Placental thickness: A sonological Parameter for estimation of gestational age

AIM OF THE STUDY: Evaluating placental thickness, measured at the insertion of the umbilical cord, as a parameter for estimating gestational age of the foetus. MATERIALS AND METHODS: The study include 450 antenatal women attending antenatal OP in the Department of Obstetrics and Gynaecology, Tirunelveli Medical College Hospital between the study period of 1st May 2013 to 1st May 2014. The dissertation is a study on the placental thickness and analyses the same. Inclusion Criteria: Normal antenatal women in all gestational ages between 14 - 40 weeks were included in the study with • A known LMP. • Singleton uncomplicated pregnancy. Exclusion Criteria: 1. Pregnancies complicated with PIH, diabetes, twins, hydrops, foetal growth restriction and congenital anomalies. 2. Placenta with morphological variations like bilobed placenta,succenturiate placenta, circumvallate placenta and placentamembranaceae are excluded. 3. Placenta with variable cord insertions like marginal or battledoreplacenta, velamentous placenta is excluded. 4. Placenta with poor visualisation of cord insertion is excluded. 5. Placenta with poor ultrasonographic visualisation were excluded 6. Poor visualisation may be due to maternal obesity, posteriorshadowing by foetal parts in late third trimesters. 7. Pregnancies complicated by vaginal bleeding both in the earlyand late pregnancy. 8. Pregnancies complicated by anaemia, cardiac disorders, uterineanomalies. All the antenatal women were subjected to sonogram using theLarson and Turbo Sequina model with a convex probe with a frequency of 2-5 M Hz. RESULTS: Placental thickness: The GA LMP and GA USG were compared with reference to Placental thickness. The comparison between the GA LMP and GA USG with reference to the different levels of placental thickness. In 10-20 mm of thickness the mean gestational ages of GA LMP and GA USG were 18.0±3.8 weeks and 16.5±2.5 mm respectively. The difference between them was statistically significant (P<0.05). Similarly in 20-30 mm the difference between them was statistically significant (P<0.05). But, in 30-40 mm and 40-50 mm the differences between the mean weeks of GA LMP and GA USG were not statistically significant (P>0.05). The mean weeks of GA LMP and GA USG were also not statistically significant (P>0.05). CONCLUSION: 1. There is a linear and direct relationship between the placental thickness and gestational age. 2. The placental thickness did not vary with parity or maternal age. 3. The placental thickness has a direct correlation with estimate foetal weight of the foetus. 4. Meticulous measurement of the placental thickness aids in the early diagnosis of Hb Bart disease, homozygous alpha thalassemia, foetal growth restriction, Diabetes and Hydropsfoetalis. 5. Placental thickness correlates best with the gestational ageespecially in the third trimester. 6. Placental thickness could be considered as an additional parameterin estimating gestational age in the third trimester

Multiple vaginal examinations and early neonatal sepsis

Background: Early onset neonatal sepsis (EONS) is caused mainly by organisms present in the genital tract. Maternal risk factors increase the incidence of EONS. This study was done to find out the association between one such risk factor i.e., multiple vaginal examinations and EONS.Methods: Case control study. 114 patients with three or more vaginal examinations after rupture of membranes were taken as cases and 114 patients with less than three vaginal examinations after rupture of membranes were taken as controls. All these babies were followed up for the development of EONS.Results: Of the 114 cases, 6 babies developed EONS. None of the babies in the control group developed EONS. So, 3 or more vaginal examinations after rupture of membranes in labour is significantly associated with early onset neonatal sepsis with p-value of 0.01305.Conclusions: Multiple vaginal examinations after rupture of membranes is a risk factor for early onset neonatal sepsis.

Disparities in Health-Related Quality of Life among Adolescent and Young Adult (AYA) Cancer Survivors

https://openworks.mdanderson.org/sumexp22/1067/thumbnail.jp

Placental thickness and its correlation with estimated foetal weight: a cross-sectional study in a tertiary care centre in South India

Background: The placenta is a multifaceted organ which modulates and modifies the maternal environment resulting in foetal development. It could be assumed that a healthy placenta culminates in a healthy foetus. Hence the morphometric analysis of a placenta during sonogram is inevitable. The aim of the study was to estimate the relationship between placental thickness and estimated foetal weight.Methods: The study was a cross-sectional study and included 450 antenatal women attending the department of Obstetrics and Gynaecology, Tirunelveli Medical College from May 2013 to May 2014. These women had regular cycles with a known Last menstrual period and a singleton foetus. After ethics committee approval, meticulous history including age, parity, demographic factors and past history were recorded. After obtaining consent, these women underwent placental thickness measurement between 14-40 weeks of pregnancy.Results: In the study mean placental thickness between the ranges of 11-49mm was 28.7mm and mean estimated foetal weight was 1.421kilogram. The correlation between the two was 0.943. Hence the positive correlation between the placental thickness and foetal weight is confirmed (p value <0.001).Conclusions: Determining the estimated foetal weight is an important reason for doing a sonogram, especially in third trimester. Placental thickness measured at the level of umbilical cord insertion can serve as an additional parameter in estimating foetal weight in addition to the foetal parameters, since there is a linear correlation between placental thickness and foetal weight

Assaying the regulatory potential of mammalian conserved non-coding sequences in human cells

The fraction of experimentally active conserved non-coding sequences within any given cell type is low, so classical assays are unlikely to expose their potential

Kangaroo mother care: a multi-country analysis of health system bottlenecks and potential solutions.

BACKGROUND: Preterm birth is now the leading cause of under-five child deaths worldwide with one million direct deaths plus approximately another million where preterm is a risk factor for neonatal deaths due to other causes. There is strong evidence that kangaroo mother care (KMC) reduces mortality among babies with birth weight <2000 g (mostly preterm). KMC involves continuous skin-to-skin contact, breastfeeding support, and promotion of early hospital discharge with follow-up. The World Health Organization has endorsed KMC for stabilised newborns in health facilities in both high-income and low-resource settings. The objectives of this paper are to: (1) use a 12-country analysis to explore health system bottlenecks affecting the scale-up of KMC; (2) propose solutions to the most significant bottlenecks; and (3) outline priority actions for scale-up. METHODS: The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks", factors that hinder the scale-up, of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for KMC. RESULTS: Marked differences were found in the perceived severity of health system bottlenecks between Asian and African countries, with the former reporting more significant or very major bottlenecks for KMC with respect to all the health system building blocks. Community ownership and health financing bottlenecks were significant or very major bottlenecks for KMC in both low and high mortality contexts, particularly in South Asia. Significant bottlenecks were also reported for leadership and governance and health workforce building blocks. CONCLUSIONS: There are at least a dozen countries worldwide with national KMC programmes, and we identify three pathways to scale: (1) champion-led; (2) project-initiated; and (3) health systems designed. The combination of all three pathways may lead to more rapid scale-up. KMC has the potential to save lives, and change the face of facility-based newborn care, whilst empowering women to care for their preterm newborns

Transcriptional Landscape of the Prenatal Human Brain

Summary The anatomical and functional architecture of the human brain is largely determined by prenatal transcriptional processes. We describe an anatomically comprehensive atlas of mid-gestational human brain, including de novo reference atlases, in situ hybridization, ultra-high resolution magnetic resonance imaging (MRI) and microarray analysis on highly discrete laser microdissected brain regions. In developing cerebral cortex, transcriptional differences are found between different proliferative and postmitotic layers, wherein laminar signatures reflect cellular composition and developmental processes. Cytoarchitectural differences between human and mouse have molecular correlates, including species differences in gene expression in subplate, although surprisingly we find minimal differences between the inner and human-expanded outer subventricular zones. Both germinal and postmitotic cortical layers exhibit fronto-temporal gradients, with particular enrichment in frontal lobe. Finally, many neurodevelopmental disorder and human evolution-related genes show patterned expression, potentially underlying unique features of human cortical formation. These data provide a rich, freely-accessible resource for understanding human brain development

Comparative cellular analysis of motor cortex in human, marmoset and mouse

The primary motor cortex (M1) is essential for voluntary fine-motor control and is functionally conserved across mammals(1). Here, using high-throughput transcriptomic and epigenomic profiling of more than 450,000 single nuclei in humans, marmoset monkeys and mice, we demonstrate a broadly conserved cellular makeup of this region, with similarities that mirror evolutionary distance and are consistent between the transcriptome and epigenome. The core conserved molecular identities of neuronal and non-neuronal cell types allow us to generate a cross-species consensus classification of cell types, and to infer conserved properties of cell types across species. Despite the overall conservation, however, many species-dependent specializations are apparent, including differences in cell-type proportions, gene expression, DNA methylation and chromatin state. Few cell-type marker genes are conserved across species, revealing a short list of candidate genes and regulatory mechanisms that are responsible for conserved features of homologous cell types, such as the GABAergic chandelier cells. This consensus transcriptomic classification allows us to use patch-seq (a combination of whole-cell patch-clamp recordings, RNA sequencing and morphological characterization) to identify corticospinal Betz cells from layer 5 in non-human primates and humans, and to characterize their highly specialized physiology and anatomy. These findings highlight the robust molecular underpinnings of cell-type diversity in M1 across mammals, and point to the genes and regulatory pathways responsible for the functional identity of cell types and their species-specific adaptations.Cardiovascular Aspects of Radiolog