Obstetric Scan Research Articles

The correlation between serum levels of soluble platelet -selectin in preeclampsia with & without intrauterine growth retardation versus normal pregnancy

Background: preeclampsia is characterized by endothelial dysfunction with vasoconstriction due to cell adhesion molecules or mediators released by defective placentation. Soluble platelet selectin, one of the cell adhesion molecules, is elevated in many inflammatory conditions including preeclampsia.Objective: To investigate if soluble platelet-selectin levels can be used as a marker for adverse outcomes in pregnancy complicated with sever preeclampsiaPatients and methods:This study involved 115 pregnant women in their third trimester of pregnancy; divided into Group A: involves 25 pregnant women with preeclampsia complicated by intrauterine growth restriction.Group B: involves 35 pregnant women with preeclampsia without intrauterine growth restriction.Control group: involve 55 pregnant women with normal blood pressure and normal fetal growth .The data were conducted from patients by special questionnaire, this involve name, age, parity, examination included vital signs, abdominal, obstetrical examination and investigations including :Liver function test, Renal function test, Complete blood picture and maternal serum levels of soluble platelet selectin was measured by enzyme-linked immunosorbent assay ,albumin in urine and serial obstetrical ultrasound scan to confirm the diagnosis of intrauterine growth retardation and Doppler study to determine fetuses at risk .Results: this study revealed a significantly higher concentration of soluble platelet selectin levels in serumofpreeclamptic women with and without intrauterine growth retardation versus normotensive and normal fetal growth. The maternal serum levels of sP-selectin in preeclampsia without intrauterine growth restriction were significantly higher than preeclampsia complicated by intrauterine growth restriction .Sensitivity was 91.7% and specificity 100% at cut off value 6.975 ng/ml of maternal soluble platelet _selectin for prediction of adverse pregnancy outcome .Conclusion: soluble platelet -selectin levels have a positive significant correlation with the severity of preeclampsia, so it can beconsidered as a marker for its severity and can be used as a predictor for adverse outcomes as itsnegatively correlated with these complications

Spontaneous Regression of a Gigantic Cardiac Rhabdomyoma

A fetal echocardiogram was performed at 37 weeks of gestation in a primi-gravida on detection of a cardiac mass in an obstetric ultrasound scan. A single homogeneous, hyper-echogenic 37×32mm cardiac mass in the interventricular septal region spilling into ventricular cavities was noted (Figure 1A). The echocardiographic examination of valves, chambers and other cardiovascular structures did not reveal any other abnormality. There was no family history suggestive of tuberous sclerosis. The family received counselling regarding a multidisciplinary team approach and the need for early surgical management.

Effectiveness of Utero-Vaginal Packing in Management of Postpartum Hemorrhage

<p>A major cause of maternal mortality and morbidity in developing world is postpartum hemorrhage (PPH). Different management options have been in use including use of oxytocins, prostaglandins, surgical exploration of genital tract, ligation or angiographic embolization of uterine/internal iliac arteries and hysterectomy. A simple and effective measure is to control bleeding with uterovaginal packing which is easy and quick to perform and saves the patient need of major surgical procedures.</p><p><strong>Objective:</strong><strong> </strong>To determine effectiveness of uterovaginal packing in control of postpartum hemorrhage, its safety and complications associated with it.</p><p><strong>Place and Duration of Study:</strong><strong> </strong>This study was carried out in Gynae unit 1 of Lady Willingdon Hospital Lahore from January 2014 – June 2015.</p><p><strong>Patients and Methods:</strong><strong> </strong>It was a prospective interventional study. The patients presenting with postpartum hemorrhage after vaginal or abdominal delivery who did not respond to medical management were included in the study. Patients who had PPH due to genital tract trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data was analyzed by SPSS version 11.</p><p><strong>Results:</strong><strong> </strong>99 patients who presented with PPH were included in study.49.5% were between age of 31 – 40 years, 38.4% were between 21– 30 years. 8.1% of patients were P1-2, 52.5% were P3-5 and 39.4% were P6 and above. 76.7% had hemorrhage after vaginal delivery and 23.3% after lower segment caesarean section. Uterineatony was the most common cause of postpartum hemorrhage, seen in 78.78% of cases, 9.09% had placenta previa, 8.08% presented with abruption placenta and 4.04% had coagulopathy. Regarding complications 7 women had to undergo hysterectomy, fever occurred in 14.14%, 8.08% had wound infection and 2 patients died of Disseminated Intravascular Coagulation (DIC). Procedure was successful in 90.9% of cases.</p><p><strong>Conclusion: </strong>Utero-vaginal packing effectively controls postpartum hemorrhage with fewer complications and its role in emergency obstetric scan not be denied.</p>

A large amniocele through a fundal uterine defect diagnosed on 2D ultrasound imaging

Introduction: Amniocele is herniation of amniotic sac through a uterine myometrial defect. It commonly results from intrauterine procedures such as suction evacuation, dilatation and curettage, manual removal of placenta and other products of conception, etc. Early diagnosis is imperative as that will go a long way to reduce morbidity and mortality. Case Report: A 35-year-old G4P3+0 women was presented to our health facility at 21st week gestation with a week history of lower abdominal pain. Obstetric ultrasound scan done at presentation revealed a fundal myometrial defect with a large amniocele through it, resulting in apparent oligohydramnios. Her first two deliveries were uneventful, but the third was complicated by post-partum hemorrhage due to retained placenta. This necessitated instrumentation and manual removal in the theatre at a secondary Health institution, four years prior to the index pregnancy. No immediate complication was noticed after the procedure. Two weeks after this diagnosis, precisely at 23rd week gestation, she had laparotomy, aimed at reducing the herniated amniotic sac and repairing the defect. This was not possible due to the narrow neck of the defect. She was then closed back and kept on exclusive bed rest and weekly sonographic evaluation of the pregnancy. A scan done at 31st week gestation revealed ruptured herniated amniotic sac into the peritoneal cavity with fetal distress. Estimated ultrasound fetal weight at this time was 1.76 kg. She had emergency cesarean section with delivery of a live very low birth weight baby whose APGAR score was 7 and 8 at 1 and 5 minutes respectively. The baby was admitted into special care baby unit (SCBU) but died 10 hours thereafter. The myometrial defect and uterine incision were repaired in layers. She did well, hemodynamically stable and was discharged on postoperative day-7. Follow-up visits were satisfactory. Conclusion: This case is presented to emphasize the need for training and retraining of physicians and midwives on active management of third stage of labor to forestall the observed pitfalls. It also brings to the fore the utility of gray scale and color Doppler ultrasound in antenatal diagnosis of uterine defect and placenta accreta.

Relationship between Ultrasonic Marker of Fetal Lung Maturity and Lamellar Body Count

BackgroundThe aim of this study was prediction the fetal lung maturity by ultrasonic markers and comparison by lamellar body count and fetal outcome. MethodsA prospective Longitudinal study Department of perinatology of performed Emam Khomeini hospital and Mirza Kochak Khan Hospital in Tehran, Iran from March 2013 to January 2014. 100 pregnant women (37-40 weeks of gestation) who were admitted for elective cesarean section and referred for an obstetric ultrasound scan at the same day of their elective cesarean section were included. Scanning with linear ultrasound with convex transducer frequency of 3.5 MHZ was utilized to measure the biparietal diameter, Amniotic fluid vernix and placental grading. Statistical analysis was performed using Spss version 20. Validity of the indicators compared with lamellar body count and fetal outcome. ResultsIn this study, from 100 patients under study, 8 cases were hospitalized in NICU (neonatal intensive care unit) which all of them had LAMELAR BODY COUNT < 14000 (10000-14000). There were 6 boys and 2 girls. In this study, there was no perinatal mortality. ConclusionsIn study we used ultrasonic marker of fetal lung maturity and related this to lamellar body count and neo natal outcome. The ultrasonic marker of fetal lung maturity can reduce mortality and morbidity in neonate.

Accuracy of Ultrasonography in Detecting Ectopic Pregnancy

To determine the accuracy of ultrasonography in detecting ectopic pregnancy. Prospective review of the outcome of women presenting with suspected ectopic pregnancy from June 2015 to December 2016, and who underwent ultrasonography in a single institution, was performed. The ultrasound findings were categorized as intrauterine pregnancy, miscarriage, ectopic pregnancy or pregnancy of unknown location. Women with pregnancy of unknown location were followed up to determine the location of the pregnancy. Those who default follow-up and persistent pregnancy of unknown location were excluded. The final outcome was confirmed either through surgical findings or follow-up obstetric ultrasound scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with 95% confidence intervals (CIs) for the diagnosis of ectopic pregnancy were assessed each month. From June 2015 to December 2016, there were 2315 consecutive women who were suspected of ectopic pregnancy. Outcome data were available for 1729 (74.7%) women. The accuracy of ultrasound scan in detecting ectopic pregnancy ranges from 96.8% to 100%. There were 529 confirmed ectopic pregnancies and 1200 had either intrauterine pregnancies or miscarriages. The overall sensitivity for ultrasound in detecting ectopic pregnancy was 98.87% (95% CI: 97.55-99.58) with a specificity of 99.0% (95% CI: 98.26-99.48), a positive predictive value of 97.76% (95% CI: 96.13-98.71) and a negative predictive value of 99.5% (95% CI: 98.89-99.77). In women who are suspected of ectopic pregnancy, 98.9% of ectopic pregnancies can be accurately diagnosed by ultrasonography.

Fetal Pericardial Effusion: Roles of Prenatal Cardiac Intervention?

Isolated fetal pericardial effusions are frequently detected on routine obstetric scans. The exact incidence and significance of this finding is not clearly understood. The perinatal outcome in such cases depends on the presence or otherwise of associated malformations and chromosomal aberrations. Management of a fetus with pericardial effusion involves a multidisciplinary review of the problem to consider the competing fetal and maternal implications. Close monitoring of the fetal biophysical profile along with serial echocardiographic assessments and pericardiocentesis may allow the delivery to be delayed until adequate lung maturity is achieved. Current evidence indicates good outcome in cases of isolated pericardial effusion. Large prospective studies are needed to resolve the issue of association with chromosomal aberration that has significant impact on antenatal management and counseling policies in such cases.

Reduced fetal brain fissures depth in fetuses with congenital heart diseases.

To screen and detect cortex gyration in fetuses with congenital heart disease (CHD) using Ultrasonography (US) during routine obstetric scans. The depth of the Sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine (CF) fissure were prospectively serially measured and compared in 45 fetuses with CHD and 45 normal fetuses. Cardiac hemodynamic parameters, including aortic valve diameter (AV), pulmonary valve diameter (PV), velocity time integral of the aortic valve (VTIav), and velocity time integral of the pulmonary valve (VTIpv), were recorded. Correlations between the fissure depths and the prenatal cardiac hemodynamic parameters and postnatal neurodevelopmental scores were assessed. SF, POF, and CF were decreased in CHD fetuses compared with the controls in late of pregnancy (P < 0.01). The diagnostic category was independently associated with smaller fissure depths in fetuses with CHD (adjusted R2 = 0.472 for SF, 0.465 for POF, and 0.425 for CF). Correlations were observed between small fissure depths and decreased left heart hemodynamic parameters (AV and VTIav) in fetuses with CHD. The SF depth was positively correlated with the neurodevelopmental scores (P < 0.01). US can be used to screen for abnormal fetal brain cortex development during routine obstetric scans and to evaluate the maturation progress during close follow-up. © 2016 John Wiley & Sons, Ltd.

Helping expectant mothers understand inadequate ultrasound images.

Obstetric ultrasound scans may fail to provide all the information that is needed because of poor visualisation. Two main causes of poor visualisation are addressed. These are poor foetal position and poor quality imaging due to beam distortion by overlying fatty tissue. To improve communication with patients attending obstetric scans, a poster and leaflet were designed to explain these causes of inadequate scans. A questionnaire was used to assess the value of the poster. 57/66 (86%) questionnaires were completed. 52 (91%) found the information on the poster was helpful and well explained. For 8 (14%) the information changed their thoughts about the scan. Clear communication aids the expectant mothers understanding of why scans may be suboptimal. The way this is recorded in the scan results is discussed.

Impact of maternal knowledge of recommended weight gain in pregnancy on gestational weight gain

Obesity is prevalent among reproductive-aged women and is associated with increased obstetric complications. Weight gain recommendations exist; however, knowledge of these recommendations is low, and few women gain appropriate weight during their pregnancies. Excessive gestational weight gain is common and is associated with adverse outcomes. Little is known about the relationship between knowledge of gestational weight gain recommendations and actual weight gain. Our objectives were to assess knowledge of weightgain recommendations in pregnancy and to determine its association with actual weight gain among women who seek care at an urban, regional perinatal center. We hypothesize that low levels of knowledge will predict inappropriate weight gain in this population. This is a cross-sectional study with linked chartreview of 338 women who sought routine obstetric ultrasound scans at an urban, regional perinatal center that serves a largelylow-income population of predominately black women. Descriptive statistics, chi-square test, and analysis of variance were performed. This population has low rates of accurate knowledge of weight gain recommendations in pregnancy (27%) and low rates of appropriate gestational weight gain (30%). Inappropriate gestational weight gain was highest among women who were obese before pregnancy. Accurate knowledge of gestational weight gain recommendations was associated with appropriate weight gain in pregnancy (P=.02), as was prepregnancy weight category (P= .004) and correct identification of prepregnancy weight category (P= .005). These findings support the need for improvements ineducational efforts about weight gain in pregnancy for high-risk, low-income women in an urban setting, which may improve compliance with the recommendations.

La simulation pour améliorer l’apprentissage de l’échographie obstétricale chez les débutants : étude pilote et revue de la littérature

The aim of this study was to evaluate the obstetrical ultrasound simulator as an initiation tool for teaching obstetrical ultrasound scanning for beginners. Twenty medical students with no experience in ultrasound scan (US) received a basic theoretical ultrasonography course on US principles and 2nd trimester biometrical measurements. The participants were then divided into 2groups (A, B). Only group A received a practical 2nd trimester scan training session on the simulator where they were asked to determine fetal and placental position, and to take the 3biometrical standardized measurements. Group B had the same training session but with a real ultrasound machine and a pregnant volunteer. The 2groups were then asked to perform an US session on real patients (22weeks) during which they had to do the same US study. The time needed to complete the whole scan was analyzed. The quality of the measurements was compared based on the previously published Objective Quality Criteria scoring. The mean total score was significantly (P=0.001) better for group A (14.3±1.4) compared to group B 10.3 (±2.75) for group A and B respectively. The time needed to accomplish the whole exam tended to be longer for group A (569±174s) compared to group A (479±104s) (P=0.18). The simulator might be a useful initiation tool to obstetric ultrasound for those who never practiced. It might prove a time sparing procedure in the training process and allow trainees to reach a basic practice level before performing examinations on actual patients.

Evaluation of the thermal effects of prenatal ultrasound on hematological analysis of young Oryctolagus Cuniculus.

Elevated temperatures can induce changes in red blood cell (RBC), white blood cell (WBC) and platelet (PLT) counts. Ultrasound heating during obstetric scans has the potential to increase body temperature owing to the phenomenon of absorption. We conducted a study to determine the thermal effects of prenatal ultrasound on RBCs, hemoglobin concentration (Hb), WBCs and PLTs in young rabbits. We selected 69 rabbits that were 1 month of age and 73 that were 5 months of age, and allocated them to four groups. The control group consisted of four pregnant does that were allowed to have a full term delivery without any ultrasound exposure. The experimental groups were subjected to one-time ultrasound exposure for 30, 60 and 90 min in the middle of each gestational stage accordingly. RBCs and Hb showed significant reductions in the experimental groups of 1- and 5-month-old rabbits (P<0.05). In addition, WBCs and PLTs yielded significant differences in the 1-month group that were not observed in the 5-month group (P>0.05). The highest values recorded were those of the WBCs of 1-month-old subjects that received 90 min of exposure at the second stage of gestation. The PLTs were the lowest values recorded in 1-month-old subjects following 90 min of ultrasound exposure at the third stage of gestation. These findings suggest that hematological fluctuations during the early stages of postnatal life persisted until 1 month of age and recovered thereafter, as the subjects progressed into adulthood. Therefore, ultrasound heating can cause significant, yet reversible effects on the hematological parameters of rabbits.

Foetal Ultrasound– A Study of Spina Bifida and Associated Anomalies in Rural Pregnant Women

Objective: To study the incidence and various types of associated anomalies and complications on obstetric ultrasound, in rural pregnant women. To reduce the maternal morbidity and mortality by early detection of these congenital neuroectodermal anomalies. To assist the obstetrician in taking decisions regarding the termination or continuation of the pregnancy in relation to the type of malformation and its prognosis. A prospective and retrospective study of spina bifida and its associated anomalies was done on 23,000 rural pregnant women coming to the Santhiram Medical College, Radiology Department for a routine obstetric scan. A total of 19 cases spina bifida were detected of which 2 cases were pure spina bifida without any complication, 14 cases had hydrocephalus and meningocele or myelomeningocele and 2 cases had meningocele without hydrocephalus. One case had anencephaly with an incidence of 1 per 1,111 cases. History of similar anomaly and intake of iron and folic acid tablets were noted. Ultrasound is an excellent modality for the diagnosis and characterisation of these neuroectodermal anomalies. Its multiplanar imaging property along with real-time image visualization makes it an excellent tool for the diagnosis and characterization of these anomalies. KEYWORDS: Congenital neuroectodermal anomalies, Spina bifida, Hydrocephalus, Meningocele, Myelomeningocele, Ultrasound, Anencephaly

Maternal Cardiac Output and Fetal Doppler Predict Adverse Neonatal Outcomes in Pregnant Women With Heart Disease.

BackgroundThe mechanistic basis of the proposed relationship between maternal cardiac output and neonatal complications in pregnant women with heart disease has not been well elucidated.Methods and ResultsPregnant women with cardiac disease and healthy pregnant women (controls) were prospectively followed with maternal echocardiography and obstetrical ultrasound scans at baseline, third trimester, and postpartum. Fetal/neonatal complications (death, small‐for‐gestational‐age or low birthweight, prematurity, respiratory distress syndrome, or intraventricular hemorrhage) comprised the primary study outcome. One hundred and twenty‐seven women with cardiac disease and 45 healthy controls were enrolled. Neonatal events occurred in 28 pregnancies and were more frequent in the heart disease group as compared with controls (n=26/127 or 21% versus n=2/45 or 4%; P=0.01). Multiple complications in an infant were counted as a single outcome event. Neonatal complications in the heart disease group were small‐for‐gestational‐age/low birthweight (n=18), prematurity (n=14), and intraventricular hemorrhage/respiratory distress syndrome (n=5). Preexisting obstetric risk factors (P=0.003), maternal cardiac output decline from baseline to third trimester (P=0.017), and third trimester umbilical artery Doppler abnormalities (P<0.001) independently predicted neonatal complications and were incorporated into a novel risk index in which 0, 1, and >1 predictor corresponded to expected complication rates of 5%, 30%, and 76%, respectively.ConclusionsDecline in maternal cardiac output during pregnancy and abnormal umbilical artery Doppler flows independently predict neonatal complications. These findings will enhance the identification of higher risk pregnancies that would benefit from close antenatal surveillance.

Association of Birth Weight with Gestational Age and Maternal Measles Antibodies

Introduction: Maternal measles antibody (MMA) offers protection against measles in early childhood, however, certain determinants of this antibody lives much to be desired. The aim of the study were to determine the association between birthweight (BW) and gestational age (GA), to assess the relationship between BW and MMA, to correlate GA with MMA and to examine the combined effects of BW and GA on MMA.Material and Methods: The work was a hospital-based cross-sectional descriptive study. Babies were enrolled using systematic random sampling method. The babies BW was measured using the bassinet scale; enzyme linked immunosorbent assay was used to determine MMA. GA of babies was determined using the mothers' last menstrual period (LMP) or by Dubowitz score or by Obstetric ultrasound scan. Data were analysed using SPSS statistical software version 16, Illinois, Chicago USA and a computer program for epidemiologist PEPI version 3.01. Spearman’s correlation (rho), Kendall’s rank correlation (tau b) and Jonckheere-Terpstra test of association of ordinal variables were determined. Univariate analysis was used to investigate the combine effects of BW and GA on MMA. Likely-hood ratio Chisquare (?2) was used for categorical data. Goodman-Kruskal index rank order of predictive association (tau) of ordinal data was also calculated.Results: 200 babies were enrolled, 101 (50.5%) were males and 99 (49.5%) females. 169 babies (84.5%) had normal BW, 117 (58.5%) were delivered at term. The mean BW was 3.04 (0.58) at 95% CI (2.96 – 3.12) kg. Association between BW and GA was significant (p=0.003), the predictive value for the association was also significant (p=0.039). Significant correlation was also observed between GA and MMA (p&lt;0.001).Conclusions: There was a significant association between BW and GA and MMA correlated well with GA.J Nepal Paediatr Soc 2015;35(1):6-12

The effectiveness of the use of high fidelity simulators in obstetric ultrasound training: A systematic review.

Introduction: The benefits of the use of ultrasound technology for point of care obstetric health evaluation have led to increased focus on training programs for physicians wanting to develop skills in this area. Simulation, in a variety of formats, has always played a role in medical and health training, with proven benefits. This systematic review determines the level of evidence available to support the use of high fidelity ultrasound simulators in the training of obstetric ultrasound scanning skills to health professionals. Methods: A systematic review of the literature was performed to define previous investigations into the incorporation of high fidelity ultrasound simulators into obstetric ultrasound training programs. The included studies were reviewed by the authors to evaluate their overall strength and quality. Data surrounding the study participants, simulator types, study design, training program format, outcome measures, and results were extracted. Results and conclusions: While the small body of evidence discovered in this review demonstrates positive results for the use of high fidelity simulators in obstetric ultrasound training, the studies included in this review demonstrate a moderate level of evidence, with some potential of bias throughout. A number of gaps in the literature were identified that could be addressed in further research.

Guidelines for the Management of a Pregnant Trauma Patient.

Abstract Objective Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. Outcomes Significant health and economic outcomes considered in comparing alternative practices. Evidence Published literature was retrieved through searches of Medline, CINAHL, and The Cochrane Library from October 2007 to September 2013 using appropriate controlled vocabulary (e.g., pregnancy, Cesarean section, hypotension, domestic violence, shock) and key words (e.g., trauma, perimortem Cesarean, Kleihauer-Betke, supine hypotension, electrical shock). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English between January 1968 and September 2013. Searches were updated on a regular basis and incorporated in the guideline to February 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technologyrelated agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Values The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Benefits, harms, and costs This guideline is expected to facilitate optimal and uniform care for pregnancies complicated by trauma

Fetal interrupted aortik ark tip B’nin antenatal değerlendirilmesi

Interruption of the aortic arch (IAA) is a rare, severe form of congenital heart defect characterized by complete anatomical discontinuity between two adjacent segments of the aortic arch. The data on the features and outcomes of fetal IAA are limited. Three anatomical types have been described according to the site of interruption. The current recommendations for screening on the obstetric fetal anomaly scan include identification of a 4-chamber view, all 4 valves, and the outflow tracts, all of which can appear to be normal to the ultrasonographer in fetuses with conotruncal anomalies. Although the identification of IAA on a prenatal echocardiogram can be challenging, a number of anatomic features can facilitate the diagnosis. We aim to present the features and outcome of a case of IAA type B referred to our centre in the light of literatures

Sonographic evaluation of maternal kidneys in normal pregnancy

Background and Objectives: Renal disease can affect the outcome of pregnancy. The renal system undergoes significant physiological and anatomical changes during pregnancy. Ultrasound is the commonest imaging modality used in the evaluation of the abdominal organs in pregnancy. The purpose of this study was to sonographically evaluate the kidneys in normal pregnancy. Methods: A prospective descriptive study in which real time B-mode renal ultrasound was performed on 500 pregnant women attending for a routine obstetric ultrasound scan. Questions about the age, parity and presence of loin pain were asked. Obstetrical ultrasound examination was initially performed followed by examination of maternal kidneys. Results: Renal collecting system dilatation was the main abnormal finding; it was present in 18.2% of cases, (15.2% right side and 3% left side). Bilateral hydronephrosis was seen in (2.6%) of cases. Rate of hydronephrosis was more in primiparous women. Other findings were renal stones (2.8% right and 1.8% left sides, respectively), ureteric stone (0.2%) and acute pyelonephritis (1%). Conclusions: This study established the value of renal sonography in the pregnant women, though not a common condition. Renal collecting system dilatation was the main finding. A significant proportion of patients with asymptomatic renal calculi were detected incidentally.

English

BACKGROUND: in India, the HIV prevalence in women of child bearing age is seen where already the risk of maternal and newborn morbidity mortality are high. There is need to investigate the association between maternal HIV infection and adverse pregnancy outcomes so the disease is better address. OBJECTIVES: To study the obstetrics and newborn outcome in pregnant women with HIV infection. METHODOLOGY: All booked ANC cases that are screened to be HIV positive in one year period are included. History taken, clinical examination is done. Patients are subjected to investigation like ANC investigation and CD4 cell count and obstetrics scan. All the patient will be followed up till term/ delivery and outcome studied. STATICAL ANALYSIS: descriptive study and chi-square test. RESULT: Maternal HIV infection is associated with incidence of low birth weight in 52.3, pre-term labour in 34.5%, PROM in 30% and IUGR in 20%. These adverse outcomes have an inverse relationship with CD4 count. Lower CD4 count is also associated with increase obstetrics, fetal complication and opportunistic infection. (P<0.05) CONCLUSION: maternal HIV infection is associated with increased incidence of adverse obstetrics and newborn outcome have an inverse relation with CD4 count.