Placental abruption complicates about 1% of singleton pregnancies and is an important cause of perinatal mortality and morbidity. Though sensitivity and reliability of ultrasound are poor for detecting or excluding placental abruption, because of the advances in ultrasound resolution, imaging and interpretation, sensitivity of ultrasound is better than what was reported previously. To determine the diagnostic performance of Aim: Ultrasonography (USG) for the detection of placental abruption and whether sonographic results correlate with maternal and foetal management and outcome Sixty patients with clinical diagnosis of placental abruption we Materials and Methods: re studied in the Obstetrics and Gynaecology Department of Gujarat Adani Institute of Medical Sciences, Bhuj over a period of 6 months. These patients underwent ultrasonography for conrmation. Obstetric and neonatal outcome and sonographic results were compared and reviewed. Sonographic sensitivity and specicity and positive and negative predictive values were calculated. Incidence of abruption in present study was 3.05% (56 Results: patients out of 1834 total deliveries). Sensitivity of ultrasonography in the diagnosis of abruption was 57% while its specicity was 100% with a positive predictive value of 100% and a 14% negative predictive value. An 87.5% of patients(28 out of 32) with a positive USG nding of abruption had Intrauterine foetal Death (IUD)/still birth while 91.6% of patients (22 out of 24) with negative USG ndings of abruption gave birth to babies who required NICU admission. Sonography has a poor sensitivity for diagnosing placental abrupt Conclusion: ion, even though it has a high specicity and PPV. In a positive sonographic result, maternal morbidity and perinatal mortality are high which needs aggressive obstetric management as compared to the normal sonography. In case of a negative sonographic nding but a strong clinical suspicion of abruption if Obstetric intervention is made in due time, foetal as well as maternal outcome are better
Background: High risk pregnancy needs special antepartum as well as intrapartum care and investigations. CTG is aadmissionscreening test to monitor fetal wellbeing by use of cardiotocograph. It monitors fetal heart rate and uterine contractions. Color Doppler is ultrasound dependent test which uses vascular flow velocities and Doppler waveform to predict fetal outcome. Objective: Comparison of efficiency of CTG & Color Doppler ultrasound for intrapartum fetal surveillance in high risk pregnancy. Methods: Retrospective study of 100 high risk pregnancies of ≥ 34 weeks POG in labor with CTG and color Doppler findings were done on admission at Gujarat Adani Institute of Medical Sciences, Bhuj. Subjects were classified into 4 groups based on CTG and color Doppler findings. Maternal and fetal outcome were recorded and correlated with CTGand color Dopplerfindings. Results: Most common cause of high-risk pregnancy was preeclampsia(n=60/100,60%).In our study, rate of normal delivery was 40% and c-section was 60% (31% elective & 29% emergency). Out of 100 fetuses, 76 were healthy, 22 were admitted in NICU (6 NICU deaths) and 2 were still birth. Perinatal outcome was most favorable with normal CTG and Color doppler and was least favorable with both of them abnormal. Outcome was intermittent in other two groups. CTG found to have sensitivity 62.5% and specificity 82.5% in detection of adverse fetal outcome. Similarly,sensitivity and specificity of color doppler was 48.8% and 98.6% respectively. Conclusions: In our study it was found that CTG is more sensitive and color Doppler is more specific in detection of adverse fetal outcome.
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