Fetal Parameters Research Articles

Fetomaternal Outcome in Eclampsia at Tertiary Care Centre: A Descriptive Cross-Sectional Study

Introduction: Eclampsia is a life threatening emergency condition that remains a leading cause of maternal and perinatal mortality. It is one of the causes of preventable maternal mortality. There are specific risks for the mother as this condition lead to seizure and may cause woman to lose consciousness and if the fetus is not delivered, this condition can cause the death of the mother and or the fetus. This study was conducted to evaluate the fetomaternal outcome in eclampsia. Materials and Methods: This is a descriptive cross sectional study done at National Medical College Teaching Hospital from 1st February 2021 to 31st January 2022. Ethical approval was obtained from IRC (regd no. F-NMC/518/076-77). During the study period 1496 women delivered. Out of this, 44 patients with generalized tonic-clonic convulsions during pregnancy / labour / within 7 days of delivery were included in the study criteria. The data analyzed included various maternal parameters, fetal parameters and pregnancy outcomes. Result: Among 1496, 44 patients (2.94%) developed eclampsia, 38.63% in age group of < 20 years, 59.09% were primigravida, 84.09% unbooked, 63.63% presented with antepartum eclampsia, delivered by caesarean 63.63%. There was 2.26% maternal mortality due to cerebrovascular accident. Perinatal mortality was 11.36% which included stillbirth 6.81%nand neonatal death 4.54%. Conclusion: Regular antenatal checkup, early detection of disease, timely referral, and early initiation and treatment in patients with eclampsia improve outcomes. Treatment of these patients should be carried out in tertiary care centers where intensive care units, NICU facilities, and multidisciplinary units are available.

Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour-A Prospective Cohort Study.

Pelvic dimensions are crucial variables in the labour process. We used magnetic resonance imaging (MRI) pelvimetry to predict the probability of vaginal delivery and distinguish the cephalopelvic disproportion risk in women with prolonged active labour. This prospective cohort study enrolled term nulliparous women willing to undergo MRI pelvimetry and a trial of labour. A nomogram, with vaginal birth as the outcome, was developed and evaluated by calibration curve and decision curve analyses. The pairwise association between maternal and fetal parameters and a prolonged first stage of labour was quantified. Head circumference (HC), abdominal circumference (AC), intertuberous distance (ITD), interspinous diameter (ISD), and body mass index (BMI) were introduced to develop a nomogram with good diagnostic performance (area under the curve = 0.799, sensitivity = 83%, and specificity = 73%). The cephalopelvic index of diameter (CID) in 54 women with a prolonged first stage of labour was much smaller in those who delivered via cesarean section compared with those who delivered vaginally (18.09 ± 1.14 vs. 21.29 ± 1.06; p = 0.046). An MRI pelvimetry-based nomogram may predict the probability of vaginal delivery. Practitioners should reassess the pelvimetry parameters to decide whether the trial of labour should be continued if it is prolonged.

Calcium, Potassium, Sodium, and Magnesium Concentrations in the Placenta, Umbilical Cord, and Fetal Membrane from Women with Multiple Pregnancies.

Calcium (Ca), potassium (K), sodium (Na), and magnesium (Mg) are the elements responsible for the fundamental metabolic and biochemical processes in the cells of the body. The demand for these elements increases significantly during pregnancy, where an adequate supply protects women from the hypertension common in pre-eclampsia and preterm labor. This study aimed to evaluate the association between macro-elements (Ca, Mg, Na, and K) in the placenta, fetal membrane, and umbilical cord and the morphometric parameters of newborns from multiple pregnancies. The study involved 57 pregnant European women with healthy uncomplicated twin pregnancies (n = 52) and triple pregnancies (n = 5); 40 pairs of dichorionic diamniotic twins, 11 pairs of monochorionic diamniotic twins, 1 pair of monochorionic monoamniotic twins, 3 trichorionic triamniotic triplets, and 2 dichorionic triamniotic triplets. Placentas (n = 107), umbilical cords (n = 114), and fetal membranes (n = 112) were collected immediately following delivery, and then weighed and measured. The levels of Ca, K, Na, and Mg were determined using inductively coupled plasma atomic emission spectroscopy (ICP-OES) in a Thermo Scientific ICAP 7400 Duo (Waltham, MA, USA). The respective mean concentrations of Ca, K, Na, and Mg (mg/kg-1 dry mass) were: 2466, 8873, 9323, and 436 in the placenta; 957, 6173, 26,757, and 326 in the umbilical cord, and 1252, 7460, 13,562, and 370 in the fetal membrane. In the studied materials from northwestern Poland, we found strong positive correlations between Ca and Mg concentrations in both the umbilical cord (r = 0.81, p = 0.00) and the fetal membrane (r = 0.73, p = 0.00); between K and Mg concentrations in the umbilical cord (r = 0.73, p = 0.00); between Ca and K concentrations in the fetal membrane (r = 0.73, p = 0.00), and we found moderately positive correlations between placental Ca concentration and placental weight (ρ = 0.42, p = 0.00) and between umbilical cord Mg concentrations and the length of the pregnancy (ρ = 0.42, p = 0.00). Negative correlations were found between Na and Ca concentrations in the fetal membrane (r = -0.40, p = 0.00) and Na concentrations in the fetal membrane and Mg concentrations in the placenta (r = -0.16, p = 0.02). Negative correlations were confirmed between the length of pregnancy and head circumference (ρ = -0.42; p = 0.00), infant weight (ρ = -0.42; p = 0.00), infant length (ρ = -0.49; p = 0.00), shoulder width (ρ = -0.49; p = 0.00); and between the infant weight and head circumference (ρ = -0.62; p = 0.00), weight before delivery (ρ = -0.36; p = 0.00), infant length (ρ = -0.45; p = 0.00), shoulder width (ρ = -0.63; p = 0.00), and weight gain during pregnancy (ρ = -0.31; p = 0.01). We found statistically significant correlations between cigarette smoking before pregnancy and the women's weight before delivery (ρ = 0.32, p = 0.00), and a negative correlation between the women's ages and infant head circumference (ρ = -0.20, p = 0.02). This is probably the first study to evaluate Ca, Na, K, and Mg concentrations in the afterbirth tissues of multiple pregnancies. It adds to the knowledge of elemental concentrations in multiple pregnancies and their possible effects on fetal morphometric parameters.

Sulfasalazine for the treatment of preeclampsia in a nitric oxide synthase antagonist mouse model

IntroductionDevelopment of a therapeutic that targets the pathophysiological elements of preeclampsia would be a major advance for obstetrics, with potential to save the lives of countless mothers and babies. We recently identified anti-inflammatory drug sulfasalazine as a prospective candidate therapeutic for treatment of preeclampsia. In primary human cells and tissues in vitro, sulfasalazine potently decreased secretion of anti-angiogenic sFlt-1 and sENG, increased production of pro-angiogenic PlGF, mitigated endothelial dysfunction, and promoted whole vessel vasodilation. MethodsUsing nitric oxide synthase antagonist Nω-Nitro-l-arginine methyl ester hydrochloride, a preeclampsia-like phenotype was induced in pregnant mice, including high blood pressure, fetal growth restriction, and elevated circulating sFlt-1. Mice were treated with sulfasalazine or vehicle from gestational day (D)13.5, with blood pressure measurements across gestation, fetal measurements at D17.5, and wire myograph assessment of vasoactivity. ResultsSulfasalazine had a modest effect on blood pressure, decreasing diastolic and mean blood pressure on D13.5, but not later in gestation, or systolic blood pressure. Sulfasalazine was not able to rescue fetal growth, in male or female fetuses. There was a suggestion of improved vasoactivity with sulfasalazine, but further clarification is required. DiscussionIn this mouse model of preeclampsia, sulfasalazine did not sustain reductions in blood pressure nor affect fetal parameters of size and weight, both desirable attributes of a viable preeclampsia therapeutic. While these data suggest sulfasalazine might improve vasoactivity, murine toxicity considerations limited the dose range of sulfasalazine that could be tested in the current study.

Pre-natal dietary imbalance of folic acid and vitamin B12 deficiency adversely impacts placental development and fetal growth

IntroductionThe common practice of supplementing folic acid during pregnancy and the absence of such guidelines for vitamin B12 lead to an imbalance of these vitamins, especially in developing countries like India, where many women are vitamin B12 deficient. MethodsThe present study was designed to explore the effect of low vitamin B12 in combination with different levels of folic acid in the parental diet on fetal growth parameters and maternal reproductive performance in a transgenerational manner. The reversibility of these effects was studied by shifting the mice to a regular diet in the F1 generation in the case of transient groups and continued on the same diet in the sustained groups after the dietary exposure in the F0 generation. ResultsVitamin B12 deficiency and different levels of folic acid resulted in the decreased placental and fetal weight of the F1 generation. Surprisingly, a decreased placental weight, low fetal weight, and reduced crown-rump length and head circumference were observed in F2 fetuses of vitamin B12 deficient with folate over-supplemented (BDFO) transient group, i.e. when F1 mice were shifted to normal diet conditions. Reduced follicles in ovaries and alteration in placental pathology in all the F0 groups and BDFO of the F1 transient group were also seen. DiscussionOverall, the study revealed that dietary imbalance of vitamin B12 and folic acid, particularly B12 deficiency with over-supplemented folic acid, negatively affects placental and fetal development and maternal reproductive performance. Such effects are passed on to the next generation too.

Dietary embelin supplementation during mid-to-late gestation improves performance and maternal-fetal glucose metabolism of pigs.

This study aimed to evaluate the effects of dietary embelin supplementation during late gestation (from days 60 to 110) on performance and maternal-fetal glucose metabolism of pigs. Sixty sows (Duroc × Yorkshire × Landrace; parity = 1.68 ± 0.03; N = 20) were randomly divided into three gestation (day 60 of pregnancy) treatments, Control pigs (CON) were fed a basal diet, and the other animals were fed a basal diet supplemented with 200 or 600 mg/kg embelin per kg of feed. The body weight, backfat thickness and litter size of the sows, and birth weight and mortality of piglets were recorded. Sows' blood and piglets' umbilical cord blood were collected for the measurements of hematological parameters and anti-oxidative and immune indexes, and maternal-fetal glucose metabolism parameters, respectively. The colostrum and milk and fecal samples of the sows were also collected for analysis of milk composition and apparent total tract nutrient digestibility. Dietary embelin had no effect on the BW and backfat thickness of the sows but significantly increased the birth weight of piglets (P < 0.05) and decreased the mortality (P < 0.05). Moreover, the white blood cell counts (day 90), neutrophil count and mean cell hemoglobin (day 110), total anti-oxidant capacity (T-AOC), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) content of the sows were increased significantly (P < 0.05) in the embelin groups than that in the CON group, whereas the malondialdehyde (MDA) content was decreased (P < 0.05). Embelin significantly increased immunoglobulin A (IgA) and immunoglobulin G (IgG) content in plasma of piglets as well as those in colostrum and milk of sows than the CON treatment (P < 0.05). In addition, dry matter, ash, and ether extract in the colostrum were similar between groups (P > 0.05), whereas the embelin significantly increased the crude protein in the milk. The apparent total tract nutrient digestibility was similar between treatments (P > 0.05). The embelin treatment significantly increased the glucose levels and lactate dehydrogenase B (LDHB) activity in sows plasma, and decreased the lactate levels in both sows and fetuses plasma (P < 0.05). Collectively, this study indicates that sows fed with embelin in mid-to-late gestation showed improved maternal health and anti-oxidative status, milk protein content, and maternal-fetal glucose metabolism, showing promise in natural plant extract nutrition for sows.

Placental thickness and its relationship to gestational age and fetal growth parameters in normal singleton pregnancies in the central region of Togo

Introduction: Accurate determination of gestational age (GA) is necessary for qualitative obstetric care, and ultrasound fetal biometry parameters are used when the last menstrual period is not known. The aim of this study was to measure by ultrasound the placental thickness (PT) and correlate it with GA and fetal growth parameters. Population and Methods: This was a descriptive cross-sectional study conducted in the Radiology and Medical Imaging Department of Sokode Regional Hospital. All low-risk pregnancies from the 11th week were included. Excel and R 4.2.2 software were used. A significance level of 5% was established for the statistical tests. Results: A total of 256 pregnancies were recorded. The mean of PT was 29.89 ± 7.42 mm. The mean of PT in the first, second, and third trimesters was 13.50 ± 3.67 mm, 24.61 ± 4.12 mm, and 34.65 ± 4.17 mm, respectively. There was a strong positive linear correlation between PT and GA (r = 0.87, P &lt; 0.00001) and between PT and estimated fetal weight (EFW) (r = 0.80, P &lt; 0.00001). The linear relationship between PT and GA could be expressed by the equation: GA = 0.894*PT-0.103. Similarly, the linear relationship between PT and EFW could be expressed by the equation EFW = 127.314*PT-2563.561. There was a strong linear correlation between PT and parameters such as biparietal diameter (r = 0.88, P &lt; 0.00001), head circumference (r = 0.89, P &lt; 0.00001), and femur length (r = 0.89, P &lt; 0.00001). Conclusions: This study demonstrated a correlation between PT and fetal growth parameters, suggesting that PT can be utilized to monitor fetal growth.

Biochemical and ultrasonographic markers in fetal surveillance

Introduction/Objective. Fetal growth restriction (FGR) is associated with increased fetal and neonatal mortality and morbidity. The study objective was to investigate the correlation of maternal blood biochemical markers routinely determined in the first and second trimester screening and ultrasound fetal surveillance parameters in the prediction of fetal growth and condition in singleton pregnancies. Methods. In the first trimester we measured serum levels of beta subunit of human chorionic gonadotropin (?HCG) and pregnancy-associated plasma protein A (PAPP-A). In the second trimester we measured values of chorionic gonadotropin (HCG), alpha fetoprotein (AFP), unconjugated estriol (E3) and inhibin A, also examined ultrasonographic biometric fetal parameters, amniotic fluid index (AFI) and Doppler resistance indexes. FGR was defined as ultrasonographically determined fetal weight and growth parameters below the 10th percentile for the gestational age. Obtained biochemical and ultrasonographic parameters were correlated. Results. Study included 104 singleton pregnancies. ?HCG in the first trimester correlated negatively with fetal growth in the second and third trimester, and the second trimester AFI. Increased PAPP-A correlated positively with elevated resistance index in medial cerebral artery, lower biophysical profile scores, and intermediate type of non-stress test. Lower values of E3 were associated with FGR. Elevated serum AFP levels were linked to oligoamnion in the third trimester. There was no correlation of inhibin A levels with fetal condition. Conclusion. First and second trimester biochemical markers of pregnancy (?HCG, PAPP-A, HCG, AFP and E3) in combination with ultrasonographic biophysical parameters of fetus have predictive value for fetal growth and development.

Задержка роста плода: современные критерии диагностики, тактика ведения беременности и родов

Objective. To prove the advantages of new diagnostic criteria for fetal growth restriction (FGR) with centile assessment of fetal biometric parameters and Doppler parameters of blood flow in the maternal-placental-fetal system. Patients and methods. A retrospective analysis was made of 364 obstetric histories and perinatal outcomes in patients diagnosed with FGR during pregnancy according to the “former” classification. Simultaneously, fetal growth was assessed using the new classification (2022); a comparative analysis of the diagnostic significance of FGR criteria in both classifications was performed. The prospective phase involved 90 patients in whom the diagnosis of FGR was based on the centile assessment of fetal biometric parameters and Doppler parameters. The examination included Doppler ultrasound and computerized cardiotocography. The histological examination of the placenta was carried out in 23 cases of FGR. Results. The use of new diagnostic criteria for FGR based on the centile assessment of fetal biometric parameters and Doppler parameters significantly reduced the rate of false-positive diagnoses of FGR from 40% to 15%. The histological examination of 21 (82%) out of 23 placentas revealed chronic placental insufficiency with equal frequency in the early (32%) and late (37%) phenotype of FGR. Conclusion. Thus, the use of new diagnostic criteria for FGR can improve the fetal growth assessment and optimize pregnancy and labor management tactics, accompanied by a decrease in the rate of unjustified preterm labor, cesarean sections, and improved perinatal outcomes. Key words: fetal growth restriction, classification of fetal growth restriction, small for gestational age

Sonographic estimation of gestational age using transverse cerebellar diameter among late trimester pregnancies in Kano, Northwest Nigeria

Background/Context: Accurate estimation of fetal gestational age (GA) is of paramount importance in the management of all pregnancies, especially for the planning of mode of the delivery and management of high-risk pregnancies. Obstetric ultrasonography is a simple, available, affordable, and noninvasive modality for estimating fetal GA due to its high safety profile. The fetal cerebellum is easily visualized and reliably identified on ultrasound in the posterior cranial fossa after 14 weeks of gestation. Aim: The aim of this study was to evaluate the utility of transverse cerebellar diameter (TCD) in determining GA in second- and third-trimester pregnancies and compare its accuracy with other established sonographically derived fetal biometric parameters. Materials and Methods: A total of 424 pregnant women in their second and third trimesters who were sure of their last menstrual period (LMP) were recruited into the study over a period of 6 months (May to November 2019) at the Radiology Department of AKTH-Kano, Nigeria. The corresponding fetal TCD and other established fetal biometric indices (biparietal diameter [BPD], head circumference [HC], abdominal circumference [AC], and femur length [FL]) were sonographically obtained and correlated. Pearson’s bivariate coefficient was used to establish the correlation between the traditional biometric indices with TCD and GA derived by LMP. Multivariate linear regression analysis was used to assess the accuracy of the studied indices in predicting GA. Results: The range for TCD in second- and third-trimester fetuses was 15.9–57.5 mm. The TCD parameter was more accurate (±1.753 days) than BPD (±2.298 days), HC (±2.337 days), and AC (±4.342 days) and marginally less accurate than FL (±1.165 days) in predicting GA among study subjects (P &lt; 0.001). Conclusion: TCD is a reliable and accurate parameter for GA estimation in late second- and third-trimester pregnancies when compared with established fetal biometric parameters among pregnant women in Kano, Nigeria.

75-g oral glucose tolerance testing does not affect fetal cardiac doppler parameters in low-risk pregnant women

The study aimed to examine whether acute hyperglycemia, caused by the 75-g oral glucose tolerance test (OGTT) can produce fetal cardiac adverse effects that are detectable with fetal cardiac Doppler ultrasound in healthy low-risk pregnancies. Healthy low-risk pregnant women who underwent 75-g OGTT during the gestational period of 24 to 28 weeks were considered eligible and during the test, they were examined with fetal ultrasound at the fasting and 1- and 2-h timepoints. The study findings included the parameters of umbilical artery pulsatility index, uterine artery, fetal heart rate, middle cerebral artery (MCA) peak systolic velocity (MCA-PSV), MCA pulsatility index, and fetal cardiac Doppler parameters including myocardial performance index, left isovolumetric contraction and relaxation times, K-index, filling time, mitral E- and A-wave velocities, and E/A ratio. The data of 53 women without gestational diabetes mellitus were used for statistical analyses. There was no statistical significance among the three-time points of OGTT regarding all the Doppler parameters (p&gt;0.05). The median MCA-PSV measured at the fasting of OGTT was significantly higher than the values measured at the first and second hour of OGTT [28 (22-42) vs. 26 (18-39) and 26 (18-38), respectively; p&lt;0.05]. This increase provided no relationship with other study parameters (p&gt;0.05). Overall, 75-g OGTT does not affect fetal cardiac Doppler parameters in healthy pregnant women except for abnormal findings of MCA-PSV. The results of the current study can provide significant support to clinicians in reducing the hesitations of women with low-risk pregnancies regarding gestational diabetes screening.

Exposure to outdoor residential noise during pregnancy, embryonic size, fetal growth, and birth outcomes

IntroductionPrevious literature suggested that noise exposure during pregnancy was not associated with adverse birth outcomes. However, no studies evaluated the association between noise exposure and embryonic and fetal growth, or mutually assessed other urban environmental exposures such as traffic-related air pollution or natural spaces. MethodsWe included 7947 pregnant women from the Generation R Study, the Netherlands. We estimated total (road traffic, aircraft, railway, and industry), road traffic, and railway noise at the participants' home addresses during pregnancy using environmental noise maps. We estimated traffic-related air pollution using land-use regression models, greenness within a 300 m buffer using the normalized difference vegetation index, and distance to blue spaces using topographical maps at the home addresses. Embryonic size (crown-rump length) and fetal growth parameters (head circumference, femur length, and estimated fetal weight) were measured by ultrasound at several gestational ages. Information on neonatal anthropometrics at birth (head circumference, length, and weight) and adverse birth outcomes (preterm birth, low birth weight, and small for gestational age) were retrieved from medical records. ResultsHigher total noise exposure during pregnancy was associated with larger crown-rump length (0.07 SDS [95%CI 0.00 to 0.14]). No association was found with fetal growth parameters, neonatal anthropometrics, and adverse birth outcomes. Similar results were observed for road traffic noise exposure, while railway noise exposure was not associated with any of the outcomes. Traffic-related air pollution was not associated with crown-rump length. Total noise exposure mediated 15% of the association between exposure to greenness and smaller crown-rump length. No association was observed between distance to blue spaces and total noise exposure. ConclusionExposure to outdoor residential noise during pregnancy was associated with larger embryonic size. Moreover, a reduction of total noise exposure during pregnancy partially mediated the association between exposure to greenness and smaller embryonic size. Additional research is warranted to confirm and further understand these novel findings.

Correlation of Fetal Anterior Abdominal Wall Thickness and Other Standard Biometric Ultrasound Measurements to Predict Fetal Macrosomia in Gestational Diabetes.

Gestational diabetes mellitus (GDM) is one of the most common medical conditions affecting pregnancy and significantly increasing the risk for maternal and perinatal complications. The aim of the present study is to study the correlation of fetal anterior abdominal wall thickness (FAAWT) and other standard fetal biometric parameters measured by ultrasound between 36 and 39 weeks of gestation with neonatal birth weight in pregnancies complicated by GDM. Prospective cohort study in a tertiary care center including 100 singleton pregnancies with GDM were subjected to ultrasound between 36 and 39 weeks of gestation. Standard fetal biometry (Biparietal diameter, Head Circumference, Abdominal circumference [AC], and Femur Length) and estimated fetal weight were calculated. FAAWT was measured at AC section and actual neonatal birth weights were recorded after delivery. Macrosomia was defined as an absolute birth weight more than 4000 g regardless of the gestational age. Statistical analysis was done and 95% confidence level was considered significant. Among 100 neonates, 16 were macrosomic (16%) and third trimester mean FAAWT was significantly higher in macrosomic babies (6.36 ± 0.5 mm) as compared to nonmacrosomic babies (5.54 ± 0.61 mm) (P < 0.0001). FAAWT >6 mm (Receiver operating characteristic curve derived) provided a sensitivity of 87.5%, specificity of 75%, positive predictive value of 40%, and negative predictive value (NPV) of 96.9% for prediction of macrosomia. While other standard fetal biometric parameters did not correlate well with actual birth weight in macrosomic neonates, only FAAWT was found to have statistically significant correlation (correlation coefficient of 0.626, P = 0.009). The FAAWT was the only sonographic parameter to have a significant correlation with neonatal birth weight in macrosomic neonates of GDM mothers. We found a high sensitivity (87.5%), specificity (75%), and NPV (96.9%) suggesting that FAAWT < 6 mm can rule out macrosomia in pregnancies with GDM.

Normal Fetal Growth Profile at 10-41 Weeks of Gestation - An Update Based on 10225 Normal Singleton Pregnancies and Measurement of the Fetal Parameters Using 3D Ultrasound.

To construct new growth charts and tables for the following fetal growth parameters: biparietal diameter (BPD), occipitofrontal diameter (OFD), head circumference (HC), abdominal transverse diameter (ATD), abdominal sagittal diameter (ASD), abdominal circumference (AC), femur length (Fe), tibia length (Ti), fibula length (Fi), humerus length (Hu), radius length (Ra), and ulna length (Ul). This prospective study was conducted at a level III ultrasound center as a population-based cross-sectional study on 10 225 normal singleton pregnancies with a gestational age between 10 and 41 completed weeks. Gestational age was confirmed in all cases by an ultrasound examination with crown-rump measurement before 10 weeks of gestation. All examinations were performed with 3 D probes. BPD, OFD, ATD, and ASD were measured as outer-to-outer measurements (skin-to-skin) after identifying the exact biometric planes by 3 D multiplanar display. HC was computed using the formula . For AC the approximate elliptical formula AC = (ATD+ASD)/2 × 3.142 was used. Measurements of the limb bones included the entire ossified shaft. Based on a nonlinear regression model for the age-specific mean values, distribution-free reference ranges were calculated for the parameters BPD, OFD, HC, ATD, ASD, AC, Fe, Ti, Fi, Hu, Ra and Ul. The new reference ranges were compared with our reference ranges published in 1996 as well as with different reference charts published by other authors. 3 D ultrasound allows a controlled demonstration of all fetal planes required for exact biometric measurements. The fetal growth profile including the 12 biometric parameters gives a precise overview of normal or abnormal fetal growth.

A Comparative Ultrasonographic Study of Fetal Biometric Parameters of Normal Fetus versus Intrauterine Growth Restriction Fetus during the Third Trimester of Pregnancy

Abstract Introduction: Intrauterine growth restriction (IUGR) is a well-known complex issue in obstetrics that can lead to significant fetal or neonatal complications, both in the short and long term. This ultrasonographic study was undertaken to compare the growth and development of the normal fetus versus IUGR fetus, during the third trimester of pregnancy in Meghalaya, Northeastern India. Materials and Methods: This was a prospective, analytical ultrasonographic study done on pregnant women in the third trimester from May 2021 to October 2022 at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong. Forty-two pregnant women (twenty-one each from normal and IUGR fetuses) were observed from the 28th week of gestation until delivery. Ultrasonographic fetal biometric parameters (FBPs) such as biparietal diameter, head circumference, abdominal circumference (AC), femur length, and estimated fetal weight were used to study fetal growth and development. The weight and length of the newborn were recorded. Multivariable linear regression analysis was used to identify the association between IUGR and FBPs as well as birth weight and length. Results: Among the FBPs, only AC parameter was statistically associated with IUGR status (P &lt; 0.05). Birth weight and birth length were significantly lower in the IUGR group compared to the normal group (P &lt; 0.001 for both). Conclusions: Among the FBPs, AC may be better suited to compare fetal growth and development between normal and IUGR fetuses during the third trimester of pregnancy.

Adverse maternal and fetal outcomes in pregnant women recovering from asymptomatic COVID-19 and fetal Doppler ultrasound parameters

Adverse maternal and fetal outcomes in pregnant women recovering from asymptomatic COVID-19 and fetal Doppler ultrasound parameters

Fetal Doppler parameters as predictors of fetal cardiac function in late-onset fetal growth restriction (FGR): a prospective study

Fetal Doppler parameters as predictors of fetal cardiac function in late-onset fetal growth restriction (FGR): a prospective study

Prenatal Sonographic Three-dimensional Virtual Organ Computer-assisted Analysis Thymic Volume Calculation May Predict Intrauterine Growth Restriction.

Intrauterine growth restriction (IUGR) refers to fetuses that are small for their gestational age. There is no effective test to predict this disease. The aim of our study is whether fetal three-dimensional (3D) ultrasonography (USG)-assisted thymus volume (TV) measurement predicts IUGR cases. Fetal 3D USG thymus measurement between 15 and 24 weeks of gestation was performed in a total of 100 women of reproductive age. Fetal TV was measured using the virtual organ computer-assisted analysis system program. All cases were followed up in terms of pregnancy complications until delivery. IUGR was developed in six cases in total. In cases with IUGR, mean fetal TV was found to be statistically significantly lower than in healthy cases without it. When the fetal TV was taken as 0.1645, the sensitivity was calculated as 89.5% and the specificity as 50% for predicting IUGR. The use of low fetal volume parameters is a significant and good indicator for predicting IUGR according to the binary logistic regression analysis result. According to the results of this study, 3D fetal TV measurement may be used in routine second-trimester sonographic anomaly screening to predict the development of fetal IUGR. In this way, fetal mortality and morbidity caused by IUGR may be reduced.

Retracted: The Role and Clinical Value of Optimized Fetal Main Pulmonary Artery Doppler Parameters in the Diagnosis and Prognosis Monitoring of Neonatal Respiratory Distress Syndrome.

[This retracts the article DOI: 10.1155/2022/1682225.].

Prevalence of abnormal umbilical arterial Doppler indices in apparently normal pregnancies in Calabar.

Intrauterine growth restriction (IUGR) may occur in the presence of normal fetal growth parameters, with resultant unanticipated perinatal morbidity and mortality. Umbilical arterial Doppler evaluation determines the fetuses susceptible to compromise by detecting IUGR early enough for successful intervention measures to be implemented. This study was aimed at determining the prevalence of abnormal umbilical arterial Doppler indices (UADI) in apparently normal pregnancies and to assess its correlation with amniotic fluid index (AFI). In this prospective cross-sectional study, obstetric sonographic examination and UADI evaluation were done on 310 apparently normal pregnant women between 26 to 40 weeks within a 6-months period. Abnormal UADI had a prevalence of 10.3%. Educational level (P = 0.000) and employment status (P = 0.000) were significantly associated with abnormal UADI. Abnormal umbilical arterial resistivity index (RI) had a significant correlation with EFW (P = 0.000) and HC/AC (P = 0.000) but no significant relationship with AFI (P = 0.593). The prevalence of abnormal umbilical arterial Doppler indices was high in apparently normal pregnancies mostly among women with low socio-economic status, with no demonstrable association with AFI.