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What Is Antenatal Hydronephrosis?
Antenatal hydronephrosis is the condition that occurs in the fetus during pregnancy. The condition is characterized by enlargement of the kidney due to the accumulation of fluid. Antenatal hydronephrosis indicates various renal disorders in the fetus. found more in males as compared to females. The condition is It is found in 0.5 percent of females and 1 percent in males. Fortunately, in almost all the case, other organs are not affected due to antenatal hydronephrosis.
How Is Antenatal Hydronephrosis Diagnosed?
Antenatal hydronephrosis is diagnosed through various methods. Some diagnostic techniques involve advanced equipment and may not be available at al the centers for diagnosing this condition. Most cases of antenatal hydronephrosis are found during a routine ultrasound at around 20 weeks gestation period.
Following are the methods to diagnose antenatal hydronephrosis:
Laboratory testing: Evaluating the urine sample of the fetus may help in identifying kidney dysfunction or renal dysplasia. Through the ultrasound-guided technique, the urine sample of the fetus is obtained. In the case of a healthy fetus, the urine so formed is hypotonic. However, in a diseased condition, the urine obtained is isotonic. Increased level of calcium, sodium, Microglobulin, and chloride indicates possible renal dysplasia.
Ultrasonography: Ultrasonography was the first diagnostic method that helped in identifying hydronephrosis in the fetus. It also helps in identifying the possible cause of accumulation of fluid in the kidney.
Magnetic Resonance Imaging: Magnetic resonance imaging during pregnancy provides more detailed condition and provide important insight into the severity of the disease. Once the severity is identified, optimum medical interventions can be designed.
Other additional procedures: The procedures that can help in diagnosis include amniocentesis, chromosomal analysis, maternal serum biochemistry, and chorionic villus sampling.
What Are The Various Grades Of Antenatal Hydronephrosis?
The grades of antenatal hydronephrosis are determined by the Antero-posterior diameter (APD) of the renal pelvis. The diameter is evaluated through ultrasonography. The grades or classification of antenatal hydronephrosisis done as mild, moderate and severe.
Following are the various grades for antenatal hydronephrosis:
Almost 57–88% of the antenatal hydronephrosis is mild while 10 to 30 % of the cases are of moderate grade. 2–13% of the cases of antenatal hydronephrosis are severe.
Antenatal hydronephrosis is caused due to the following conditions:
Ureteral obstruction or blockage: This obstruction may be either
Ureteropelvic junction obstruction (UPJ) or ureterovesical junction obstruction (UVJ) or megaureter. The UPJ obstruction is indicated when there is a dilation of the pelvic-calyceal system without any ureteral dilation.
Renal anomalies: Generally, only a single ureter drains the urine from a kidney. However, in almost 1 % of the humans, there are two ureters originated from a kidney. This duplication does not cause any complications in the majority of patients. In approximately 1 in 1500 infants, there is an obstruction in the upper tube.
Urethral obstruction: Urethral obstruction in the fetus may also lead to antenatal hydronephrosis.
Vesicoureteral reflux: When there is the backflow of urine from the ureter and bladder towards the kidney, the urine does not flow properly and gets accumulated.
Polycystic Kidney: Due to the complete obstruction of the ureter, one of the kidneys is not normally developed. The other kidney functions normally and the baby usually born with a multicyclic kidney.
If there is a prolonged obstruction of urine and increased pressure, this may cause a progressive reduction in kidney function. Medical interventions may reduce the pressure and allow the kidney to function but may not be able to regain the lost function.
No intervention is required in antennal hydronephrosis due to various reasons such as lack of technology for accurate diagnosis, non-identification of the definite reason for the fluid accumulation, and no strong data corresponding to safety and efficacy of medical/surgical interventions. However, a follow-up is required during the post-natal period in infants with varying degrees of antenatal hydronephrosis.
#Postnatal Management Of Hydronephrosis#Polycystic Kidney#antenatalhydronephrosis#AntenatalHydronephrosisDiagnosed
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#best pediatric urologist in india#best pediatric urologist surgeon in india#phimosis surgery cost in india#best hypospadias surgeon in india#buried penis correction#renal pelvis in fetus#when to see a urologist for bedwetting#Pediatric Surgery#Pediatric Urosurgery India#Low Cost Pediatric Urology Surgery India#Types of Pediatric Surgeries in India#Pediatric Urology Details in India#Affordable Price Pediatric Urology in India#Best Pediatric Urology Surgery in India#Benefits of Pediatric Surgery in India
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Committed Care For Children's Urological Issues In India Through Laparoscopy Surgery
Committed Care For Children’s Urological Issues In India Through Laparoscopy Surgery
Pediatric Urology Surgery: Overview
Pediatric urology is diagnosis and treatment of the congenital and the acquired urological conditions & diseases in children. The pediatric urologists cure conditions of male reproductive tract and the female urinary tract. Urinary tract consists of organs that filter blood and form urine, tubes that carry urine from kidneys, and organ that stores urine, and…
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Pregnancy Pillow: A Wise Pregnancy Investment
The notion of sleeping on your left side also helps blood to flow around the placenta, too as stop the weight of the foetus from pushing documented on your renal system. How is a new mom to sort it out? Preparing a list of being pregnant and breastfeeding supplies it doesn't break the actual can be practiced with a little help. Here are a couple pointers to get started. The symphysis pubis is the bones meet at the front side of the pelvis. Ligaments hold these bones together. These joints are not meant to let you for movement, but whenever a woman becomes pregnant, they'll move permit for for infant to undergo. A hormone called relaxin is released naturally to loosen the ligaments to let movement during birth. Symphysis Pubic Dysfunction occurs when these ligaments are loosened too much and too rapidly. The extra weight on the pelvis definitely makes the pelvis move and may cause mild to severe problems. The U shaped pillows are also called as a corner and belly body pillows. They seem in order to all the bases by means of comes to a total bed sheets. The thing overall performance is that the size of these pillows typically big, or very leading. If that precisely what you aspire for and also have an excessive bed, this might because the choice to be able to. They have a lot of versatility too and could be used assist you you sleep in whatever position feels safe for you. Whether its neck, back hip or leg discomfort, could certainly maneuver these pillows a number of ways in order to choose a sleep inducing comfy position. Healthy Sleeping: Doctors suggest that pregnant women sleep over their side, specifically their left side. Why is this? The side sleeping position is the healthiest position for mothers-to-be. It primarily in order to do an issue weight for the growing unborn child. When a woman sleeps on her back, complete weight of your uterus and fetus rest on the spine. In order to booth backaches and impeded blood flow to the placenta. Pregnancy Body Pillow| body piloow | best body pillows is best to be used starting brand-new trimester. Is usually hard for just a person that undergoing pregnancy to have any sleep in any of factors positions - on her back, or one her side, and pretty much definitely she cannot sleep for my child stomach. Growing growth of the baby as well as the uterus causes problems for that woman as sleeps. The best pregnancy pillow was engineered to get you started. It's a regular occurance that best of luck that been recently created has some issues. But, don't let the negative issues stop you from using the application. If you can come up with a in order to deal with it, then it won't turn into a problem you.
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Ultrasound Scan center near Sarjapur road Bangalore - addon scans and labs
We addon scans and labs are best in Diagnostic Services and Health Check-ups in a most safety way and with extreme Guidance. We are located at Sarjapur road Bangalore to provide the best Diagnostic Services and Health Check-ups for you and your loved ones.
Visit add-on scans and labs for Ultrasound Scans:
Ultrasound scans creates images of the interior of the body by using sound waves.
It helps to diagnose the causes of pain, swelling, and fever in the body's internal organs, as well as examine a pregnant woman's baby and an infant's brain and hips.
But as positive, ultrasound scans are totally safe, non-invasive and it does not use ionizing radiation.
add-on scans and labs offer best ultrasound scans in Bangalore and are identical with quality and customer service with high safety.
We offer the following scans:
Whole abdomen and Pelvis Scan
Transabdominal Pelvis Scan
Transvaginal Pelvis Scan
Follicular Scan
Pregnancy Scans
· Early Pregnancy Scan(6weeks-10weeks)
· NT & NB Scan (12weeks-13weeks)
· Anomaly Scan/TIFFA (18weeks-22weeks)
· Fetus Growth Scan/Biophysical profile(28weeks-32weeks)
· Term Scan(34weeks-37weeks)
· Fetal Doppler study
· Fetal Echo(22weeks-24weeks)
· Limited study for AFI/Doppler & Cervical length
Neck Scan/Thyroid scan
Chest Scan
Musculoskeletal scan which includes Shoulder, Ankle, Elbow, Knee, and extremity scans
Soft tissue scan
Doppler study- Arterial/Venous/Renal artery/AV fistula/Carotid
Sonofistulogram for fistula
Pediatrics scan- Neurosonogram/Hip scan/Spine scan
KUB Scan
Breast Scan (Sonomammogram)
Ultrasound-guided FNAC
Preparations on Ultrasound scans:
· You have to drink at least 3-4 cups of water to fill the urinary bladder for optimum scan.
· A day before the scan, you can fast for 10 hours and eat a fat-free diet.
· You have to wear a comfortable clothing
· To reduce your precious waiting time, book an appointment
· add-on scans and labs requests to carry the doctor's appointment form as well as any latest ultrasound scan files or other health documents.
Why add-on scans and labs?
· add-on scans and labs offer male and female Radiologist for your comfort.
· As a Radiologists in this diagnostic centre, we are totally focused on services and have 30 plus years of experience.
· Offering instant reports after the scan
· We are well specialized and experienced in Pregnancy, Musculoskeletal, Doppler & General Scans
· Health Care is promised 365 days a year, with customer-friendly doctors and staff.
· Online reports will be available here
add-on scans and labs offer best ultrasound scans in Sarjapur Road, Bangalore for every individual with affordable price and high safety.
Get your First Ultrasound scan at top diagnostic centre in Bangalore.
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Antenatal Hydronephrosis Treatment In Delhi, India - Dr Prashant Jain
What Is Antenatal Hydronephrosis?
Antenatal hydronephrosis is the condition that occurs in the fetus during pregnancy. The condition is characterized by enlargement of the kidney due to the accumulation of fluid. Antenatal hydronephrosis indicates various renal disorders in the fetus. found more in males as compared to females. The condition is It is found in 0.5 percent of females and 1 percent in males. Fortunately, in almost all the case, other organs are not affected due to antenatal hydronephrosis
How Is Antenatal Hydronephrosis Diagnosed?
Antenatal hydronephrosis is diagnosed through various methods. Some diagnostic techniques involve advanced equipment and may not be available at al the centers for diagnosing this condition. Most cases of antenatal hydronephrosis are found during a routine ultrasound at around 20 weeks gestation period. Following are the methods to diagnose antenatal hydronephrosis:
Laboratory testing: Evaluating the urine sample of the fetus may help in identifying kidney dysfunction or renal dysplasia. Through the ultrasound-guided technique, the urine sample of the fetus is obtained. In the case of a healthy fetus, the urine so formed is hypotonic. However, in a diseased condition, the urine obtained is isotonic. Increased level of calcium, sodium, Microglobulin, and chloride indicates possible renal dysplasia.
Ultrasonography: Ultrasonography was the first diagnostic method that helped in identifying hydronephrosis in the fetus. It also helps in identifying the possible cause of accumulation of fluid in the kidney.
Magnetic Resonance Imaging: Magnetic resonance imaging during pregnancy provides more detailed condition and provide important insight into the severity of the disease. Once the severity is identified, optimum medical interventions can be designed.
Other additional procedures: The procedures that can help in diagnosis include amniocentesis, chromosomal analysis, maternal serum biochemistry, and chorionic villus sampling.
What Are The Various Grades Of Antenatal Hydronephrosis?
The grades of antenatal hydronephrosis are determined by the Antero-posterior diameter (APD) of the renal pelvis. The diameter is evaluated through ultrasonography. The grades or classification of antenatal hydronephrosisis done as mild, moderate and severe. Following are the various grades for antenatal hydronephrosis:
GRADING OF ANHII TRIMESTERIII TRIMESTER
Mild4-< 7 mm7 – < 9 mm
Moderate7 – ≤ 10 mm9 – ≤ 15 mm
Severe>10 mm>15 mm
Almost 57 – 88% of the antenatal hydronephrosis is mild while 10 to 30 % of the cases are of moderate grade. 2-13% of the cases of antenatal hydronephrosis are severe.
What Is The Etiology Of Antenatal Hydronephrosis?
Antenatal hydronephrosis is caused due to the following conditions:
Ureteral obstruction or blockage: This obstruction may be either Ureteropelvic junction obstruction (UPJ) or ureterovesical junction obstruction (UVJ) or megaureter. The UPJ obstruction is indicated when there is a dilation of the pelvic-calyceal system without any ureteral dilation.
Renal anomalies: Generally, only a single ureter drains the urine from a kidney. However, in almost 1 % of the humans, there are two ureters originated from a kidney. This duplication does not cause any complications in the majority of patients. In approximately 1 in 1500 infants, there is an obstruction in the upper tube.
Urethral obstruction: Urethral obstruction in the fetus may also lead to antenatal hydronephrosis.
Vesicoureteral reflux: When there is the backflow of urine from the ureter and bladder towards the kidney, the urine does not flow properly and gets accumulated.
Polycystic Kidney: Due to the complete obstruction of the ureter, one of the kidneys is not normally developed. The other kidney functions normally and the baby usually born with a multicyclic kidney.
What Are The Possible Complications Of Antenatal Hydronephrosis?
If there is a prolonged obstruction of urine and increased pressure, this may cause a progressive reduction in kidney function. Medical interventions may reduce the pressure and allow the kidney to function but may not be able to regain the lost function.
What Are The Treatment Options For Antenatal Hydronephrosis?
No intervention is required in antennal hydronephrosis due to various reasons such as lack of technology for accurate diagnosis, non-identification of the definite reason for the fluid accumulation, and no strong data corresponding to safety and efficacy of medical/surgical interventions. However, a follow-up is required during the post-natal period in infants with varying degrees of antenatal hydronephrosis.
How Postnatal Management Of Hydronephrosis Is Done?
Post-natal management of infants with moderate to severe hydronephrosis is done by identifying the cause of the condition and designing a treatment strategy. KUB ultrasound is done usually 48-72 hours after birth. Antibiotics are administered as prophylactic therapy. Before discharge, complete diagnosis, evaluation, and treatment should be provided to the infant.
What Is The Prognosis Of Antenatal Hydronephrosis?
Most fetuses with antenatal hydronephrosis have an excellent prognosis. The condition resolves on its own in many cases. The morbidity and mortality depend upon various factors such as underlying cause, or whether one or both the kidneys are affected.
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Well-Being Scans Explained In Brief
A well-being scan is often necessary to assess how your unborn baby has grown. More often than not, your obstetrician or midwife will advise you whether a Wellbeing scan is something that is necessary or not.
Well-being and growth scans are basically medical scans. The scans usually last 30 minutes or less. In this scan, they measure specific parts of your baby to confirm if there has been a normal and satisfactory growth according to what is expected from your due date.
Here are some of the specific things that will be assessed during the Wellbeing Scan at Peterborough Clinics:
Check fetal growth
Monitor anomalies with your baby (e.g. the fetal renal pelvis dilatation)
Review the findings from the prior Private Ultrasound Scan
Assess placental position
What should you expect to happen on the day?
You should book an appointment as soon as you decide that you need to get a well-being scan. When you arrive at the clinic, you will be required to provide information about your pregnancy before the sonographer takes you through the entire scanning room.
You will be required to lie straight on a table so as to expose your tummy before a clear gel is applied gently on your tummy as the sonographer gently moves the probe over the tummy and records images.
They will take your baby’s specific measurements in order to monitor its growth. Also, a vaginal scan may be conducted as this gives a view of the baby. A vaginal scan is also great if you are having a low-lying placenta.
After completing the scan, an on-site obstetrician or a radiologist will review the results you receive the report.
The purpose of Wellbeing Scans at Peterborough Clinics
The Wellbeing Scans at Peterborough Clinics is done for various reasons. Simply put, the purpose of this pregnancy scan is:
To locate what position is the placenta of your baby
To determine the lie or the presentation of your baby
To measure and identify fetal heart rate
To measure or determine the amniotic fluid index
To determine what gender is your fetus. The doctors will do this upon your request
To examine the Doppler flow of the fetus umbilical cord in order to check the placental function
To establish the current estimated weight of the fetus
To measure the fetus’ abdomen, head and femur bone so as to assess the fetal growth
So, that is basically what the process of Wellbeing scan at Peterborough Clinics involves.
#Well being scan Clinic Peterborough#Peterborough Baby Scan Packages#Fetal Health Scan Peterborough#Baby Scan Offers Peterborough
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Abdominal Pain – Medical Knowldege
Description Parietal pain: Irritating material causing peritoneal inflammation Pain transmitted by somatic nerves Exacerbated by changes in tension of the peritoneum Pain is sharp, well localized with abdominal, rebound tenderness and involuntary guarding Visceral pain: Afferent impulses result in poorly localized pain based on the embryologic origin rather than true location of an organ. Pain of foregut structures to the epigastric area Pain from midgut structures to the periumbilical area Pain from hindgut structures to the suprapubic region Distention of a viscous or organ capsule or spasm of intestinal muscularis fibers Pain is constant and colicky Inflammation: Focal tenderness develops once the inflammation extends to the peritoneum Ischemia from vascular emergencies: Pain is severe and diffuse Referred pain: Felt at distant location from diseased organ Due to an overlapping supply by the affected neurosegment Abdominal wall pain: Constant, aching with muscle spasm Involvement of other muscle groups Etiology Peritoneal irritants: Gastric juice, fecal material, pus, blood, bile, pancreatic enzymes Visceral obstruction: Small and large intestines, gallbladder, ureters and kidneys, visceral ischemia, intestinal, renal, splenic Visceral inflammation: Appendicitis, inflammatory bowel disorders, cholecystitis, hepatitis, peptic ulcer disease, pancreatitis, pelvic inflammatory disease, pyelonephritis Abdominal wall pain Referred pain: (e.g., intrathoracic disease) Diagnosis Signs and Symptoms History Pain Nature of onset of pain Time of onset and duration of pain Location of pain initially and at presentation Extra-abdominal radiations Quality of pain (sharp, dull, crampy) Aggravating or alleviating factors Relation of associated finding to pain onset Anorexia Nausea Vomiting (bilious, coffee-ground emesis) Malaise Fainting or syncope Cough, dyspnea, or respiratory symptoms Change in stool characteristics (e.g., melena) Hematuria Changes in bowel or urinary habits History of trauma or visceral obstruction Gynecologic and obstetric history Postoperative (e.g., cause ileus) Family history (e.g., familial aortic aneurysm) Alcohol use and quantity Medications: (e.g., aspirin and NSAIDs) Physical Exam General: Anorexia Tachycardia Tachypnea Hypotension Fever Yellow sclera (icterus) Distal pulses and pulse amplitudes between lower and upper extremities Abdominal: Distended abdomen Abnormal bowel sounds: High-pitched rushes with bowel obstruction Absence of sound with ileus or peritonitis Pulsatile abdominal mass Rebound tenderness, guarding, and cough test for peritoneal irritation (e.g., appendicitis, peritonitis) Rovsing sign, suggestive of appendicitis: Palpation of left lower quadrant causes pain in right lower quadrant (RLQ). Psoas sign suggests appendicitis (on right) Pain on extension of thigh Obturator sign suggests pelvic appendicitis (on the right only) Pain on rotation of the flexed thigh, especially internal rotation McBurney point tenderness associated with appendicitis: Palpation in RLQ 2/3 distance between umbilicus and right anterior superior iliac crest causes pain. Murphy sign, suggestive of cholecystitis: Pause in inspiration while examiner is palpating under liver Carnett sign indicates abdominal wall pain Pain when a supine patient tenses the abdominal wall by lifting the head and shoulders. Tender or discolored hernia site Rectal and pelvic examination: Tenderness with pelvic peritoneal irritation Cervical motion tenderness Adnexal masses Rectal mass or tenderness Guaiac positive stool Genitourinary: Flank pain Dysuria Costovertebral angle tenderness Suprapubic tenderness Tender adnexal mass on pelvis Testicular pain: May be referred from renal or appendiceal pathology Referred pain: Kehr sign (diaphragmatic irritation due to blood or other irritants) causes shoulder pain. Extremities: Pulse deficit or unequal femoral pulses Skin: Jaundice Liver disease (caput medusa) Hemorrhage Grey Turner sign of flank ecchymosis Cullen sign is ecchymotic area round the umbilicus Herpes zoster Cellulitis Rash (Henoch–Schönlein purpura [HSP]) Essential Workup For a woman in reproductive age group a pregnancy test is essential Where applicable for majority of cases, ultrasonography should be done with CT used in cases of negative or inconclusive ultrasonography. Diagnostic Tests and Interpretation Lab CBC Serum electrolytes, creatinine, and glucose ESR LFTs Lactic acid Serum lipase: More sensitive and specific than amylase Urinalysis Stool analysis and culture Pregnancy testing (age reproductive women) Imaging EKG: Consider if risk factors for coronary artery disease are present Abdominal radiograph: Supine and upright CT is superior for suspected visceral perforation and bowel obstruction. Upright CXR: Pneumoperitoneum Intrathoracic disease causing referred abdominal pain US: Biliary abnormalities Hydronephrosis Intraperitoneal fluid Aortic aneurysm Intussusception US (Doppler ultrasonography) Volvulus and malrotation Testicular and ovarian torsion Hepatitis, cirrhosis, and portal vein thrombosis Abdominal CT: Spiral CT without contrast: Renal Colic Retroperitoneal hemorrhage Appendicitis CT with intravenous contrast only: Vascular rupture suspected in a stable patient (e.g., acute abdominal aortic aneurtsn [AAA], aortic dissection) Ischemic bowel Pancreatitis CT with IV and oral contrast: Indicated when there is a suspicion of a surgical etiology involving bowel History of inflammatory bowel disease Thin patients (low BMI) Diverticulitis CT angiography: Mesenteric ischemia AAA IVP: CT has replaced the use of intravenous urography in detection of ureteral stones Barium enema: Intussusception Treatment and confirmation of intussusception is with air contrast enema. MRI: If concerns for radiation exposure or nephrotoxicity Contraindicated in patients with metallic implants Pregnancy Considerations Ultrasonography and MRI should be preferred to prevent exposure of ionizing radiation to the fetus. Differential Diagnosis AAA Abdominal epilepsy or abdominal migraine Boerhaave syndrome Adrenal crisis Early appendicitis Bowel obstruction Cholecystitis Constipation +/– fecal impaction Diabetic ketoacidosis Diverticulitis Dysmenorrhea Ectopic pregnancy Esophagitis Endometriosis Fitz-Hugh–Curtis syndrome Gastroenteritis Hepatitis Incarcerated hernia Infectious gastroenteritis Inflammatory bowel disease Irritable bowel syndrome Ischemic bowel Meckel diverticulitis Neoplasm Ovarian torsion Ovarian cysts (hemorrhagic) Pancreatitis Pelvic inflammatory disease Peptic ulcer disease Renal/ureteral calculi Renal Infarction Sickle cell crisis Spider bite (Black widow) Splenic infarction Spontaneous abortion Testicular torsion Tubo-ovarian abscess UTI Volvulus Referred pain: Myocardial infarction Pneumonia Abdominal wall pain: Abdominal wall hematoma or infection Black widow spider bite Herpes zoster Pediatric Considerations Under 2 yr: Hirschsprung disease Incarcerated hernia Intussusception Volvulus Foreign body ingestion 2–5 yr: Appendicitis Incarcerated hernia Meckel diverticulitis Sickle cell crisis HSP Constipation Treatment Ed Treatment/Procedures Nasogastric tube decompression and bowel rest IV fluids and electrolyte repletion Antiemetics are important for comfort. Narcotics or analgesics should not be withheld. Send for blood type and cross-match for unstable patient Surgical consultation based on suspected etiology Medication Fentanyl: 1–2 μg/kg IV qh Morphine sulfate: 0.1 mg/kg IV q4h PRN Ondansetron: 4 mg IV Prochlorperazine: 0.13 mg/kg IV/PO/IM q6h PRN nausea; 25 mg PR q6h in adults Promethazine: 25–50 mg/kg IM/PO/PR
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BEST INFORMATION ABOUT CONGENITAL CMV AND BIRTH DEFECTS
Cytomegalovirus, or CMV, is a very common member of the herpes family of viruses. By age 40, half of the adult population has been infected with CMV. Usually, a CMV infection is short-lived, does not produce noticeable symptoms, and afterward lies dormant in the body for life.
But what happens if a pregnant woman picks up CMV for the first time during a pregnancy, or has a recurrent infection from a previous exposure? Are there risks to the fetus? And if so, how can your healthcare provider help to minimize these risks?
In this article, we will address the birth defects associated with congenital CMV and ways to protect yourself and your growing baby. If you’d like to know more about CMV during pregnancy in general, check out our article Cytomegalovirus (CMV) Infection.
Visit us to know more about Cosmetic Surgery Vashi
Congenital CMV Birth Defects: In The Womb
Not all babies born to CMV-infected mothers develop congenital CMV, and not all that do pick up CMV will experience long-term effects. However, it is important to be aware of the risks because some of them can affect how your child will live his or her life.
What is the risk of passing CMV to my baby during pregnancy?
In general, 1 of every 150 to 200 babies in the USA is born with congenital CMV. This makes CMV the most frequent congenital viral infection. Though this seems like a large percentage of births, only 1 in 5 of these infants born with congenital CMV will experience any adverse symptoms or long-term issues.
The virus has the potential to travel through the mother’s blood and pass through the placenta, infecting the developing baby.
If you have the virus before you become pregnant: There is a very low chance of passing it to your baby. The chance heightens if you are reinfected with a different strain of the virus (see statistic below), or if you have a reactivation of the virus during your pregnancy.
If you contract the virus (primary infection) during your pregnancy: It is more likely to pass on CMV to your baby if you get a primary infection during the pregnancy than it is to pass it if you were previously infected. If you have a primary CMV infection during pregnancy, there is approximately a 40% chance of passing the virus to your baby.
The risk of transmission from mother to baby is highest if she gets a primary CMV infection in the third trimester (40-70%) and is lowest if the primary infection begins in the first or second trimesters (30-40%).
Can congenital CMV harm my developing baby?
CMV can pass to your baby at any time during your pregnancy, and any congenital CMV symptoms that are present after birth develop in the womb. So in a sense, yes, CMV can harm your developing baby.
However, the risk of death to a fetus from contracting CMV is extremely small. Doctors have witness seizures in a fetus after contracting congenital CMV, but most of these babies are able to survive and thrive well past birth.
There are quite a few abnormal ultrasound readings that may indicate a congenital CMV infection, including but not limited to:
Organomegaly (abnormal organ enlargement) – spleen, liver, and others
Abnormal dilation of lateral brain ventricles, the ureter, and/or the renal pelvis
Intracranial calcifications
Microcephaly
Placental thickening
Fetal hydrops
Ascites
Hepatic, intestinal, or periventricular echodensities
One or more of these may indicate congenital CMV; however, many of these abnormalities are linked to a plethora of other diseases or syndromes.
Congenital CMV Birth Defects: Types
Which birth defects are associated with congenital CMV? The main ways that congenital CMV can affect an infant immediately or over time are:
1. Hearing loss
2. Mental disability
3. Seizures
4. Vision loss
5. Decreased muscle strength (including cerebral palsy)
6. Decreased coordination
7. Microcephaly
However, it is important to remember that the majority of infants born with CMV do not suffer any long-term effects or ailments.
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Urogenital system
Early in improvement the ureteric bud grows out from the mesonephric duct, which later becomes the ureter, which drains urine produced via the kidneys, in which it's miles accrued inside the renal pelvis and enters both the cloaca or the urinary bladder - in the kidney the ureteric bud paperwork collecting tubules that are non-stop with the urogenital system. The usual purpose of the reproductive machine is to provide sex cells, deliver egg and sperm cells collectively, offer for the nourishment of the embryo or fetus until hatching or beginning, and to launch young from the maternal frame. The urinary and genital systems have awesome and particular capabilities. The first, the elimination of nitrogenous wastes and the upkeep of water stability; the alternative, the reproduction of species. However, due to their similar developmental origins and the sharing of commonplace structures, they're typically considered as an unmarried device.
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Time and items for pregnancy examination (11 items)
After pregnancy, pregnancy examination can detect whether the fetus is healthy in the abdomen, so it is necessary for pregnant women to be checked on time. But what are the time and items for pregnancy? First of all, we divided the whole pregnancy into three stages: early pregnancy (first weeks - twelfth weeks), second trimester (thirteenth weeks - twenty-eighth weeks) and late gestation (twenty-ninth weeks - fortieth weeks). Pregnancy testing frequency of each cycle is not the same, usually, when pregnant 5 - 11 weeks you should go to the hospital to check the frequency of the second trimester cards, for a four week in late pregnancy for every two weeks, 37 weeks later it should be once a week, until delivery. The inspection items also include routine items and special inspection items in accordance with individual circumstances.
Introductory stage in early pregnancy
Time: Fifth weeks - eleventh weeks
Check the cards
Check item: body weight, blood pressure, uterine height, abdominal circumference, edema inspection, auscultation of fetal heart, blood routine, urine routine, leucorrhea, syphilis screening etc..
The body weight, blood pressure, uterine height, abdominal circumference, edema inspection, auscultation of fetal heart and other projects are routine check.
Monitor blood pressure to see if mom will have pregnancy induced hypertension. Some pregnant women have normal blood pressure before pregnancy, but they show high blood pressure later in pregnancy. Therefore, regular production tests and blood pressure measurements each time can be controlled promptly and effectively when blood pressure is just beginning to rise. By weighing the weight of pregnant women, we can dynamically observe the health status of mother and child, so this is the necessary content for each birth examination. In early pregnancy, weight loss may decrease because of early pregnancy or poor eating.
Whether the fetus is in good condition in the uterus, fetal heart is an important indicator. The fetal heart monitor, continuous observation of fetal heart rate tracings, uterine contraction, according to the relationship between the three records of fetal intrauterine reaction reserve capacity, whether there is hypoxia and fetal distress. The initial examination of blood routine, urine routine, and leucorrhea, syphilis screening is also very important. Because pregnant women and fetuses increased metabolism, kidney burden, stimulate the impact of pregnancy, urinary tract smooth muscle tension decreased, right ureter by right uterine compression, pregnant women prone to deformity of renal pelvis nephritis, pregnancy testing urine timely response of pregnant women urinary system
In addition, if pregnant women do not have to check before pregnancy, early HIV screening and eugenics four tests in pregnancy.
Middle class in the second trimester
Time: thirteenth weeks - twenty-eighth weeks
Once every 4 weeks
Check item: body weight, blood pressure, uterine height, abdominal circumference, dropsy examination, fetal heart auscultation, urine routine, blood routine, Down syndrome screening and ECG, ultrasound examination.
In addition to routine examinations, it is also important to do down screening at this stage.
Down syndrome, namely mongolism, sporadic chromosome disease. Fetal birth after serious mental retardation, pregnancy through the blood test rate of 75 - 85%.. The disease is neither effective prevention methods, nor effective treatment methods, only through prenatal screening, early detection, timely measures. Therefore, each mother, especially the elderly, quasi mother, it is best to do a Down's screening, in order to avoid family tragedies.
The incidence of miscarriage, premature birth, stillbirth, intrauterine growth retardation, fetal distress and neonatal asphyxia were significantly higher in pregnant women with heart diseases. The electrocardiogram can reflect the cardiac function of pregnant women and timely respond to the occurrence of pregnancy complicated with heart disease. In addition, B ultrasound examination in the second trimester of pregnancy is also very important.
Now, the United States advanced GE four-dimensional color Doppler ultrasound, using four-dimensional imaging technology (4D), can visually, three-dimensional display of three-dimensional structure of human organs, and dynamic, real-time observation of three-dimensional structure. The development of four-dimensional color Doppler ultrasound examination of the fetus can display fetal face, limbs and organs of the state, even the fetus in the womb can also be observed; for fetal models, such as cleft lip, cleft palate, skeletal dysplasia can make the early diagnosis. Four dimensional color Doppler ultrasound best examination time is 26 - 28 weeks between, can achieve the best inspection effect.
Final trimester: twenty-ninth weeks - fortieth weeks
Twenty-ninth - 36 weeks, not two weeks, once a week after 37 weeks
Check item: body weight, blood pressure, uterine height, abdominal circumference, dropsy examination, fetal heart auscultation, urine routine, blood routine, pelvic examination, electrocardiogram, ultrasound, fetal monitoring. In the first 36 weeks, the movement began to decrease, pregnant women to the doctors to learn how to measure fetal heart rate and fetal movement. Regular fetal auscultation and fetal monitoring should be performed at this time. Second trimester B ultrasound examination can understand the situation of the cervix, testing amniotic fluid volume is normal, assess fetal size, etc., can be used to predict what type of delivery, ready to meet the baby's smooth birth.
The more frequent the labor, the more frequent the examination, about once a week. When the mother's heart to be careful and meticulous, close observation, always pay attention to your body what wind sways grass "". The above is Doug mom introduced the basic procedure of pregnancy test and routine project, I believe you have been pregnant pregnant mother to know, of course, specific inspection items and time according to the different circumstances of each person, arranged by the doctor to focus.
During pregnancy, regular obstetric examination, measurement of blood pressure and body weight about uterine height and abdominal circumference can be found early pregnancy complications timely correction of abnormal fetal position and found abnormal fetal development, combined with the specific circumstances of the pregnant women and the fetus to determine the mode of delivery. Can reduce the birth of deformed babies, protect the health of pregnant women, and help the normal development of the fetus.
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Antenatal Hydronephrosis Treatment In Delhi, India
What Is Antenatal Hydronephrosis?
Antenatal hydronephrosis is the condition that occurs in the fetus during pregnancy. The condition is characterized by enlargement of the kidney due to the accumulation of fluid. Antenatal hydronephrosis indicates various renal disorders in the fetus. found more in males as compared to females. The condition is It is found in 0.5 percent of females and 1 percent in males. Fortunately, in almost all the case, other organs are not affected due to antenatal hydronephrosis.
How Is Antenatal Hydronephrosis Diagnosed?
Antenatal hydronephrosis is diagnosed through various methods. Some diagnostic techniques involve advanced equipment and may not be available at al the centers for diagnosing this condition. Most cases of antenatal hydronephrosis are found during a routine ultrasound at around 20 weeks gestation period.
Following are the methods to diagnose antenatal hydronephrosis:
Laboratory testing: Evaluating the urine sample of the fetus may help in identifying kidney dysfunction or renal dysplasia. Through the ultrasound-guided technique, the urine sample of the fetus is obtained. In the case of a healthy fetus, the urine so formed is hypotonic. However, in a diseased condition, the urine obtained is isotonic. Increased level of calcium, sodium, Microglobulin, and chloride indicates possible renal dysplasia.
Ultrasonography: Ultrasonography was the first diagnostic method that helped in identifying hydronephrosis in the fetus. It also helps in identifying the possible cause of accumulation of fluid in the kidney.
Magnetic Resonance Imaging: Magnetic resonance imaging during pregnancy provides more detailed condition and provide important insight into the severity of the disease. Once the severity is identified, optimum medical interventions can be designed.
Other additional procedures: The procedures that can help in diagnosis include amniocentesis, chromosomal analysis, maternal serum biochemistry, and chorionic villus sampling.
What Are The Various Grades Of Antenatal Hydronephrosis?
The grades of antenatal hydronephrosis are determined by the Antero-posterior diameter (APD) of the renal pelvis. The diameter is evaluated through ultrasonography. The grades or classification of antenatal hydronephrosisis done as mild, moderate and severe.
Following are the various grades for antenatal hydronephrosis:
GRADING OF ANH
II TRIMESTER
III TRIMESTER
Mild
4-< 7 mm
7 – < 9 mm
Moderate
7 – ≤ 10 mm
9 – ≤ 15 mm
Severe
>10 mm
>15 mm
Almost 57 – 88% of the antenatal hydronephrosis is mild while 10 to 30 % of the cases are of moderate grade. 2-13% of the cases of antenatal hydronephrosis are severe.
Antenatal hydronephrosis is caused due to the following conditions:
Ureteral obstruction or blockage: This obstruction may be either Ureteropelvic junction obstruction (UPJ) or ureterovesical junction obstruction (UVJ) or megaureter. The UPJ obstruction is indicated when there is a dilation of the pelvic-calyceal system without any ureteral dilation.
Renal anomalies: Generally, only a single ureter drains the urine from a kidney. However, in almost 1 % of the humans, there are two ureters originated from a kidney. This duplication does not cause any complications in the majority of patients. In approximately 1 in 1500 infants, there is an obstruction in the upper tube.
Urethral obstruction: Urethral obstruction in the fetus may also lead to antenatal hydronephrosis.
Vesicoureteral reflux: When there is the backflow of urine from the ureter and bladder towards the kidney, the urine does not flow properly and gets accumulated.
Polycystic Kidney: Due to the complete obstruction of the ureter, one of the kidneys is not normally developed. The other kidney functions normally and the baby usually born with a multicyclic kidney.
If there is a prolonged obstruction of urine and increased pressure, this may cause a progressive reduction in kidney function. Medical interventions may reduce the pressure and allow the kidney to function but may not be able to regain the lost function.
No intervention is required in antennal hydronephrosis due to various reasons such as lack of technology for accurate diagnosis, non-identification of the definite reason for the fluid accumulation, and no strong data corresponding to safety and efficacy of medical/surgical interventions. However, a follow-up is required during the post-natal period in infants with varying degrees of antenatal hydronephrosis.
Post-natal management of infants with moderate to severe hydronephrosis is done by identifying the cause of the condition and designing a treatment strategy. KUB ultrasound is done usually 48-72 hours after birth. Antibiotics are administered as prophylactic therapy. Before discharge, complete diagnosis, evaluation, and treatment should be provided to the infant.
Most fetuses with antenatal hydronephrosis have an excellent prognosis. The condition resolves on its own in many cases. The morbidity and mortality depend upon various factors such as underlying cause, or whether one or both the kidneys are affected.
#Vesicoureteral Reflux#antenatal hydronephrosis#Postnatal Management Of Hydronephrosis#Treatment Options For Antenatal Hydronephrosis#Ureteropelvic junction obstruction
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