Routine third trimester ultrasonography in predicting adverse perinatal outcomes: a prospective cohort study at a tertiary-care hospital in Eastern India.

AIMS: Fetal growth restriction (FGR) may go undetected in the antenatal period with subjective clinical evaluation, and there is a growing propensity to perform a third-trimester scan, especially in the developed countries. The literature on the importance of the same in developing countries like ours, is scant. Hence, this study was undertaken to evaluate the role of routine third-trimester ultrasonography along with Doppler in predicting adverse perinatal outcome. METHODS: A prospective cohort study was conducted at a tertiary-care hospital, in which routine third-trimester ultrasonography was performed for 265 antenatal women, and included estimation of amniotic fluid index (AFI), estimated fetal-weight (EFW), and cerebroplacental ratio (CPR). Women were categorized as having normal parameters or having at least one abnormal parameter. Post-natal adverse perinatal outcomes including low birth-weight, hypoglycemia, poor Apgar scores, prolonged hospital stay, need for ventilatory support, neonatal asphyxia, neonatal sepsis and early neonatal death were recorded. Prediction analyses for sensitivity, specificity, positive and negative predictive values were done. Receiver Operating Characteristic (ROC) curves were plotted for threshold for each parameter for adverse outcome. RESULTS: Out of 260 women that were analyzed, 47.5% had no clinically identifiable risk factors, and 52.5% had at least one abnormal parameter. Sensitivity and negative predictive value for adverse outcome were highest for composite ultrasound finding (85.4% and 90.4% respectively). Specificity, positive predictive value and diagnostic accuracy were highest for CPR (97.8%, 86.7% and 76.9% respectively). CONCLUSION: Routine third trimester ultrasonography, including Doppler, can help in risk-stratification of otherwise clinically low-risk pregnancies.

Bengali Migrant Workers in South India: A Mixed-Method Inquiry into Their Earnings, Livings and Struggle During Covid Pandemic.

This study has tried to compare the earning and non-earning aspects of migrant workers from West Bengal engaged in different types of work in Karnataka and Kerala based on survey of 111 Bengali-speaking migrant workers and a number of in-depth interviews and FGDs. The study has found that most of the migrant workers landed in south India only after working in Kolkata, northern or western Indian cities. Lack of regular employment opportunities and low-wage rate in rural as well as urban West Bengal are the dominant reasons for their migration. Hostile social environment and increasing earning uncertainties in northern and western Indian cities along with higher-wage rate in south India are reasons for the migrant workers shifting to south India. On an average, they earn Rs. 1.7 lakhs annually and are able to send almost two-thirds of their earnings as remittances. Except the rag pickers in Bengaluru, all other migrant workers live without their families at destination locations. The living conditions of the migrant workers, especially the rag pickers, are poor. Continuous inflow of migrant workers from eastern and north-eastern India is now a challenge for the incumbent Bengali migrant workers in south India; however, majority of them are not willing to return to West Bengal in future. The pandemic and successive rounds of lockdown in destination and home states have unsettled their lives. Not only their income has fallen, getting job and movement across different destination locations has become uncertain too. They have now hardly any resource to cope up with this continuing uncertainty.