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Evaluation of Effect of Pregnancy on the Size of Spleen during Pregnancy on Ultrasound

Submitted to:
Ma’am Saba
Submitted by:
Ridaba Mashmoom
Roll no:
21007
Discipline:
BS(Hons) R.I.T
Department:
Allied Health Professionals
Government College University Faisalabad

Introduction:
Medical imaging is a term of non-invasive methods that enable radiologist to look inside the body. It replaces the need for surgery and allow medical professionals to view organs and areas. It has become essential for all medical conditions and diseases. Off all modalities ultrasound is one off the imaging modality to see internal structures. Ultrasound use sound waves of high and low frequency that produce from the transducer and that place on the body surface like skin, vagina, rectum. It is the safest modality for pregnancy as compared to other modalities like CT. The use of ultrasound in pregnancy is very common because of its simple in use and can be repeated in many times. It can be used in any stage of pregnancy. Beckmann C, et al, 2005 It is used to see fetus and its growth. It is also used to find out the fetuses in number in pregnancy. It is frequently use in pregnancy because there is no evidence of its harmful effect on fetus. Ultrasound is also used to measure the size of organs like liver spleen uterus size etc. Here ultrasound is used to measure the spleen size during pregnancy because of its non-ionizing radiation. Spleen is the bean shaped structure. Spleen is the organ upper far left part of the abdomen to the left of the stomach. It is under the diaphragm, protected by 9th through 11th ribs, in the mid-back. Normal splenic weight is 150 grams. Spleen play a multiple role in the body. It is used to filter blood. Spleen is a part of immune system. Red blood cells that are old are recycled in spleen. Platelets and white blood cells are restored in spleen. When spleen is removed then our immune system become weak or compromised. In human body normal spleen size is 11cm (4.3 inches) in its longest dimension. In 1983, work on normal splenic size, liver and portal vein on ultrasound had done. Niederau C, et al, 1983. In 1995, assessment was done for splenic volume. Rodrigues AJ, et al, 1995. In 1999, splenic size measured through autopsy. Loftus WK, et al, 1999. In 2010 work had done in Rajasthani population for the normal measurement of spleen and liver. Mittal R, Chowdhary DS, 2010. Spleen size varies between people. In 2002, patient who had thrombocytopenia undergo study of measurement of spleen volume. Marco P, et al, 2002 In 2006 spleen size measurement in collegiate athletes had done. Hosey RG, et al, 2006. In 2005 splenic size measured in tall healthy athletes. Spielman AL, et al, 2005. Normal pregnancy that is a physiological condition which produce changes in various body’s system. In 2008 work had done on maternal changes. Morrafi D, et al, in 2008. In pregnancy many pathological diseases occur in females. These pathological diseases may cause enlargement of spleen. Work had done to prove the pathological diseases in pregnancy that was the reason for enlarging of spleen Morrafi D, et al, in 2008 Kimberly D, et al, in 2002 Tamayo SG, et al, in 1993. In 2013 spleen anomalies also studied. Yildiz AE, et al, 2013. In 2002, comparison of ultrasound and CT in measurement of splenic size had conducted. Lamb PM, et al, 2002. In 2006, maternal spleen size on ultrasound measured throughout pregnancy. Maymon R, et al, 2006. In 2015 splenic volume measured in relation with body parameters in Jordanian population. Burdan H, et al, 2015. In 2016 spleen dimension measured in adult of North-Western Nigeria. Yahuza M.A, et al, 2016. Much work on spleen had been conducted but the work on the effect of pregnancy on spleen need consideration.

Objective:
The aim of conducting this is that in Pakistan there is less work on spleen in pregnancy. That’s why I will conduct this research in our region. I will conduct this to confirm that there will be effect of normal pregnancy on spleen size or not in this region. If pregnancy affect the size of spleen then what will be the change value of size of spleen.

Material and Methods:

Study area and sample size:
Cross-sectional study will be conducted on 150 normal pregnant females for measuring the spleen size in Mailsi district Vehari. Pregnant females will be chosen randomly in government hospital Mailsi (THQ). This study will be conducted in period of 4 months.
Machine:
Real time imaging will be used. Gray scale ultrasound machine that will have a transducer of 3.5-5 MHz frequency fitted with it.
Patient Preparation:
First history of the volunteer will be taken. Volunteer will be asked to drink water before scan. Volunteer height and weight will be measured before scan. Consent form will also be taken. Ask the volunteer about her gestation week. Parity will be asked to the volunteer.
Method:
All examination will be done in supine position. Deep inspiration will be required during examination. Length of spleen will be measured by placing a transducer in longitudinal position. Length of spleen will be measured from the dome to the tip of the spleen. After that splenic shape, position and echotexture will be seen. Mean will be calculated and then percentage will find out. After that data will be arrange in pie chart, or bar or frequency tables etc. For analyzing the data software will be SPSS. Calculate the values and p value will be significant for consideration.

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