Prediction Of Fetal Outcome Research Articles

Role of Ultrasonography Placental Thickness in Third Trimester in the Prediction of Fetal Outcome

Introduction: The Placenta is a functional unit between the mother and foetus. Placental thick play’s important role in foetal outcome. This study conducted to assess Placental Thickness ultra-sonographically at 32nd and 36th weeks of gestation and to assess the role of placental thickness in the prediction of foetal outcome.
 Methodology: The present study was conducted among 237 women to study the relationship of ultra-sonographically assessed Placental Thickness in the third trimester with Foetal Outcome and its correlation with Placental Pathology.
 Results: Among 237 women. Highest number of women (48.5%) were from age group 25 to 29 years followed by 20 to 24 years (42.6%). Mean birth weight increases with along with placental thickness at 32nd week (p <0.01) as well as at 36th week (p <0.01). Cases with <7 APGAR score at 5 min were significantly higher in placental thickness less than 10th percentile at 32nd week (p<0.01). Newborn having lower placental thickness at 32nd or at 36th week gestation required NICU more often (p<0.01).
 Conclusion: From the present study we conclude that there was a significant positive correlation between placental thickness and birth weight. Neonatal outcome was good (higher APGAR score and less NICU admission rate) when placental thickness was within normal range Lower birth weight was significantly higher in less than 10th percentile placental thickness group.

A clinical study on Doppler velocimetry of umbilical artery and middle cerebral artery in post-dated pregnancy in the prediction of fetal outcome

A clinical study on Doppler velocimetry of umbilical artery and middle cerebral artery in post-dated pregnancy in the prediction of fetal outcome

Echocardiographic characteristics and clinical outcomes in fetuses with pulmonary stenosis or pulmonary atresia with intact ventricular septum

To summarize echocardiographic characteristics of the anatomy and hemodynamic and clinical outcomes in fetuses with isolated pulmonary stenosis (PS) or pulmonary atresia with intact ventricular septum (PA/IVS). This was a single-center retrospective study of fetuses with isolated PS or PA/IVS. Echocardiographic variables and clinical outcomes after delivery were evaluated and compared. Between 2016 and 2021, 115 livebirths with isolated PS or PA/IVS were included. Proportion of fetuses with mild, moderate and critical PS and PA/IVS was 41.7%, 18.3%, 26.1% and 13.9%. Fetuses with more severe PS had worse anatomic and hemodynamic profiles. Specifically, the cardiothoracic ratio, pulmonary valve (PV) velocity, degree and velocity of tricuspid regurgitation increased as PS severity increased; and the pulmonary artery/aorta ratio, right ventricle/left ventricle long-axis (TV/MV) ratio, tricuspid valve/mitral valve annulus (TV/MV) ratio, and tricuspid valve inflow duration/cardiac cycle ratio decreased as PS severity increased (P <0.001 for all). PV velocity ≥2m/s predicted PV pressure ≥40mm Hg after delivery, with an AUC of 0.81; TV/MV ratio combined with RV/LV ratio predicted clinical outcomes, with an AUC of 0.88. Live births with more severe PS had higher mortality rate (mild 0 vs. moderate 0 vs. critical 11% vs. PA-IVS 36%) and lower rate of developing bi-ventricles (mild 100% vs. moderate 95% vs. critical 89% vs. PA-IVS 36%). Findings of this study help better understand the anatomy and hemodynamic and clinical outcomes in fetuses with isolated PS or PA/IVS, which could have implications for prenatal counseling and prediction of fetal outcome.

The Role of Ultrasonographic Assessment of the Placental Thickness in the Prediction of Fetal Outcome

The Role of Ultrasonographic Assessment of the Placental Thickness in the Prediction of Fetal Outcome

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Pregnant women and their partners' views and experiences of reduced fetal movements: a narrative literature review

Background/Aims Globally, 2 million stillbirths occur annually, 98% of which occur in low-income settings. In low-income settings, stillbirth may be associated with maternal perception of reduced fetal movements. However, little is known about maternal experiences of reduced fetal movements and subsequent engagement with health services in low-income settings. This narrative literature review initially aimed to improve understanding of views and experiences of reduced fetal movements in pregnant women in low-income settings using information synthesised from international studies. However, only a small number of articles from low-resource settings were found. Methods The literature reviewed qualitative, quantitative and mixed-method studies guided by a systematic approach. The findings were discussed narratively. Results A total of 40 studies were identified, only four of which were from low-income settings. The four main themes identified were: maternal perception of fetal movements, facilitators and barriers to seeking healthcare, reduced fetal movements as a predictor of fetal outcomes and knowledge of fetal movements and management strategies. Conclusions A variety of factors may influence maternal perception of reduced fetal movements and experience of care. As most studies were conducted in high-income settings, it is imperative to describe women's experiences of reduced fetal movements in low-income settings.

Assessment of use of ultrasonographic placental thickness in prediction of fetal outcome

Background: Any disease process affecting the mother will have impact on both the fetus and the placenta. The present study was conducted to assess use of ultrasonographic placental thickness in prediction of fetal outcome.Materials & Methods: 48 with singleton pregnancy between 18 and 40 years of age, with normal BMI were included. Obstetric ultrasound was performed on using a 3.5-MHz curvilinear transducer. Post-delivery birth weight of the baby, placental weight, Apgar score, maturity of baby and sex of the baby were noted. Birth weight of the baby was recorded. Placental thickness at 32 and 36 weeks was correlated with birth weight and neonatal outcome. Results: The mean placental thickness at 32 weeks was 33.2 mm and at 36 weeks was 35.8 mm. The difference was significant (P< 0.05). There was correlation between between placental thickness and Apgar score at 32 weeks and at 36 weeks (p value = 0.05), which is statistically significant. However, no correlation was found between placental thickness and BMI of the patient (r = 0.007 at 32 weeks and r = −0.006 at 36 weeks).Conclusion: Placental thickness at 32 and 36 weeks corresponds well with gestational age and is a good prognostic factor in assessing neonatal outcome.

Value of Middle Cerebral/Umbilical Artery Resistance Index Ratio in Neonatal Outcome in Patients with Intrauterine Growth Restriction (Prospective Study)

Background: Fetal growth disorders are usually associated with perinatal morbidity and mortality. Accurate assessment of intrauterine fetal growth is difficult, but recent advances have improved with positive implications for antenatal care.Aim of the work: The aim of this study was to assess the accuracy of the umbilical and middle cerebral artery resistance index in prediction of fetal outcome in pregnancies with intra-uterine growth restriction (IUGR).Patients and Methods: Forty-five pregnant females had been included in a prospective study. All had a confirmed diagnosis of intra-uterine growth restriction (IUGR). Doppler ultrasound had been performed to record fetal umbilical and middle cerebral artery (MCA) resistance indices every one week (from 32 weeks onwards). Post-delivery birth weight of the baby, Apgar score at 0 and 5 minutes had been documented and correlated with doppler indices. Results: One-fifth of the mothers participating in the study (20%) had pre-term birth and 6.7% missed the follow-up. Umbilical artery resistance index (RI) at a cut off value of (0.79) had a diagnostic accuracy of 93%. MCA RI best cut off value was 0.63 with diagnostic accuracy of 73.9%. Also, for C/U ratio had diagnostic accuracy of 92.9%. Finally, there was significant, proportional correlation between MCA RA and C/U ratio from one side and APGAR score at 0 and 5 minutes from the other side. However, the correlation between UARI and Apgar score was inverse and statistically significant. Conclusion: Doppler velocimetry of fetal circulation can provide important information regarding fetal well-being, with subsequent impact on fetal outcome.

HbA1c as a Predictor of Fetal Outcomes in Pregestational Diabetes Mellitus

HbA1c as a Predictor of Fetal Outcomes in Pregestational Diabetes Mellitus

Role of amniotic fluid echogenicities in the prediction of fetal outcome

Background: The amniotic fluid (AF) is a highly complex and dynamic system that is studied as a data point to interpret fetal well-being. Homogeneously, echogenic AF is due to the presence of innumerable echogenic particles in the fluid and is an uncommon finding. Echogenic AF has been attributed to meconium, blood, and vernix caseosa. The current study was undertaken to evaluate the significance of echogenic AF in the assessment of fetal outcome. Objective: The objective was to study the significance of echogenic AF in the assessment of fetal outcome. Materials and Methods: The present study was a prospective observational study conducted in the Department of Obstetrics and Gynaecology, SKIMS, Soura, Srinagar, from May 2019 to December 2019. A total of 34 participants with ultrasonographic evidence of echogenic liquor were included in the study. They were followed till the delivery for the determination of the fetal outcome. The fetal outcome was studied in terms of Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score; neonatal intensive care unit (NICU) admission rate; and stillbirth rate. Results: Out of 34 participants, 18 participants had vernix caseosa, 8 had meconium, 6 had blood, and 2 had clear liquor amnii. Out of 18 participants with vernix, all 18 fetuses had APGAR score >7/10 with no NICU admission and no stillbirth. Out of eight participants with meconium, six babies had APGAR score

OC31.03: Prediction of postnatal outcome in fetuses with a congenital lung malformation: a two‐year follow‐up study

OC31.03: Prediction of postnatal outcome in fetuses with a congenital lung malformation: a two‐year follow‐up study

Correlation of Cerebroplacental Ratio (CPR) With Adverse Perinatal Outcome in Singleton Pregnancies

For many years clinical research has been concerned with doppler sonography as a non-invasive tool for intrauterine fetal status assessment. A new focus is now placed on the measurement of cerebroplacental index (CPR) as a predictor of fetal outcome. Our aim was to investigate the relationship between the cerebroplacental ratio (CPR), the delivery mode and the fetal outcome in singleton pregnancies. A retrospective cohort study of pregnancies in which doppler sonography of middle cerebral artery (MCA) and umbilical artery (UA) was conducted up to 9 weeks before delivery took place. Patients with pathological (CPR≤1.0) and normal CPR (>1.0) were compared by umbilical cord pH, APGAR scores, birth weight, delivery week and delivery mode. A total of 2,270 singleton pregnancies were included. The APGAR score for 1, 5 and 10 minutes and the gestational age at delivery were significantly lower in the group of patients with pathological CPR (p<0.001). Overall, 50% of the cohort had a cesarean section, the difference between the groups was statistically significant (p<0.001), with a higher amount of cesareans in the group of patients with pathological CPR. The multiple regression analysis showed a significantly improved pH of delivery when cesarean section (p<0.001), female sex of fetus (p=0.013) and higher CPR (p=0.035) were present. The measurement of CPR is an important, non-invasive predictive parameter and leads to the identification of a risk collective even in the non-selected patient population and thus probably to a reduction of perinatal morbidity.

Role of Ultrasonographic Placental Thickness in Prediction of Fetal Outcome: A Prospective Indian Study.

Placenta is the connecting organ between the mother and the fetus. It supplies oxygen and all the necessary elements for the growth and development of the fetus. In normal pregnancy, the growth of the placenta remains concordant with the growth of the fetus. The sonographic assessment of placenta can give information about the nutritional status of the fetus. It is known that normal placental thickness approximately equals gestational age. It is historically documented that placental weight is one-fifth of the fetal weight and abnormally thin or thick placenta is associated with increased incidence of perinatal morbidity and mortality. However, there are very few studies correlating placental thickness with Neonatal outcome. To correlate ultrasonographic placental thickness at 32 and 36 weeks pregnancy with neonatal outcome. To propose placental thickness as a simple test for prediction of neonatal outcome. Placental thickness at 32 and 36weeks was measured by ultrasound, in 130 pregnant mothers with confirmed dates and uncomplicated singleton pregnancy. Placental thickness was categorized as normal (10th-95th percentile), thin (<10th percentile) and thick (>95th percentile) at each stage and was correlated with birth weight and neonatal outcome. Neonatal outcome was good in women with normal placental thickness (10th-95th percentile) at 32 and 36weeks and was compromised in women with thin (<10th percentile) and thick (>95th percentile) placentae. Placental thickness at 32 and 36weeks corresponds well with gestational age and is a good prognostic factor in assessing neonatal outcome. Therefore, placental thickness should be measured in addition to biometric parameters in antenatal women undergoing ultrasound.

P28.08: Thorax‐to‐head ratio and defect diameter‐to‐head ratio in giant omphaloceles as predictor for fetal outcome

P28.08: Thorax‐to‐head ratio and defect diameter‐to‐head ratio in giant omphaloceles as predictor for fetal outcome

Prenatal US Findings of Musculoskeletal Anomalies

Fetal musculoskeletal malformations take a number of pathologic forms, among which a variety of lethal dysplasias and several anomalies have a poor perinatal and postnatal outcome. Precise antenatal ultrasonographic diagnosis of bone dysplasia may be very difficult, but differentiation between a lethal and a nonlethal variety is very important in terms of antenatal care and the prediction of fetal outcome. Variety of lethal skeletal dysplasias commonly show very short long bones and narrow thorax. For the differential diagnosis of fetal skeletal dysplasia, comprehensive evaluation of fetal bones including cranium, face, ribs, and spine is very important. Genetic counseling is critical and individualized multidisplinary prenatal and postnatal care is important for the management of fetal skeletal dysplasias. Several anomalies leading to limb loss or contracture as the expression of other pathologic entities have a poor outcome, and their early detection is also very important for the management of a pregnancy. Focal musculoskeletal anomalies can occur in isolation or in association with a large variety of syndromes, malformations and disorders. Thus, the early and accurate prenatal diagnosis of anomalies is important not only for detecting the anomaly itself, but is also helpful with regard to these other, associated, anomalies.

Thorax-to-head ratio and defect diameter-to-head ratio in giant omphaloceles as predictor for fetal outcome.

To investigate the relationship between the thorax diameter and defect diameter of giant omphaloceles as a predictor for fetal outcome. In a retrospective study, 17 fetuses with isolated giant omphaloceles were included for evaluation. The anterior-posterior thorax diameter and the defect diameter were measured from ultrasound images. For analysis, the thorax-to-head ratio (T/HC), the defect diameter-to-head ratio (DD/HC), and the quotient of the defect diameter and the thorax diameter (DD/T) were calculated. The days of ventilation (t ventilation), the duration until hospital discharge (t hospital), and the type of treatment were recorded as outcome parameters. No relationship was found between the calculated ratios (T/HC, DD/HC, or DD/T) and neither t hospital (r=-0.418, p=0.095; r=-0.153, p=0.556; and r=-0.023, p=0.929; respectively) nor t ventilation (r=-0.391, p=0.121; r=0.041, p=0.875; and r=0.121, p=0.645, respectively). The type of postnatal treatment was not associated with the three calculated ratios or t hospital (r=0.155, p=0.553; r=0.019, p=0.942; and r=0.012, p=0.965; r=-0.009, p=0.973, respectively). In 53% of cases, t hospital was delayed due to additional and independent postnatal complications. Thorax diameter or defect diameter of giant omphaloceles is not predictive for fetal outcome. The perinatal care of these abdominal wall defects still remains a multidisciplinary challenge, but the outcome of giant omphaloceles is favorable at experienced centers.

OC05.04: Prenatal and postnatal neuroimaging for the prediction of outcome in fetuses with congenital cytomegalovirus infection

OC05.04: Prenatal and postnatal neuroimaging for the prediction of outcome in fetuses with congenital cytomegalovirus infection

Prediction of fetal outcome without intrauterine intervention using a cardiovascular profile score: a systematic review and meta-analysis

Objective: With the help of fetal echocardiography, cardiovascular profile score (CVPS) can be evaluated. However, no general agreement has been recognized on the prediction value of CVPS on fetal adverse outcome.Methods: Literature review has identified up to Nov 2012 in the databases. Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1 and Meta-disc 1.4. The differences among different cut-offs were measured by STATA 11.0.Results: Result from seven studies reported an outcome in favor of significant lower CVPS in fetus of adverse outcome with std. mean difference of −1.17 (95% CI = −1.78, −0.55). The overall performance of CVPS ≤6 prediction adverse outcome evaluated as area under the summary receiver operating characteristic curves (AUC) was 0.8777. The AUC of CVPS ≤7 was 0.8728 and the AUC of CVPS ≤8 was 0.7207. However, the result indicated the performance of CVPS ≤6 prediction adverse outcome had a statistical significance comparing to other two cut-offs.Conclusion: Analysis has proven the CVPS is a credible index for predicting fetal adverse outcome. And once CVPS decreased at eight, the patient should be observed carefully. With the CVPS dropped at seven, treatment is demanded immediately while some cases suffer irreversible cardiac dysfunction.

P15.25: Cerebrouterine ratio in third trimester as predictor of fetal outcome

<scp>P</scp>15.25: Cerebrouterine ratio in third trimester as predictor of fetal outcome

Fetal death associated with diffuse mesangial sclerosis combined with bilateral multicystic kidney

Abstract Prenatal diagnosis of kidney disease has been greatly increased due to the improvement of antenatal ultrasound techniques, even if a level of uncertainty in differential diagnosis still leads to difficulties in the prediction of fetal outcome and in the counseling of parents. We have followed with ultrasound a 36-year-old secundigravida, referred for fetal renal ultrasound evaluation because of enlarged bilateral cystic kidneys and anhydramnios. Karyotype was normal (46,XY). On the 21st week, the kidneys were slightly enlarged with normal morphology. Beginning with the 28th week, repeated scans showed a reduction of amniotic fluid and an increasing number of renal cysts. Pregnancy was followed to the 37th week when fetal death occurred without warning. Postmortem gross examination showed bilateral enlarged kidneys and histology-defined diffuse mesangial sclerosis with poorly developed cortex and renal dysplasia with multiple cysts. This is an unusual case of multiple renal congenital abnormalities difficult to interpret and which made necessary a multidisciplinary approach due to its complexity. Nevertheless, etiology was not defined. The broad spectrum of antenatal manifestation of prenatally onset kidney diseases requires the identification of more prognostic signs to define fetal outcome and improve parental guidance.