Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm labor cases compared to term labor cases, indicating increased fetal adrenal gland growth in preterm labor as an adaptation to increased fetal stress. FZD/TGD ratio had high sensitivity of 100% and specificity of 86% in predicting preterm birth, performing better than FZD, TGD, or cervical dilation alone. Increased FZD/TGD ratio may help identify women at risk of preterm birth and guide clinical management.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.
Abstract—3D ultrasound (3-dimensional sonography) when combined with sonosalpingography, it provides detailed information regarding internal and external contours of the uterus, without the need for radiation contrast material or surgical intervention. This study was done because of the need of such diagnostic modality that is highly accurate as well as least invasive. A descriptive study was conducted on 50 infertile females to assess the diagnostic value of 3-dimensional SHG in reference of diagnostic hystero-laproscopy (DHL) assuming as gold standard. It was found that sensitivity of 3-dimensional SHG reasons of tubal patency, ovarian pathology and uterine cavity was found 97.6%, 90.91% and 71.43% respectively. And diagnostic accuracy of 3-dimensional SHG in reference of DHL for tubal patency, ovarian pathology and for uterine cavity was found 96%, 92% and 96% respectively. So it can be concluded from present study that 3-Dimensional sonohysterography is an efficient tool to assess women with infertility. Its sensitivity, specificity, and diagnostic accuracy is comparable to hysterolaproscopy.
Characterization and the Kinetics of drying at the drying oven and with micro...Open Access Research Paper
The objective of this work is to contribute to valorization de Nephelium lappaceum by the characterization of kinetics of drying of seeds of Nephelium lappaceum. The seeds were dehydrated until a constant mass respectively in a drying oven and a microwawe oven. The temperatures and the powers of drying are respectively: 50, 60 and 70°C and 140, 280 and 420 W. The results show that the curves of drying of seeds of Nephelium lappaceum do not present a phase of constant kinetics. The coefficients of diffusion vary between 2.09.10-8 to 2.98. 10-8m-2/s in the interval of 50°C at 70°C and between 4.83×10-07 at 9.04×10-07 m-8/s for the powers going of 140 W with 420 W the relation between Arrhenius and a value of energy of activation of 16.49 kJ. mol-1 expressed the effect of the temperature on effective diffusivity.
Accuracy of cervico vaginal fetal fibronectin test in predicting risk of spon...Open Access Research Paper
Preterm delivery is the leading cause of neonatal mortality. One of the best predictors to assess the risk of preterm labour (PTB) is by measuring fetal fibronectin (fFN) in cervico vaginal secretion after 26 weeks of pregnancy. The aim is to evaluate the diagnostic accuracy of qualitative cervico vaginal fFN in symptomatic women and asymptomatic high risk women during antenatal care. Prospective study which was conducted in Basrah Maternity and Child Hospital. It included 106 pregnant women at gestational age more than 26 weeks who had uterine contraction with or without pervious risk factors for PTB. Cervico vaginal fluid sampling was undertaken from all women included in the study after the age of 26 weeks of gestation and qualitative fFN assessment was done with 50ng/ml is the cut off point for positivity. As regard qualitative fFN assessment for predicting of PTB sensitivity, specificity, PPV, NPV, were 71%, 87%, 40.50%, 94% respectively in symptomatic women. While in asymptomatic women with previous high risk had 26% sensitivity, 84% specificity, 32% PPV, and 87% NPV. Qualitative assessment of fFN in cervico vaginal fluid is good predictive marker in detecting of PTB.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
AN ANALYSIS OF OUTCOMES IN TWIN PREGNANCIES WITH ACTIVE FETAL SURVEILLANCE AN...Apollo Hospitals
The incidence of multiple gestations is increasing with
increasing maternal age and use of assisted reproduction
techniques. Selective fetal reduction of multifetal pregnancies is now widely practiced to reduce the higher order multiples to twins based on evidence from nonrandomised studies which suggests that this will improve the perinatal outcome. The proportion of twin pregnancies with unique fetal and maternal problems is therefore increasing. Optimising maternal, fetal and perinatal outcomes in twin pregnancies continues to be a formidable challenge in the present day clinical practice.
— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.
Abstract—3D ultrasound (3-dimensional sonography) when combined with sonosalpingography, it provides detailed information regarding internal and external contours of the uterus, without the need for radiation contrast material or surgical intervention. This study was done because of the need of such diagnostic modality that is highly accurate as well as least invasive. A descriptive study was conducted on 50 infertile females to assess the diagnostic value of 3-dimensional SHG in reference of diagnostic hystero-laproscopy (DHL) assuming as gold standard. It was found that sensitivity of 3-dimensional SHG reasons of tubal patency, ovarian pathology and uterine cavity was found 97.6%, 90.91% and 71.43% respectively. And diagnostic accuracy of 3-dimensional SHG in reference of DHL for tubal patency, ovarian pathology and for uterine cavity was found 96%, 92% and 96% respectively. So it can be concluded from present study that 3-Dimensional sonohysterography is an efficient tool to assess women with infertility. Its sensitivity, specificity, and diagnostic accuracy is comparable to hysterolaproscopy.
Characterization and the Kinetics of drying at the drying oven and with micro...Open Access Research Paper
The objective of this work is to contribute to valorization de Nephelium lappaceum by the characterization of kinetics of drying of seeds of Nephelium lappaceum. The seeds were dehydrated until a constant mass respectively in a drying oven and a microwawe oven. The temperatures and the powers of drying are respectively: 50, 60 and 70°C and 140, 280 and 420 W. The results show that the curves of drying of seeds of Nephelium lappaceum do not present a phase of constant kinetics. The coefficients of diffusion vary between 2.09.10-8 to 2.98. 10-8m-2/s in the interval of 50°C at 70°C and between 4.83×10-07 at 9.04×10-07 m-8/s for the powers going of 140 W with 420 W the relation between Arrhenius and a value of energy of activation of 16.49 kJ. mol-1 expressed the effect of the temperature on effective diffusivity.
Accuracy of cervico vaginal fetal fibronectin test in predicting risk of spon...Open Access Research Paper
Preterm delivery is the leading cause of neonatal mortality. One of the best predictors to assess the risk of preterm labour (PTB) is by measuring fetal fibronectin (fFN) in cervico vaginal secretion after 26 weeks of pregnancy. The aim is to evaluate the diagnostic accuracy of qualitative cervico vaginal fFN in symptomatic women and asymptomatic high risk women during antenatal care. Prospective study which was conducted in Basrah Maternity and Child Hospital. It included 106 pregnant women at gestational age more than 26 weeks who had uterine contraction with or without pervious risk factors for PTB. Cervico vaginal fluid sampling was undertaken from all women included in the study after the age of 26 weeks of gestation and qualitative fFN assessment was done with 50ng/ml is the cut off point for positivity. As regard qualitative fFN assessment for predicting of PTB sensitivity, specificity, PPV, NPV, were 71%, 87%, 40.50%, 94% respectively in symptomatic women. While in asymptomatic women with previous high risk had 26% sensitivity, 84% specificity, 32% PPV, and 87% NPV. Qualitative assessment of fFN in cervico vaginal fluid is good predictive marker in detecting of PTB.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Placental Elastography in Intrauterine Growth Restriction: A Case–control Studyasclepiuspdfs
Background: Intrauterine growth restriction (IUGR) is related to poor fetal outcome. Though, various tools are available for evaluation of IUGR they are notreliable inearly diagnosis of IUGR. Shear wave elastography (SWE) can be used to study the change in mechanical properties of various disease which can be a potential technique for early diagnosis of IUGR. Objective: The objective of the study was to compare the differences in SWE values of placentas between IUGR and normal pregnancies. Methodology: Normal second- and third-trimester pregnancies and IUGR pregnancies between 24 and 42 weeks period of gestation (POG), meeting the inclusion criteria were matched for age group and POG. SWE of placenta was performed in supine position during quiet respiration. The SWE of placenta was measured by placing the region of interest in relatively homogeneous area. The placental elasticity values obtained in pregnancies complicated by IUGR were compared with that of normal controls. Umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler findings were correlated with placental elasticity value of IUGR pregnancies.
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Ectopic pregnancy refers to the pregnancy occurring outside the uterine cavity, predominantly i.e. 90% of them in the fallopian tube. Ectopic pregnancy affects 11 in 1000 pregnancies and is a significant cause of morbidity and at times mortality in the first trimester of pregnancy. In a 20-year longitudinal study on ectopic pregnancy in a defined
population of women aged 15e39 years the rate of ectopic pregnancy per 1000 diagnosed conceptions increased
from 5.8 during 1960e4 to 11.1 during 1975e9. The mean annual incidence of ectopic pregnancy per 1000 women
increased from 0.6 to 1.2 during the same period. The numbers of ectopic pregnancies per 1000 diagnosed
conceptions increased with increasing age of the women and were 4.1 in the teenage group, 6.9 in women aged
20e29 years, and 12.9 in women aged 30e39.
Abstract— Cervical ripening is an essential factor for initiation of normal labour for vaginal delivery. Prior to onset of spontaneous labour the cervix undergoes a gradual process of ripening. But in certain cases it does not occur spontaneously at term and sometimes induction of labour is required. Then cervical ripening means high bishop score in essential for successful induction of labour. This comparative study was conducted at Bikaner to compare induction of labour by vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and Intra cervical Dinoprostone gel 0.5 mg. For this purpose 100 clients were given vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and 100 clients were given Intra cervical Dinoprostone gel 0.5 mg. It was observed in this study that Dinoprostone gel is more efficacious for cervical ripening and labour induction in cases of nulliparous & primiparous at term with unfavourable cervix with intact membranes, as compared to misoprostol in terms of shorter total duration of labour, shorter mean induction delivery interval, more spontaneous vaginal deliveries, and reduced incidence of LSCS as well as instrumental deliveries.
Background: Cervical screening through conventional cervical cytology is most commonly used throughout the world. The Cervical cancer is the second most common cancer worldwide and in developing countries, the leading cause of death. It is one of the most preventable and curable of all cancers.
Objective: To Study the role of Pap smear in detecting neoplastic and non-neoplastic lesions of cervix and to determine the occurrence of various lesions in remote area of Bagalkot.
Methods: This is prospective study of 240 women with age group 20 to 60 years was carried out from May 2015 to June 2016 cytology section of pathology department, S. Nijalingappa Medical College & H.S.K Hospital & Research Centre, Bagalkot, India. Pap smears were prepared, fixed, stained and carefully examined.
Results: In this study, Reactive cellular changes associated with inflammation was the most common with 182 cases (75.8%) followed by Low-grade squamous intraepithelial lesions (SIL) with 11 cases (4.5%), then atypical squamous epithelial cells of undetermined significance 8 cases (3.3%), High-grade squamous intraepithelial lesions with 5 cases (2.1%), Atrophy with 3 cases (1.3%) and Atypical Glandular Cell in 3 cases (1.3%). The average age of women for all the epithelial abnormalities was 40 years.
Conclusion: This study will increase awareness of the Pap test and cervical cancer, thereby paving a way for the prevention of cervical cancer.
Key-words- Pap smear, Cervical cancer, The Bethesda System, Squamous intraepithelial lesions (SIL)
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Placental Elastography in Intrauterine Growth Restriction: A Case–control Studyasclepiuspdfs
Background: Intrauterine growth restriction (IUGR) is related to poor fetal outcome. Though, various tools are available for evaluation of IUGR they are notreliable inearly diagnosis of IUGR. Shear wave elastography (SWE) can be used to study the change in mechanical properties of various disease which can be a potential technique for early diagnosis of IUGR. Objective: The objective of the study was to compare the differences in SWE values of placentas between IUGR and normal pregnancies. Methodology: Normal second- and third-trimester pregnancies and IUGR pregnancies between 24 and 42 weeks period of gestation (POG), meeting the inclusion criteria were matched for age group and POG. SWE of placenta was performed in supine position during quiet respiration. The SWE of placenta was measured by placing the region of interest in relatively homogeneous area. The placental elasticity values obtained in pregnancies complicated by IUGR were compared with that of normal controls. Umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler findings were correlated with placental elasticity value of IUGR pregnancies.
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Ectopic pregnancy refers to the pregnancy occurring outside the uterine cavity, predominantly i.e. 90% of them in the fallopian tube. Ectopic pregnancy affects 11 in 1000 pregnancies and is a significant cause of morbidity and at times mortality in the first trimester of pregnancy. In a 20-year longitudinal study on ectopic pregnancy in a defined
population of women aged 15e39 years the rate of ectopic pregnancy per 1000 diagnosed conceptions increased
from 5.8 during 1960e4 to 11.1 during 1975e9. The mean annual incidence of ectopic pregnancy per 1000 women
increased from 0.6 to 1.2 during the same period. The numbers of ectopic pregnancies per 1000 diagnosed
conceptions increased with increasing age of the women and were 4.1 in the teenage group, 6.9 in women aged
20e29 years, and 12.9 in women aged 30e39.
Abstract— Cervical ripening is an essential factor for initiation of normal labour for vaginal delivery. Prior to onset of spontaneous labour the cervix undergoes a gradual process of ripening. But in certain cases it does not occur spontaneously at term and sometimes induction of labour is required. Then cervical ripening means high bishop score in essential for successful induction of labour. This comparative study was conducted at Bikaner to compare induction of labour by vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and Intra cervical Dinoprostone gel 0.5 mg. For this purpose 100 clients were given vaginal prostaglandin E1 tablet (tablet Misoprostol 25 µg 4 hourly) and 100 clients were given Intra cervical Dinoprostone gel 0.5 mg. It was observed in this study that Dinoprostone gel is more efficacious for cervical ripening and labour induction in cases of nulliparous & primiparous at term with unfavourable cervix with intact membranes, as compared to misoprostol in terms of shorter total duration of labour, shorter mean induction delivery interval, more spontaneous vaginal deliveries, and reduced incidence of LSCS as well as instrumental deliveries.
Background: Cervical screening through conventional cervical cytology is most commonly used throughout the world. The Cervical cancer is the second most common cancer worldwide and in developing countries, the leading cause of death. It is one of the most preventable and curable of all cancers.
Objective: To Study the role of Pap smear in detecting neoplastic and non-neoplastic lesions of cervix and to determine the occurrence of various lesions in remote area of Bagalkot.
Methods: This is prospective study of 240 women with age group 20 to 60 years was carried out from May 2015 to June 2016 cytology section of pathology department, S. Nijalingappa Medical College & H.S.K Hospital & Research Centre, Bagalkot, India. Pap smears were prepared, fixed, stained and carefully examined.
Results: In this study, Reactive cellular changes associated with inflammation was the most common with 182 cases (75.8%) followed by Low-grade squamous intraepithelial lesions (SIL) with 11 cases (4.5%), then atypical squamous epithelial cells of undetermined significance 8 cases (3.3%), High-grade squamous intraepithelial lesions with 5 cases (2.1%), Atrophy with 3 cases (1.3%) and Atypical Glandular Cell in 3 cases (1.3%). The average age of women for all the epithelial abnormalities was 40 years.
Conclusion: This study will increase awareness of the Pap test and cervical cancer, thereby paving a way for the prevention of cervical cancer.
Key-words- Pap smear, Cervical cancer, The Bethesda System, Squamous intraepithelial lesions (SIL)
Similar to Ultrasound Assessment of Fetal Adrenal Gland in Term and Preterm Labor Cases (20)
Slack (or Teams) Automation for Bonterra Impact Management (fka Social Soluti...Jeffrey Haguewood
Sidekick Solutions uses Bonterra Impact Management (fka Social Solutions Apricot) and automation solutions to integrate data for business workflows.
We believe integration and automation are essential to user experience and the promise of efficient work through technology. Automation is the critical ingredient to realizing that full vision. We develop integration products and services for Bonterra Case Management software to support the deployment of automations for a variety of use cases.
This video focuses on the notifications, alerts, and approval requests using Slack for Bonterra Impact Management. The solutions covered in this webinar can also be deployed for Microsoft Teams.
Interested in deploying notification automations for Bonterra Impact Management? Contact us at sales@sidekicksolutionsllc.com to discuss next steps.
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
UiPath Test Automation using UiPath Test Suite series, part 4DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 4. In this session, we will cover Test Manager overview along with SAP heatmap.
The UiPath Test Manager overview with SAP heatmap webinar offers a concise yet comprehensive exploration of the role of a Test Manager within SAP environments, coupled with the utilization of heatmaps for effective testing strategies.
Participants will gain insights into the responsibilities, challenges, and best practices associated with test management in SAP projects. Additionally, the webinar delves into the significance of heatmaps as a visual aid for identifying testing priorities, areas of risk, and resource allocation within SAP landscapes. Through this session, attendees can expect to enhance their understanding of test management principles while learning practical approaches to optimize testing processes in SAP environments using heatmap visualization techniques
What will you get from this session?
1. Insights into SAP testing best practices
2. Heatmap utilization for testing
3. Optimization of testing processes
4. Demo
Topics covered:
Execution from the test manager
Orchestrator execution result
Defect reporting
SAP heatmap example with demo
Speaker:
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
Smart TV Buyer Insights Survey 2024 by 91mobiles.pdf91mobiles
91mobiles recently conducted a Smart TV Buyer Insights Survey in which we asked over 3,000 respondents about the TV they own, aspects they look at on a new TV, and their TV buying preferences.
Securing your Kubernetes cluster_ a step-by-step guide to success !KatiaHIMEUR1
Today, after several years of existence, an extremely active community and an ultra-dynamic ecosystem, Kubernetes has established itself as the de facto standard in container orchestration. Thanks to a wide range of managed services, it has never been so easy to set up a ready-to-use Kubernetes cluster.
However, this ease of use means that the subject of security in Kubernetes is often left for later, or even neglected. This exposes companies to significant risks.
In this talk, I'll show you step-by-step how to secure your Kubernetes cluster for greater peace of mind and reliability.
GDG Cloud Southlake #33: Boule & Rebala: Effective AppSec in SDLC using Deplo...James Anderson
Effective Application Security in Software Delivery lifecycle using Deployment Firewall and DBOM
The modern software delivery process (or the CI/CD process) includes many tools, distributed teams, open-source code, and cloud platforms. Constant focus on speed to release software to market, along with the traditional slow and manual security checks has caused gaps in continuous security as an important piece in the software supply chain. Today organizations feel more susceptible to external and internal cyber threats due to the vast attack surface in their applications supply chain and the lack of end-to-end governance and risk management.
The software team must secure its software delivery process to avoid vulnerability and security breaches. This needs to be achieved with existing tool chains and without extensive rework of the delivery processes. This talk will present strategies and techniques for providing visibility into the true risk of the existing vulnerabilities, preventing the introduction of security issues in the software, resolving vulnerabilities in production environments quickly, and capturing the deployment bill of materials (DBOM).
Speakers:
Bob Boule
Robert Boule is a technology enthusiast with PASSION for technology and making things work along with a knack for helping others understand how things work. He comes with around 20 years of solution engineering experience in application security, software continuous delivery, and SaaS platforms. He is known for his dynamic presentations in CI/CD and application security integrated in software delivery lifecycle.
Gopinath Rebala
Gopinath Rebala is the CTO of OpsMx, where he has overall responsibility for the machine learning and data processing architectures for Secure Software Delivery. Gopi also has a strong connection with our customers, leading design and architecture for strategic implementations. Gopi is a frequent speaker and well-known leader in continuous delivery and integrating security into software delivery.
Dev Dives: Train smarter, not harder – active learning and UiPath LLMs for do...UiPathCommunity
💥 Speed, accuracy, and scaling – discover the superpowers of GenAI in action with UiPath Document Understanding and Communications Mining™:
See how to accelerate model training and optimize model performance with active learning
Learn about the latest enhancements to out-of-the-box document processing – with little to no training required
Get an exclusive demo of the new family of UiPath LLMs – GenAI models specialized for processing different types of documents and messages
This is a hands-on session specifically designed for automation developers and AI enthusiasts seeking to enhance their knowledge in leveraging the latest intelligent document processing capabilities offered by UiPath.
Speakers:
👨🏫 Andras Palfi, Senior Product Manager, UiPath
👩🏫 Lenka Dulovicova, Product Program Manager, UiPath
Software Delivery At the Speed of AI: Inflectra Invests In AI-Powered QualityInflectra
In this insightful webinar, Inflectra explores how artificial intelligence (AI) is transforming software development and testing. Discover how AI-powered tools are revolutionizing every stage of the software development lifecycle (SDLC), from design and prototyping to testing, deployment, and monitoring.
Learn about:
• The Future of Testing: How AI is shifting testing towards verification, analysis, and higher-level skills, while reducing repetitive tasks.
• Test Automation: How AI-powered test case generation, optimization, and self-healing tests are making testing more efficient and effective.
• Visual Testing: Explore the emerging capabilities of AI in visual testing and how it's set to revolutionize UI verification.
• Inflectra's AI Solutions: See demonstrations of Inflectra's cutting-edge AI tools like the ChatGPT plugin and Azure Open AI platform, designed to streamline your testing process.
Whether you're a developer, tester, or QA professional, this webinar will give you valuable insights into how AI is shaping the future of software delivery.
The Art of the Pitch: WordPress Relationships and SalesLaura Byrne
Clients don’t know what they don’t know. What web solutions are right for them? How does WordPress come into the picture? How do you make sure you understand scope and timeline? What do you do if sometime changes?
All these questions and more will be explored as we talk about matching clients’ needs with what your agency offers without pulling teeth or pulling your hair out. Practical tips, and strategies for successful relationship building that leads to closing the deal.
Elevating Tactical DDD Patterns Through Object CalisthenicsDorra BARTAGUIZ
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Ultrasound Assessment of Fetal Adrenal Gland in Term and Preterm Labor Cases
1. The Egyptian Journal of Hospital Medicine (July 2021) Vol. 84, Page 1711-1718
1711
Received: 2/4/2021
Accepted: 28/5/2021
This article is an open access article distributed under the terms and conditions of the Creative
Commons Attribution (CC BY-SA) license (http://creativecommons.org/licenses/by/4.0/)
Ultrasound Assessment of Fetal Adrenal Gland in Term and
Preterm Labor Cases
Heba Maged Abo Shady1
, Mohamed Ahmed Samy Kandil1
,
Ashraf Anas Zytoon2
, Shaimaa Mahmoud Youssef1
Departments of 1
Gynecology & Obstetrics and 2
Radiodiagnosis, Faculty of Medicine - Menoufia University, Egypt
*Corresponding author: Shaimaa Mahmoud Youssef, Mobile: (+20)01063603679,
E-Mail: shaimaayoussef606@gmail.com
ABSTRACT
Background: Preterm birth (PTB) remains a major cause of perinatal morbidity and mortality worldwide. Compared
with term deliveries, early PTB (< 34 weeks' gestation) carries a 7-fold increased risk of neonatal death.
Objective: To compare the Fetal Zone Depth (FZD) of fetal adrenal gland in term and preterm labor cases
Patients and Methods: Thirty-three preterm pregnant women at 29-36 weeks of gestation with single pregnancy and
clinical diagnosis of preterm labor and control group of 33 pregnant women at 37-40 weeks with term pregnancy were
included in this study. FZD and Total Gland Depth (TGD) of fetal adrenal gland were ultrasonographically measured
and FZD/TGD ratios were calculated and compared between the two groups.
Results: No difference was found between the two groups in respect of age and number of pregnancies (P > 0.05). Yet,
preterm birth history rupture of membrane, cervical dilatation and mode of delivery were higher in preterm group (P
<0.05). Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term
group (52% ± 5% vs. 29% ±9%; P <0.001).
Conclusion: The growth in FZ as a fetal adaptation mechanism in increased fetal stress in preterm labor cases was at a
significant level. Once supported by more comprehensive studies, we think that this result would be beneficial in the
prediction of preterm labor in clinical practice.
Keywords: Preterm labor, Adrenal gland, Fetal zone, Ultrasonography.
INTRODUCTION
Identification of women at risk for PTB is one of
the critical prerequisites for effective intervention and
improvement in outcome. For the last several decades,
significant effort has been focused toward discovery of
an accurate method to predict PTB.
Traditional predictors such as obstetric risk
factors and clinical presentation are helpful but seldom
completely define the population that will truly deliver
preterm (1)
. Approximately 20-30% of the preterm births
(i.e. 1-4% of all births) are caused by medical and
obstetric reasons. While, 70-80% of these births may be
linked to spontaneous idiopathic reasons associated or
not associated with premature rupture of membranes
(PROM) (2)
. Preeclampsia, fetal distress, Fetal Growth
Retardation (FGR), abruption placenta and fetal death
may be referred to as the medical and obstetric causes (3)
.
The prediction and prevention of preterm births
are among the major issues of obstetrics. Prediction and
prevention of preterm births by determining the risk
factors would be the most appropriate approach with a
view to reduce the preterm birth rates. Risk scoring
systems, digital examination of the cervix, biochemical
markers, ultrasonographic cervical length measurement
are the methods used in predicting preterm labor (4, 5)
.
Currently, ultrasonographic cervical length
measurement is the most frequently used method in
clinical practice for the prediction of preterm labor (6, 7)
.
There is evidence to support the view that
activation of the fetal hypothalamic-pituitary-adrenal
axis, and the cross talk between a variety of placental and
fetal adrenal gland endocrine signaling pathways play an
important role in initiation of the normal parturition
process (8)
.
Biochemical activation causes increased
dehydroepinadrosterone-sulfate production in the central
zone of the fetal adrenal gland (fetal zone). Accordingly
the whole fetal adrenal gland increases in size and this
increase is predominantly due to significant enlargement
of the central fetal zone (9)
. Arguments in support of this
process have been provided by an autopsy study, which
demonstrated that neonates that delivered in the setting
of idiopathic PTB had significantly higher adrenal gland
weight than those that delivered secondary to
fetal/maternal hemorrhage(1)
.
The recent studies conducted in this context
revealed that the ultrasound-measured fetal adrenal
gland volume is highly predictive of preterm birth,
independent of expected birth weight and gestational
week (1-10)
. Hence, this study aimed at comparing the fetal
adrenal gland FZD/TGD ratios in preterm and term labor
through ultrasonographic assessment.
PATIENTS AND METHODS
The study was carried out on 66 patients attending
Outpatients and Emergency Unit of Gynecology and
Obstetrics Department, from December 2019 to
December 2020. Thirty three preterm pregnant women
at 29-36 weeks of gestation with single pregnancy were
admitted to the hospital with the clinical diagnosis of
preterm labor. On the other hand, a control group of 33
pregnant women between 37 and 40 weeks with term
3. https://ejhm.journals.ekb.eg/
1713
Figure (1): Incidence of main outcomes (preterm labor, term labor, delivery ≤ 7 days, delivery > 7 days, vaginal
delivery, cesarean delivery) estimated by the current study as contrasted with those estimated from previous studies.
Regarding mode of delivery, 14 cases were vaginal and 15 cases were caesarean (Table 2).
Table (2): Characteristics of patients who underwent preterm or term delivery
Variable Term delivery (n=37) Preterm delivery (n=29) P-value
Parity 0.773†
P0 6 (16.2%) 3 (10.3%)
P1 10 (27.0%) 4 (13.8%)
P2 7 (18.9%) 16 (55.2%)
P3 9 (24.3%) 6 (20.7%)
P4 4 (10.8%) 0 (0.0%)
P5 1 (2.7%) 0 (0.0%)
History of PTL 0.036‡
Negative 35 (94.6%) 22 (75.9%)
Positive 2 (5.4%) 7 (24.1%)
Membranes <0.001§
Intact 34 (91.9%) 12 (41.4%)
Ruptured 3 (8.1%) 17 (58.6%)
Mode of delivery 0.011§
Vaginal 29 (78.4%) 14 (48.3%)
Caesarean 8 (21.6%) 15 (51.7%)
Fetal adrenal gland enlargement (FZD/TGD ratio) was statistically significantly higher in preterm group
compared to the term group (52% ± 5% vs. 29% ± 9%; P < 0.001) (Table 3).
Table (3): Comparison of FZD, TGD and FZD/TGD ratio in patients undergoing preterm or term delivery
Variable Value
Term
delivery
(n=37)
Preterm
delivery
(n=29)
Mean
Difference
95% CI P-
value†
Lower Upper
Cervical dilatation
(cm)
0.6 ± 1.3
(0.0 to 5.0)
0.00 ± 0.00 1.48 ± 1.72 -1.48 -2.05 -0.92 <0.001
FZD (cm) 0.28 ± 0.12 (0.07
to 0.57)
0.22 ± 0.08 0.36 ± 0.12 -0.14 -0.19 -0.08 <0.001
TGD (cm) 0.72 ± 0.21 (0.30
to 1.09)
0.76 ± 0.22 0.68 ± 0.20 0.08 -0.03 0.18 0.148
FZD/TGD ratio 0.394 ± 0.136
(0.194 to 0.635)
0.29 ± 0.09 0.52 ± 0.05 -0.23 -0.26 -0.19 <0.001
There is a direct positive relationship between cervical dilatation and preterm labor. Also there is a direct
positive relationship between increases FZD that lead to increase FZD/TGD Ratio in patients undergoing preterm
delivery. On ROC analysis, the area under the curve (AUC) for FZD, TGD or TZD/TGD ratio was 0.821, 0.603 and
0.983. The ROC curve shows that the FZD sensitivity was 79% and specificity was 86%. TGD sensitivity was 69% and
specificity 54% (Figure 2).
0.0
20.0
40.0
60.0
80.0
100.0
Turan et
al., 2011
Guler et al.,
2015
Ibrahim et
al., 2015
Agarwal et
al., 2017
Present
study
Incidence
rate
(%)
Outome
Main Outcomes
Preterm labor
Term labor
Delivery ≤7 days
Delivery >7 days
Vaginal delivey
Caesarean delivery
4. https://ejhm.journals.ekb.eg/
1714
Figure (2): Comparison of the area under receiver-operating characteristic curves (AUROC) for cervical dilatation,
FZD, TGD or TZD/TGD ratio.
The best cut off value of present study was FZD/TGD ratio with sensitivity 100% and specificity 86% in
prediction of preterm birth as in other studies made (Figure 3).
Figure (3): Area under ROC curve for prediction of preterm delivery using TZD/TGD Ratio estimated by the current
study as contrasted with those estimated from previous studies
On the other hand PPV and NPP of FZD were 74% and 83% respectively. PPV and NPP of TGD were 54% and
69% respectively (Table 4).
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
0.80
0.90
1.00
Agarwal et al., 2017 Present study
Area
under
ROC
Study
ROC Curve Analysis
5. https://ejhm.journals.ekb.eg/
1715
Table (4): Receiver-operating characteristic (ROC) Curve for prediction of preterm delivery using cervical dilatation,
FZD, TGD or TZD/TGD ratio
ROC index
Predictor
Cervical
dilatation
FZD TGD TZD/TGD ratio
AUC 0.741 0.821 0.603 0.983
Standard error 0.000 0.049 0.068 0.000
Lower bound (95%) 0.741 0.725 0.470 0.983
Upper bound (95%) 0.741 0.916 0.736 0.983
Cut-off 2.0 cm 0.290 cm 0.740 cm 0.402
Sensitivity 48% 79% 69% 100%
Lower bound (95%) 31% 61% 51% 86%
Upper bound (95%) 66% 90% 83% 100%
Specificity 100% 78% 54% 86%
Lower bound (95%) 89% 62% 38% 71%
Upper bound (95%) 100% 89% 69% 94%
PPV 100% 74% 54% 85%
NPV 71% 83% 69% 100%
LR+ +Inf 3.67 1.50 7.40
LR- 0.52 0.26 0.57 0.00
TP 14 23 20 29
TN 37 29 20 32
FP 0 8 17 5
FN 15 6 9 0
Sensitivity + Specificity 1.483 1.577 1.230 1.865
Yonden (J) index 0.483 0.577 0.230 0.865
Accuracy 77% 79% 61% 92%
ROC = receiver-operating characteristic, AUC = area under curve, PPV = positive predictive value, NPV = negative
predictive value, LR+ = likelihood ratio positive, LR- = likelihood ratio negative, FN = false negative, FP = false
positive, TN = true negative, TP = true positive.
PPV and NPP of FZD/TGD ratio were 85% and 100% respectively that was the most accurate method in
prediction of preterm labor as in other studies (Figure 4).
Figure (4): Diagnostic accuracy (sensitivity, specificity, PPV, NPV) for TZD/TGD ratio for prediction of preterm
delivery estimated by the current study as contrasted with those estimated from previous studies.
On ROC analysis, the area under the curve (AUC) for prediction of preterm birth using cervical dilatation, FZD,
TGD or FZD/TGD ratio. The best cut off value using FZD/TGD ratio (AUC=0,983) (Table 5).
0
20
40
60
80
100
Sensitivity Specificity PPV NPV
Axis
Title
Measure of accuracy
Diagnostic Accuracy
Turan et al., 2011
Ibrahim et al., 2015
Agarwal et al., 2017
Present study
6. https://ejhm.journals.ekb.eg/
1716
Table (5): Comparison of receiver-operating characteristic (ROC) Curves for prediction of preterm delivery using
cervical dilatation, FZD, TGD or TZD/TGD ratio
Variable AUC SE 95% CI
CD 0.741 0.047 0.619 to 0.841
FZD 0.821 0.053 0.707 to 0.904
TGD 0.603 0.070 0.475 to 0.721
TZD/TGD Ratio 0.983 0.011 0.916 to 0.999
Comparison ΔAUC SE 95% CI z-statistic P-value
CD vs. FZD 0.079 0.077 -0.071 to 0.229 1.035 0.301
CD vs. TGD 0.138 0.086 -0.029 to 0.306 1.618 0.106
CD vs. TZD/TGD 0.242 0.051 0.143 to 0.341 4.787 <0.0001
FZD vs. TGD 0.218 0.111 -0.0003 to 0.435 1.958 0.0503
FZD vs. TZD/TGD 0.163 0.049 0.066 to 0.260 3.290 0.001
TGD vs. TZD/TGD 0.380 0.071 0.240 to 0.520 5.327 <0.0001
Figure (5): Female patients 29 years old p3 NVD 33 weeks admitted at emergency room, by premature rupture of
membrane history of preterm labor in the last delivery by measuring fetal zone enlargement = 0.59 and patient delivered
< 7 days from admission.
DISCUSSION
Preterm birth (PTB) remains a major cause of
perinatal morbidity and mortality worldwide.
Compared with term deliveries, early PTB (< 34 weeks
gestation) carries a 7-fold increased risk of neonatal
death. Following PTB, survivors can experience
significant long-term cognitive, behavioral, emotional,
sensory, and motor deficits. (7)
.
The studies conducted for long years focused on
the assessment of maternal responses of the maternal
mechanisms responsible for the etiology of premature
labor. However, in clinical cases like preterm labor with
raised fetal stress, the assessment of clinical results of
hypothalamic-pituitary-adrenal axis, hormonal
structures perpetuating this axis and this hormone
stimulation recently become important. The focal point
of this study, FZ of the fetal adrenal gland produces the
precursors of the steroid hormones transforming into
estrogen and other cortisol derivatives in the placenta.
Fetal cortisol increases placental corticotropin-releasing
hormone (CRH) and causes the release of PGE2 and
PGF2α of the placental endogenous birth labor different
than the pituitary corticotropin releasing hormone.
Considering the site of cortisol production reaching
maximum levels in circulating maternal blood at 34-
36th weeks of pregnancy under the rules of adaptation
to fetal stress with estrogen; one will see that the
increase in FZ width of the preterm cases is an expected
7. https://ejhm.journals.ekb.eg/
1717
result (3, 11)
.
In this study, we compared 29 preterm labor
cases with 37 cases of spontaneous delivery at term.
Though they seem to be the same in respect of
mechanism and fetal response, preterm and term labors
are actually far from being similar particularly when we
consider the anatomical responses to hormonal effects
like increment in depth of fetal adrenal gland.
FZD/TGD ratio was higher in preterm birth group,
compared to the term birth group (P < 0.001).
Examining the entire risk factors of preterm labor, all
the reasons except for maternal age and ethnic origin
contribute to the environment of a difficult intrauterine
fetal growth and development. While this environment
implies a mechanism of severe stress adaptation, the
lack of such features in a term fetus accounts for the
difference between the two comparisons.
The results obtained in our study propound that
the ultrasonographic assessment of fetal adrenal gland
and fetal zone enlargement may be beneficial for the
cases presented with preterm labor symptoms. We think
that these assessment results may provide rapid
administration and treatment facilities with real
indications for the patient groups admitted with preterm
labor symptoms. For instance, one may encounter the
fact of the implementation of unnecessary treatments as
cerclage, tocolysis and steroids in cases of increased
fetal zone enlargement.
The fetal adrenal gland volume in the risky
group as an unusual method for preterm labor; fetal
adrenal gland volumes of the deliveries before 37th
week, as an indicator of hypothalamic-pituitary-adrenal
functioning were assessed by three-dimensional
ultrasonography. Fifty three patients with preterm labor
symptoms and 73 cases without symptoms were
included in this study. Corrected adrenal gland volume
for estimated fetal weight was measured and 422
mm³/kg was set as limit value. The probability of
delivery within 5 days of the cases exceeding this value
was statistically significant (1)
. In another study of the
same group, corrected adrenal gland volume for
estimated feta weight, fetal zone enlargement of adrenal
gland and cervical length were assessed by two and
three dimensional ultrasonography. The ratio between
whole gland depth and central fetal zone depth, vaginal
ultrasound assessment of cervical length data and
specificity and sensitivity of prediction of preterm labor
of corrected fetal adrenal gland volume measurements
within 7 days, were elaborated here, as in our study. As
a result of 7-day follow-up of fetal zone enlargement
independent from obstetrical history and tocolytic
treatment, specificity and sensitivity levels were higher
compared to the other two methods in respect of ending
in preterm labor (1)
.
Agarwal et al. (12)
highlighted that fetal adrenal
gland biometry and elastography of the antenatal cervix
are beneficial in prediction of preterm birth. The
correlation between SWS of the cervix, trans-abdominal
(TA) cervical length, and fetal adrenal enlargement is
also demonstrated with the relative difference in their
levels of accuracy. Also, they showed that FZE of both
adrenal glands are in agreement with each other. Hence,
this eliminated the ambiguity in adrenal gland selection
and found that cAGV was higher in preterm deliveries
with 67% sensitivity and 76% specificity at cut-off
value of 415 mm3
/kg (p < 0.001), while enlargement of
the fetal zone of the adrenal gland showed 90%
sensitivity and 80% specificity at cut off value of
47.7%, shear wave speed was 96.7% sensitivity and
87% specificity at cut off value of 2.87 (m/s) and
cervical length was 63% sensitivity and 47% specificity
at cut off value of 2.0 (cm).
Ibrahim et al. (13)
compare the diagnostic
accuracies of 3D ultrasound measurements of cAGV
and FZE as predictors of PTB with those of the currently
recommended PTB prediction tests, such as ultrasound
measurements of the CL and cervicovaginal fetal
fibronectin (CVFF). Moreover, this was the first study
to compare the above parameters in women who
presented only with threatened PTL after excluding
women with PROM to restrict the final statistical
analysis entirely to the process of PTB. The sensitivity
and specificity of CL as a predictor of PTB within 7
days of enrollment were 81.5% and 56.2 % respectively,
along with 51.2 % PPV and 84.4 % NPV. The role of
the short cervix in PTB pathogenesis is controversial.
The sensitivity and specificity of CVFF as a predictor
of PTB within 7 days of enrollment in this study were
74.1 and 68.8 % respectively, with 57.1 % PPV and 82.5
% NPV. While, a cAGV of ≥ 405 mm3
was associated
with the highest sensitivity (92.6 %) and specificity
(95.8 %), as well as higher PPV (92.6 %) and NPV (95.8
%), compared to those of FZE (92.6 and 89.6 %
respectively) and CL (81.5 and 56.2 % respectively).
Guler et al. (2)
compared the diagnostic
accuracies of ultrasound measurements of CL and FZE
as predictors of PTB. 29 preterm labor cases compared
to 33 cases of spontaneous delivery at term. FZD/TGD
ratio was higher in preterm birth group compared to the
term birth group (P < 0.001), while P value of cervical
length was 0.27. This study propound that the
ultrasonographic assessment of fetal adrenal gland and
fetal zone enlargement may be beneficial for the cases
presented with preterm labor symptoms.
The results obtained in our study propound that the
ultrasonographic assessment of fetal adrenal gland and
fetal zone enlargement may be beneficial for the cases
presented with preterm labor symptoms. We think that
these assessment results may provide rapid
administration and treatment facilities with real
indications for the patient groups admitted with preterm
labor symptoms. For instance, one may encounter the
fact of the implementation of unnecessary treatments as
cerclage, tocolysis and steroids in cases of increased
fetal zone enlargement (Figure 5).
8. https://ejhm.journals.ekb.eg/
1718
CONCLUSION
2D ultrasound evaluation of the fetal zone is a
noninvasive clinical tool, which holds promise to
change the clinical practice and management of PTB.
Two-dimensional measurement of the depth of the
adrenal fetal zone offers the potential to accurately
predict PTB within 7 days.
Abbreviations:
AUC: area under the curve
cAGV: corrected adrenal gland volume
FGR: fetal growth retardation
FZ: fetal zone
FZD: fetal zone depth
FZD: fetal zone enlargement
NPP: negative predictive value
PPV: positive predictive value
PTB: preterm birth
PROM: premature rupture of membrane
TGD: total gland depth
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