A study to evaluate accuracy of gestational age, comparing conventional method against duration of intermenstrual interval consideration

Background: Most methods of calculating gestational length are based upon 28 day cycle. If a woman has a cycle which is significantly shorter than 28 days and she delivers before her due date calculated by her LMP, this arises an anticipation of a premature baby, but the fetus is mature by all criteria of maturity assessment. Dr. Modi (Text Book of Medical Jurisprudence) stated, ‘duration of pregnancy in homo homosapiens is 10 times the inter-menstrual interval’. Keeping this in mind we undertook this study.Methods: The study was done for a duration of 1 year. The gestational age of patients was calculated from the routine Naegele’s formula and inter-menstrual interval. The maturity of neonate was assessed by using Ballard’s score. This data was co-related for further evaluation.Results: Although 39 (19.5%) neonates were expected to be preterm, 24 (12%) actually turned out to be preterm according to Ballard’s score. Rest 15 neonates, premature by Naegele’s formula, should be in “premature” group, turned out to be well developed, by Ballard’s score, almost 37.5% of early delivery group, (significant at P<0.05)Conclusions: This showed that the baby attained maturity at a lesser gestational age which corresponded to 10 times the inter-menstrual interval

A study on the perinatal outcome in cases of oligohydramnios

Background: Amniotic fluid has an important role in the fetal growth and development. It provides the fetus, with a protective low resistance environment which is suitable for the growth and development. With normal amount of amniotic fluid index ranging from 5 to 24 cms, Amniotic fluid index of 5 cms were taken. AFI >10 cms was considered to be normal. Various outcome measures recorded were, induced Vs spontaneous labor, gestational age at delivery, nature of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery Apgar score at one minute and five minutes, birth weight, admission to neonatal intensive care unit, perinatal morbidity and perinatal mortality.Results: Normal quantity of liquor amnii is essential for normal and successful outcome of pregnancy, as it provides a safe milieu interior for the foetus in utero. Deprivation of required quantity, will adversely affect the neonatal outcome. Oligohydramnios, in itself is enough to cause such damage, by creating chronic hypoxic situation.Conclusions: The fetal morbidity and mortality increases if additional antenatal complications of   preeclampsia and post-term pregnancy are present along with oligohyrdramnios

Association of serum uric acid and C-reactive protein levels in prediction of pre-eclampsia

Background: Hypertensive disorders during pregnancy increase maternal and infant risk. The greatest impact is associated with the pregnancy-specific syndrome, preeclampsia, a consistently clinically worsening situation. PE is a complication of pregnancy, constituting a major cause of maternal and foetal morbidity, and mortalityHyperuricemia and increased CRP level, in pre-eclamptic patients need to be confirmed, in a designed strategy, in which uric acid and CRP level are  measured before the development of preeclampsia, or early in pregnancy, in order to identify and monitor the patients, “at risk of preeclampsia”, and thus  provide the best prenatal care for these women and their babies.Methods: The study was done in Dhiraj Hospital in Obstetrics and Gynecology Department. The study duration was 1 year. It is a prospective type of study comprising of patients, who were attending ANC clinic and were booked cases at Dhiraj hospital. Serum uric acid and C-reactive protein were estimated along with other routine investigations for all patients attending ANC clinic. All the subjects were divided into two groups: (i) Group-1 (Study Group): Fifty diagnosed pre-eclamptic patients in third trimester of pregnancy (37-40 weeks) whose serum uric acid and CRP levels were already raised during her antenatal visits in second trimester, (ii) Group-2 (Control Group): fifty two normal pregnant women of comparable gestational age.Results: The mean values of serum uric acid and CRP levels remain higher in study group than that of control group. This difference is statistically significant (p= 0.02).Conclusions: All the patients in study group whose measurement of uric acid and CRP levels were high, developed pre-eclampsia. So it can be fairly concluded, that the observed elevations in serum uric acid level or CRP level or both, preceded the development of pre-eclampsia

A study on the perinatal outcome in cases of oligohydramnios

Background: Amniotic fluid has an important role in the fetal growth and development. It provides the fetus, with a protective low resistance environment which is suitable for the growth and development. With normal amount of amniotic fluid index ranging from 5 to 24 cms, Amniotic fluid index of &lt;5 cm defines oligohydramnios as, originally described by Phelan et al1. Many studies show that oligohydramnios is associated with variety of ominous pregnancy outcomes, such as fetal distress, low birth weight, increased incidence of caesarean section,   higher perinatal morbidity, and perinatal mortality. Since, these disorders of liquor amnii has a significant impact on pregnancy and fetus, it prompted us to carry out this study with sincere efforts to find out its effect on pregnancy outcome.Methods: The study was done in Dhiraj Hospital in Obstetrics and Gynecology department. The study duration was period of 18 months  from February 2014 to July 2015. It was a prospective study, comprising of patients, who had reported to hospital for regular antenatal visits. The study group was taken on sole criteria of AFI &lt;5cms. It is considered as a contributing factor for intranatal and perinatal morbidity. To prove our point, in control group, patients with AFI &gt;5 cms were taken. AFI &gt;10 cms was considered to be normal. Various outcome measures recorded were, induced Vs spontaneous labor, gestational age at delivery, nature of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery Apgar score at one minute and five minutes, birth weight, admission to neonatal intensive care unit, perinatal morbidity and perinatal mortality.Results: Normal quantity of liquor amnii is essential for normal and successful outcome of pregnancy, as it provides a safe milieu interior for the foetus in utero. Deprivation of required quantity, will adversely affect the neonatal outcome. Oligohydramnios, in itself is enough to cause such damage, by creating chronic hypoxic situation.Conclusions: The fetal morbidity and mortality increases if additional antenatal complications of   preeclampsia and post-term pregnancy are present along with oligohyrdramnios

Association of serum uric acid and C-reactive protein levels in prediction of pre-eclampsia

Background: Hypertensive disorders during pregnancy increase maternal and infant risk. The greatest impact is associated with the pregnancy-specific syndrome, preeclampsia, a consistently clinically worsening situation. PE is a complication of pregnancy, constituting a major cause of maternal and foetal morbidity, and mortalityHyperuricemia and increased CRP level, in pre-eclamptic patients need to be confirmed, in a designed strategy, in which uric acid and CRP level are  measured before the development of preeclampsia, or early in pregnancy, in order to identify and monitor the patients, “at risk of preeclampsia”, and thus  provide the best prenatal care for these women and their babies.Methods: The study was done in Dhiraj Hospital in Obstetrics and Gynecology Department. The study duration was 1 year. It is a prospective type of study comprising of patients, who were attending ANC clinic and were booked cases at Dhiraj hospital. Serum uric acid and C-reactive protein were estimated along with other routine investigations for all patients attending ANC clinic. All the subjects were divided into two groups: (i) Group-1 (Study Group): Fifty diagnosed pre-eclamptic patients in third trimester of pregnancy (37-40 weeks) whose serum uric acid and CRP levels were already raised during her antenatal visits in second trimester, (ii) Group-2 (Control Group): fifty two normal pregnant women of comparable gestational age.Results: The mean values of serum uric acid and CRP levels remain higher in study group than that of control group. This difference is statistically significant (p= 0.02).Conclusions: All the patients in study group whose measurement of uric acid and CRP levels were high, developed pre-eclampsia. So it can be fairly concluded, that the observed elevations in serum uric acid level or CRP level or both, preceded the development of pre-eclampsia