (r = 0.978) and a similar type of correlation was also seen with HC (head circumference) (r = 0.979), AC (abdominal circumference) (r = 0.966), FL (femur length) (r = 0.976) and USG GA (ultrasonogram gestational age) (r = 0.983).Conclusions: In the normally developing foetus, the TCD increases in a linear fashion with advancing gestational age. The data of this study suggest foetal TCD on ultrasound is a reliable predictive biometric parameter of gestational age.
Background: Placenta is the vital link between fetus and the uterine wall. Based on location, it can be classified as anterior, posterior, lateral, fundal and low lying. Placental location can be easily determined in the antenatal period using ultrasound. Materials and Methods: Design: Prospective observational study. Study period: One year from January 2018 to February 2019 in a tertiary hospital in Salem district of Tamilnadu. Study population: After informed consent, 200 women with singleton pregnancy of ≥28 weeks attending antenatal OPD were included in the study. Women were followed up with ultrasound at 28 weeks and 34 weeks to identify any maternal and fetal adverse effects such as gestational hypertension, preeclampsia, preterm birth and NICU admission. Results: The mean age of the study participants was 24.3 ± 43 years. Of the 200 women, 42% (n=84) of placenta were situated in fundus, 30% (n=60) were anterior, 18% (n=36) were lateral, 8% (n=16) were posterior and 2% (n=4) were low lying. Gestational hypertension was present in 22%, 13%, 12% in lateral, anterior and posterior placental location respectively. Preeclampsia was seen in 22% in lateral placental location. Preterm labour, PROM, low birth weight and NICU admission were common in posterior and lateral placental location.Conclusion:There was statistically significant association between low lying, posterior and lateral placental location and adverse maternal fetal outcomes. Hence ultrasound can be used as the safe, cost effective, non-invasive tool in predicting the adverse maternal and neonatal outcome.
Background: The objectives of the study were to evaluate the Prediction of foetal macrosomia based on sonographic measurements of foetal fat layer, Interventricular septal thickness and umbilical cord thickness in Gestational Diabetes Mellitus at term.Methods: After assessment of inclusion and exclusion criteria 100 antenatal women of gestational age more than 37 weeks selected for study in the Department of Obstetrics and Gynaecology of Vinayaka Mission’s Kirupananda variyar medical college and hospital, Salem. Participants underwent a third trimester scan and three extra measurements i.e. Umbilical cord thickness, Interventricular septal thickness and foetal fat layer are measured in addition to the normal examination.Results: In present study umbilical cord thickness had good sensitivity and negative predictive value. Hence, if umbilical cord thickness is less than 90th centile the chance of macrosomia is less, the cut off of foetal fat layer ≥5 mm as predictor of macrosomia had sensitivity of 84.2% and specificity of 86.4% and cut off of Interventricular septal thickness ≥3.9mm as a predictor of macrosomia had sensitivity of 84.2%, specificity of 64.2%, negative predictive value of 95.9%. Thus, interventricular septal thickness and foetal fat layer is a reliable predictor of macrosomia.Conclusions: From this study authors concluded that Umbilical cord thickness, foetal fat layer and Interventricular septal thickness are good predictors of foetal macrosomia. In the assessment of risk of macrosomia in addition to the ultrasonographic measurements the clinical risk factors must be considered.
Background: The aim of the study is to compare the efficacy, tolerance and compliance between oral iron and intravenous infusion of iron in iron deficient antenatal mother.Methods: This is a prospective randomised clinical and interventional study in the department of Obstetrics and Gynaecology in Vinayaka Mission Kirupananda Variyar Medical College and Hospital. The antenatal women attending the antenatal op were screened for Hb status. Those antenatal women of gestational age 16-34 weeks with Hb level between 7-10g% and diagnosed to have iron deficiency anemia by peripheral smear and serum ferritin were included in this study after getting informed consent. The total numbers of 100 mothers were allotted into two major groups, group A and group B of 50 subjects each. Group A: 50 pregnant women given oral iron supplementation (carbonyl iron 100 mg twice a day). Group B: 50 pregnant women given intravenous iron sucrose therapy after calculating the total iron requirement. The rise in hemoglobin in both the groups were comparedResults: In this study the mean rise of hemoglobin in carbonyl iron was 0.914±0.20 gm% whereas in iron sucrose group was 2.43±0.20gm%. This showed that iron sucrose (i.v) had better rise in Hb than carbonyl iron (oral).Conclusions: The present study revealed that intravenous iron sucrose therapy was bettertolerated with higher increase in mean haemoglobin compared to oral iron therapy. There were no serious side effects with intravenous iron sucrose therapy. Intravenous iron sucrose is a good substitute to oral iron therapy in moderate anaemia.
BACKGROUNDNovel influenza A or swine flu causes widespread outbreak of respiratory infection worldwide. Pregnancy and postpartum has four to five-fold increased risk of complications and serious illness. The present study was undertaken to analyse the maternal and perinatal outcome of women with swine flu in pregnancy and postpartum period. METHODSThis was a retrospective study done in a tertiary hospital in Salem district of Tamilnadu. Only confirmed cases of swine flu in pregnancy and postpartum were included in the study. The study period was October 2015 to November 2018. Patient symptoms, signs, laboratory abnormalities, criteria for ICU admission, maternal and perinatal outcome were analysed in this study. RESULTSA total of thirty-one women was included in the study. All were throat swab positive for H1N1 Real Time PCR. The overall maternal mortality was 9.6 % and perinatal mortality was 16.6 %. Pneumonia, respiratory failure and coagulopathy were the cause s of maternal deaths. CONCLUSIONSVaccination, high index of suspicion, early diagnosis, antiviral therapy, and early referral to higher centres is mandatory in all suspected cases of swine flu in pregnant and postpartum woman to reduce both maternal and perinatal complications. HOW TO CITE THIS ARTICLE: Priya GP, Jeyamani B, Nithya S, et al. Maternal and perinatal outcome of women with swine flu in pregnancy and postpartum.
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