Background: Fetal biophysical profile is a well-established method of antepartum surveillance in high risk pregnancy. Classical biophysical profile with all parameters (fetal breathing movements, fetal tone, fetal gross body movements, amniotic fluid volume and non-stress test) needs two phase testing by ultrasound and external Doppler monitor to record fetal heart rate, is more cumbersome, time consuming and expensive.Methods: This study was a prospective clinical study which consisted of 70 patients having pregnancy with high risk factors. The patients were evaluated with the modified biophysical profile consisting of NST recording for 20mins, followed ultrasound assessment of amniotic fluid volume, using four quadrant technique.Results: When the Modified biophysical profile is normal, it gives reassurance that the fetal status is good with good perinatal outcome. When the MBPP is abnormal there is increased incidence of perinatal morbidity as well as mortality.Conclusions: Modified biophysical profile is an effective primary antepartum fetal surveillance test in high risk pregnancies in predicting perinatal outcome.

Background: The aim of this study is to know the association between the meconium stained amniotic fluid and its association with the perinatal outcome.Methods: All the patients coming to present hospital for delivery with meconium stained liquor during the study period were included in the study.Results: 163 cases with meconium stained liquor (MSAF) were included in the study, 124(76.1%) and 39(23.9%) had thin and thick MSAF respectively. Among these cases, thick MSAF was more associated with high fetal heart rate (FHR) variability (p value- 0.030), associated with increased rate of operative interference (64.1%; p value- 0.001), abnormal Apgar score (p value-0.003 at 1min and 0.001 at 5min) and increased neonatal intensive care unit (NICU) admission (33.3%; p value - <0.001).Conclusions: Present study showed that thick meconium is associated with more complications like increased operative interference, birth asphyxia, meconium aspiration syndrome, low Apgar score, prolonged NICU stay and overall increased perinatal mortality compared to thin meconium stained liquor. As the gestational age increased the incidence of meconium increased and a greater number of thick meconium had abnormal CTG.

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Background: Preterm birth possess a major health burden to the society due to its long -term morbidity, perinatal mortality and high financial expenditures associated with it. Transvaginal ultrasonographic measurement is an effective and objective way of measuring the cervical length. Cervical length <25 mm is considered as the best cervical parameter with a good predictive accuracy for preterm birth. This study was taken up to study the role of cervical length measurement in predicting preterm labor by Trans vaginal sonography (TVS) and to measure cervical length and follow up cases to study the fetal outcome. Methods: Sagital long-axis view of endocervical canal along the entire length was obtained with high frequency endovaginal probe and the length of cervix from external to the internal os was measured. Atleast three measurements were obtained and the best shortest measurement in millimeters was recorded. Transfundal pressure was applied for 15 seconds and cervical length was obtained again. The cases are followed till delivery and outcome is noted. Results: Out of 134 study group of low risk women, 5.9% women and 50% of the women with short cervical length (<25 mm) had preterm birth. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of our study are 75%, 95.2%, 50%, 98.4%, 94% respectively. Among the 134 newborns, majority of the admissions (14) were due to birth asphyxia followed by meconium aspiration syndrome. Conclusions: TVS is a useful technique in assessing the cervical changes during pregnancy and predicting the preterm birth especially when performed between 16-24 weeks of gestational age could identify all the women having short cervical length along with other changes of cervix.

Advanced abdominal pregnancy is a rare event occurring once in every 25,000 births. We report a case of advanced abdominal pregnancy misdiagnosed as placenta previa. 28-year-old G4P3L3 was referred to us on 31 Jan 2008 with history of 8 months of amenorrhea and intermittent pain abdomen. Examination revealed an apparent uterine size of 34 weeks gestation with the fetus in transverse lie. Ultrasonography revealed a single live intrauterine pregnancy of 32 weeks with transverse lie with central placenta previa with oligohydramnios. She was treated conservatively. After 13 days of hospital stay, she complained of loss of fetal movements. Ultrasonography revealed an intrauterine death with transverse lie and central placenta previa. In view of central placenta previa, she was taken up for LSCS. A dead fetus of 2.1 kg of term maturity was present in the amniotic sac in the abdominal cavity. The placenta was attached around the left fallopian tube. The left ovary was also embedded in the placenta. Right-sided fimbriectomy with left-sided adenexectomy was done, removing the placenta along with adenexa. Postoperative period was uneventful.