Role of doppler ultrasonography in prediction of adverse perinatal outcome in intrauterine growth retardation (IUGR)

Introduction: A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through the blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome - Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation. Materials and methods: A total of 172 singleton pregnancies between 33 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus. Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Duration of this study was two years, from December 2019 to November 2021. Results: Out of 172 cases, 146 were live born and 26 were neonatal death. There were 7 cases of intrauterine death of fetuses and 5 were still born. Out of the live born 27 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia. Conclusion: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse fetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised fetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised fetuses and helps to determine the optimal time of delivery.

Síndrome de tetraamelia: informe de un caso / Tetra-amelia syndrome: a case report

A still born male baby with tetra-amelia syndrome is reported, with craniofacial abnormalities and pulmonary agenesis. It presented complete absence of all four limbs in association with cleft lip and palate on the right side. The mother medical history revealed no remarkable details. The fetus died shortly after its birth. The embryonic correlation of the case is discussed. Proper health education, antenatal screening and genetic counseling can reduce the risk of such congenital anomalies.

Se informa el caso clínico de un mortinato del sexo masculine con el síndrome de tetraamelia, que mostró ausencia de las cuatro extremidades, unido a anomalías craneofaciales y agenesis pulmonar. Presentó ausencia total de las 4 extremidades unido a labio leporino, paladar hendido del lado derecho. Los antecedentes maternos no revelaron detalles considerable. El feto falleció poco después de su nacimiento. Se discute la correlación embriónica del caso. La educación para la salud adecuada, la pesquisa prenatal y el consejo genético pueden reducir el riesgo de estas anomalías congénitas.

Spectrum of congenital malformations in newborns: in a medical college hospital in South India.

The study was carried out with the aim to determine the overall rate of congenital malformations, incidence in live births and stillbirths, as well as incidence affecting various organ systems, at a medical college hospital in Karnataka and compare them to previous studies Methods: All intramural deliveries between June 2012 and March 2014 were included in the study. All the new-borns were examined for congenital malformations soon after birth and every day during routine ward rounds. Relevant radiological, histo-hematological and genetic tests were carried out. Results: During the study period there were 3016 births out of which 2941 were live births and 75 were still born. 93 babies had one or more malformations. The overall incidence of malformations was 3.083%. Incidence of malformations among live births was 2.72% whereas it was 17.33% among still born babies. Musculoskeletal malformations accounted for 27.5% of all the malformations. This was followed by cutaneous 19.16%, genitourinary 15.83%, gastrointestinal 12.5%, neurological 10% and cardiac 5.83%. Conclusion: Congenital anomalies are a major cause of stillbirths and infant mortality. Musculoskeletal malformations were the commonest system involved. Still born babies had a significantly higher incidence of malformations and also had a higher incidence of multiple malformations.