Outcome in pregnancies with unexplained antepartum hemorrhage

A prospective study of 48 women with bleeding from genital tract after 26 weeks gestation are included. None of them had a clinical diagnosis of abruption or ultrasound evidence of placenta previa, so they were diagnosed as unexplained antepartum hemorrhage. 15 of the 48 had poor outcome, 7 of them were premature deliveries. The results of Doppler studies of uterine and umbilical arteries, fetal biophysical profile or FHR variation were not significantly different between the 2 outcome groups. There was no significant difference in outcome between the women with unexplained APH and the matched comparison group. It was concluded that morbidity related to unexplained APH is associated with preterm delivery rather than with damaged utero-placental function

Perinatal fetal outcome in mild polyhydramnios

Mild polyhydramnios was defined sonographically as an amniotic fluid index of 24.1-39.9 during fetal biophysical testing. All subjects had singleton gestations not complicated by conditions known to predispose to polyhydramnios. Mild polyhydramnios was diagnosed in 48 of 279 patients [8.2%] undergoing fetal testing at 26-42 gestational weeks. Premature delivery, intrapartum complications, and neonatal depression were no more frequent in the pregnancies complicated by mild, unexplained polyhydramnios than in a comparable control group with normal fluid volume. The mild polyhydramnios group showed a significantly higher incidence of birth weight greater than 4000 g than did the control group [18.66 versus 8.6%, P <0.05]. It was concluded that mild idiopathic polyhydramnios in late gestation is relatively common. Except for a higher incidence of large for gestational age fetuses, this condition by itself is not associated with an increased risk of adverse perinatal outcomes

Role of prostaglandin in the management of prelabour of the membranes at term

To compare conservative versus prostaglandin augmentation of prelabor rupture of membranes [P.R.O.M.] in healthy primigravidae women at term, 50 patients were chosen for conservative management [group 1] and 50 patients for active management [group 2]. Group 1 was observed up to 24 hours after P.R.O.M. in hospital, while group 2 was managed with PGE2 gel [2 mg] installed into the posterior fornix and repeated after 6 hours [1 mg] in both groups. If labor was not established 24 hours later, intravenous [I.V.] oxytocin was given by titration. There was a significant reduction in the [P.R.O.M.] to delivery time in the prostaglandin group without a significant increase in infective morbidity or cesarean section rate, and fewer women required oxytocin augmentation. In the conservative group, [51%] required oxytocin augmentation compared with [31%] in the PGE2 group

Doppler umbilical artery flow velocity waveforms in relation to birth weight in high risk pregnancy

High risk population at Um El-Queen Hospital were investigated with the Doppler umbilical artery FVW forms and correlated with cardiotocography and biophysical profile. There were 56 high risk patients including insulin dependent diabetes, pregnancy induced hypertension [P.I.H.], chronic hypertension, suspected intrauterine growth retardation [I.U.G.R.], and 70 control patients. 9 of high risk patients showed abnormal umbilical artery FVW values but only 3 of them showed antenatal fetal compromise. Only 5 of this 9 cases had intrauterine growth retardation [I.U.G.R.] with birth weight less than 50th centile. It is shown that umbilical artery FVW may be normal yet fetal compromise may be present or occurs shortly with possible I.U.F.D., this is more true in cases of diabetic pregnancy. There is more positive correlation between umbilical artery FVW and biophysical profile and N.S.T. in other types of high risk pregnancies including pregnancy induced hypertension growth retardation. FVW can not be relied on in diabetic pregnancy