Prolongation of a pregnancy with second trimester severe oligohydramnios to term: a case report

The occurrence of oligohydramnios complicating a pregnancy is seen in 0.8 to 5.5 % of pregnancies. Severe Oligohydramnios, though not clearly defined, but clinically with an AFI of less than 5 cm appears to be an important predictor for an abnormal fetal outcome. In general, the prognosis of mid trimester oligohydramnios is still poor. Hence we report a case with a very favourable neonatal outcome following severe oligohydramnios documented in early pregnancy. The aim of this case report is to add our experience to the currently limited literature regarding the best treatment of this unique obstetrical problem

Role of dual biomarkers and uterine artery doppler study in predicting PIH and IUGR in antenatal patients registered in a tertiary care centre

Background: The incidence of IUGR is between 3 to 7%, whereas that of Hypertensive disorders of pregnancy is about 10% of pregnant women around the world. These conditions are associated with a high rate of perinatal morbidity and mortality, posing a need for the detection of the potential causes of maternal and foetal morbidity and mortality and for the prediction of these conditions early during pregnancy.Methods: Patients with first antenatal visit before 10 weeks gestation underwent routine NT scan between 11–13 weeks with bilateral UAD-RI of the maternal uterine arteries. The placental volume was assessed. Serum dual biomarker test (β hCG and PAPP-A) was performed after this scan and analysed as multiples of median (MoM). Blood pressure was recorded at every ANC visit till 2 weeks after delivery. Neonatal head and chest circumference, birth length and weight were recorded.Results: The mean values of PAPP-A levels of Non-PIH and PIH groups were 1.32±0.91 MoM and 0.68±0.39 MoM respectively, showing statistically significant difference.  The serum PAPP-A levels showed statistically significant difference between Non-IUGR and IUGR groups (1.24±0.87 MoM and 0.46±0.20 MoM respectively).Conclusions: In our study, PAPP-A level is observed as a good indicator for possible prediction of PIH and IUGR whereas levels of β hCG and UAD-RI were not good predictors. The role of Placental volume in prediction of IUGR needs to be explored further with larger sample size. Future studies are needed with a larger group with inclusion of measurement of PI values

Delayed interval twin delivery of a fetus with a favourable neonatal outcome after a preterm delivery of the first twin: a case report

Assisted reproductive techniques have proved to be a boon for infertile couples. With advent of newer techniques, the incidence of successful multiple pregnancies has also risen. Considering the emotional and financial aspects of the treatment and the risk of preterm delivery in such cases, our intent is not only to salvage one of the twins in case of unfortunate preterm delivery of the other but also to deliver a viable second twin with better chance of survival and favourable neonatal outcome. The current case describes a 34-year woman with previous 2 failed IVF conceptions, on external progesterone support, carrying a twin gestation in preterm labour. Upon the inadvertent delivery of the first twin, a cervical cerclage was done, and she was given conservative management, including bed rest and head low position in view of short cervix, with an aim to delay the delivery of the other. An interval of 66 days was achieved with surgical as well as medical management, following which a healthy second twin was born