SEARCH · PubMed Health

Results for “Biometry”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources

PubMed2005

Ultrasound biomicroscopy in the subtypes of primary angle closure glaucoma.

PURPOSE: To evaluate the anterior segment parameters in the subtypes of primary angle closure glaucoma (PACG) using ultrasound biomicroscopy. METHODS: Five groups, each comprising 30 consecutive patients, diagnosed to have subacute PACG, acute PACG, chronic PACG, primary open angle glaucoma (POAG), and healthy controls were included in the present study. All patients underwent slit-lamp biomicroscopy, direct ophthalmoscopy, 90D fundus examination, gonioscopy, applanation tonometry, visual field testing, A-scan biometry, and ultrasound biomicroscopy (UBM). The anterior segment parameters recorded included: trabecular-iris angle, angle opening distance, trabecular ciliary process distance, and the iris thickness among other parameters. RESULTS: On ultrasound biomicroscopy the trabecular iris angle of control and POAG groups was more than all the subtypes of PACG (P < 0.001). The trabecular iris angle of subacute PACG (P < 0.001) and chronic PACG (P = 0.003) was more than acute PACG. Angle opening distance of controls and POAG group was significantly more than acute PACG and chronic PACG (P < 0.001). The trabecular ciliary process distance of POAG group and controls was more than subacute PACG, acute PACG, and chronic PACG. The trabecular ciliary process distance of subacute PACG (P < 0.001) and chronic PACG (P < 0.001) was more than acute PACG. Eyes with acute PACG had the least iris thickness at the three different positions tested. There was a positive correlation between the anterior chamber angle (trabecular iris angle) and the following parameters: trabecular ciliary process distance, angle opening distance, anterior chamber depth, and the axial length (r = 0.57). CONCLUSION: Eyes with primary angle closure glaucoma have a thinner iris with a shorter trabecular iris angle, angle opening distance, and trabecular ciliary process distance. The eyes with acute primary angle closure glaucoma have the narrowest angle recess.

Acute Disease↗

PubMed2006

On the prediction of optical aberrations by personalized eye models.

PURPOSE: The purpose of this study is to develop and analyze a method to obtain optical schematic models of individual eyes. Each model should be able to reproduce the measured monochromatic wave aberration with high fidelity. METHODS: First, we choose a generic eye model as the input guess and then apply a two-stage customization procedure. Stage 1 consists of replacing, in the initial generic model, those anatomic and optical parameters with experimental data measured on the eye under analysis. The set of experimental data was that provided by a standard clinical preoperative examination, namely lens topography, ultrasound biometry, and total wave aberration. Then, the second stage is to find the unknown lens structure that would reproduce the measured wave aberration through optical optimization. Two totally different initial eye models have been compared; one considers a simpler constant refractive index for the lens, whereas the second model has a gradient-index (GRIN) lens. RESULTS: This automatic customization method has been applied to 19 eyes with different degrees of spherical ametropia (from +0.4 D to -8 D). Two models have been obtained for each eye (constant and gradient index lens). The results were highly satisfactory, with 100% convergence, and with average RMS prediction errors approximately lambda/100. This is one order of magnitude lower than typical measurement errors. The models with a constant refractive index lens tended to overestimate surface curvatures, whereas for the GRIN model, lens surfaces were too flat. CONCLUSIONS: The proposed method is highly efficient and robust giving a high-fidelity reproduction of the wavefront in all cases attempted so far. Limitations found in reproducing the geometry of the lens seem to be associated with the use of inaccurate models of its refractive index.

Accommodation, Ocular↗

PubMedDate not supplied

Maturation changes of goat spermatozoa during transit throught the epididymis.

Epididymal maturation of spermatozoa was studied in eight sexually mature goats. The parameters studied were biometry, loss of cytoplasmic droplet and motility. Along the epididymal duct, the size of the sperm head increased while the cytoplasmic droplets were progressively and gradually lost. The cauda sperm showed forward motility, a property conspiciously lacked by the caput and corpus spermatozoa. Possible relation of these changes with the development of fertility has been discussed.

Animals↗

PubMed1988

IOL prediction: an evaluation of preoperatively determined intraocular lens power accuracy.

A retrospective survey of 612 eyes that had undergone cataract extraction and IOL implantation was undertaken to evaluate the accuracy of ultrasound biometry combined with keratometry using the SRK regression formula, for the preoperative prediction of intraocular lens powers. A mean error of +0.35 dioptre sphere (DS) (SD +/- 0.98) was found for the series overall, with a significant (P less than 0.005) difference between the distribution of postoperative refractive errors using the S.R.K. formula for IOL prediction and the use of a standard lens of 19.5 DS. The consistency of results was tested for those patients with greater or less than normal axial length. Linear regression analysis showed no correlation between axial length and postoperative refractive error and therefore does not support the adjustment of predicted IOL powers by a factor based on axial length. Statistically significant differences were found between surgeons' results, supporting the practice of A-constant modification for individual surgeons.

Cornea↗

PubMedDate not supplied

Age dependence of ocular biometric measurements under cycloplegia with tropicamide and cyclopentolate.

BACKGROUND: Cyclopentolate continues to be the cycloplegic of choice for refracting young children, although many studies of ocular biometry promote the use of tropicamide. METHODS: To clarify the role of drug type in biometric measurements, cycloplegia was induced in two disparate age groups using cyclopentolate and tropicamide on two separate occasions. Refraction, phakometry and A-scan ultrasonography measurements were made on two groups of Tibetan children resident in Nepal. RESULTS: Cyclopentolate produced significantly more cycloplegia in the younger group, which was supported by phakometry measurements. However, in clinical terms, the difference between the measurements was not significant. CONCLUSION: We conclude that although cyclopentolate is more effective than tropicamide in relaxing accommodation in young children, the use of a local anaesthetic prior to instillation of tropicamide produces refractive data virtually equivalent to that of cyclopentolate, regardless of the age group measured. However, biometric measurements may be susceptible to greater error when near fixation targets are used during phakometry procedures.

Journal Article↗

PubMed2006

Repeatability and agreement of two A-scan ultrasonic biometers and IOLMaster in non-orthokeratology subjects and post-orthokeratology children.

PURPOSE: Our aim was to determine the repeatability of measurements of axial length (AL) and anterior chamber depth (ACD) made with two ultrasonic biometers and the IOLMaster in a group of non-orthokeratology (ortho-k) adult subjects and to investigate the agreement among instruments in children undergoing ortho-k therapy and in children wearing spectacles. METHODS: To determine repeatability, AL and ACD were measured twice in 22 non-ortho-k young adults using two A-scan ultrasonic biometers (A-5500 and A-2500) and the IOLMaster. To determine agreement, AL and ACD were measured with the same instruments in 30 children undergoing ortho-k therapy and 30 spectacle-wearing children. RESULTS: In the adult subjects, there were no significant differences in ACD and AL measurements obtained from the three instruments (repeated measures ANOVAs, p > 0.05). There was also no significant between-measurement difference for each instrument. The between-measurement agreement was better for the IOLMaster (95% limits of agreement (LA): -0.04 and +0.05 mm for both AL and ACD) than for the two A-scan ultrasonic biometers (95% LA: -0.12 and +0.11 mm for AL; -0.22 and +0.27 mm for ACD). Among the children, AL measurements with all three instruments were not significantly different from each other for both the children undergoing ortho-k therapy and those wearing spectacles (repeated measures ANOVAs, p > 0.05). The 95% LA of differences obtained from any two instruments were also comparable for both groups of subjects (within -0.20 mm and +0.20 mm). ACD measurements of the children were significantly different among the three instruments (repeated measures ANOVAs, p < 0.05). No significant differences in ACD measurements were found between A-5500 and A-2500 for both groups of children (paired t tests, p > 0.017). CONCLUSIONS: The repeatability of AL and ACD measurements with the IOLMaster was very good, and was better than with the A-scan ultrasonic biometers. The agreements in AL measurements between A-scan ultrasonic biometers and IOLMaster were comparable in both the ortho-k and the spectacle-wearing subjects, and were comparable to the repeatability of the A-scan ultrasonic biometers. ACD measurements between A-scan ultrasonic biometry and the IOLMaster were not comparable. AL measurements with the IOLMaster can replace the measurements from the two A-scan ultrasonic biometers used, however, the reverse is not true. AL and ACD measurements with all three instruments were unaffected by the flattened cornea following ortho-k lens wear.

Adult↗

PubMed1998

Fetal growth retardation, particularly within lymphoid organs, following repeated maternal injections of betamethasone in sheep.

OBJECTIVE: To examine the effect of single or repeated injections of maternally administered corticosteroids on fetal growth in sheep. METHODS: Forty-six date-mated singleton gestation ewes were allocated at random to one of 3 groups: a single, or repeated injections of betamethasone, or a control group which received saline. On days 125 (preterm) or 145 (term) caesarean section delivery was performed. After lambs were killed, measures of size and weight were recorded. Data were analysed using Fishers Exact test and the Student's t-test. RESULTS: Significant betamethasone dose dependent reductions in body and organ weights and biometry were found at preterm and term gestational ages (p < 0.05). There was little catch up growth in those in whom delivery was delayed until term. Thymus, spleen and liver were particularly targeted. CONCLUSION: Repeated injections of betamethasone to the pregnant ewe cause significant reductions in fetal growth with little evidence of catch up by term. The effect of repeated maternal injections of corticosteroids in human pregnancy will await the results of randomized controlled trails.

Animals↗

PubMed1993

The effect of introduction of umbilical Doppler recordings to obstetric practice.

OBJECTIVE: To assess the effect on obstetric practice of clinician access to umbilical artery Doppler ultrasound results. DESIGN: Randomised controlled trial. SETTING: A large teaching hospital. SUBJECTS: Two thousand two hundred and eighty-nine pregnancies defined as being at risk by referral for Doppler or fetal monitoring. INTERVENTIONS: Continuous wave Doppler studies of umbilical artery. Results immediately available to clinicians. MAIN OUTCOME MEASURES: Fetal outcome: perinatal mortality, Apgar score and admission to the neonatal unit. Obstetric intervention: admission to hospital, induction of labour and caesarean section. Use of of fetal well being: cardiotocography, biophysical profile and ultrasound biometry. RESULTS: The treatment and control groups were comparable in age, parity, gestation at point of entry and risk features. There were no overall differences in perinatal outcome, obstetric intervention or use of fetal monitoring. Examination of a subset recruited only because of hypertension or suspected intrauterine growth retardation (n = 754) similarly showed no difference attributable to group randomisation. Comparison of only those pregnancies retrospectively defined as low risk and high risk showed more use of cardiotocography in the high risk group with access to Doppler (P = 0.007) but no difference in the low risk group. CONCLUSION: Doppler umbilical artery recording has been shown to perform well in prediction power of antenatal fetal compromise. What has been examined in this study is the response of clinicians to the test. The results suggest that obstetricians do not use the test to modify their risk assessment, and, therefore, the need for fetal monitoring in particular pregnancies. There is a real need for accumulation of information from very large data sets, particularly in the prediction power of Doppler for antenatal fetal compromise from apparently chronic utero-placental cause to guide use of monitoring resources. If simply added to existing fetal monitoring techniques in a hospital where these are widely used, then umbilical artery Doppler recordings may at present simply involve extra resources of staff and expenses, without benefit.

Adult↗

PubMed1997

Gestational age and induction of labour for prolonged pregnancy.

OBJECTIVE: To examine the length of gestation according to menstrual and ultrasound scan dates, and the rate of induction of labour in a unit with a routine induction policy for prolonged pregnancy. DESIGN: Retrospective analysis of computer files of 24,675 pregnancies delivered in a teaching hospital between 1988 and 1995, which had a record of the last menstrual period and a dating ultrasound scan. Detailed survey of 168 casenotes of consecutive inductions of labour to establish the indications given. SETTING: Teaching hospital with policies of routine mid-trimester ultrasound scan and routine induction for prolonged pregnancy at 290 to 294 days. MAIN OUTCOME MEASURES: Gestational age at delivery by menstrual history and ultrasound biometry in spontaneous and induced labours. RESULTS: The single largest category of reasons given for induction of labour was prolonged pregnancy. 'Post-term pregnancy', from the date of expected delivery as recorded in the notes, together with 'maternal request' and 'social factors', were the reasons given for induction of labour in 71.3% of cases. Menstrual dates systematically overestimated gestational age at term when compared with scan dates. After 41 weeks, this difference exceeded the confidence limits for second trimester scan dating error, suggesting that most pregnancies which are considered 'prolonged' according to menstrual dates are in fact mis-dated. The median gestational age for induced labours was 286 days by last menstrual period but only 280 days by scan, and most (71.5%) inductions done post-term (> 294 days) according to menstrual dates were not post-term if scan dates alone are used to calculate the gestational age. The average induction rate over the seven year study period was 16.6%. It was higher when there was any gestational age error in either direction (16.8%) compared with when menstrual and scan dates were in complete agreement (13.7%, OR 1.27, CI 1.09-1.47, P < 0.001). The induction rate was highest (up to 21.8%) in the cases where menstrual dates overstated gestational age without exceeding the usual limits for adjusting dates according to scan. Such overestimation within tolerance limits of 7, 10 or 14 days occurred in 37.1%, 45.8%, or 52.6% of all pregnancies, respectively. CONCLUSIONS: Most pregnancies undergoing post-term induction are not post-term when assessed by ultrasound dates. Regardless of whether prolonged pregnancy is considered to be a risk factor requiring intervention, the proportion of pregnancies considered 'post-term' can be reduced considerably by a dating policy which ignores menstrual dates and establishes the expected delivery date on the basis of ultrasound dates alone.

Cesarean Section↗

PubMed2002

Relationship between customised birthweight centiles and neonatal anthropometric features of growth restriction.

OBJECTIVE: To determine the relationship between customised birthweight centiles (adjusted for maternal and fetal physiological variables) and neonatal anthropometric features of intrauterine growth restriction (IUGR). DESIGN: Observational study. POPULATION: Two-hundred and seventy women with low risk pregnancies participating in a cohort study of serial ultrasound biometry. METHODS: Customised birthweight centiles were calculated following adjustment for maternal weight, height and ethnic origin, gestational age at delivery, birth order, and sex of the infant. Three separate neonatal anthropometric measures were used to define IUGR: subscapular or triceps skinfold thickness <10th centile; ponderal index <25th centile; and mid-arm circumference to occipito-frontal circumference ratio (MAC/OFC) <- 1 standard deviation (SD). Relationship of the centiles to these outcomes was evaluated using likelihood ratios (LR) and kappa statistic. These approaches allowed us to examine the strength of the association: an LR of 5-10 would be expected to generate moderate changes in the pre-test probability of IUGR, whereas a kappa value of 0.2-0.4 would reflect fair agreement between customised birthweight centiles and neonatal anthropometric measures. RESULTS: Customised birthweight centile of 10 or less had the following LR values for the various anthropometric criteria for IUGR: 5.1 (95% CI 3-8.5) for low skinfold thickness; 4.3 (95% CI 2.5-7.1) for low ponderal index; and 3.9 (95% CI 2-6.6) for low MAC/OFC ratio. The kappa values were: 0.4 (95% CI 0.26-0.51) for low skinfold thickness; 0.33 (95% CI 0.21-0.46) for low ponderal index; and 0.13 (95% CI 0-0.26) for low MAC/OFC ratio. CONCLUSION: In a low risk population, customised birthweight centiles can only be moderately useful in the identification of neonates with low skinfold thickness and low ponderal index.

Anthropometry↗

PubMed2005

A comparison of fetal organ measurements by echo-planar magnetic resonance imaging and ultrasound.

OBJECTIVES: To compare fetal organ size measured using echo-planar magnetic resonance imaging and 2D ultrasound. To determine the relative accuracy with which each technique can predict fetal growth restriction. DESIGN: A cross sectional, observational study comparing two different measurement techniques against a gold standard, in a normal clinical population and an abnormal population. SETTING AND POPULATION: Seventy-four pregnant women (33 who were ultimately found to be normal and 37 with fetal growth restricted fetuses) were recruited from the City Hospital Nottingham UK to be scanned once (at various gestations). METHODS: Each fetus had a standard ultrasound biometry assessment followed by magnetic resonance imaging measurement of organ volumes. MAIN OUTCOME MEASURES: For each measurement for both techniques, the normal population was plotted with 90% confidence intervals. Fetal growth restricted subjects were compared with the normal population using this plot; 2 x 2 tables were created for each measurement. This was used to calculate the relative sensitivities and positive predictive value of the different measurements. A Bland-Altman plot was used to compare the ultrasound and magnetic resonance imaging measurements of fetal weight. RESULTS: Brain sparing was seen in ultrasonic head circumference measurements, but an overall reduction in fetal growth restriction brain volume was apparent using magnetic resonance imaging at late gestations. Across the whole range of gestational ages, ultrasound assessment of fetal weight was the best predictor of fetal growth restriction. CONCLUSION: Ultrasound fetal weight assessment appears to identify more fetuses with fetal growth restriction than abdominal circumference. The brain sparing apparent in ultrasonic head circumference measurements of fetuses with fetal growth restriction masks a reduction in brain volume observed with magnetic resonance imaging.

Abdomen↗

PubMed2005

Effects of hyperglycaemia on ocular development in rabbit: refraction and biometric changes.

AIM: To determine the effect of acute and chronic hyperglycaemia on the refraction and development of the rabbit eye. METHODS: Ocular dimensions of five alloxan-induced hyperglycaemic and six control rabbits were measured over 9 weeks using A scan biometry. Refraction was measured using retinoscopy. The animals were 10 weeks of age at the start of the experiment. RESULTS: The acute onset of hyperglycaemia was associated with a fast and stable 2 D hyperopic shift in refraction. Lens thickness increased during the first 2 weeks of hyperglycaemia, returned to near normal thickness after 3-5 weeks of hyperglycaemia and then decreased in thickness in the last 4 weeks of the study. The hyperopic refraction remained unchanged during changes in lens thickness. Nine weeks of hyperglycaemia was associated with a 25% reduction in the growth of both the globe and the lens and a 17% decrease in body mass compared with the controls. CONCLUSION: The hyperopic refraction change of acute hyperglycaemia is likely to be because of a change in the refractive index of the cortical fibres of the lens and is the probable source of the fluctuating refraction seen in diabetic patients. Chronic hyperglycaemia reduced the axial development of the eye and is the probable source of the chronic hyperopic refraction seen in children with Type I diabetes.

Acute Disease↗

PubMed1995

Severe twin-twin transfusion syndrome: current management concepts.

The presence of functioning vascular anastomoses within the monochorionic placentation of a monozygotic twin pregnancy is responsible for the twin-twin transfusion syndrome. This is a heterogeneous disorder with a wide spectrum of severity. In the most severe form it results in the oligohydramnios-polyhydramnios sequence with a marked disparity in intertwin biometry and amniotic fluid volume. Without therapy, the perinatal mortality of severe twin-twin transfusion syndrome is 60-100%. Several therapeutic interventions have been attempted with therapeutic amniocentesis producing the most consistent improvement in fetal survival rates. The outcome of 10 cases of severe twin-twin transfusion syndrome, presenting as the oligohydramnios-polyhydramnios sequence, is presented. Gestational age at presentation ranged from 20-34 weeks. Three fetuses were hydropic at initial presentation and of these only 1 survived. All cases were treated with serial aggressive therapeutic amniocentesis, the number of procedures ranging from 1-9/patient. The volume of amniotic fluid removed ranged from 3,200-14,000 mL. Gestation was prolonged a mean of 46 days (range 1-106 days). The perinatal survival rate was 65% (13/20 infants). Preterm premature rupture of membranes and secondary preterm birth complicated 1 pregnancy treated with therapeutic amniocentesis. Short-term morbidity in the liveborn infants was predominantly secondary to prematurity and renal cortical necrosis. Severe twin-twin transfusion syndrome is the most common aetiology of the oligohydramnios-polyhydramnios sequence. Therapeutic amniocentesis offers an intervention that may reduce the high perinatal loss rate previously observed with this disorder.

Adult↗

PubMed2001

Induction policy and missed post-term pregnancies: a mathematical model.

The aim of this study was to compare the clinical performance of ultrasound dates and ultrasound dates combined with menstrual dates for the detection of post-maturity. A computer model was designed which uses the statistical distributions of the duration of normal pregnancy, day of ovulation in relation to the menstrual cycle and ultrasound error for estimating gestational age. The clinical performance of the different dating methods was then analysed from these variables, on simulations of 30,000 cases. The efficacy of different dating methods for detecting post-maturity was determined by generating receiver-operator characteristics (ROC) curves. The proportion of post-term pregnancies (294 days and over) predicted by the model (3.5%) agrees with published values. There is a steep rise in missed cases if induction is delayed beyond 10 days from the expected date of delivery, reaching 20% on day 294. Elective delivery on day 290 will detect 98.9% of cases destined to deliver post-term, with an induction rate of 10%; the respective figures for induction on day 294 are 79% and 3.8%. The ROC curves for the detection of post-maturity suggest that use of the mid-trimester biparietal diameter (BPD) is better than a 7-day or 10-day rule. Timing of elective delivery is the most important variable affecting the detection rate for post-maturity There is no advantage in using menstrual dates when ultrasound biometry is available.

Bias↗

PubMed2005

Use of umbilical-cerebral Doppler ratios in predicting fetal growth restriction in near-term fetuses.

OBJECTIVE: To compare the sensitivity and specificity of different umbilical-cerebral ratios in the prediction and detection of fetal growth restriction in near-term fetuses when the umbilical arterial waveform is within normal. METHODS: A prospective cross-sectional observational study was carried out recruiting consecutive singleton pregnancies with clinically suspected fetal growth restriction after 34 weeks gestation. The umbilical-cerebral ratios were then calculated from the S/D, RI and PI values and correlated with immediate perinatal outcome. RESULTS: A total of 187 patients were recruited. Twelve cases had abnormal UA Doppler flow velocity waveform studies. Of the 175 with normal UA Doppler findings, 92 (53.1%) were confirmed to have fetal growth restriction (FGR) with birth weights below the tenth centile for gestation. The detection rate of FGR by ultrasound biometry was 96.7%. The mean umbilical artery S/D, RI and PI values were higher in the fetal growth restriction group, while the middle cerebral artery values were lower as compared to fetuses with no growth restriction. A small but significant difference was seen in the umbilical-cerebral ratios of the different indices between the two groups. Receiver operator characteristic curves showed that there was little difference between the performances of the S/D, RI or PI ratios and all had limited power in predicting fetal growth restriction. CONCLUSION: In the presence of normal umbilical artery Doppler waveforms, umbilical-cerebral ratios have limited power to predict fetal growth restriction.

Blood Flow Velocity↗

PubMed2006

Activin A, hypoxia and the prediction of obstetric outcomes.

On the back of sheep experiments showing that uterine hypoxia induces a rapid and sustained elevation of fetal activin A levels, we undertook two prospective studies to explore whether this novel observation could be exploited clinically. The first was a prospective labour ward study investigating whether umbilical arterial activin A levels at delivery correlated with either neonatal hypoxic ischaemic encephalopathy or pH. Unfortunately, we were unable to demonstrate a link with either, but found that levels were significantly depressed among those who had an emergency Caesarean section, suggesting a possible role in active labour. Second, we investigated the link between activin A and intrauterine growth restriction (IUGR), a condition of fetoplacental hypoxia, by measuring levels in women presenting for antenatal ultrasound biometry with clinical suspicion of a small baby. We found that, compared to pregnancies with a baby that was small for gestational age (SGA) but otherwise healthy, levels were 2.4 and 8 times higher, respectively, in pregnancies complicated by IUGR, and those complicated by both IUGR and preeclampsia. However, a single blood sample of activin A was unable to distinguish between IUGR and SGA pregnancies with sufficient sensitivity to be clinically useful. Our studies were unable to demonstrate clinical utility for the experimental observation linking activin A and hypoxia.

Activins↗

PubMed2006

Ultrasound and clinical predictors for Caesarean delivery after labour induction at term.

OBJECTIVE: To assess the relationship of ultrasound assessment for amniotic fluid, fetal weight, cervical length, cervical funneling and clinical factors on the risk of Caesarean delivery after labour induction at term. METHODS: On hundred and fifty-two women scheduled for labour induction at term agreed to participate. Sonography was performed to obtain fetal biometry, amniotic fluid index and cervical length and to detect funneling at the internal cervical os. The sonographic findings were concealed. Study women received standard care during labour induction. RESULTS: On univariate analysis using Fisher's exact test, parity, cervical length and Bishop score were associated with Caesarean delivery. Following multivariable logistic regression analysis, only nulliparity (adjusted odds ratio (AOR) 5.2 (95% CI 2.2-12.2): P<0.001) and transvaginal ultrasound-determined cervical length of more than 20 mm (AOR 2.8 (95% CI 1.0-7.4): P=0.04) were independent predictors of Caesarean delivery in labour induction. Maternal age, maternal height, gestational age, indication for labour induction, amniotic fluid index, cervical funneling and ultrasound-estimated fetal weight did not predict Caesarean delivery. CONCLUSION: In women who had undergone labour induction at term with a singleton fetus, nulliparity and cervical length of more than 20 mm on transvaginal sonography were independent predictors of Caesarean delivery. This information is helpful for pre-induction counselling.

Adult↗

PubMed2006

Impact of alcohol exposure after pregnancy recognition on ultrasonographic fetal growth measures.

BACKGROUND: More than 3 decades after Jones and Smith (1973) reported on the devastation caused by alcohol exposure on fetal development, the rates of heavy drinking during pregnancy remain relatively unchanged. Early identification of fetal alcohol exposure and maternal abstinence led to better infant outcomes. This study examined the utility of biometry for detecting alcohol-related fetal growth impairment. METHODS: We obtained fetal ultrasound measures from routine ultrasound examinations for 167 pregnant hazardous drinkers who were enrolled in a brief alcohol intervention study. The fetal measures for women who quit after learning of their pregnancies were compared with measures for women who continued some drinking throughout the course of their pregnancies. Because intensity of alcohol consumption is associated with poorer fetal outcomes, separate analyses were conducted for the heavy (average of >or=5 drinks per drinking day) alcohol consumers. Fetal measures from the heavy-exposed fetuses were also compared with measures from a nondrinking group that was representative of normal, uncomplicated pregnancies from our clinics. Analyses of covariance were used to determine whether there were differences between groups after controlling for influences of gestational age and drug abuse. RESULTS: Nearly half of the pregnant drinkers abstained after learning of their pregnancies. When women reportedly quit drinking early in their pregnancies, fetal growth measures were not significantly different from a non-alcohol-exposed group, regardless of prior drinking patterns. Any alcohol consumption postpregnancy recognition among the heavy drinkers resulted in reduced cerebellar growth as well as decreased cranial to body growth in comparison with women who either quit drinking or who were nondrinkers. Amphetamine abuse was predictive of larger cranial to body growth ratios. CONCLUSIONS: Alterations in fetal biometric measurements were observed among the heavy drinkers only when they continued drinking after becoming aware of their pregnancies. Although the reliance on self-reported drinking is a limitation in this study, these findings support the benefits of early abstinence and the potential for ultrasound examinations in the detection of fetal alcohol effects.

Alcohol Drinking↗