Informatics Publishing Limited

N. Hephzibah Kirubamani ¹, M. R. Meenatshi ², B. Aupamma ²

Affiliations
1 1Obstetrics & Gynaecology Department, Saveetha Medical College, Saveetha University
2 Saveetha Medical College, Saveetha University

Abstract

Introduction: Fetal growth assessment, for induction and timing of repeat caesarean, relies on accurate gestational age. Various ultrasonography fetal biometry has been used to assess gestational age in practice. This information is invaluable because most obstetrical management decisions are strongly influenced by consideration of fetal development, which closely correlates with fetal age. Aim: To evaluate the accuracy of fetal Transverse Diameter of Heart (TDH) measured by real time ultrasound to predict the gestational age during second&Third diameter and to correlate with FL. BPD, AC, HC to assess variation. Materials & Methods: Prospective Study was carried out at Saveetha Medical College. Total 150 cases attending antenatal clinic in first, second&third trimesters were considered. Routine measurements of FL, BPD, HC, AC along with TDH taken. TDH is taken in mm at closed AV valve junction, outer to outer points in four chamber view of heart. Results: Out of 150 cases 64 were in second trimester, 86 in third trimester. 102 patients had confirmed first trimester gestational age TDH in second&third trimester is more closed to actual gestational age than average gestational calculated by other parameters. The TDH was calculated and found that the variance in the second half (from 28 weeks onwards) was stated to be very less as shown in the tabulated value as variance of 0.01376 as against first half of 0.0393. The population confidence interval was 0.95%. From Predicted value of TDH&confidence interval, we suggest that when compared to other parameters like BPD Bipariteal diameter, HC head circumference FL femur length. AC abdominal circumference - TDH Transverse diameter of heart dimensions are equivalent to actual gestational age from 28 week on wards. Conclusion: TDH can be a useful parameter when LMP is not known. It can be used as additional parameter when ever needed.

Keywords

Transverse Diameter of Heart, TDH, Gestational Age Parameter, Fetal Biometry

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N. Hephzibah Kirubamani ¹, M. R. Meenatshi ²

Affiliations
1 Department of Obstetrics and Gynaecology, Saveetha Medical College and Hospital, Saveetha University, Thandalam, Chennai – 602105, Tamil Nadu, IN
2 Saveetha Medical College and Hospital, Thandalam, Chennai – 602105, Tamil Nadu, IN

Abstract

It was thought that Umbilical Cord Coiling plays an important role in protecting the umbilical cord from external pressure such as tension, pressure, stretching or entanglement. The mechanism of coiling still remains undetermined. According to several studies abnormal umbilical coiling is associated with poor perinatal outcomes. Objectives: To evaluate the sonographic accuracy in determining Umbilical Coiling Index (UCI). To correlate it with postnatal examination of umbilical coiling and its association with obstetric and perinatal outcome. Material and Methods: Prospective observational study was conducted at Saveetha Medical College Obstetrics Department. For 200 pregnant women USG umbilical coiling index was measured during routine foetal evaluation between 28 to 40 weeks. USG-Umbilical Coiling Index was correlated with postnatal umbilical coiling index and its association with obstetric& perinatal outcome was calculated. Sonologist was blinded for pregnancy outcome. Results: USG –UCI was normal in 52%, hypocoiling 12% and hypercoiling 36%.In normal coiling there was no antenatal or intranatal problems. In hypocoiling Spontaneous Preterm Delivery was 50% and Low Birth Weight was38.9%, FGR 11.1%. In hypercoiling group Oligohydramnios was 14.8%, Intrapartum fetal distress33.3%, Meconium staining of liquor 16.6 %. In normal coiling all of them delivered naturally. In hypocoiling and in hypercoiling mode of delivery either forceps 7% or LSCS 41%.NICU admission in hypocoiling was 18 % and in hypercoiling 3%. Perinatal mortality was NIL. USG-Umbilical Coiling Index Sensitivity 97.8 specificity, 62.5%, Positive predictive value 96.77% Negative predictive value 71.4%. Conclusion: In our study there is a good correlation between USG-UCI and postnatal UCI. Our study confirms that there is an adverse perinatal outcome with both hypocoiling and hyper coiling of the umbilical cord.

Keywords

Hypocoiling, Hypercoiling, Perinatal Outcome, Umbilical Cord, Umbilical Cord Coiling, UCI-Umbilical Coiling Index

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