Neonatal adrenal abscess is a rare condition. Bilateral adrenal abscess are extremely rare. We present this case focusing on the usefulness of needle aspiration under ultrasonographic guidance. The bilateral suprarenal cystic masses are identified by ultrasonography and different sequences of magnetic resonance imaging.

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Objective: To determine the best predictor of fetal hypoxia amongst the color Doppler indices resistivity index(RI), pulsality index(PI) and systolic/ diastolic (S/D) ration of umbilical artery (UA), middle cerebral artery(MCA), descending abdominal aorta (DAA), MCA/UA PI ratio and abnormal flow pattern, absent end diastolic flow/reverse end diastolic flow (AEDF/REDF) in umbilical artery and descending abdominal aorta, in prediction of adverse perinatal outcome in normal and intrauterine growth retardation (IUGR) fetuses with or without pregnancy induced hypertension (PIH). Material and Method: 100 women with normal Singleton pregnancies and 100 women with IUGR with or without PIH or both were prospectively examined with Doppler Ultrasonography of the umbilical artery, middle cerebral artery & descending abdominal aorta and perinatal outcomes was evaluated in relation to their indices and compared with each other. Observation: In study group sixty four fetuses (64%) had one major or minor adverse perinatal outcome in comparison to control group which had only 6% adverse perinatal outcome. In study group premature delivery was 46%, lower segment cesarean section (LSCS) was 38%, and perinatal death was 22%. Fetuses with absent end diastolic flow/reverse end diastolic flow (AEDF/REDF) in umbilical artery and descending abdominal aorta had 100% perinatal mortality. Conclusion: Umbilical artery SD Ratio (cut off ≥3), middle cerebral artery / umbilical artery PI < 1.08, AEDF / REDF abnormal flow pattern in umbilical artery and descending abdominal aorta were found to be the best Doppler indices for prediction of adverse perinatal outcome in women with PIH and IUGR.

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BACKGROUNDThe growth of the human fetus is a complex process resulting in an increase in size over time and has been the subject of extensive study. Before the advent of ultrasound evaluation, physicians interested in the growth process of the fetus could only look at the infant at delivery and infer as to what happened in utero. Based on these observations, clinicians were able to categorize fetuses in very general terms on the basis of their age and size. In the second and third trimester of pregnancy the fetus has grown sufficiently in size, so that extreme anatomic details are visualized by ultrasonography. There are a number of structures that can be identified and measured during this time, but the basic foetal measurement we have used to estimate age with ultrasound are-biparietal diameter (BPD) and femur length (FL). The ultrasonographic examination comprised of recording of, Biparietal Diameter (BPD) and Femur Length (FL). The foetal growth parameters i.e. BPD and femur length FL of every patient were measured serially using real time ultrasonographic examination. RESULTSThe means of all measurement were tabulated and were compared individually with western normograms. CONCLUSIONThe accuracy of the individual parameter for different weeks of gestation was noted. This accuracy indicated that, the correctly diagnosed gestational age by sonographic parameters are not equally homologous with known menstrual age. The specificity and sensitivity of BPD and FL was found to be more appropriate in predicting gestational age in second trimester and its reliability decreases in third trimester. KEYWORDSBiparietal Diameter (BPD) and femur Length (FL); Ultrasonography (USG). HOW TO CITE THIS ARTICLE:Khare S, Mandle H, Chatterjee M, et al. Estimation of gestational age by real time ultrasonography (biparietal diameter and femur length) to estimate the foetal morphometry in II and III trimesters. J. Evid.