Medpulse International Journal of Gynaecology

Medpulse International Journal of Gynaecology

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  • Publisher: MedPulse Publishing Corporation
  • Country of publisher: india
  • Date added to EuroPub: 2019/Nov/07

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  • Language of fulltext: english
  • Time from submission to publication: weeks

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  • Year open access content began: 2017
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This journal has '192' articles

Incidence of PCOS in epileptic women on Valproic acid

Incidence of PCOS in epileptic women on Valproic acid

Authors: Sharvari V Jadhav, Vikramsinha K Jadhav
Year: 2017, Volume: 3, Number: 1
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Abstract

Epilepsy is the most common neurological disease among people of all ages, including women of reproductive age. It is affecting about 50 million in the world and about 50% of them are women. By definition, it is characterized by recurrent (two or more) epileptic seizures that are not provoked by any factor. To study the incidence of PCOS in epileptic women taking valproic acid for treatment. This cross sectional study was carried out to find the incidence of PCOS among epileptic women. between July 2017 to December 2017. It is suggested that obesity and associated hyperinsulinemia contribute to the development of polycystic ovaries and hyperandrogenism in WWE who use VPA therapy

Keywords: PCOS, epilepsy
Evaluate immediate post-placental intrauterine contraceptive device (IPPIUCD) insertion by ultrasonography and clinical follow up

Evaluate immediate post-placental intrauterine contraceptive device (IPPIUCD) insertion by ultrasonography and clinical follow up

Authors: Khetrabasi Subudhi, Abhishek Kujur
Year: 2017, Volume: 3, Number: 1
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Abstract

Aims and Objective: To evaluate immediate post-placental intrauterine contraceptive device (IPPIUCD) insertion by ultrasonography and clinical follow up. Method: This study was conducted in the department of Obstetrics and Gynaecology, MKCG Medical College, Berhampur, Odisha from November 2014 to October 2016. Immediate post placental intrauterine contraceptive device (IPPIUCD i.e. CuT-380A) was inserted after vaginal delivery and during caesarean section and followed up till 6 weeks of insertion. USG performed at 24 hours and follow up at 6 weeks both clinically and by performing USG. Results: Out of 580 patients 62.8% received IPPIUCD after VD and 37.2% after caesarean section. USG done after 24 hours and IUCD’s >10 mm from fundus seen in 19.5% cases. 65.2% cases came back for follow up. Expulsion rate at 6 weeks was 9.8% and seen more in VD group and in multipara. Menorraghia in 16.7% cases and more in VD. Pain abdomen at follow up seen in 12.6% cases and similar in both VD and CS groups. Infection at 6 weeks was 2.1%. Expulsion rate was more with infection (57.1%).Expulsion rate(8.2%) and pain abdomen(74.4%) was higher with misplaced cases. At 6 weeks, misplaced IUCD’s seen in 5.5%. 93.2% at 6 weeks had properly placed IUCD’s. Removal rate was 8.5%. The leading causes for removal were menorrhagia, pain abdomen(4.4%,3.2% respectively). Conclusion: IPPIUCD (CuT-380A) is a highly acceptable contraceptive. No complications like uterine perforation, infection, pregnancy in situ occurred during the study and follow up period. Clinical and USG are the important methods for evaluation. It is beneficial for both clients and service providers. IPPIUCD is an important, useful, safe, convenient, highly acceptable, long acting, doesn’t affect tlactation and highly efficacious, temporary contraceptive method after delivery.

Keywords: IPPIUCD, EXPULSION RATES, MISPLACED IUCD, CuT-380A.
Study of clinical and pathological correlation of AUB patients undergoing hysterectomy

Study of clinical and pathological correlation of AUB patients undergoing hysterectomy

Authors: Bharati Misra, Subhesh Kumar Bhol
Year: 2017, Volume: 3, Number: 1
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Abstract

Objective: AUB usually occurs in perior postmenopausal age group. Causes of AUB according acronym (PALM-COEIN) by FIGO (2011). They are –polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, Ovulatory dysfunction, endometrial, iatrogenic and not yet classified. Diagnosis was by clinically, investigation, ultrasonography and confirmed by histopathology. Management can be medical, minor procedures D and C, ablative procedure andhysterectomy. Methods: AUB cases (400) examined. History taken about age, parity, clinical symptoms, duration and amount of blood loss. Information about gynaecological complains, medical diseases, hormonal, operative treatment, general examination, systemic examination done and diagnosis made. CBC, RFT, TFT and Pap smear done.USG pelvis done. Endometrium sent for HP study. Hysterectomy specimens sent for HP examination. Final diagnosis compared with clinical and ultrasonography diagnosis. Results: Maximum patients were 41-50years(41.2%).Maximum AUB were multiparous around 90 % 2nd para and above. Common symptoms were HMB51.5 %.Indications was fibroid uterus 48.25 %. Endometrial biopsy was proliferativeendometrium 47.25%. Hysterectomy by abdominal route 76.75 %. Procedure was TAH and BSO. Simple endometrial hyperplasia was commonest 55.8 %. Histopathological study specimen showed leiomyoma (39.75 %). Follicular cyst ovary 40 %. Fibroid diagnostic accuracy by clinical and Sonographymethods are 78 % and 100 %. Adenomyosis diagnostic accuracy by clinical and Sonography methods are 91.2 % and 62.7%. Conclusion: Maximum patients were perimenopausal agegroup and multiparous. Common AUB symptom was HMB. Common diagnosis was leiomyoma. Diagnosis confirmed by USG and histopathology. Common endometrial patterns was proliferative. Common finding was simple endometrialhyperplasia in perimenopausal ages and complex hyperplasia in postmenopausal ages. Hysterectomy remains definite treatment in AUB patients.

Keywords: Heavy menstrual bleeding, Abnormal uterine bleeding, Hysterectomy, Histopathology study, Fibroid, Adenomyosis, Dysmenorrhea
Maternal and perinatal outcome in instrumental vaginal delivery

Maternal and perinatal outcome in instrumental vaginal delivery

Authors: Qurram Khan, P. E. Bhingare, S N Gadappa, S S Kamath
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Amidst the continuing critical interest surrounding the ancient art of instrumental delivery an attempt is being made to study the current institutional status of instrumental vaginal delivery, and its maternal and neonatal outcome. Aims and Objectives: 1) To study the incidence of instrumental vaginal deliveries as practiced for the common indications. 2) To study the outcome of instrumental vaginal deliveries. Material and Methods: This was a prospective interventional study conducted in the study period of 2 Years. Women were recruited only after a written informed valid consent and the mode of attempted instrumental vaginal delivery was in accordance to the operator’s analysis and judgment, Observation: 1) Maximum Women belong to 20-24 age group 2) 79.5% instrumental vaginal delivery were in primigravida women. 3) Incidence of instrumental vaginal delivery was 1.05%. 4) Foetal distress was the commonest indication both in forceps and vacuum group. 5) The success rate of instrumental vaginal delivery was 95.4%. 6) Episiotomy extension was the commonest complication noted in 10.9% of cases. 7) At one minute 29% babies had Apgar score <7. superficial mark, retinal hemorrhage, hyperbilirubinemia were common neonatal morbidity. 8) NICU admission rate was 10.9%. Conclusion: Instrumental vaginal delivery has an on going role in modern obstetrics and is safe and effective mode of delivery in the hand of trained obstetrician when used at right time and with correct technique.

Keywords: vaginal delivery
Prevalence of hypothyroidism in patients with provisional diagnosis of dub

Prevalence of hypothyroidism in patients with provisional diagnosis of dub

Authors: Sanghamitra Mohapatra, Susanta Kumar Behera
Year: 2017, Volume: 3, Number: 1
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Abstract

Objective: DUB accounts for 10% of all the gynecology related problems. This study is conducted to evaluate and detect the thyroid dysfunction in patients with dysfunctional uterine bleeding in all age groups especially in menorrhagic patients and to refer positive cases to the physician for the further management of thyroid disorder. Methods: This prospective study consisted of 100 women who presented with menorrhagia to the out-patient department of OBG at MKCG Medical College Berhampur, Odisha, which is a tertiary level hospital, over a period of two years from Sept. 2014 to oct.2016.These patients were categorized as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid based on thyroid profile. Results: In the study conducted, 20% were detected with thyroid disorders of which subclinical hypothyroidism was most prevalent (11%), 8% had hypothyroidism and 1% had hyperthyroidism. Conclusion: There is a high prevalence of thyroid disorders in cases clinically diagnosed as DUB. In our study 20% of the patients detected with thyroid disorder were treated medically which was more accurate and cost effective. Hence the biochemical evaluation of T3, T4, TSH is extremely important, valuable and should be made mandatory in cases of DUB to detect thyroid dysfunction thereby avoiding unnecessary surgery.

Keywords: Menorrhagia, dysfunctional uterine bleeding, hypothyroidism, hyperthyroidism, subclinical hypothyroidism.
Study of evaluation of puberty menorrhagia

Study of evaluation of puberty menorrhagia

Authors: Lakshmi Rachkonda, Savita Kadam, Swati Shiradkar
Year: 2017, Volume: 3, Number: 1
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Abstract

Puberty menorhagia is defined as excessive bleeding occurring between menarche and 19 years of age. Onset of menstruation is influenced by many factors like genetic, nutrition, body weight and maturation of hypothalamic pituitary ovarian axis. A study was conducted in MGM Medical College and Hospital, Aurangabad between October 2013 to October 2015. 52 adoloscents with complaints of menorrhagia were studied regarding their age, relation of bleeding in reference to menarche, socioeconomic status. The duration and type of symptoms was assessed along with investigations

Keywords: Menorrhagia, Puberty, Anovulatory cycles, adolescent, PCOS, Hypothyroidism.
A comparative study of occurrence of anaemia in pregnancy among the tea-tribe communities and non tea-tribe communities attending Assam medical college and hospital, Dibrugarh

A comparative study of occurrence of anaemia in pregnancy among the tea-tribe communities and non tea-tribe communities attending Assam medical college and hospital, Dibrugarh

Authors: Deepa Borgohain, Himangshu Malakar
Year: 2017, Volume: 3, Number: 1
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Abstract

Objectives: To determine the occurrence of anaemia of pregnancy and common types of anaemia in tea tribe and non tea tribe communities attending Assam Medical College and Hospital, Dibrugarh. Methods: 200 anaemic pregnant women over 20 weeks of gestation attending AMCH OPD or labour room were divided into 2 groups of 100 patients each; Group A with women from tea tribe and Group B from non tea tribe communities. Proper history, thorough clinical examination and necessary investigations were carried out. Severity and common types of anaemia, relation of anaemia in pregnancy with different demographic variables and antenatal checkups; duration of onset of labour, neonatal outcome, occurrence of LBW and stillborn babies were studied in both groups. Results: Most common type of anaemia in both the groups was iron deficiency anaemia. Mean haemoglobin level in Group A patients was lower (7.31±1.83 g%) as compared to Group B patients (8.41±1.41 g%), p value<0.0001. Occurrence of severe anaemia was much higher in Group A patients (38%) as compared to Group B patients (10%). Mean number of antenatal checkups was much lower in Group A patients (1.83±1.28) as compared to that of Group B patients (2.92±1.18). In both the groups, anaemia is more common among lower socioeconomic class and those with low educational status (p<0.0001). Mean gestational period of onset of labour was lower in Group A patients (36.17±2.92 weeks) as compared to Group B patients (37.72±1.80 weeks);p<0.0001. Mean birth weight of babies from tea tribe communities was much lower (2.34±0.61 kg) than the other communities (2.7±0.46 kg), p value 0.0007. No statistical significance was found in stillbirths from both communities. Conclusion: Severity as well as outcome of pregnancy was much worse in pregnant women of tea tribe communities as compared to non tea tribe communities.

Keywords: Anaemia in pregnancy, tea tribe communities
Etiological factors for development of pelvic organ prolapse in a rural medical college hospital in north-east Bihar: A retrospective case-control study

Etiological factors for development of pelvic organ prolapse in a rural medical college hospital in north-east Bihar: A retrospective case-control study

Authors: Swapan Kumar Kundu, Sekhar Chakrabarti, Arpan Chatterjee, Soumyajyoti Kundu
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Pelvic organ prolapse (POP), including anterior and posterior vaginal prolapse, uterine prolapse, and enterocele, is a common group of clinical conditions affecting millions of women. Objectives: The aim of the case-control study was to identify etiological factors predictive for development POP and to determine the relationship between these factors and stage of POP. Methods: In a case-control study, 240 patients with primary POP and 308 women without POP were included. Age, parity, smoking, body mass index (BMI), menopause, and hormone replacement therapy (HRT) were investigated. Result: Independent risk factors for POP included age over 70, parity higher than 3, and menopause. Age, parity, menopause, and HRT were significantly associated with stage of POP. Genital hiatus (GH) and perineal body (PB) showed a significant positive and negative correlation with age and parity, respectively. Menopause and HRT were also associated with them. Conclusion: Age, parity and menopause are possible risk factors of POP and associated with the lengths of GH and PB in POP women. Further, these etiological factors and HRT are significantly correlated with the severity of the disease

Keywords: Pelvic organ prolapse; etiological factor; Stage.
Prediction of fetal outcome in high risk pregnancy with a modified biophysical profile

Prediction of fetal outcome in high risk pregnancy with a modified biophysical profile

Authors: Tara Sweta Arya, Rashmi Thapa
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Assessment of fetal well-being is important to arrive at timely diagnosis of fetal compromise and management to achieve optimal perinatal outcome. The modified biophysical profile (MBPP),combining Non stress test (NST) and the amniotic fluid index (AFI), is easier to perform and less time consuming. The present study was undertaken to study the effectiveness of modified biophysical profile in predicting perinatal outcome in high risk pregnancy cases. Material and Methods: 100 high risk pregnant women of more than 32 weeks attending the antenatal outpatient clinic or admitted to the ward were evaluated with the modified biophysical profile consisting of NST recording for 20 mins, followed ultrasound assessment of amniotic fluid volume, using four quadrant technique. Results: All 9 cases with both parameters abnormal had thick meconium stained liquor. When both parameters (NST and AFI) were normal 2 patients had APGAR score of <7, when both parameters were abnormal, 7 patients had APGAR score of <7.When both parameters were normal, perinatal morbidity was present in 39% cases, when both parameters were abnormal 100%cases had perinatal morbidity. Discussion: The BPP is a well-established method for antepartum fetal well-being evaluation. It can be used as a primary antepartum fetal surveillance test to predict perinatal outcome and provide timely intervention in high risk pregnancies.

Keywords: Modified biophysical profile, Non stress test, amniotic fluid index, perinatal morbidity, high risk pregnancy
Histopathological analysis of uterus and appendages following total abdominal hysterectomy

Histopathological analysis of uterus and appendages following total abdominal hysterectomy

Authors: Tara Sweta Arya, Sneha Bhushan
Year: 2017, Volume: 3, Number: 1
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Abstract

Background: Hysterectomy is the most commonly performed gynecological surgical procedure. Histopathological examination helps in justifying the indications to perform this major surgery and is of utmost important in patients with genital cancer. This study was aimed at histopathological analysis of uterus and appendages following total abdominal hysterectomy. Material and Methods: A total of 110 cases of total abdominal hysterectomies conducted over a period of one year and histopathological analyses of uterus and appendages was done. Results: The age group of 41-50 years was the commonest age group (58%) undergoing the surgery. The most common clinical presentation was excessive irregular or frequent bleeding problems 68 (61.8%) followed by pain abdomen 32 (29.1%).On Histopathological examination, the commonest pathology was found to be Leiomyoma in 49.1% (n=54) followed by Adenomyosis (25.45%).The clinical diagnosis correlated well with histopathological diagnosis. Discussion: Histopathological analysis of the hysterectomy specimens should be a mandatory procedure, even if the gross appearance is normal. It also provides a correlation with the clinical and preoperative diagnosis and leads to appropriate management in the postoperative period.

Keywords: Abdominal hysterectomy, histopathology, leiomyoma.
Ruptured rudimentary horn pregnancy: A case report

Ruptured rudimentary horn pregnancy: A case report

Authors: Amod Mahajani, Preeti Mahajani
Year: 2017, Volume: 3, Number: 1
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Abstract

True incidence of uterine anomalies is not known. Mullerian duct anomalies occur in 2-3% of all women but can be as high as 10–15% while the incidence of unicornuate uterus is 0.4%. Unicornuate uterus with Rudimentary horn is found when one mullerian duct fails to elongate while other develops normally. In class II American Fertility society Classification Unicornuate uterus associated with horn is divided into communicating and non - communicating type. Although the percentage of Rudimentary horn pregnancy is rare, the risk of maternal morbidity & mortality is high

Keywords: Mullerian duct anomalie, rudimentary horn of uterus, laparotomy.
Etiology and management of intrauterine fetal death

Etiology and management of intrauterine fetal death

Authors: Mitali Madhusmita Dash, Ritanjali Behera
Year: 2017, Volume: 3, Number: 2
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Abstract

Aim: To study the aetiology and management of intrauterine fetal death. Methods: This was a prospective study carried out in MKCG medical college and hospital over a duration of 21months. Results: There were 721 cases of intrauterine fetal death, out of 15,755 deliveries during the study period giving rise to a still birth rate of 45.76. 66% were in the age group 21-30 yrs. 50.5% were in their first pregnancy.46.87%, 35.92% belonged to SES class IV and V respectively. 80.9% cases were unbooked. 54.64% cases were preterm. Aetiological factor could be ascertained in 79.82% cases and no cause could be explained in 20.18%cases. PIH and its complications accounted to a maximum of 16.22% cases followed by severe anaemia (12.34%) and abruptio placentae (11.37%). Rupture uterus (6.51%) was most common intrapartum cause of stillbirth. 58% were males and 42% were females. Fresh still born (55.1%) were more than macerated still born (44.9%).61.30% weighed 2500grams or less. Conclusion: The common associated risk factors of IUFD like PIH and its complications, severe anaemia in our community can be prevented with early booking, regular ANC and health counselling. Intrapartum complications accounted 14.96% cases of stillbirth which could have been prevented with early diagnosis and timely referral. Identification of High risk pregnancies and referral to higher centre may save many babies.

Keywords: IUD, Stillbirth
Effect of hypocaloric diet and home based exercises in improving fertility in polycystic ovarian syndrome patients

Effect of hypocaloric diet and home based exercises in improving fertility in polycystic ovarian syndrome patients

Authors: Sharon Deepthi Rasquinha, Richard Santosh Martis, Victor Rasquinha
Year: 2017, Volume: 3, Number: 2
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Abstract

Background: Polycystic ovarian syndrome (PCOS) is a complex heterogeneous endocrine disorder. It is a common disorder affecting 4-12% of women of reproductive age. Aims and Objectives: To Study effectiveness of Exercise for the management of infertility in the patients of PCOD. Methodology: After the permission of Institutional ethical committee this prospective study was carried out. 61 women who diagnosed PCOS at the Department of OBGY of a tertiary health care during the one year period i.e. January 2016 to January 2017 were included into study. Those who want to participate the exercise program for six month were included in Study group (n=29) the women who were not willing to participate in the exercise program were enrolled in control group (32). All the women completed the study without any complications. For hirsutism ferriman-gallwey semi quantitative scoring was used and for Acne Global acne grading system 13 was calculated The data was analyses at 6mnoth period after treatment. The statistical analysis paired t-test and chi-square test was applied. Result :Variables of Control and study group were significantly differed i.e. Average Body weight (kg) 83.64 ± 3.12, And 74.96 ± 1.32 (t = 13.89, df = 59, P<.0001), Average BMI (kg/m2)-33.85 ± 1.11, 27.85 ± 1.24 ( t = 20.10, df = 59, P<.0001, Average Waist circumference (cm)-101.23 ± 2.92, 95.12 ±1.34 (t=19.34, df = 59 P<.001), Average Hirsutism score-19.13 ± 4.65, 12.43 ± 2.54 (t=11.2,df = 59 P<.01). Menstrual history of Control and Study group differed significantly, Average Number of menstrual cycles 4.92 ± 1.21 and 7.92 ±1.1 (t = 10.09, df = 59, P<0.001). Amenorrhea, Oligomenorrhea, Regular cycles was of control and study were 31.03%, 51.72 %, 0.0% and 37.5%, 20.68%, 62.5% respectively.( χ2=21.13,df=2,P<0.001). Fertility parameters studied by Ultrasound like average Antral follicle count in Study group i.e. (AFC) 13.1 ± 3.62 was significantly more in control group i.e. 8.92 ± 4.72. (t=11.22, df = 59, P<0.001), but Total ovarian volume (CC) was not differed in the two groups i.e. 13.12 ±6.52, 12.92 ± 5.82 respectively in control and study group. Effect of Clomiphene in two different groups; Average Ovulation per treatment cycle differed significantly in control group i.e. O.42± 0.13 as compared to study group 1.62 ± 0.23 (t=9.23 df = 59, P<0.01), but the pregnancy outcome like Pregnancy loss among patients who conceived were good in study group i.e. 3/14 (21.42%) as compared to 3/4 (75%) but this is not statistically significant ( χ2=1.969, df=1,P<0.1606). Conclusion: It can be concluded from our study that the 3 month home based aerobic exercise program significantly improved the fertility parameters like average Antral follicle count, Average Ovulation per clomiphene treatment cycle, More no of Regular cycles of menstruation also the parameters like Average Hirsutism score. Average Body weight, Average BMI, Average Waist circumference were significantly reduced. So from our study we recommend 3 month home based aerobic exercise program for the improvement of PCOS symptoms.

Keywords: PCOD/PCOS (Polycystic Ovarian Disease/Syndrome), BMI, Hirsutism score, Average, Acne Score.
Acardiac fetus in a triplet pregnancy: A rare case report

Acardiac fetus in a triplet pregnancy: A rare case report

Authors: Kalavati Jaju, Pravin Mundada, Shivprasad Mundada
Year: 2017, Volume: 3, Number: 2
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Abstract

Acardiac twinning is a rare complication of monozygotic multifetal gestation is that is thought to be the consequence of twin reversal arterial perfusion syndrome. In our case and an acardiac fetus in a triplet is presented. This case was undiagnosed triplet pregnancy. Despite advances in diagnostic modalities and prenatal case, many times the complications associated with multifetal pregnancies may remain undiagnosed. Complication are more with monochorinic twin gestation due to placental sharing “twin reversed arterial perfusion sequence or “ acardiac twin” is one such complications . this case report presents an antenatal undiagnosed diachorionic diamniotic, monochorionic diamniotic triplet pregnancy this case report present an antenatally undiagnosed monochorionic pregnancy, resulting in preterm delivery of healthy normal two babies along with an acardiac acephalus fetus.

Keywords: Acardiac acephalus, monochorionic, twin reversed arterial perfusion. Triplets
Sonographic prediction of gestational age: Accuracy of BPD and FL in term pregnancy in predicting gestational age

Sonographic prediction of gestational age: Accuracy of BPD and FL in term pregnancy in predicting gestational age

Authors: Mangala B Rudrawadi, Mahananda Melkundi
Year: 2017, Volume: 3, Number: 2
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Abstract

Background: Predicting gestational age is the most important part of obstetrical management, ultrasound at present is the best available tool for obtaining certain fetal parameters that correlate with gestational age. Aims and Objectives: 1) To evaluate the usefulness and accuracy of fetal growth monitoring by comparing a fetal femur length, biparietal diameter in predicting gestational age. 2) Comparison of gestational age as obtained by BPD and FL with the known gestational age as got from LNMP. Materials and Methods: The study was conducted in Basweshwar Teaching and General Hospital and Sangameshwar hospital attached to M R Medical College Gulbarga between September 2012 to September 2013. 100 women at term were selected by simple random sampling technique after considering all inclusion criteria in the study. Term pregnancy, Single fetus with vertex presentation with absence of any maternal disease were included in the study. Congenital malformation, Multiple pregnancy, Malpresentation and IUGR were excluded in the study. Conclusion: Femur length proves to be a more reliable parameter than biparietal diameter in predicting the gestational age at term.

Keywords: Gestational age, fetal biometry, pregnancy, ultra sonography

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