Pregnancy and Birth

Biophysical Profile and Color Doppler Ultrasound in the High Risk Pregnancy Presented by: Dr. Farzad Afzali Kasra Ultrasound Clinic   • BPP is applying to detect prenatal asphyxia • Doppler ultrasound is a modality for detecting fetal hypoxia and acidosis • Doppler can also predict later pre- eclampsia at the 24-26 gestational weeks.   • Hypoxia: Low oxygen tension • Asphyxia: Low oxygen and high CO2 • Ischemia: Drop in blood flow Comment So, Doppler ultrasound can predict fetal distress sooner than BPP   • Prediction of the effect of an asphyxial insult on the fetus requires a measure of:

The foetal blood in the chorionic villi is separated from the maternal blood, in the intervillous spaces, by the Placental Barrier which is composed of :1. Endothelium of the foetal blood vessels, 2. The villous stroma, 3. The cytotrophoblast, and 4. The syncytiotrophoblast.

HELLP Syndrome as a Separate Entity Dr. Mohammed Abdalla EGYPT, Domiat G. HospitalHELLP Syndrome May it be a separate entity? yes   HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet count, is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia, but it may be a separate entity.

DEFINITIONExcessive blood loss sufficient to affect the general condition of the mother.INCIDENCELow parity 0.3%Para 4 or > 2%Babiszki et al, 1999

Generalized skin thickening of more than 5mm and / or two or more of the following • Pericardial Effusion • Pleural Effusion • Ascites • Placental Enlargement

• The following guidance is evidence based. • Developed by the National Collaborating Centre for Women's and Children's Health • Developed at October 2003, valid till 2007 • The grading scheme used for the recommendations (A, B, C, D, good practice point [GPP], and NICE 2002)

Condition in which the cervix fails to retain the conceptus during pregnancy. Cervix length less than?? Premature ripening of the cervix Definition

Doppler History • Fitzgerald & Drumm. Umbilical artery studies 1977 BMJ • Eik-Nes et al. Fetal aortic velocimetry: Dupplexscanner 1980 Lancet • Campbell et al. Utero-placental circulation: Dupplex scanner 1983 Lancet • Wladimiroff et al. MCA/UA PI ratio 1987 OG Kiserud et al. Ductus venosus velocimetry 1991 Lancet

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