Background: Placental thickness appears to be a promising parameter for estimation of gestational age of the fetus due to steady increase in placental thickness with gestational age. Aim of the work: To investigate the relationship between placental thickness and fetal outcome in patients with intrauterine growth restriction [IUGR]. Patients and Methods: This study included patients with fetuses diagnosed clinically and by ultrasound as IUGR [estimated fetal weight <10 th percentile for gestational age], singleton pregnancy, gestational age between 28-40 weeks of gestation, maternal age between 20-40 years old and body mass index between 18-30 kg/m 2. The placental thickness was measured at the second and third trimesters and correlated with the fetal outcome. Results: Results revealed that, estimated fetal weight significantly increased in normal placenta when compared to either thin or thick placentae. In addition, thin placentae had significantly low fetal birth weight [1936.4±409.2] when compared to thick placentae [2236.4±410.1] or normal placentae [2636.4±421.4]. Also, Apgar score was significantly higher and need for NICU admission were significantly lower with normal placentae. In addition, there is significant positive correlation between 3rd trimester placental thickness and fetal birth weight, placental weight and APGAR score. Conclusion: Placental thickness could predict deviations from norms of birth weight in late pregnancy. It seems to be promising for estimation of gestational age of the fetus and predicting fetal outcome.

Background: Evidence exist indicating that, trace elements could play a role in preeclampsia [PE]. However, controversy exist regarding the role of the value of trace elements supplementation on the pregnancy outcome. Aim of the work:To estimate serum levels of some trace elements [selenium, calcium, magnesium, iron and zinc] in females developed preeclampsia and compare them to healthy pregnant females and correlate it with pregnancy outcome.Patients and Methods: 140 females were included in each group [preeclampsia and controls]. All had been assessed clinically, and by laboratory and ultrasound investigations. In addition, serum levels of selenium, calcium, magnesium, iron and zinc, had been determined and correlated with pregnancy outcome.Results: There was statistically significant increase of all trace elements in preeclamptic when compared to control groups. There was significant increase of females with deficient zinc, iron, calcium, magnesium and selenium in PE when compared to control group [83.6%, 19.3%, 30.7%, 27.9% and 40.0% vs 22.9%, 5.7%, 4.3%, 2.9% and 5.0% respectively]. The odds ratio where higher for zinc, followed by selenium, magnesium, calcium and finally iron deficiency. In addition, zinc, iron, calcium, magnesium and selenium were inversely and significantly correlated with systolic blood pressure. Preeclampsia was associated with worse maternal-fetal outcome when compared to controls. Conclusion:Lower levels of studied trace elements are associated with development of preeclampsia and we assume that, supplementation by such elements could reduce the risk of preeclampsia. However, this assumption needs to confirmed in future trials.

Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.

Introduction and Aim: An accurate determination of gestational age (GA) is crucial to the management of all pregnancies, particularly high-risk pregnancies. This study aimed to comparing between the accuracy of ultrasonographic fetal kidney length and Transcerebellar diameter in GA determination in third trimester. Patients and methods: The study was a cross sectional one, carried out at the department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. The study had been performed between January 2021 and January 2022. All were submitted to a detailed history, routine antenatal investigations, general and obstetrical examination. Then, measurements of all fetal biometric parameters were recorded using a real- time, grayscale, 3.5–5.0 MHz curvilinear array transducer. Results were compared to the gestational age determined by last menstrual period. Results: The patient age ranged between 18 and 37 years, their weight ranged between 55 and 109 kg, while gravidity ranged between 1 and 5 and parity ranged between 0 and 4. The GA as determined by last menstrual period (LMP) was ranged between 28 and 40 weeks. The calculated GA by different measurements were also included and they were around the same measurements as determined by LMP.  This was confirmed by the absent statistically significant difference between GA by LMP and any of calculated gestational age by any method. The mean fetal kidney length is more accurate in determination of gestational age than transcerebellar diameter (96.3% vs 89.8%) and both were significantly correlated with other calculated gestational ages. Conclusion: The length of the fetal kidney length proportionately correlated with fetal gestation age with powerful correlation coefficient. Fetal kidney length is found to be more accurate in GA determination than transcerebellar diameter (TCD).

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