Courbes de croissance d'une population foetale de la maternite de Kingasani

Objectifs. Etablir les courbes de croissance foetale standard des percentiles 10; 50 et 90 du diametre biparietal (BIP); du perimetre cephalique (PC); de la circonference abdominale (CA); du diametre abdominal transverse (DAT); de la longueur du femur (LF); ainsi que de l'estimation ponderale du foetus (EPF) d'une population obstetricale de la maternite la plus frequentee de Kinshasa.Methodologie. Il s'agit d'une etude prospective longitudinale portant sur 261 grossesses uniques d'evolution normale suivies de la 20eme a la 40eme semaine durant 18 mois. La mesure du diametrebiparietal (BIP); du perimetre cranien (PC); de la circonference abdominale (CA); du diametre abdominal transverse (DAT); de la longueur du femur; et l'estimation du poids foetal (EPF) ont ete realisees par un meme operateur toutes les 4 semaines. La moyenne; la mediane et leurs dispersions ont ete calculees avec le logiciel SPSS 15;0 et les courbes ont ete tracees a l'aide du logiciel Microsoft Office Excel 2007. Resultats. Des courbes de croissance standard pour le IP; PC; CA; DAT; LF et EPF ont ete etablies pour notre population et montrent des differences avec celles desautres populations. Conclusion. Les auteurs ont etabli des courbes de croissance normale de la biometrie d'une population foetale de la maternite de Kingasani. Elles pourraient constituer un outil utile pour suivre la croissance foetale et diagnostiquer les troubles de croissance intra-uterin dans ce milieu

Prediction of Successful Induction of Labour with Dinoprostone in a Homogeneous Group of Patients

Objectives. The aim of the present study was to compare the efficiency of transvaginal ultrasonography and the Bishop's scoring system in predicting the success of labour induction. Methods. Transvaginal ultrasonography for cervical evaluation and cervical palpation for Bishop scoring were performed in all patients by the same obstetrician. This prospective study was conducted in the Perinatology and Maternity Care Unit of Etlik Zubeyde Hanim Maternity and Women's Health Teaching and Research Hospital between September 2007 and February 2008. Eighty-four patients induced with prostaglandin E2 (dinoprostone) for medical indications were included in the study. Results. No significant association was found between transvaginal measurement of cervical length and the success of labour induction (p=0.201). We found no statistically significant difference between failure of labour induction and successful labour induction in terms of transvaginal measurement of cervical length (area under the curve (AUC) 0.583; 95 confidence interval (CI) 0.452 - 0.714). A significant association between the Bishop's score and failure of labour induction (p=0.029) was found. A statistically significant relationship was found between failure of labour induction and successful labour induction in terms of the Bishop's score (AUC 0.632; 95 CI 0.513 - 0.751). The best cut-off point for predicting successful labour induction was a Bishop's score of 2 or more. The sensitivity and specificity levels associated with this point were 82.4 and 44.9; respectively (positive predictive value 50.9 and negative predictive value 78.6). Conclusions. Bishop's scoring system was more successful than assessment of cervical length by ultrasound in predicting failed induction in a homogeneous group of patients in whom labour was induced with prostaglandin E2

Sonographic Evaluation of Cervical Length Changes during Normal Pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age; the absence of any risk factors for preterm birth; and uncomplicated pregnancy. Cervical length was measured in a straight line. Height; age and weight of patients were also obtained. There was a relationship between gestational age and cervical length; which could be described with a linear regression (R = 0.44; P0.05). Our study shows an increase in cervical length with gestational age. Reference ranges constructed for the whole gestational period could be more clinically applicable and useful than a single cut off value for more efficient prevention and management of preterm birth