Correlation of admission labour admission test in low risk pregnancies with pregnancy outcome

Background: Aim of the study was to evaluate the role of NST (labour admission test) as a screening method in management of low risk pregnancies and to study the correlation of NST with fetal outcome.Methods: A prospective observational study conducted over 500 patients managed at our centre after proper evaluation. Patients were evaluated for mode of delivery and neonatal outcome.Results: The maximum number 352 of patients belonged to 20-30 years age group, 113 patients belonged to 31-35 age group. 200 patients were of 37-40 weeks gestation and 185 were of 40-41 weeks gestation. There were 125 patients in the 41-42 weeks gestational period. Among the 500 pregnant mothers who were included in the study 82.6% had Normal NST, 11.6% had suspicious and 5.8% had pathological NST. Cesarean rate was 14.4% in normal NST group, 58.62% in suspicious group and 72.41% in pathological group study. 6.77% in Normal group had meconium stained liquor at delivery whereas 29.31% in suspicious group and 37.93% in pathological group had same.Conclusions: The non-stress test is an important screening tool to identity the fetus in jeopardy in utero. This enables an appropriate timely intervention to achieve the most favorable outcome.

Reference Ranges for Ultrasonographic Measurements of the Uterine Cervix in Low-Risk Pregnant Women / Valores de referência das medidas ultrassonográficas do colo uterino em gestantes de baixo risco

Abstract Objective To define transvaginal ultrasound reference ranges for uterine cervix measurements according to gestational age (GA) in low-risk pregnancies. Methods Cohort of low-risk pregnantwomen undergoing transvaginal ultrasound exams every 4 weeks, comprisingmeasurements of the cervical length and volume, the transverse and anteroposterior diameters of the cervix, and distance fromthe entrance of the uterine artery into the cervix until the internal os. The inter- and intraobserver variabilities were assessed with the linear correlation coefficient and the Student t-test. Within each period of GA, 2.5, 10, 50, 90 and 97.5 percentiles were estimated, and the variation by GA was assessed with analysis of variance for dependent samples. Mean values and Student t-test were used to compare the values stratified by control variables. Results After confirming the high reproducibility of the method, 172 women followed in this cohort presented a reduction in cervical length, with an increase in volume and in the anteroposterior and transverse diameters during pregnancy. Smaller cervical lengths were associated with younger age, lower parity, and absence of previous cesarean section (C-section). Conclusion In the studied population, we observed cervical length shortening throughout pregnancy, suggesting a physiological reduction mainly in the vaginal portion of the cervix. In order to better predict pretermbirth, cervical insufficiency and premature rupture of membranes, reference curves and specific cut-off values need to be validated.

Resumo Objetivo Elaborar curvas de referências de medidas ultrassonográficas de colo uterino por idade gestacional (IG) em gestações de baixo risco. Métodos Coorte de gestantes de baixo risco, submetidas a ultrassom transvaginal repetido a cada 4 semanas, com medida do comprimento, dos diâmetros anteroposterior e transverso, da distância entre a entrada da artéria uterina no colo e o orifício interno, e do volume do colo. Foi avaliada a variabilidade inter e intraobservador entre as medidas com o coeficiente de correlação linear e teste t de Student. Para cada faixa de IG, estimaram-se os percentis 2,5, 10, 50, 90 e 97,5 dos valores das medidas, com a variação por IG avaliada por análise de variância para amostras dependentes. As comparações dos valores por variáveis de controle foram feitas por meio dos cálculos de médias e teste t de Student. Resultados Assegurada a alta reprodutibilidade do método, as 172 mulheres acompanhadas na coorte apresentaram redução das medidas de comprimento de colo com o decorrer da gestação, com aumento de volume e dos diâmetros anteroposterior e transverso. O menor comprimento cervical foi associado à menor idade materna, menor paridade, e ausência de cesárea prévia. Conclusão Na população estudada foi observada redução no comprimento cervical com o decorrer da gestação, sugerindo encurtamento fisiológico principalmente à custa da porção vaginal do colo. Há a necessidade de validar tais curvas de referência e pontos de corte específicos para uma melhor predição de risco de parto pré-termo, insuficiência cervical, e amniorrexe prematura.

Utility of First Trimester Anomaly Scan in Screening of Congenital Abnormalities in Low and High Risk Pregnancies.

The primary objective of the present study is to assess the feasibility and value of first trimester anomaly scan in both high risk and low risk pregnant patients. All high risk and low risk patients with live fetus and 11- to 14-week gestation were enrolled in study after informed and written consent. All patients were screened for congenital anomalies by 11-14 week ultrasound scan (first trimester anomaly scan) as part of routine prenatal care. Second trimester scan was conducted at 18 to 22 weeks gestation. The results of the first trimester anatomic survey were correlated with second trimester target scan to evaluate value of first trimester scan for early detection of anomalies. Overall prevalence of congenital anomalies in study population was 2.6%. Out of these 64.4% were detected by first trimester anomaly scan, while another 35.6% were detected by mid gestation scan. Detailed first trimester anomaly scan and first trimester fetal echocardiography should be performed to detect the fetal anomalies early.