Antenatal umbilical cord parameters and perinatal outcome

Background: The objective of the study was to study the association between antenatally determined umbilical cord thickness and coiling index at/after 34 weeks of gestation and the measures of perinatal outcome.Methods: Umbilical cord thickness and coiling index were determined sonographically at or after 34 weeks of gestation in 100 singleton pregnancies. The influence of the antenatal cord findings was analyzed for their associations with measures of perinatal outcome in high and low risk pregnancies. Intrapartum fetal heart rate abnormalities, meconium staining of liquor, birth weight, Apgar score and the need for neonatal intensive care (NICU) admission were considered as measures of perinatal outcome.Results: Mean cord thickness was 1.62 ± 0.26 cm and the coiling index was 0.42 ± 0.08 in the present observation of 100 cord sonographies. There were 39 pregnancies with high risk attributes. High risk pregnancies were found to have higher proportion of cases with lean (<1.3 cm; p = 0.04) and hypercoiled cord (>0.5; p = 0.00). Among individual associations thicker cord (>1.9 cm) and macrosomia (p = 0.01), hypercoiled cord and polyhydramnios (p = 0.02) were significant. More number of primigravidas were seen to have hypercoiled cord (p = 0.04). Association between cord parameters and meconium stained amniotic fluid, low Apgar score or NICU requirement could not be established.Conclusions: No association between antenatal umbilical cord characteristics and perinatal outcome was found in pregnancies at high risk for poor perinatal outcome

A rare case of term viable secondary abdominal pregnancy following rupture of a rudimentary horn: a case report

<p>Abstract</p> <p>Introduction</p> <p>Abdominal pregnancy is a rare event, but one that represents a grave risk to the health of the pregnant woman. An abdominal pregnancy is defined as an ectopic pregnancy that implants in the peritoneal cavity. Early abdominal pregnancy is self-limited by hemorrhage from trophoblastic invasion with complete abortion of the gestational sac that leaves a discrete crater. Advanced abdominal pregnancy is a rare event, with high fetal and maternal morbidity and mortality.</p> <p>Case presentation</p> <p>This is a case report of a 22-year-old primigravida with an abdominal pregnancy from a ruptured rudimentary horn. She was diagnosed as a case of term pregnancy with placenta previa with a transverse fetal lie and cervical fibroid and was prepared for an elective cesarean section. Intra-operatively, a live term female baby was extracted from the peritoneal cavity and it turned out to be an abdominal pregnancy from a ruptured rudimentary horn of a unicornuate uterus, which is a very rare condition. Mother and baby were in good condition after such a catastrophic event.</p> <p>Conclusion</p> <p>This case illustrates a rare obstetric condition which can be a severe catastrophic condition leading to maternal mortality and morbidity. It is imperative for every obstetrician to have in mind the possibility of abdominal pregnancy, although rare, especially in pregnant patients with persistent abdominal pain and painful fetal movements.</p

Antenatal umbilical cord parameters and perinatal outcome

Background: The objective of the study was to study the association between antenatally determined umbilical cord thickness and coiling index at/after 34 weeks of gestation and the measures of perinatal outcome. Methods: Umbilical cord thickness and coiling index were determined sonographically at or after 34 weeks of gestation in 100 singleton pregnancies. The influence of the antenatal cord findings was analyzed for their associations with measures of perinatal outcome in high and low risk pregnancies. Intrapartum fetal heart rate abnormalities, meconium staining of liquor, birth weight, Apgar score and the need for neonatal intensive care (NICU) admission were considered as measures of perinatal outcome. Results: Mean cord thickness was 1.62 +/- 0.26 cm and the coiling index was 0.42 +/- 0.08 in the present observation of 100 cord sonographies. There were 39 pregnancies with high risk attributes. High risk pregnancies were found to have higher proportion of cases with lean (<1.3 cm; p = 0.04) and hypercoiled cord (>0.5; p = 0.00). Among individual associations thicker cord (>1.9 cm) and macrosomia (p = 0.01), hypercoiled cord and polyhydramnios (p = 0.02) were significant. More number of primigravidas were seen to have hypercoiled cord (p = 0.04). Association between cord parameters and meconium stained amniotic fluid, low Apgar score or NICU requirement could not be established. Conclusions: No association between antenatal umbilical cord characteristics and perinatal outcome was found in pregnancies at high risk for poor perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000): 1211-1215