ABSTRACT
Background: The placenta is a multifaceted organ which modulates and modifies the maternal environment resulting in foetal development. It could be assumed that a healthy placenta culminates in a healthy foetus. Hence the morphometric analysis of a placenta during sonogram is inevitable. The aim of the study was to estimate the relationship between placental thickness and estimated foetal weight.Methods: The study was a cross-sectional study and included 450 antenatal women attending the department of Obstetrics and Gynaecology, Tirunelveli Medical College from May 2013 to May 2014. These women had regular cycles with a known Last menstrual period and a singleton foetus. After ethics committee approval, meticulous history including age, parity, demographic factors and past history were recorded. After obtaining consent, these women underwent placental thickness measurement between 14-40 weeks of pregnancy.Results: In the study mean placental thickness between the ranges of 11-49mm was 28.7mm and mean estimated foetal weight was 1.421kilogram. The correlation between the two was 0.943. Hence the positive correlation between the placental thickness and foetal weight is confirmed (p value <0.001).Conclusions: Determining the estimated foetal weight is an important reason for doing a sonogram, especially in third trimester. Placental thickness measured at the level of umbilical cord insertion can serve as an additional parameter in estimating foetal weight in addition to the foetal parameters, since there is a linear correlation between placental thickness and foetal weight.
ABSTRACT
Background: Early onset neonatal sepsis (EONS) is caused mainly by organisms present in the genital tract. Maternal risk factors increase the incidence of EONS. This study was done to find out the association between one such risk factor i.e., multiple vaginal examinations and EONS.Methods: Case control study. 114 patients with three or more vaginal examinations after rupture of membranes were taken as cases and 114 patients with less than three vaginal examinations after rupture of membranes were taken as controls. All these babies were followed up for the development of EONS.Results: Of the 114 cases, 6 babies developed EONS. None of the babies in the control group developed EONS. So, 3 or more vaginal examinations after rupture of membranes in labour is significantly associated with early onset neonatal sepsis with p-value of 0.01305.Conclusions: Multiple vaginal examinations after rupture of membranes is a risk factor for early onset neonatal sepsis.
ABSTRACT
OBJECTIVE: To document effects of intrapartum risk factors for early onset sepsis (EOS) on CRP levels in neonates and to assess the suitability of this test in diagnosing EOS. DESIGN: Cohort study. SETTING: Labour and post natal wards in a tertiary level teaching hospital in India. SUBJECTS: 250 neonates at risk of developing infection. METHODS: CRP levels in cord blood and neonatal blood at 24 hrs were estimated using commercial kits. Babies were observed for signs of sepsis for at least 48 hours. RESULTS: Seven (2.8 Percent) neonates had elevated CRP levels in the cord blood. At 24 hours, 102 (40.8 Percent) babies had elevated levels. Elevated cord CRP levels was significantly associated with rupture of membranes for 24 hours (p =0.04), labour more than 12 hours (p = 0.002), and maternal fever (p = 0.01). At 24 hours, elevated CRP levels were associated with primiparity (p= 0.006), more than three vaginal examinations after membrane rupture (p=0.02), meconium staining of amniotic fluid (p =0.02) and amnioinfusion (p =0.02). Ten (4 Percent) babies developed EOS. The negative predictive value for elevated CRP levels at 24 h was 99 Percent. CONCLUSION: Several intrapartum risk factors for EOS can cause elevation in CRP levels. However, this test may be useful in excluding infection.