We present autopsy findings of a case of limb body wall complex (LBWC). The fetus had encephalocele, genitourinary agenesis, skeletal anomalies and body wall defects. The rare finding in our case is the occurrence of both cranial and urogenital anomalies. The presence of complex anomalies in this fetus, supports embryonal dysplasia theory of pathogenesis for LBWC.
Objective
To derive population specific transverse cerebellar diameter/abdominal circumference ratio (TCD/AC ratio) for the assessment of normal fetal growth.
Materials and methods
A one-year prospective observational study conducted at the KLE University's teaching hospital, Belgaum. The TCD/AC ratio was calculated for 434 obstetric patients, who met the inclusion criteria and the arithmetic mean and 1 standard deviation (SD) was calculated for the population studied.
Results
Within the study population, the TCD/AC ratio assessed for normal fetal growth with gestational age ranging from 18 to 34 weeks was found to be a constant with a mean of 13.56 +/− 1.21(1 SD).
Conclusion
A normal standard value to assess normal fetal growth is required for a given set of population in order to be compared with those fetuses with intrauterine growth restriction (IUGR). The TCD/AC value in our study remained a constant between gestational ages ranging from 18 to 34 weeks with a mean of 13.56 +/− 1.21.
Informed consent is the heart of ethical research. For any consent to be ethically valid, it should meet certain critical criteria— disclosure and understanding of relevant information, decision making competency of the participants, voluntariness of the decision and documentation of the agreement. Meeting all these criteria to obtain ethically valid consent from laboring women while conducting intrapartum trials is challenging because there is little time available during labor to provide study specific information necessary for the participant to understand and decide to sign the consent form. Moreover, women during labor may be anxious and distressed due to labor pains which is thought to interfere with the capacity to make decisions in some cases. Emphasis on these concerns may ultimately lead to the exclusion of many eligible women in labor from intrapartum clinical trials. In this paper, we discuss the ethical challenges and also the proposed recommendations to obtain ethically valid consent from women for conducting intrapartum clinical trials.
Introduction: Preterm labor (PTL) is one of the leading causes of perinatal morbidity and mortality. It is one of the major public health problems, especially with reference to mortality, disability and health care expenses. Incidence: The overall incidence of PTL is around 10-15% (6-15% Range) 3 (The incidence of PTL in our institute (JNMC) was 10.2% during 2006-2007. Out of all PTL 50% occur spontaneously, 25% following preterm prelabor rupture of membranes (PPROM) and another 25% iatrogenic (Induced due to maternal and/or fetal risks). Risk factors: Previous history of preterm labor is one of the important risk factor(risk of PTL in subsequent pregnancies is 14.3% and 28% after one and two preterm births. Others include multiple pregnancy, uterine over distension (polyhydramnios, macrosomia and fibroids), uterine anomalies, cervical incompetence, bacterial vaginosis, bleeding in early pregnancy, poor socioeconomic status, elderly and adolescent age group and tobacco use. Predictors : Cervical length assessment by USG, fetal fibronectin, vaginal pH are being used. Prevention: Progesterone and clindamycin (abnormal vaginal flora) antibiotic is being used with reasonable evidence. Treatment: Corticosteroids and antibiotics help in reducing neonatal morbidity and mortality and tocolytics (nifedepine and atosiban are recommended) helps in allowing the steroids to act. Newer developments: New predictors like higher vaginal pH (> 4.5) and Gram stain score of 9 to 10 with Nugent criteria in early pregnancy is increasingly associated with preterm labor. Search for selective and safe tocolytic is also under consideration, specially the prostaglandin synthetase inhibitors and the role of potassium channels in myometrium. Conclusion: Successful prediction, prevention and treatment of preterm labor has significant influence on the perinatal outcome, health care expenditure and quality of life. As the cause for preterm labor is still an enigma, it is difficult to predict, prevent and treat PTL successfully. At present the treatment of PTL is mainly antibiotics, tocolytics and corticosteroids with varied success.
A total of 60 patients with primary and secondary infertility were included in the study. Women with acute pelvic infection were excluded from the study.
Aim: Ovarian cysts in the newborn period are simple cysts which resolve on their own. Complications like torsion leading to loss of ovarian units are well documented. Surgical treatment should always be performed in a way to protect the ovaries and to ensure future fertility. The aim of this study was to study the safety and efficacy of laparoscopic management of neonatal ovarian cysts.Materials and Methods: Neonates with ovarian cysts over last 6 years were retrospectively studied. Thirty seven ovarian cysts were detected antenatally and 32 of them persisted postnatally. All babies were asymptomatic. Nine babies with cyst size more than 5cms underwent laparoscopic deroofing, fenestration or cystectomy; the rest 23 babies were managed conservatively. Sonographic monitoring was done at monthly interval for change in contents, echogenicity of walls and features of torsion. Follow up was done with USG at 3 and 6 months and MRI after 1 year.Results: No procedure related complications were seen in the laparoscopy group and no loss of ovarian units were seen in 1 year follow-up. In the observation group, cysts resolved in 3- 12 months period. Three babies developed complications and 4(17%) ovarian units were lost.Conclusion: Ovarian cysts are the most frequent among intra-abdominal cysts in newborns. Neonatal ovarian cysts are known to resolve spontaneously. Laparoscopic management of these cysts is safe and efficacious even in neonatal age and should be the treatment of choice when indicated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.