Aim: To see the predictability of the shear wave elastography assessment of placental elasticity (kpa) for early detection of hypotrophic fetuses Design: Cross sectional comparative.300 single tone pregnancies previously diagnosed as normal and hypotrophic fetuses were included, the placental elasicity assessed by shear wave elastography of both groups and compared. Methods: We took biometric measurements and Doppler indicis of the uterine, umbilical, and middle cerebral arteries in both groups and screened them for grayscale and colour doppler ultrasonography. The placental elasticity was measured by Shear wave elastography in these groups .The comparison of strain ratios between these groups were done. Statistical analysis was carried out using the Mann-Whitney test. By plotting ROC curves, cut-off values for elasticity were analysed. On Shear wave elastography measurements, the sensitivity and specificity and diagnostic accuracy of hypotrophic fetuses were planned and developed. Results: The mean placental elasticity in hypotrophic fetuses and normal group was 28.71 ± 7.28 and 5.64 ± 1.53 respectively while the median placental elasticity in IUGR group was 27 ± 7 and 5.50 ± 2 with statistically higher median in hypotrophic groups, p-value < 0.001. Conclusion: In hypotrophic fetuses, as placental stiffness values are much higher, therefore for early detection of compromised hypotrophic fetuses , as a non-invasive, supplementary tool to gray-scale and Doppler, the Shear-wave elastography can be used. Keywords: Hypotrophic fetuses, Shear-wave elastography, Placental Elasticity (kpa), IUGR, Uterine artery, Umbilical artery, Middle cerebral artery, resistive index, pulsatility index,

Background: Hypertensive disorders are an important medical problem of gestation. Hypertensive disorders of pregnancy (HDP) are a significant cause for maternal and fetal morbidity as well as mortality. Intrauterine growth retardation (IUGR) commonly describes the condition of fetus whose size or growth is subnormal. IUGR fetus is frequently described as symmetrical and asymmetrical IUGR in term of their body proportions. Asymmetric growth retardation is typically linked to uteroplacental inadequacy. Hypertension is one of the maternal causes of placental insufficiency. Aim: To compare head circumference and abdominal circumference ratio in normotensive and patients with pregnancy induced hypertensive disorders after 28 weeks of gestation. Methodology: A cross sectional analytical study was carried on 113 pregnant females in which 57 women were normotensive and 56 women were hypertensive. All individuals were scanned by two- dimensional ultrasound following 28 weeks of pregnancy to evaluate sonographic parameters HC and AC. The HC/AC ratio was estimated by dividing head circumference with abdominal circumference. Results: Out of 57 normotensive patients 27 (36.48%) fetuses were diagnosed with IUGR having HC/AC ratio more than 1, while 30 had normal HC/AC ratio. In 56 hypertensive patients 47(63.51%) fetuses were diagnosed with IUGR having HC/AC ratio greater than 1, however 9(23.07%) fetuses had HC/AC ratio within normal range. So out of total 113 patients, 74 fetuses were found with IUGR while 39 fetuses had HC/AC ratio within normal ranges. Our study found that a cut off value of ≥ 1.0974 for HC/AC ratio could be used as diagnostic parameter in predicting IUGR. Conclusion: HC/AC ratio is a useful parameter for the detection of IUGR. Keywords: Head Circumference, Abdominal Circumference, Intra Uterine Growth Retardation

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Objective: Comparison of Placental Elasticity and different spectral Doppler indices in normal and intrauterine growth restricted fetuses to establish efficacy of shear wave elastography in early detection of Intrauterine Growth Restricted (IUGR). Design: Cross sectional comparative. 290 pregnant women previously diagnosed by ultrasound as normal and intrauterine growth restriction fetuses which were included in this study, placental elasicity in both groups was evalauted by SWE (shearwave elastography) and compared. Methods: Primarily both groups were scanned for grayscale and Color Doppler ultrasonography in which we took the measurements of resistivity and pulsatility indices of umbilical artery (UA), uterine artery and MCA (middle cerebral artery). In these groups placental elasticity was evaluated by SWE .The ratios of strain were compared between both groups. Statistical study was carried out by using Mann-Whitney test. Cut-off values for elasticity were analyzed by plotting receiver operative characteristic curve (ROC), sensitivity. Specificity and DA (diagnostic accuracy) for IUGR were designed established on Shear wave elastography measurements. Results: The mean placental elasticity in intrauterine growth restriction (IUGR) and in normal groups was 28.71+7.28 and 5.64+1.53, respectively while in the IUGR group median placental elasticity was 27+7 and 5.50+2 with statistically elevated median among patients in the IUGR group (P

Ovarian biophysical profile refers to assessment of ovaries to produce a successful conception and implantation environment. The ovarian scoring system for reproduction comprises the following parameters, taken in mid-cycle: ovarian volume, follicular size, and ovarian artery Doppler flow Resistive index and pulsatility index. Objective: To determine the diagnostic accuracy of sonographic transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as gold standard. Material and methods: The study comprised women visiting the department with diagnosed infertility for treatment during the period of two years. A total of 550 cycles were inducted primarily referred for ovarian assessment by ultrasound with patent tubes and normal utero-ovarian morphology. All those women having no conception with normal semen analysis of their husbands. Male factor infertility was also excluded. Baseline transvaginal sonography (TVS) was performed at proliferative phase, of the cycle. Mature follicles were studied by TVS. On an individual basis, the following parameters, that is, follicle size, ovarian volume and ovarian artery Doppler Pulsatility index, Resistive index were studied. Follicle size and ovarian artery Doppler flow were highly significant for a pregnancy. Results: The Ovarian biophysical profile was determined by applying the ovarian scoring system for reproduction (OSSR). In this research we compare infertile females with fertile. Out of 550 patients 243 (44.18%) patients were infertile and 307 (55.82%) were normal were discussed, as for as the primary infertile females were 99 (18.00%) and secondary infertile females were 144 (26.18%) and normal were 307 (55.82%). Out of five hundred and fifty cycles 331 woman had a perfect ovarian biophysical profile score of 10. The mean score of fertile was 9.39 ±1.56 and in infertile female was 7.05±2.55. The p- values <0.001. The sensitivity and specificity of ovarian biophysical profile at cut off value 1is 100% and 0.04%. The sensitivity and specificity of ovarian biophysical profile at cut off value 8 it can be consider to rule out in future with 85.3% and 63.8% respectively. Conclusions: Ovarian scoring system for reproduction (OSSR) can prove to be a simple, diagnostic and authentic score to predict the ovarian environment and thereby helping in the prediction of the outcome in infertility. Six out of the nine parameters were found to be high score to predict a pregnancy all by themselves, but these parameters needed expertise and better instrumentation for evaluation. Of the remaining three parameters, two was same or equal on an individual basis and one was found to be not significant.