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Predictive Role of Serum Lactate Dehydrogenase and Creatine Phosphokinase in Bowel Ischemia In Cases of Acute Intestinal Obstruction
No full textStudy of Accuracy of Fast (Focussed Assessment with Sonography in Trauma) in Acute Abdominal Condition Requiring Emergency Surgical Intervention in Patients Presenting to Government Stanley Hospital
No full textComparative study between Polydioxanone (PDS) and Poly Polypropylene (Prolene) for Abdomen Wound Closure After Laparotomy
No full textStudy of Umbilical Artery, Middle Cerebral Artery and Fetal Aortic Isthmus Doppler in Intrauterine Growth Restriction and Its Perinatal Outcome at a Tertiary Care Hospital in Chennai: A Prospective study
Get PDFAIM OF THE STUDY:
• Role of umbilical artery, middle cerebral artery, and fetal aortic isthumus waveforms in predicting adverse pregnancy outcomes in clinically suspected IUGR and the role of doppler velocimetry in clinical management of such pregnancies.
OBJECTIVES:
1. To analyse the blood flow in fetal aortic isthumus, umbilical artery middle cerebral artery, in a group of patients with clinically suspected high risk pregnancies
2. To assess the value of Doppler ultrasound in analyzing PERINATAL OUTCOME in patients with clinically suspected high risk pregnancies.
Study center: Govt. RSRM Lying in Hospital, Chennai.
Duration of Study: November 2020 to December 2021
Study Design: Prospective study.
METHODOLOGY:
This study will be conducted on 200 women with high risk pregnancies within inclusion criteria admitted to Govt. RSRM Lying in hospital, Chennai.
A routine history taking, general examination, obstetric examination will be done.
Patients will be explained about the atraumatic nature of the investigation and informed written consent will be obtained.
Synthetic ultrasound gel will be applied over the abdomen to get good accoustic coupling.
The instrument used will be a mindray colour Doppler ultrasound machine with a convex transducer 2 t 5 mhz frequency.
Doppler wave form will be obtained after localising the vessels by B mode real time scanner.
Pulsed Doppler will be used to get the Doppler signals after localising the vessels.
The maximum Doppler shift frequencies were obtained and various ratios will be calculated from each vessel. Doppler examination will be done when fetus is in apneic state to avoid influence of fetal respiration on doppler signals
The gestational Age will be based on the LMP ,Ultrasound biometry performed before 20th week if LMP is uncertain. Follow up Doppler studies will be conducted if clinically indicated or in case of worsening Doppler indices.
Inclusion criteria:
All antenatal cases more than 30 weeks of gestation singleton pregnancies, clinically diagnosed as the following are included.
IUGR (EFW <10TH percentile for gestational age).
Those who gave consent for the study.
The gestational Age will be based on the LMP, Ultrasound biometry performed before 20th week if LMP is uncertain.
Exclusion criteria:
The following pregnancies were excluded.
Cardiovascular disease,
Multiple gestation,
Fetus with congenital anomalies,
Renal disease,
Essential hypertension prior to pregnancy,
Intrauterine death at the time of first doppler examination.
Sample size: 200.
CONCLUSION:
• The present study noted an adverse fetal outcome in cases of severe preeclampsia and or IUGR which showed abnormal Doppler results.
• The finding of REDF is ominous and AEDF also correlated with poor fetal outcome with a perinatal mortality of 60%.
• In our study AIEDF had the highest sensitivity of 100% in predicting adverse fetal outcomes.
• Because CPR incorporates data not only on the placental side but also the fetal response it can be considered potentially more advantageous.
• Doppler patterns follow a longitudinal trend with early changes in the umbilical artery followed by middle cerebral artery.
• Doppler investigation of the fetal circulation plays an important role in monitoring the redistributing fetus and thereby may help to determine the optimal time for delivery.
• Doppler serves as an important yardstick for the obstetricians when dealing with pregnancies complicated with preeclampsia and growth restriction
To Study the Clinical Profile of Patients with Neurological Disorders During Pregnancy and Peurperium: Prospective Observational study
Get PDFBAKGROUND:
Neurological disorders in pregnancy can be pregnancy related or can be caused by exacerbation of a pre existing neurological condition or sometimes may even be detected for the first time during pregnancy in which it might be an incidental finding. The diagnosis and management of the neurological disorders in pregnancy is always a challenging task. Physiological and hormonal changes can precipitate new neurological symptoms. During pregnancy, women are vulnerable because many medications and diagnostic tests are avoided considering possible harm to the fetus. The present study was hence undertaken to analyse the influence of neurological disorders.
on pregnancy outcome.
MATERIALS AND METHODS:
This is a Observational type of study where 50 women with neurological disorders admitted in GOVT RSRM Lying Hospital, Royapuram were included in this study. The study period was 10 months .The patients were selected on inclusion and exlusion criteria. The relevant data is collected and analysed.
RESULTS:
In our study multigravida had major incidence of neurological manifestations. The most common pattern is seizure followed by giddiness with altered sensorium.In our present study neurological event occured first in the antenatal period and in the post partum period .In our study the other comorbidity associated was anemia followed by gestational diabetes.
CONCLUSION:
Neuroimaging is both a diagnostic and complimentary tool in the management of neurological disorders before, during and after pregnancy. New onset seizures in a non-epileptic, normotensive woman will have adverse maternal and perinatal outcome, hence early intervention would be recommended. Prompt diagnosis and treatment of the cause have a better outcome.
Pre conceptional counselling for all the epileptic patients should be given. All epileptic women should be advised tae preconceptinal folic acid supplementation daily . These epileptic patients should be evaluated in conjuction with neurologist. Seizure free interval of more than 2 years are potential candidates. If complete with drawal is not possible, monotherapy could be attempted to reduce the risk of fetal malformations. Also Contraception is an important consideration for women with epilepsy
A Cross Sectional study on Psychiatric Morbidities, Sleep Disturbances, Quality Of Life in Post Coronary Artery Bypass Graft Surgery Patients
No full textCorrelation between 6 Minute Walk Test and Pulmonary Artery: Aorta Ratio in CT Chest of Patients with COPD in Predicting Pulmonary Hypertension
No full textAssessment of High Sensitivity Cardiac Troponin T Levels in relation to Short Term Outcome of Acute Ischemic Stroke in a Tertiary Care Centre
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