The abnormal Doppler result usually precedes the appearance of abnormal BPP. The abnormal Doppler result helps to identify the fetus at risk that needs further surveillance.

Objectives:To compare transvaginal sonography for cervical length measurement and digital examination for Bishop score assessment in women undergoing labor induction at term. Patients and Methods:A prospective study involved 140 women subjected to induction of labor. Preinduction assessment of Modified Bishop score and transvaginal ultrasound measurement of cervical length was done. Results:One hundred and forty nulliparous women had CL <28 mm and modified Bishop score of ≥7; 84.8% (123/140) of them delivered vaginally and (17/140) delivered by cesarean section Analysis of the ROC curves for cervical length and Modified Bishop score indicated that both were predictors of Successful vaginal delivery (area under the curve 0.766 vs. 0.728; with optimal cutoffs for predicting Vaginal delivery of ≤ 18 mm for cervical length and Bishop score >7. Cervical length had superior sensitivity (83.74% vs. 65.4%) and marginally better positive (95.4% vs. 94.1%) and negative (37.5% vs. 21.8%) predictive values. Conclusions:Transvaginal sonography for cervical length measurement is better tolerated than digital examination for Modified Bishop score assessment.

Background. Scoliosis is a common problem among neuromuscular disorders with increased incidence of morbidity and mortality. The management of neuromuscular scoliosis (NMS) is complex and requires a cooperative multi-disciplinary team to provide meticulous perioperative care. Conservative treatment, such as bracing, can delay but not replace surgical correction. However, surgery has the risk of higher perioperative complication rates in this patient population. Aim. It is a retrospective study to evaluate clinical outcome, approaches, pitfalls in management of NMS patients undergoing surgical correction. Materials and methods. We retrospectively evaluated patients with NMS who underwent surgery for scoliosis from 2004 to 2018. Sixty-eight patients were included in the study after meticulous preoperative checkup. In most cases an single-pedicle screw construct was used, but in a few others a hybrid construct was used. A follow up was performed to make a clinical and radiological assessment and recorded all measurements and any complications. A telephone questionnaire was used for functional evaluation and patient/parent satisfaction with surgery. Only 52 patients could participate in the questionnaire. Results. The mean follow up period was 43.28 months, and the mean age at the time of surgery was 14.29 years. The mean preoperative Cobbs angle was 71.7, while that of final follow-up was 34.6. The mean Cobbs correction percentage was 53.25%. For correction of fixed pelvic obliquity 15, a sacropelvic extension was done in 60.29% of cases. Complications occurred in 39.71% of operated cases; chest related in 36.11% (of all complications), hardware-related 16.67%, visceral complications (as paralytic ileus) in 13.89%, decubitus ulcer and delayed wound healing in 13.89%, deep wound infection in 8.33%, CNS complications (as status epilepticus) in 8.33%, and death in 2.78% (one case). The results of the questionnaire indicated favorable functional outcomes and patient/family satisfaction with surgery. Conclusion. Despite the perioperative difficulties seen in patients with NMS, patients who had relatively higher postoperative morbidity and mortality, most patients/parents were satisfied with the results of the spinal deformity surgery. The patients/parents would recommend surgery to other patients with similar disorders.