ABSTRACT
Background: Intrauterine growth restriction remains a leading contributor to perinatal mortality and morbidity. There is no cure, management is reliant on a structured antenatal surveillance program with timely intervention. Recent advances in ultrasound and Doppler have elucidated several mechanisms of evolution of disease and prediction of threat of intrauterine hypoxia and acidaemia well in advance of other surveillance tests. Materials and methods: This prospective study was conducted in 110 high risk pregnant women attending OPD, admitted in antenatal wards and labor room at Government General Hospital, Siddipet, over a period of 2 years from October-2016 to September 2018; Ultrasound examination was done for interval growth, AFI, placental pathology. Fetal well-being was assessed with Doppler studies of UA and MCA, daily fetal movement count, NST, BPP. Results: In the present study, PIH was found to be the commonest (50.9%) cause of IUGR. Abnormal Doppler Indices in Umbilical and MCA correlated statistically with lower birth weight, higher rates of caesarean delivery, oligohydramnios, lower Apgar scores, perinatal death, and higher admissions to NICU. AEDF/REDF was associated with highest perinatal loss, poor perinatal outcome. Cerebroplacental ratio < 1 (C/U<1) had 100% specificity and 100% PPV. Conclusion: Doppler technology enables a better understanding of the hemodynamic changes in the fetus. It can help in identifying the changes in the fetal circulation well in advance of other surveillance tests, thus identify the truly hypoxic fetus. Interval changes in Doppler indices are useful in determining monitoring frequencies and optional time for delivery.
ABSTRACT
Background: Preterm delivery is a major contributor to neonatal morbidity and mortality and its prevention assumed special importance in the practice of obstetrics It is well known that the risk of neonatal death increases exponentially with decreasing gestational age and weight Aim of present study was to study the incidence of bacterial Vaginosis in established preterm labor and also in Pregnant Women with previous History of Preterm Labor in our Population as several recent studies have documented association between bacterial vaginosis and Preterm labor Materials and methods: The present study was undertaken for a period of two years from 2015- 2017 at Government Hospital, Siddipet 50 Cases with high risk for preterm labor were included in the study and 50 cases with term labor in control group Results: Majority of the women in both groups were between 20-24 years Majority of the cases had no previous abortion in both the groups Mean gestational age who has gone into preterm labor was 31-33 weeks The incidence of BV was higher among the study group (36%) compared to control group and was statistically significant (p<005) BV has significantly associated with 345 fold risk for preterm labor (odd’s ratio – 345) CI 128-98 statistically significant when compared to controls Conclusion: In this study, a significant difference in the presence of BV in patients of preterm labor and term labor was found (P<005) This observation could indicate a definite association of BV with preterm labor The relative risk of the presence of the BV in preterm labor was found to be 345 (95% CI -128 -918) Also BV was associated with 25 fold increased risk for preterm labor at earlier gestational age