BACKGROUNDThe condition in which the foetus does not reach its growth potential is called Intrauterine Growth Restricted (IUGR). The mothers who are generally healthy and well nourished, the incidence of IUGR is 3-5%. The incidence of IUGR is 15-20% or higher in a women population with hypertension or previous growth restricted foetus.The aim of the study is to assess foetal compromise by Doppler ultrasound investigation of the foetal circulation. A total of 50 singleton pregnancies with suspected IUGR pregnancy attending the outpatient ward of Obstetrics and Gynaecology. Inclusion Criteria-Pregnancies from 29 weeks to 42 weeks of gestation complicated by intrauterine growth restriction and who are ultrasound confirmed. In the first trimester, gestational age determination was estimated by history of menstruation or biometry of foetus. Exclusion Criteria-Patients who had multiple gestations, congenital anomalies and history of membranes rupture. All the patients in the study were subjected to clinical history in detail to assess the risk factors of IUGR pregnancy, biometry of ultrasound and amniotic fluid assessment followed by Doppler ultrasound evaluation of uterine arteries, umbilical artery, middle cerebral artery, descending foetal thoracic aorta, ductus venous and umbilical vein.
RESULTSMajority of the patients were in the age group of 21-24 years. All the patients were in the age group of 19-30 years. 45% of antenatal mothers examined were between 28-31 weeks of gestational age, 35% were between 32-36 weeks of gestation, 20% were between 37-42 weeks of gestation age. 15 antenatal mothers had elevated uterine artery resistance index (30%), 12 antenatal mothers had persistent early diagnostic notch (24%), 11 antenatal mothers had elevated systolic/diastolic ratio (22%), 12 antenatal mothers had elevated uterine artery pulsatility index (24%), 15 antenatal mothers had elevated umbilical artery pulsatility index (30%), 10 antenatal mothers had elevated resistance index (20%) and 25 antenatal mothers had elevated systolic/diastolic ratio (50%). 8 (16%) foetus showed absence of end-diastolic flow in the umbilical artery flow velocity and 2 (4%) had reversal of end-diastolic flow in the umbilical artery flow velocity with a total of 10 (20%) foetuses having abnormal waveforms. There were 5 cases of intrauterine deaths, out of which 3 had absence of diastolic flow and 2 had reverse diastolic flow. Decreased pulsatility index of foetal middle cerebral artery was in 22 (44%) foetus, normal pulsatility index of foetal middle cerebral artery was in 28 (56%) foetuses. Elevated pulsatility index of descending thoracic aorta was in 26 (52%) foetuses, normal pulsatility index of descending thoracic aorta was in 24 (48%) of foetuses. Umbilical vein and ductus venous Doppler study showed that 20 (40%) of the foetuses had presence of pulsatile flow in the umbilical vein flow velocity waveform and 30 (60%) showed absence of pulsatile flow. There were 5 intrauterine deaths and 45 livebirths. Of the 45 livebirths, 10 neonates w...
Background: For many couples' advent of a baby is the most beautiful gift of life. Involuntary childlessness by itself does not threaten physical health but can have a strong impact on the psychological and social wellbeing of couples. The aim of the present investigation was comparison of different ovulation protocols in patients undergoing controlled ovulation hyperstimulation with Intra uterine insemination. Methods: A Prospective observational study was conducted in the department of obstetrics and gynaecology. 200 couples who underwent 541 cycles with controlled ovarian hyperstimulation. Variables selected for analysis were female age, menstrual history, duration of infertility, number of cycles, number dominant follicle diameter, endometrial thickness. Results: Maximum patients underwent ovulation induction with clomiphene citrate (202/541) and then with letrozole (202/541). Conclusions: Nowadays when the costs of health care are limited, intrauterine insemination can hold its place as a low-cost method of infertility treatment. Conclusively with careful selection of subjects, appropriate controlled ovarian stimulation and intra uterine insemination, good pregnancy rates with low multiple pregnancy rates can be achieved.
Aetiology of placenta praevia is obscure. It is caused by low implantation of the blastocyst at a site low in uterine cavity. The cause of low implantation is unknown, but certain factors are known to predispose to development of placenta praevia. All patients who came with history of painless bleeding per vagina after 28 weeks of gestation were hospitalized. A thorough history of vaginal bleeding (warning haemorrhage) was taken .Cases with confirmed diagnosis of placenta praevia on ultrasonography were included in the study. Placental anomalies were present in 4 (4.76 percent) cases, out of which, 2 cases (2.38 percent) were of adherent placenta. Placenta was removed in piece meal and PPH was controlled by bimanual compression and injection prostodin and methergin.
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