A before and after study on the effect of fetal acoustic stimulation test on non stress test parameters / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: To determine the effect of Fetal Acoustic Stimulation Test on Non Stress Test Parameter METHODS: A total of 650 subjects (power of 80%) were enrolled. Subjects were both high risk and non high risk pregnancies, at more than 36 weeks AOG with normal AFI. All subjects underwent non stress test followed by non stress test with acoustic stimulation test for minimum of 20-40 minutes. Once consent was obtained, a low frequency sound transducer (40 hertz) was applied on the maternal abdomen to provide acoustic stimulation. The data was gathered, analyzed and compared. RESULTS: Acoustic Stimulation Test improved the results of NST by having reactive results, longer duration accelerations, improved variability from minimal to moderate variability, and increased number of fetal movement. CONCLUSION: AST is not a standalone procedure but merely an adjunct to other antenatal tests for fetal surveillance such as BPS and Doppler.

Association of transvaginal ultrasound endometrial thickness and fractional dilatation and curettage histopathology report in the evaluation of perimenopausal bleeding: A five year retrospective review / Philippine Journal of Obstetrics and Gynecology

A total of 365 women were included in this retrospective study that aimed to correlate the transvaginal ultrasound endometrial thickness and histopathology report of the fractional dilatation and curettage among those presenting with perimenopausal bleeding. The incidence of perimenopasual bleeding was 6.32%. Most were in the 46- 50 years age range and were within gravida 1 to 3 presenting with menometrorrhagia. Transvaginal endometrial thickness was mostly within 0.5cm to 1.50cm. Most common endometrial pathology were endometrial polyp, disordered endometrium and simple hyperplasia without atypia. The incidence of adenocarcinoma was 0.8%. There was no significant correlation between age, gravity and parity and the endometrial thickness as measured on transvaginal ultrasound. There was a significant difference in mean endometrial thickness when comparing patients presenting with vaginal spotting and menorrhagia, vaginal spotting and menometrorrhagia and metrorrhagia and menometrorrhagia. There was a statistically significant difference between the endometrial thickness of those with normal histopathology report, meaning endometrium with no pathology and appropriate with menstrual cycle and those with pathologic findings. Using a cut-off of greater than or equal to 1cm for endometrial thickness showed an OR of 3.57, 95%CI 1.24-10.53 for significant pathologic finding on histopathology report with 69.5% sensitivity, 61.1% specificity, 97.2% positive predictive value and a 9.4% negative predictive value.

Risk factors associated with malignant endometrial lesions in postmenopausal women presenting with abnormal uterine bleeding: a retrospective review

Objectives: To identify clinical, sonographic and hysteroscopic characteristics associated with malignant endometrial lesions. Methods: This is a retrospective descriptive study that included all menopausal women presenting with vaginal bleeding in a tertiary care hospital from January 2007 to June 2010. Clinical, sonographic and hysteroscopic findings were evaluated as predictor variables for development of endometrial adenocarcinoma. Results: Thirteen out of the 215 patients had endometrioid adenocarcinoma, in women presenting with postmenopausal bleeding, with a prevalence rate of 6%. A trend towards harm is seen among the following factors: age of > 60 years (OR 1.19; 95% CI, 0.29-4.46), menarche /- 10mm (OR 2.02; 95% CI, 0.58-7.09), lesion of diameter /- 10mm, hysteroscopic characteristics (lesion diameter of less than 1 em, presence of cystic space and soft consistency) increases the probability of carcinoma.

Idiopathic thrombocytopenic purpura in pregnancy / Philippine Journal of Obstetrics and Gynecology

A case of Idiopathic Thrombocytopenic Purpura (ITP) in pregnancy managed by multidisciplinary team approach is discussed. A case of 35-year old patient with ecchymoses and easy bruisability at four months age of gestation is presented. Diagnostics revealed prolonged bleeding time with peripheral blood smear and bone marrow aspirate biopsy consistent with ITP. Pertinent findings and evidence on management strategies on ITP in pregnancy were discussed and a consensus was arrived at. The patient was maintained on oral steroids, underwent fetal being surveillance and platelet count monitoring. Patient unremarkably delivered vaginally to a term livebirth who eventually developed neonatal thrombocytopenia. The neonate was treated with steroids and likewise discharged improved.