No abstract

Androgens are converted to estrogens by the enzyme called aromatase. This process called aromatization is inhibited by a group of drugs called aromatase inhibitors (AIs). Letrozole is a nonsteroidal inhibitor that reversibly binds aromatase. Decrease in circulating estradiol level leads to release of negative feedback at hypothalamus pituitary level, thereby increasing follicle stimulating hormone (FSH) secretion resulting in stimulation of growth of ovarian follicles. Letrozole is well tolerated and is used in different protocols of ovarian stimulation. The extended spectrum of uses includes addition with gonadotrophins in poor responders, ovarian hyperstimulation syndrome (OHSS) prevention, fertility preservation in cancer patients. Due to its wide range of use, easy availability, affordability and good tolerability, Letrozole has emerged as a first line drug for ovulation induction.

Background: Accurate diagnostic tests to identify fetuses at risk for in-utero death or injury have long been an important goal for obstetricians and perinatologists. Umbilical Artery Doppler and biophysical profile score are two tests available for antepartum fetal surveillance.Methods: The study consisted of 100 patients with either presence of PIH (30) or IUGR (28) or both (42). Testing was begun was at 33 weeks. UAD was performed; S/D, RI and PI indices were calculated. Fetal BPS was determined.Results: Fetal weight was estimated to be less than 2kg in last scan was 23.52% cases in pih/ iugr group versus 6.4% in controls whereas incidence of oligohydramnios was 29.5% versus 91.17% respectively, and number of babies admitted to NICU was 11.47% versus 70.58% respectivelyConclusions: Doppler and biophysical studies can greatly help in arriving at an appropriate strategy for management.