Placenta bipartite is a rare variation of placental morphology. The estimated incidence is up to 2-8 % of pregnancy. There is no distinct racial, ethnic or geographical prediction observed. The diagnosis of an anomalous placenta is important for patient management at the time of delivery. Specifically, the bilobed placenta can be associated with first-trimester bleeding, polyhydramnios, abruption, and retained placenta. Careful attention to the cord insertion is also required for optimal fetal management. We report a case of a 24 years multi gravida with previous history of 2 C/S who had regular antenatal checkup and her pregnancy was uneventful till 36 wks. Her early USG at 16 weeks showed low lying placenta little away from the internal os of cervix. She was advised to take complete bed rest, avoid journey and coitus. Couple was warned about pervaginal bleeding, which may occur any time and also advised to ready at least four blood donors. Her 2nd USG scan at 26wks showed placenta bipartite and insertion of cord over the internal os of cervix. Patient was treated conservatively and dose of inj. Oradexon was completed at 32wks for lung maturation. At 36 weeks, patient perceived less foetal movement and then emergency LUCS with BLTL was done. Baby was well and her postpartum period was uneventful.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 101-103
Objective: To examine the diagnostic value of umbilical artery velocity waveforms for the early detection of pregnancy induced hypertension and fetal growth restriction. To determine the utility of color Doppler Sonography of the fetoplacetal circulation for early detection of high risk pregnancies. Methods: This prospective study was conducted in the Department of Obstetrics & Gynecology, Sir Sallimullah Medical Collage & Mitford Hospital Dhaka in collaboration with radiology and imaging department of Dhaka hospital in 1st July, 2006 to 30 June, 2008. 126 randomly selected patients from 17-35 years of ages whose umbilical artery Doppler sonography was done between 16-22 weeks of gestation. All the patient were taken umbilical artery Doppler ultrasonography. Informed consent was taken from all patients. Results: A total 126 subjects of 16 to 22 weeks of gestation were included in this series. On application of the student‘t’ test for S/D ratio between normal and abnormal waveforms of the umbilical artery was found significant difference (P<.0001). Distribution of patient according to umbilical artery systolic / diastolic ratio (n=126). Normal UA waveform 76 (60%), abnormal UA waveform 50(40%), Age (Mean ±SD) in year, normal UA waveform 25.63 ± 4.47 and abnormal UA waveform 25.86±3.75. Para: Primiparous normal UA waveform 36 (60%) & abnormal UA waveform 24 (40%), multiparous normal UA waveform 40 (60.6%) & abnormal UA waveform 26 (39.4%). Gestation age at scan in weeks (Mean± SD), normal UA waveform 19.5 ±2.5, abnormal UA waveform 19±2.0. Gestation age at delivery in weeks (Mean± SD), normal UA waveform 39.03±1.61, abnormal UA waveform 35.78 ±1.53, P value 0.0001. Birth wt. in Kg. (Mean ±SD), normal UA waveform 3.10 ±0.38, abnormal UA waveform 2.42 ±0.53, P value 0.0001. S/D ratio (Mean ±SD), normal UA waveform 2.40 ±0.31, abnormal UA waveform 5.46±1.62, P value 0.0001. Cases with an abnormal outcome in relation to whether the umbilical artery waveform was classified as normal or abnormal (n=126). Abnormal outcome in PIH normal UA waveform (n=76) 4%, PIH abnormal UA waveform (n=50) 14%, P value 0.001. In PIH/FGR, normal UA waveform (n=76) 1% & abnormal UA waveform (n=50) 5%, P value 0.024. FGR normal UA waveform (n=76) 5% & abnormal UA waveform (n=50) 13%, P value 0.002. Asphyxia normal UA waveform (n=76) 0% & abnormal UA waveform (n=50) 3%, P value 0.017. PIH /IUD normal UA waveform (n=76) 0% & abnormal UA waveform (n=50) 1%. A significant association was found when the Chi Square (X 2) test was used to examine the relationship between umbilical artery blood flow and the outcome of patient (i.e FGR, PIH, fetal asphyxia). The screening test had a sensitivity of 78.26% & specificity of 82.5% and accuracy 80.95%. The predictive value of a positive test was 72% and of a negative test 86.84%. Conclusion : A close linear relationship between diagnosis of high risk pregnancy & umbilical artery Doppler velocity waveforms was observed .As umbilical artery Doppler is easy to perform and it is done in between 16 to 22 weeks of gestation can be done along with anomaly scan which is also done at 20-22 week of gestation. So, UA Doppler does not cause additional USG scan. Along with anomaly scan UA Doppler will help to screen out high risk pregnancy.
Objective: To find out the complications of a pregnant woman with premature rupture of membrane (PROM) and assess the outcome of it. Materials and Methods: This prospective study was carried out at the
This descriptive cross sectional study was carried out to determine the current status of Quality Assurance Scheme in undergraduate medical colleges of Bangladesh. This study was carried out in eight (four Government and four Non- Government) medical colleges in Bangladesh over a period from July 2015 to June 2016. The present study had an interview schedule with open question for college authority and another interview schedule with open question for head of department of medical college. Study revealed that 87.5% of college had Quality Assurance Scheme (QAS) in their college, 75% of college authority had regular meeting of academic coordination committee in their college, 50% of college had active Medical Education Unit in their college, 87.5% of college authority said positively on publication of journal in their college. In the present study researchers interviewed 53 heads of department with open question about distribution, collection of personal review form, submission with recommendation to the academic co-coordinator, and annual review meeting of faculty development. The researchers revealed from the interviews that there is total absence of this practice which is directed in national guidelines and tools for Quality Assurance Scheme (QAS) for medical colleges of Bangladesh. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 33-39
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