To Identify the Role of Longitudinal Measurements of Foetal Aortic Isthmus Blood flow using Doppler Ultrasonography in the prediction of Perinatal Morbidity and Mortality

Umbilical cord ulceration has been associated with congenital upper intestinal (duodenal or jejunal) atresia and can lead to fatal fetal intrauterine hemorrhage. We report a case of spontaneous hemorrhage from the umbilical cord, incidentally noted at the time of ultrasound in a 33-week fetus with suspected duodenal atresia, in which immediate delivery resulted in a good outcome. Despite many reports in the literature of congenital upper intestinal atresia and its association with umbilical cord ulceration, the propensity for this lesion for fetal hemorrhage, and the resulting perinatal morbidity and mortality, there appears to be a gap in the dissemination of this knowledge. In fetuses with suspected congenital upper intestinal atresia, recognition of the entity of umbilical cord ulceration may be improved by ultrasound with special attention to the amount of Wharton’s jelly within the cord. Routine antepartum fetal surveillance may reduce perinatal morbidity and mortality from this condition. A high index of suspicion is needed to make the diagnosis of umbilical cord ulceration in association with congenital upper intestinal atresia. The role of amniotic fluid bile acids in the genesis of this disorder needs further study.

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Role of Ultrasound in Detection of Abruptio Placentae and its Clinical Correlation

Nepalese Journal of Radiology ◽

10.3126/njr.v8i2.22982 ◽

2018 ◽

Vol 8 (2) ◽

pp. 35-39

Author(s):

Sangeeta Devi Gurung ◽

Junu Shrestha ◽

Prakash Sharma

Keyword(s):

Gestational Age ◽

Fetal Outcome ◽

Morbidity And Mortality ◽

Perinatal Morbidity ◽

Abruptio Placentae ◽

Ultrasound Findings ◽

Recorded Data ◽

A Prospective Study ◽

Singleton Pregnancies

Introduction: Abruptio placentae is one of the major complications in second half of pregnancy. It accounts for 0.4-1 % of all deliveries. With the advent of ultrasonography, though abruptio placentae has been diagnosed however the sensitivity is less. Those patients clinically suspicious of abruption placenta with negative ultrasound findings can have positive intrapartum findings suggestive of abruptio. Fetal outcome is associated with the gestational age. Preterm deliveries with abruption have higher incidence of perinatal morbidity and mortality as compared to term pregnancies.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara from July 2017 to July 2018. All the cases of more than twenty eight weeks gestation, singleton pregnancies without preexisting maternal medical diseases suspicious of abruption placentae were included in the study. Ultrasonological and intrapartum findings were recorded. Data was analyzed using SPSS (VERSION16).Results: Out of forty patients presented with per vaginal bleeding, sixteen were diagnosed as placental abruption either clinically or ultrasonographically. Only ten patients had positive ultrasound findings of retroplacental clot or subchorionic hemorrhage. Out of six patients with negative ultrasound findings, only four had positive Intrapartum findings suggestive of abruption placenta. The specificity (100%) of ultrasound in diagnosing abruption was more than the sensitivity (71.43%) and the accuracy was 75%.Conclusion: Ultrasound is less sensitive in diagnosing abruption placenta and the lesser the gestational age, the more in the increase in perinatal morbidity and mortality.

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