ABSTRACT
Fetal weight is a very important factor to make a decision about labor and delivery. Assuming that in large fetuses, dystocia and other complications like cerebral edema, neurological damage, hypoxia and asphyxia may result during or after the delivery. On the other hand, one of the causes of high perinatal mortality in our country is high rate of low birth weight. Rural people may not have access to ultrasonography which is one of the methods to predict birth weight. For these people alternative easy method is necessary. So we can assess fetal birth weight by measuring symphysio-fundal height. Total 100 consecutive pregnant women of gestational age more than 32 weeks admitted for delivery in the Obstetric and Gynaecology department of Faridpur General Hospital were the subject of this study. After selection of cases, a thorough clinical history was taken and elaborate physical examination was done. Common criteria for collection of data were followed in every case. The fetal weight estimated by Johnson's formula was recorded in the predesigned data sheet and then was compared with birth weight following delivery of the fetus. Collected data were compiled and relevant statistical calculations were done using computer based software. Statistical tests (Correlation) were done between actual birth weight (taken as dependant variable) and fetal weight (found by Johnson's Formula), symphysio fundal height (SFH), pre-delivery weight and height of the patients (taken as independent variables) and the tests revealed that actual birth weight was significantly correlated with fetal weight (found by Johnson's Formula), SFH, pre-delivery weight and height of the patients. Among these fetal weight and SFH had shown highest correlation. Regression analysis showed that SFH, maternal height and maternal weight explained respectively 59%, .011% and .009% of observed variation of birth weight.
ABSTRACT
Background: In vitro studies have shown that C-reactive protein ( CRP ) attenuates nitric oxide production and inhibits angiogenesis, which may result in impaired collateral development. The aim of this study was to investigate the association between CRP levels and the extent of coronary collaterals. Materials and methods: A total of 100 patients who had a stenosis of >95% in any major coronary artery in angiograms were included in the study. The CRP was measured from a venous blood sample with a high- sensitivity assay. Collaterals of the epicardial coronary arteries were then studied and graded in a scale of 0 - 3 according to Rentrop classification. Results: Mean age was 49.6 years and 86% were male. The mean CRP level was found 15.57 ±12.85 mg/L in grade 0 (n =25 ), 11.38± 11.11 mg/L in grade I( n=20 ), 9.22± 10.15 mg/L in grade II ( n=34 ) and 8.97±8.44 mg/L in grade III ( n =21 ) collateral group. The mean CRP values reduced significantly (p<0.05) as the Rentrop collateral grade increased which indicated that patients with a higher grade of collaterals significantly had less CRP. Subjects with a higher grade of collaterals were significantly less likely to have diabetes mellitus [odds ratio (OR): 0.53, 95%; CI: 0.13, 0.91] or acute coronary syndrome [ odds ratio (OR) :0.67 , 95%; CL 0.43, 0.95] or higher CRP values [odds ratio (OR) 0.56 per 10 unit increase, 95%; CL 0.22, 0.92] but they were more likely to have higher number of vessels with significant stenosis [odds ratio (OR) : 1.59 ; 95% CI: 1.34, 1.87]. After adjusting for age, gender, clinical presentation with acute coronary syndrome, diabetes mellitus and the number of vessels with significant stenosis, each 10-unit increase in CRP values corresponded to 39% reduced- odds of having a higher collateral grade ( OR: 0.61, 95%: CL0.1 1,0.68). Conclusion: It may be concluded that elevated levels of CRP are significantly and inversely associated with angiographically visible coronary collateral development assessed by Rentrop classification.