Aim: To determine the role of Color Doppler Sonography in evaluation of fetal outcome in normal and hypertensive pregnant females. Method:The study was carried out on 58 antenatal females (22 normotensive, 36 hypertensive) in their third trimester of pregnancy. After detailed history taking and physical examination, study of various arteries was performed using color Doppler ultrasound {TOSHIBA ECCO-CE CX} with 3.5 MHz curvilinear probe. Doppler measurements were taken with the mother in recumbent position during fetal inactivity and apnea. Arteries evaluated included -bilateral uterine arteries, umbilical artery, fetal middle cerebral and fetal aorta. Calculation of Systolic/Diastolic ratio(S/D), resistive (RI) and pulsality indices (PI) was done .The indices were correlated with fetal outcome.Results: In our study, 34(94.44%) out of 36 hypertensive patients showed abnormal uterine artery flow of which 11 {32.35%} had intrauterine growth retardation (IUGR) and 1 Intrauterine death of fetus ( IUD) as fetal outcome. 29 patients of 36 hypertensive patients had abnormal umbilical artery flow of which 11{30.5%} had IUGR as fetal outcome. Only one patient having severe hypertension had reversed end diastolic velocity (REDV) in umbilical artery and had sudden IUD. Another patient had absent end diastolic velocity (AEDV) and the baby expired 2 days after birth. 28 (77.78%) patients showed brain sparing effect {BSE} with reduced value of indices in fetal middle cerebral artery. Out of these, 11(30.5%) patients had small for gestational age (SGA) babies and 1(2.7%) had IUD. In hypertensive pregnancies 22 (61.1%) cases showed values of S/D, RI and PI above 2 SD, of which 11(50%) patients had SGA babies. Conclusion:Color Doppler can detect changes in fetomaternal and uteroplacental circulation accurately which seem to correlate strongly with the pregnancy outcome; abnormal indices showing strong correlation with adverse fetal outcome. It helps us to monitor fetal well being, take timely action, plan the treatment and prevent adverse fetal outcome in high risk pregnancies.
Fibromatosis colli or sternocleidomastoid tumor of infancy is a condition of benign proliferation of fibrous tissue within the sternocleidomastoid muscle leading to focal or diffuse enlargement of the sternocleidomastoid muscle and is often clinically associated with torticollis. Radiological imaging especially ultrasound, if performed by an expert radiologist plays an important role in differentiating this benign condition from other causes of neck masses in this age group, thereby preventing unnecessary investigations in a neonate and decreasing parent`s anxiety. We hereby, present a case report of a sternomastoid tumor in a two week old neonate diagnosed using high frequency ultrasound, signifying that every physician should be aware of this clinical entity in a neonate and refer them immediately for ultrasound.
Study DesignRetrospective study.PurposeTo note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases.Overview of LiteratureSpinal tuberculosis, or Pott's spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt management of these pathologies are essential in preventing various complications.MethodsWe retrospectively reviewed 40 cases of atypical tuberculosis and metastasis affecting the spine from the year 2012 to 2014, with 20 cases each that were proven by histopathological examination. MR imaging was performed on 1.5 T MR-Scanner (Magnetom Avanto, Siemens) utilizing standard surface coils of spine with contrast injection. Chi-square test was used for determining the statistical significance and p-values were calculated.ResultsThe most common site of involvement was the thoracic spine, seen in 85% cases of metastasis and 65% cases of Pott's spine (p=0.144). The mean age of patients with tubercular spine was found to be 40 years and that of metastatic spine was 56 years. The following MR imaging findings showed statistical significance (p<0.05): combined vertebral body and posterior elements involvement, skip lesions, solitary lesion, intra-spinal lesions, concentric collapse, abscess formation and syrinx formation.ConclusionsTuberculosis should be considered in the differential diagnosis of various spinal lesions including metastasis, fungal spondylodiskitis, sarcoidosis and lymphoma, particularly in endemic countries. Spinal tuberculosis is considered one of the great mimickers of disease as it could present in a variety of typical and atypical patterns, so proper imaging must be performed in order to facilitate appropriate treatment.
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