Objective: To investigate the variations in normal Doppler indices of the portal vein during the post-operative period following living donor liver transplantation (LDLT).
Methodology: This retrospective cohort study was carried out at Pakistan Kidney and Liver Institute and Research Centre from July 1 to December 31 2021. It included all adult patients over 16 years of age who underwent Living Donor Liver Transplant (LDLT). Triplex Doppler ultrasound of LDLT recipients was performed intraoperatively and postoperatively for 5 consecutive days. Subsequent scans were performed at 2 weeks, 4 months, and 6 months after the transplant. Portal vein velocities were taken at the extrahepatic part, anastomosis, and intrahepatic part. Statistical analysis was performed using SPSS version 20.
Results: The study involved 91 patients, with ages ranging from 17 to 73 years and a mean age of 44.9 years. Among the recipients, 79% were male and 21% were female. The portal venous velocities varied between 31 cm/s and 357 cm/s. All patients had antegrade portal venous flow. The portal venous velocities normalized within 4-6 months following LDLT.
Conclusion: A wide range of portal venous velocities can be encountered following LDLT without clinically significant outcome and these usually normalize within 4-6 months following LDLT.
Background: Amniotic fluid index (AFI) is a key element in fetal biophysical profile that predicts pregnancy outcome especially near term in primigravidae. The objective of the study was to determine a reference range of AFI in primigravidae of a local population having gestational age from 37 to 42 weeks.
Methodology: This study was carried out from January 2019 to December 2019 after approval from Institutional Review Board and Ethical Committee at Shifa International hospital, Islamabad, Pakistan. Applying inclusion and exclusion criteria, a sample of 272 was selected. AFI was calculated for each subject using ultrasound and recorded on a data collection sheet. For the sake of simplicity and clinical relevance, the population was further stratified as term pregnancy (gestational age 37-39 weeks) and postdates pregnancy (40-42 weeks). The reference range of AFI was then calculated using mean ±two standard deviations.
Results: The reference range of AFI for gestational age of 37-42 weeks (population as a whole) was 6.8- 17.2 cm. For term pregnancy, it was 7.5- 17.5 cm, and for postdate pregnancy, it was 5.8 to 15.4 cm.
Conclusion: The reference range of AFI for gestational age of 37 to 42 weeks in Primigravida women was 6.8 to 17.2 cm. There is a decreasing trend in AFI as pregnancy advances from term to postdate.
Keywords: Amniotic Fluid Index, Gestational age, Primigravida, Reference Range.
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