Objective To assess the predictive value of cerebroplacental ratio (i.e., S/D ratio of middle cerebral artery to S/D ratio of Umbilical artery) in detection of perinatal outcome in high-risk pregnancies.Material and Method This retrospective study was conducted on 150 patients between 28 and 40 weeks of gestation (25 low risk and 125 high risk) who attended OPD and indoor wards of Teerthanker Mahaveer medical college and research center, Moradabad. All patients had serial color Doppler ultrasounds done after taking informed consent which was repeated at 2 weeks interval, and data were collected with regard to perinatal outcome. Result and ConclusionCerebroplacental ratio is having higher sensitivity and negative predictive value in detection of IUGR, Meconium aspiration syndrome, operative interference for fetal distress, and NICU admissions in comparison to its components. So, better prediction of neonatal outcome can be done by C/U ratio.Keywords Cerebroplacental ratio (C/U) Á Doppler Ultrasound Á Meconium aspiration syndrome Á Middle cerebral artery (MCA) Á Umbilical artery (UA) Á Systolic flow/end diastolic flow (S/D ratio)

The aim of present investigation is to study the efficacy and safety of tranexamic acid in reducing blood loss during and after cesarean section. Tranexamic acid is a competitive inhibitor of plasminogen activation, and at much higher concentrations, a noncompetitive inhibitor of Plasmin. Plasmin may be formed by conformational changes in plasminogen, it's binding to and dissolution of the fibrin matrix is inhibited. Tranexamic acid significantly reduces the amount of blood loss during and after the lower segment cesarean section. The use of tranexamic acid was not associated with any side effects or complication like thrombosis, nausea, vomiting and diarrhea.

The above study was conducted to find out the perinatal outcomes in pregnancies with oligohydramnios, especially in the third trimester of pregnancy. METHODS: This prospective and observational study was conducted in a Medical college and research centre at Moradabad city, U. P, from January to December 2012. In this study 78 singleton pregnant women with gestational age from 28-42 weeks with less amniotic fluid index (AFI) were analyzed for perinatal outcome. Data were expressed as number (percentage). Proportion test was performed for comparison between two groups, P value <0. 05 was taken as level of significance. RESULTS: Women with oligohydramnios were significantly associated with an abnormal antepartum fetal heart rate (FHR), meconium stained fluid, Apgar score less than 7 or NICU admission. Also subjects with AFI of 5. 0 cm or less had a higher rate of cesarean section for fetal distress. CONCLUSIONS: Antepartum oligohydramnios is associated with an increased risk of fetal heart rate abnormalities. Although in our population it is not predictive of adverse perinatal outcome as measured by low Apgar score and NICU admission, yet this may be reflective of the aggressive antepartum and intrapartum management that these patients received.

BackgroundSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes Coronavirus disease has caused one of the most damaging pandemics in the recorded human history. ObjectiveTo assess pregnancy outcomes with COVID-19 lessons learned from the pandemic. Study designThis retrospective observational study was conducted at Teerthanker Mahaveer Medical College and Research Centre, Moradabad, a level 3 COVID hospital in Northern India, with a patient pool of all the antenatal females diagnosed COVID 19 positive via a positive quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) test of maternal pharyngeal and nasal swab samples in the given time period of three months and ten days, i.e., May 25, 2020 to September 3, 2020. In conjunction with maternal outcomes, neonatal outcomes including evidence of perinatal transmission of SARS-CoV-2 was assessed by testing neonatal pharyngeal swab samples. ResultsOut of 100 COVID-19 positive patients, the average age of women was 26.2 years, 73 women (73%) were asymptomatic, and 50 patients (50%) women had associated co-morbidities such as anaemia in 38 (38%) women, gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) in four patients (4%) each, respectively. No case of spontaneous abortion in early gestation was reported. Out of 100 patients, 32 (32%) patients delivered during their stay, out of which 17 women (53.1%) delivered via cesarean section which was performed mainly due to obstetric indications. One maternal death was reported due to antepartum eclampsia which was unrelated to COVID-19 complications. Five neonates were born prematurely, out of which three were delivered followed by spontaneous premature preterm rupture of membranes (PPROM).The Appearance Pulse Grimace Activity Respiration (APGAR) score was recorded to be ≥9 at the five minutes mark in 28 out of 30 live babies (93.3%) and the birth weight of the babies ranged from 1.8 to 3.5 kg) with an average birth weight of 2.71 kg. Two neonatal deaths were reported due to respiratory distress. There were two documented intrauterine demise (IUD) cases both due to PIH. Furthermore, all 30 live neonates tested for SARS CoV-2 had negative results. ConclusionThe spectrum of Coronavirus infection leans more towards asymptomatic and mild symptomatic clinical presentation. Favourably, the likelihood of spontaneous preterm birth was not escalated in our current study and remained low. The rate of intrauterine fetal demise and neonatal death were less. As none of the neonates tested positive for COVID-19, there is no corroborative proof of vertical perinatal transmission.

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