Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome

Background: Increased resistance in uteroplacental circulation is associated with pregnancy complications. The aim of this study was to determine the role of uterine artery PI at 23-24 weeks gestation in predicting adverse pregnancy outcomes.Methods: 200 singleton pregnancies were prospectively examined with color Doppler to determine the PI of uterine artery at 23-24 weeks and study its correlation with subsequent development of adverse maternal and fetal outcomes defined as any or the combination of preeclampsia, intrauterine growth restriction (IUGR), intrauterine death (IUD), preterm delivery and placental abruption.Results: There were 13 cases (6.5%) with abnormal uterine artery Doppler results and 8 (61.5%) of them developed preeclampsia, out of these 8, 1 had IUGR as well and 3 had iatrogenic preterm delivery due to severe preeclampsia. 2 (15.4%) out of 13 had only IUGR. The pregnancies with adverse outcomes had significantly higher mean PI than those with normal outcomes (1.2±0.3 versus 0.857±0.179; p <0.001). The sensitivity, specificity, PPV and NPV of PI ≥95th percentile in the prediction of adverse pregnancy outcome was 35.71%, 98.26%, 76.92% and 90.37% respectively. The birth weight in higher mean PI group was significantly lower than in pregnancies with PI <95th percentile (2.33±0.49 kg versus 2.86±0.48 kg; p <001). No cases of spontaneous preterm labor, IUD or abruption were present in higher mean PI group.Conclusions: Increased uterine artery PI at 23-24 weeks of pregnancy is associated with an increased risk of adverse pregnancy outcomes.

Validity of clinical and sonographic diagnosis of IUGR: a comparative study

Background: IUGR refers to a condition in which a fetus is unable to grow to its genetically predetermined potential size. It is the major cause of perinatal morbidity and mortality in developing countries. The present study was conducted to compare the validity of clinical diagnosis against sonographic diagnosis of IUGR.Methods: This study was conducted in the department of Obstetrics and Gynaecology, SMGS Hospital, Jammu from Octobar 2013 to September 2014. It included 247 women with singleton pregnancies with longitudinal lie. They underwent serial clinical assessment using SFH, AG and weight gain along with Ultrasound and Doppler of Umbilical &amp; Middle cerebral artery. Birth weight of newborns was measured at delivery and was thereafter correlated with clinical and sonographic diagnosis; to access their validity.Results: Sensitivity of SFH in detecting IUGR was 71.4% against 75.7% by Ultrasound and was highest with Doppler of 82.9%. Specificity was 43.6% by SFH, 64.3% by Ultrasound and 86.2% by Doppler. Doppler also had the highest NPV of 92.6% against 79.1% by SFH and 86.8% by Ultrasound. The combination of clinical and ultrasound diagnosis increased the sensitivity to 95.2% and NPV to 95.91%. However, the combination of clinical and Doppler assessments did not significantly change the outcome.Conclusions: Doppler is the single best investigation available for diagnosing IUGR with a high specificity and NPV. However, importance of clinical diagnosis cannot be overlooked, especially in a developing country with limited resources like ours. In the absence of Doppler combined clinical and Ultrasound assessment should be considered

Maternal haemoglobin and perinatal outcome in a tertiary care hospital in Jammu city, India

Background: Maternal anemia is a common problem worldwide. The objective of this study was to assess the prevalence of anemia in women attending a tertiary care centre in their third trimester of pregnancy and to study the relation of maternal hemoglobin with perinatal outcome.Methods: This study was conducted in the Department of Obstetrics and Gynecology, SMGS Hospital, Jammu for a period of one year from Nov. 2015 to Oct. 2016. A total of 767 women in their third trimester (>28 weeks) were enrolled and were followed till delivery. Their hemoglobin levels were noted and its association with adverse maternal and fetal outcomes was studied.Results: It was seen that out of 767 patients, 193 (25.16%) were non-anemic and 574 (74.83%) were anemic out of which 343 (44.71%) were mildly anemic, 160 (20.86%) had moderate anemia and 70 (9.12%) had severe anemia. There was increased incidence of preterm delivery, PPH, preeclampsia, eclampsia, CCF, mortality & blood transfusions in the anemic group as compared to the non-anemic group. Among the adverse fetal outcomes, there was increased incidence of intrauterine deaths, intrauterine growth restriction, NICU admissions, meconium stained liquor, low birth weight babies and APGAR scores <7/10 among the anemic group as compared to the non-anemic group.Conclusions: Maternal anemia is a significant risk factor for adverse maternal and perinatal outcome and its prevalence continues to be high especially in developing countries like India. So, correction of maternal anemia still remains one of the most important step towards better obstetrical care

Pregnancy outcome in overt hypothyroidism

Background: To study the pregnancy outcomes in terms of miscarriage, gestational hypertension, preeclampsia, placenta previa, placental abruption, preterm labour, preterm PROM, rate of caesarean section, postpartum hemorrhage, premature birth, low-birth weight, fetal distress in labour, fetal death and congenital anomalies.Methods: The studied subjects included all pregnant women reported to the hospital for a period of one year (November 2012 to October 2013). They were subjected to detailed history, general physical, systemic, local examinations, routine investigations, thyroid function tests (serum TSH, T3, T4) and divided into two groups, Group-I: Overt hypothyroidism (TSH >10Mu/L; T3 and T4 <normal) and Group-II: Euthyroid pregnant women (control group).Outcomes of study group were compared with control group. The data was analyzed using computer software Microsoft Excel and SPSS version 19.0 for Windows. Chi square test was performed to evaluate statistical significance. A p-value of <0.05 was considered as statistically significant.Results: 17045 women reported to hospital during one year period and after applying exclusion criteria 14810 women qualified. Out of these, 14770 pregnant women were found euthyroid and 40 (0.23%) women were overt hypothyroid. Pregnancy outcome like miscarriage (p<0.001), placental abruption (p<0.03), preterm premature rupture of membrane (p=0.003), low birth weight (p<0.001) and premature birth (p=0.003) was found to be statistically significant.Conclusions: Due to adverse pregnancy outcome, women in early pregnancy should be screened for thyroid disorder and those found hypothyroid should be treated

Maternal and fetal outcome in subclinical hypothyroidism in Jammu region, North India

Background: Pregnancy is a period that places great physiological stress on both the mother and the fetus in the best of times. The objective of this study was to study the maternal outcomes in terms of miscarriage, gestational hypertension, preeclampsia, placenta previa, placental abruption, preterm labour, preterm PROM, rate of caesarean section and postpartum hemorrhage. And to study the fetal outcomes in terms of premature birth, low-birth weight, fetal distress in labour, fetal death and congenital anomalies.Methods: The studied subjects included all pregnant women reporting to the hospital for a period of one year November 2012 to October 2013. All participants were subjected to detailed history, thorough general physical, systemic, local examinations, and routine investigations, thyroid function tests (serum TSH, T3, T4). All participants were divided into two groups, group-I: pregnant women diagnosed with subclinical hypothyroidism (TSH 5-10Mu/L; T3 and T4 normal), group-II: euthyroid pregnant women (control group). Maternal and fetal outcomes of subjects in the first group (study) were compared with control group. The data was analyzed using computer software Microsoft Excel and SPSS version 19.0 for Windows. Chi square test was performed to evaluate statistical significance. A p-value of <0.05 was considered as statistically significant.Results: A total of 17045 pregnant women reported to labour room and OPD and 15120 women qualified after applying exclusion criteria. Out of these, 14770 pregnant women were found euthyroid and subclinical hypothyroidism was identified in 350 (2.05%) women. Maternal outcome in study group in terms of miscarriage (p<0.001), gestational hypertension (p<0.001), placental abruption (p<0.0001) and preterm premature rupture of membrane (p=0.007) was found to be statistically significant when compared with control group, while fetal outcome in terms of fetal distress (p<0.001), low birth weight (p<0.001) and premature birth (p=0.002) was found to be statistically significant.Conclusions: In view of adverse maternal and fetal outcome, detecting and treating the women with subclinical hypothyroidism in early pregnancy will improve the perinatal outcome

Comparison of single spot urinary albumin-creatinine ratio with 24-hour urinary protein excretion in women with preeclampsia

Background: The measurement of albumin: creatinine ratio (ACR) in a spot urine sample avoids the influence of variation in urinary solute concentration and provides a more convenient and rapid method to assess protein excretion. The aim of this study was to evaluate urinary spot ACR as a new marker for proteinuria and to study its correlation and accuracy in comparison with 24-hour urinary protein.Methods: The prospective one-year study was conducted on 100 pregnant women, 18-40 years, >20 weeks gestation with a diagnosis of preeclampsia. A spot midstream urine sample was taken for detection of albuminuria by dipstick method. Another spot sample was taken for detection and calculation of spot ACR. The 24-hour urine collection was taken immediately afterward to evaluate 24-hour urinary protein excretion.Results: A positive linear relation exists between ACR and 24-hour urinary protein excretion The ROC revealed cut-off of 20.4 with 88.5% sensitivity, 75% specificity, 98.8% positive predictive value and 21.4% negative predictive value. Spot urinary ACR >20.4 correctly identified women having 24-hour urinary protein excretion in excess of 0.3 gm/DL.Conclusions: A strong correlation exists between single spot urinary ACR with 24-hour urinary protein excretion in women with preeclampsia

Pregnancy outcome in overt hypothyroidism

Background: To study the pregnancy outcomes in terms of miscarriage, gestational hypertension, preeclampsia, placenta previa, placental abruption, preterm labour, preterm PROM, rate of caesarean section, postpartum hemorrhage, premature birth, low-birth weight, fetal distress in labour, fetal death and congenital anomalies.Methods: The studied subjects included all pregnant women reported to the hospital for a period of one year (November 2012 to October 2013). They were subjected to detailed history, general physical, systemic, local examinations, routine investigations, thyroid function tests (serum TSH, T3, T4) and divided into two groups, Group-I: Overt hypothyroidism (TSH &gt;10Mu/L; T3 and T4 &lt;normal) and Group-II: Euthyroid pregnant women (control group).Outcomes of study group were compared with control group. The data was analyzed using computer software Microsoft Excel and SPSS version 19.0 for Windows. Chi square test was performed to evaluate statistical significance. A p-value of &lt;0.05 was considered as statistically significant.Results: 17045 women reported to hospital during one year period and after applying exclusion criteria 14810 women qualified. Out of these, 14770 pregnant women were found euthyroid and 40 (0.23%) women were overt hypothyroid. Pregnancy outcome like miscarriage (p&lt;0.001), placental abruption (p&lt;0.03), preterm premature rupture of membrane (p=0.003), low birth weight (p&lt;0.001) and premature birth (p=0.003) was found to be statistically significant.Conclusions: Due to adverse pregnancy outcome, women in early pregnancy should be screened for thyroid disorder and those found hypothyroid should be treated

Comparison of single spot urinary albumin-creatinine ratio with 24-hour urinary protein excretion in women with preeclampsia

Background: The measurement of albumin: creatinine ratio (ACR) in a spot urine sample avoids the influence of variation in urinary solute concentration and provides a more convenient and rapid method to assess protein excretion. The aim of this study was to evaluate urinary spot ACR as a new marker for proteinuria and to study its correlation and accuracy in comparison with 24-hour urinary protein.Methods: The prospective one-year study was conducted on 100 pregnant women, 18-40 years, &gt;20 weeks gestation with a diagnosis of preeclampsia. A spot midstream urine sample was taken for detection of albuminuria by dipstick method. Another spot sample was taken for detection and calculation of spot ACR. The 24-hour urine collection was taken immediately afterward to evaluate 24-hour urinary protein excretion.Results: A positive linear relation exists between ACR and 24-hour urinary protein excretion The ROC revealed cut-off of 20.4 with 88.5% sensitivity, 75% specificity, 98.8% positive predictive value and 21.4% negative predictive value. Spot urinary ACR &gt;20.4 correctly identified women having 24-hour urinary protein excretion in excess of 0.3 gm/DL.Conclusions: A strong correlation exists between single spot urinary ACR with 24-hour urinary protein excretion in women with preeclampsia

Hydrogenation of Ferrimagnetic Graphene on a Co Surface: Significant Enhancement of Spin Moments by C–H Functionality

Using ab initio density functional theory, we present a novel way of simultaneously enhancing the induced magnetic moment and opening up the band gap of a graphene sheet supported on ferromagnetic transition metal surface. Specifically, we have demonstrated that by simply hydrogenating graphene supported on ferromagnetic Co surface at saturation coverage, (i) there is a <b>six</b>-fold increase in the magnitude of the induced magnetic moment compared with the pristine graphene on the Co surface and (ii) for both the spin-up and the spin-down channels there is a band gap opening at the K-point of the Brillouin zone