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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
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Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 6)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 5)
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Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 14)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 14  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Does folic acid reduce congenital anomalies and adverse pregnancy outcomes
           in women received long-term low dose methotrexate'

    • Authors: Ahmed M. Farag, Safaa A. Ibrahim
      Pages: 1 - 10
      Abstract: Background: Methotrexate (MTX) which is folic acid antagonist is used to treat many diseases, including rheumatic, inflammatory, autoimmune disorders or malignancies; it is also used for the medical treatment of ectopic pregnancy and termination of pregnancy. The objective of this study was to assess the impact of folic acid in preventing congenital anomalies (CAs) in the fetus of pregnant that take long-term low dose methotrexate.Methods: The study included 1569 with history of low dose methotrexate therapy <25 mg/week that stopped one month before pregnancy, they were divided into 3 groups; Group 1 comprised 272 pregnant women, Group 2 comprised 367 pregnant women both groups take folic acid 4-5 weeks preconception and for the first 12-13 weeks gestation, the dose in the 1st group was 0.4 mg/day while in 2nd Group 4 mg/day, Group 3 comprised of 930 pregnant disease-matched with no folic acid. Group 4 comprised of 1015 pregnant no underlying autoimmune and no folic acid intake.Results: The overall rate of CAs and cardiovascular CAs were higher in fetuses of Group 3 (OR: 1.7; 95% CI: 1.1-2.7) and (OR: 2.7; 95% CI: 1.4-5.2) respectively compared to the overall rate of CAs and cardiovascular CAs in other groups. Other adverse outcomes as abortion, preterm delivery, preeclampsia, placenta abruption, PROM, low birth weight, admission to NICU, IUGR and IUFD were higher in Group 3 and 4 than in Group 1 and 2. There were no significant differences in umbilical arterial PH. The Apgar scores <7 at 1, 5 min and gestational age at delivery were higher in Group 1 and 2 than Group 3 and 4.Conclusions: There was a certain reduction in methotrexate teratogenic effect on the fetuses with folic acid intake during pregnancy, these pregnancies might benefit from taking of folic acid in high doses before conception and during the first trimester of pregnancy and improvement in fetal and maternal outcomes but the explanation of this effect requires further study.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195996
      Issue No: Vol. 9, No. 1 (2019)
       
  • The knowledge, attitude, and action of Northern Iranian women about
           cervical cancer and screening

    • Authors: Ali Ahmadzadeh Amiri, Mohammad Reza Haghshenas, Amir Ahmadzadeh Amiri, Fatemeh Daneshvar
      Pages: 11 - 17
      Abstract: Background: Cervical cancer is one of the most prevalent cancers in the world among women which its early diagnosis plays an important role in the prognosis. There are many factors that contribute to the participation in the screening programs, most notably the level of knowledge and attitude of people towards cancer. Understanding the level of these factors in the female population and its association with participation in screening programs is important. Therefore, the aim of this study was to determine the knowledge, attitude and practice of women in the north of Iran to compare these factors between two groups with different baseline knowledge.Methods: This cross-sectional study was carried out among female medical clients and healthcare staff in a healthcare center in the north of Iran. All the eligible patients were interviewed and were asked to fill a questionnaire containing the demographic data, knowledge, attitude, and action about cervical cancer and screening. The data were analyzed by SPSS v24.Results: A total of 283 females entered our study of which 156(55.1%) were clients of the healthcare center and 127(44.9%) were non-physician healthcare staff. Ninety (60.8%) of clients and 39(56.5%) of the staff have performed pap smear at least once (p=0.556). The levels of knowledge and attitude were significantly lower in the clients (p < 0.001 and p=0.003, respectively). There were no significant differences regarding the level of knowledge and attitude between those who performed pap smear and those who did not (0.621 and 0.788, respectively).Conclusions: Increasing awareness, especially improving attitudes in the female population, should be the focus of the health care system to encourage more women to participate in screening programs.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195997
      Issue No: Vol. 9, No. 1 (2019)
       
  • One year observational study of stillbirths in a referral hospital of
           Saurashtra region

    • Authors: Mehul T. Parmar, Zalak V. Karena, Kruti D. Shah
      Pages: 18 - 22
      Abstract: Background: Stillbirths constitute a major part of perinatal death, and India ranks first in absolute number of stillbirths. The causes of stillbirth differ in different parts of the world and are affected by fetomaternal factors and type of antenatal and intrapartum care. The objective of this study was to evaluate the stillbirth rate as well as the aetiology and risk factors for stillbirths in our institute.Methods: All stillbirths delivered at or above 28 weeks of gestation or weighing more than 1000 gms in P. D. U. Medical College and Hospital, Rajkot during study period of 1 year were enrolled in the study. The stillbirth rate of the institute was studied. Socio-demographic, maternal and fetal factors of stillbirth cases were analysed.Results: Stillbirth rate of our institute was 41.63 per 1000 births. 70% cases belonged to rural region and 48% cases were referred to our hospital from other institutes. Stillbirth was found more in multigravida women with 67.2% cases. 57.01% stillborn babies were males, 34.71% of stillborns had extremely low birth weight and were pre-term. 54.78% stillborns were macerated. In 24.8% cases, aetiology of stillbirth was unknown. Antepartum haemorrhage contributed 19% cases, asphyxia -16.8% cases and pre-eclampsia-12.1% cases of stillbirth in our study.Conclusions: Proper screening and antenatal and intrapartum supervision and timely referral to the tertiary care centre can play an important role in decreasing the rate of stillbirths. 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195572
      Issue No: Vol. 9, No. 1 (2019)
       
  • Obstetrical outcome of pregnancy complicated with first trimester bleeding
           and subchorionic hematoma

    • Authors: Kiran Agarwal, Ritu ., Amrita Singh, Anjali Singh, Amrita Mishra
      Pages: 23 - 27
      Abstract: Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195640
      Issue No: Vol. 9, No. 1 (2019)
       
  • Impact of perioperative period on disease-free survival among carcinoma
           ovary patients treated with the interval cyto-reductive surgery at a
           tertiary cancer centre in Kerala, India: a retrospective study

    • Authors: Adarsh Dharmarajan, Vinin N. V., Chandran K. Nair, Sanjay Badesara, Kalaiselvi Selvaraj, Priya Rathi
      Pages: 28 - 33
      Abstract: Background: Global incidence of ovarian malignancies is 300,000 as per GLOBOCAN 2018. The treatment protocol for advanced ovarian malignancies (stage IIIc and stage IV) includes neo-adjuvant chemotherapy and surgery followed by adjuvant chemotherapy. Aims of the study was to determine the effect of duration of chemo interruption on disease free survival of ovarian malignancies treated by interval cytoreduction followed by surgery.Methods: A total 48 patients were studied for events such as recurrence, death, patient’s status on last follow up, peri-operative period between 3rd cycle of chemo therapy and 4th cycle of chemo therapy. Based on the median duration of peri operative period patients was classified as early or delayed receivers of adjuvant chemo therapy. Difference in duration of over-all survival and disease-free survival was analysed through Kaplan Meier survival analysis using log-rank test. Hazard ratio adjusted for background characteristics such as staging, performance status, grade of tumour were analysed using cox proportional hazard model.Results: The two peri operative period categories based on mean value (85 days) didn’t show any significant association to disease free interval (minimum-21days, maximum-146 days, Hr = 1.3, p-value = 0.52). Other established factors like stage, extent of resection, response to chemotherapy, also didn’t show any significant association. Serum marker level showed a significant negative correlation with disease free survival (minimum-9 days, maximum-30659, p-value =.04, Hr = 3.19).Conclusions: The study could not establish any correlation between peri operative period and median disease-free survival. The small sample size is a limiting factor, well controlled randomized trials may needed for further clarification.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195623
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study on prevalence of anemia in pregnancy in South India

    • Authors: Sarala V., Ushadevi Gopalan
      Pages: 34 - 37
      Abstract: Background: Anemia in pregnancy is a major health problem worldwide, especially in developing countries like India. Maternal and fetal outcomes are poor in pregnant patients with anemia. The most important cause of anemia is iron deficiency anemia which can be prevented by early oral iron supplementation.Methods: This cross-sectional study was conducted in the department of obstetrics and gynecology of our tertiary care teaching institution for a period of one year. 1290 pregnant women coming to the antenatal OPD were screened for anemia and 490 women. Patients who were not anemic were excluded. 800 patients were enrolled in the study. Each patient was interviewed using a structured interview schedule and the data obtained was analyzed.Results: The percentage of anemia in pregnant women was 62% in our study of which 40% were mildly anemic, 55% were moderately anemic and 5% were severely anemic. Maximum number of anemic women -mild, moderate and severe was seen in the age group 20-24 years. Mild and severe anemia was seen more in the secondary educated women. Maximum percentage of anemia was seen in the lower socio-economic status followed by middle and was lowest in the higher socio-economic status group. Prevalence of anemia was almost equal in primigravida and multigravidas (around 50%) but 80% of severely anemic patients were multigravida. Almost 68% took iron and folic acid tablets regularly.Conclusions: Treating anemia in pregnant women will go a long way in improving maternal and fetal outcome. Hence a future healthy younger generation can be produced. Iron tablets can be distributed at school to young girls to prevent anemia in future women.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195617
      Issue No: Vol. 9, No. 1 (2019)
       
  • Awareness, attitude and practice of contraception amongst post-partum
           women in a rural tertiary care hospital, Telangana, India

    • Authors: Nabhi V. R. Murty, Madhuri M., Vijayalakshmi G., Vasantha K., Kavitha K., Uma B.
      Pages: 38 - 43
      Abstract: Background: India was the first country in the world to start the National Family Welfare Program in 1951. But population stabilization has been a difficult target to achieve and by the year 2028, our population is expected to surpass that of China. This study was conducted among puerperal women delivered at our hospital to know their awareness about various methods of contraception and willingness to practice any of these methods.Methods: This cross-sectional interview-based study was conducted in the department of obstetrics and gynecology at Bhaskar Medical College and Hospital, Moinabad, Hyderabad from September 2015 to August 2016. The study sample were women who delivered in our hospital and a set questionnaire was used.Results: A total of 502 women in the post-partum period were included in the study.88.85% women were aware of any modern contraceptive. 30.85% of these women were aware of only the surgical method, i.e. sterilization; and another 58% women were aware of temporary methods also. Most of them knew about multiple methods, but tubectomy was the main method was known to the maximum (78%). As the literacy levels rose, awareness about temporary methods and male sterilization also increased. 70% of the study population were not aware of free availability of all these methods at Government hospitals and at our hospital.80.5% of these women were motivated after this study to accept a contraceptive method.Conclusions: There is a great unmet demand for contraception among rural women in India. Proper dissemination of the information about free availability of these methods by rural health workers, hospital staff and making these accessible in the peripheral areas of the country will help these couples. Providing oral, written and visual information to all the pregnant women at each ante-natal visit will be additional methods.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195647
      Issue No: Vol. 9, No. 1 (2019)
       
  • Maternal and fetal outcomes with the use of prostaglandins E2 as a
           cervical ripening agent for induction of labour

    • Authors: Shagun Gupta, Neha Kuntal, Virendra Kumar Gupta
      Pages: 44 - 47
      Abstract: Background: In modern medicine induction of labour is required in patients for a good feto-maternal outcome. PGE2 is a prostaglandin analogue which has been used as a cervical ripening agent to improve bishops score. Objective of this study was to evaluate the efficacy of intravaginal PGE2 gel as a cervical ripening agent in unfavourable cervix for induction of labor and any complications associated with its use.Methods: This study comprised of 90 women who required labor induction. Singleton pregnancy above 37 weeks, live intrauterine fetus, Cephalic presentation, Bishop score of 1-6, reactive FHR pattern were included. Women who required only single induction were categorized as Group 1. Those requiring more than one dose after reassessment of bishops scoring at 6, 12 and 18 hours belonged to Group 2.Results: Group1 had more of younger population below 30 years consisting more primigravidas with > 80% women having gestational age of > 39 weeks. Most common indication for induction of labour in both groups was post-dated pregnancy. 65 patients received one dose of cerviprime gel forming Group 1. In Group 2, 72% received 2 doses and 28%, 3 doses of gel. Initial bishops score mean was 4.2 in Group 1 and 4.1 in Group 2. Mean change in bishop score was analysed after 6, 12, and 18 hours of instillations of PGE2 gel. Significant p value was obtained in all groups requiring one, two and three doses of gel. In Group 1, 12.3% and in Group 2, 16% had LSCS. Maternal side effects were minimal and neonatal outcome was good.Conclusions: The study showed that intravaginal application of PGE2 is effective, safe and acceptable method as a cervical ripening agent for labor induction in women with poor bishops score. It reduces caesarean delivery rate without increasing maternal and neonatal morbidity.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195597
      Issue No: Vol. 9, No. 1 (2019)
       
  • A preliminary study on identifying specific risk factors of post-partum
           depression

    • Authors: Afiya M. Shafi, Rohit Jain, Smita Pandey
      Pages: 48 - 55
      Abstract: Background: Pregnancy and childbirth are important events in the life of a woman and also highly vulnerable period of various physiological and psychological illnesses. Several literatures propound that 22% young Indian mothers are showing depressive symptoms after delivery. The consequence of maternal depression is adverse both for mother and development of the child. Objective of this study was to examine the social and obstetric factors contributing post-partum depression.Methods: Women, 18-35 years of age, having four days to one-year postpartum period was taken from the tertiary care hospital settings. Terminal illness, still birth delivery and comorbid psychiatric illness was excluded. Screening and diagnosis of postpartum depression done based on international classification of diseases (ICD 10) using Edinburgh post-natal depression scale (EPDS). A comparative approach by the means of descriptive statistics was implied for data analysis where mothers with depressive symptoms are experimental group and non-depressed mothers were acted as the controls.Results: Study findings indicated a statistically significant association between postpartum depression and risk factors such as occupation and average social economic class, first time delivery.Conclusions: It is a preliminary study in a restricted geographical area, not covering the neurobiological risk factors of postpartum depression. Hence, the future study will focus on the large sample size in a multi areal population for assuring the accuracy of the result.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195589
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study on perception about antenatal care among primigravida attending a
           tertiary care hospital

    • Authors: Priya Somu, Sakthi Narmatha D.
      Pages: 56 - 59
      Abstract: Background: Maternal mortality rate and Infant mortality rate remains high in India when compared to several other countries. Understanding and being aware about the basic care provided during pregnancy is an important factor to make the pregnant woman to utilize the antenatal care. Hence this study was planned to assess the existing knowledge of primi gravid mothers attending the tertiary health care center about the various antenatal care services provided.Methods: This cross-sectional study was conducted among the primi gravid females attending the outpatient department of Obstetrics and Gynecology in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai during months of June 2018 to May 2019. A total of 280 primi gravid mothers were included in the study. Data was collected through one to one interview and analyzed using statistical package for social sciences (SPSS) version 17.Results: In this study 82.9%, 70.4%, 80.7% of the mothers were aware about consumption of IFA tablets, TT injection and adequate ANC visits, respectively. PNDT act was known to 76.1% of the participants. Only 12.5% of the primi mothers were aware about Janani Suraksha Yojna (JSY) scheme and 91.8% of the mothers were aware about Dr. Muthulakshmi Maternity Benefit scheme.Conclusions: Knowledge about ANC services was found to be fair among the primi mothers but not sufficient, which shows the need for the healthcare professionals to educate young woman even from adolescent age itself.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195624
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study on knowledge and practices of antenatal care among pregnant women
           attending antenatal clinic at a tertiary care hospital, Gujarat, India

    • Authors: Rohit Jain, Chintan Upadhyay, Bipin Nayak
      Pages: 60 - 64
      Abstract: Background: Improving maternal health is one of the eight-millennium development goals (MDGs). Since 1990, maternal deaths worldwide have dropped by 47%. This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a tertiary care hospital in Gujarat and their association with various sociodemographic factors.Methods: A cross-sectional study was carried out among 384 pregnant women in their 3rd trimester attending the antenatal clinic in a tertiary care hospital of Gujarat during April 2018 to September 2018. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info software.Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES) had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC.Conclusions: These findings can be used to plan a health intervention program aiming to improve the maternal health practices and eventually improve the health status of the women.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195639
      Issue No: Vol. 9, No. 1 (2019)
       
  • Stuck situations in morbidly adherent placenta: how to tackle'

    • Authors: Manvi Dua, Sangeeta Arya, Kiran Pandey, Anil Verma
      Pages: 65 - 69
      Abstract: Background: Morbidly adherent placenta is associated with high maternal morbidity and mortality. Its increased prevalence seems to be proportional to the increasing number of caesarean sections. In this study the presentation and management of 32 cases was reviewed with morbidly adherent placenta and maternal and perinatal outcomes from 2014 to 2016, at the hospital.Methods: Study type was retrospective. We reviewed clinical information from patients’ case sheets regarding the risk factors, preparations prior to cesarean section, intraoperative and postoperative complications. Results were interpreted and conclusions were withdrawn.Results: Among the 32 cases, 28 were diagnosed prenatally while 4 were diagnosed intraoperatively. Out of 28 patients, 5 patients were diagnosed early between 14 and 18 weeks of gestational age and other 23 were diagnosed during third trimester by ultrasonography. Caesarean hysterectomy was required in 28 cases.4 were managed conservatively, out of which hysterectomy proved to be necessary in the postpartum period because of severe secondary postpartum hemorrhage in 2 cases. Average no of hospital stay is 10 days ranging from 8-18 days.Conclusions: Prenatal diagnosis of morbidly adherent placenta is essential to plan for the better maternal and perinatal outcome. The decision to perform a cesarean hysterectomy or conservation of uterus (using balloon tamponade or putting haemostatic sutures) is based on the extent of infiltration, the patient’s hemodynamic status, and her desire for future pregnancy. The risk of infection and severe hemorrhage remains high if conservative management is chosen and requires prolonged close monitoring postoperatively. Ideally all the cases should be electively planned and operated by senior surgeon and experienced assistants with senior anesthetist, urosurgeon and physician, with full backup of ICU and blood bank. 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195998
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of etiopathogenesis and clinical profile of patients presenting with
           abnormal uterine bleeding

    • Authors: Namrata Yeole, Arun H. Nayak, Madhuri Mehendale
      Pages: 70 - 76
      Abstract: Background: AUB is a common condition affecting 14-25% of women of reproductive age and may have a significant impact on their physical, social, emotional and material quality of life. AUB can occur at any age in various forms and has different modes of presentation. The key to successful clinical management is to recognize or identify the causative factors responsible.Methods: This study was conducted over 100 patients. Patients with complaints of menstrual irregularity between menarche to premenopausal age group were considered. Data about age, parity, menstrual history, obstetric history, medical history, physical examination, thyroid function test, radiological findings and histopathology were collected and studied.Results: Incidence of AUB is more common in 5th decade of life. Menorrhagia is the most common bleeding pattern. It is concluded that DUB is the most common cause of AUB. Among the other organic pathological causes, fibroid is the commonest. Maximum number of apparently normal patients with abnormal uterine bleeding belong to category of sub clinical hypothyroid.Conclusions: Accurate analysis of endometrial sample is the key to effective therapy and rational approach to treatment of women with abnormal uterine bleeding.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195999
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of fetomaternal outcome in cases of premature rupture of membrane at
           tertiary care rural institute of Western Uttar Pradesh, India

    • Authors: Jigyasa Singh, Vaibhav Kanti, Vandana Verma
      Pages: 77 - 81
      Abstract: Background: Premature rupture of membranes (PROM) is the rupture of the fetal membranes before the onset of labor. Preterm PROM complicates approximately 3 percent of pregnancies and leads to one third of preterm births. It increases the risk of prematurity and leads to a number of other perinatal and neonatal complications.Methods: This was a prospective study carried out at the department of obstetrics and gynaecology, UPUMS, Saifai from April 2018 to September 2018 (6 months study). Patients with Spontaneous rupture of membranes any time beyond 28th week of pregnancy, but before the onset of labour. Patients with following conditions were excluded from the study- meconium stain liquor, cord prolapse, antepartum haemorrhage, active infection at other sites, active liver disease.Results: A total of 103 cases of premature rupture of membrane (PROM) were recorded from April 2018 to September 2019 among 1523 admitted pregnant patients. Most of the patients 56 (54.36%) were delivered by caesarean section (C/S). Previous C/S, oligohydramnios, fetal distress, chorioamnionitis were the common indications for doing C/S. Forty-seven (45.63%) patients were delivered vaginally.Conclusions: Most of the affected women belongs to 20-24 years of age (53.39%). Term PROM was more in comparison to PPROM and most of them were multigravidae. Cesarean section rate was high. Most common complication was of subclinical urogenital infection (51.02%).
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196000
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study of evaluation of unhealthy cervix by various diagnostic modalities

    • Authors: Ami M. Gohil, Sanjay Ponde, Poorvi Agrawal, Himadri Bal
      Pages: 82 - 86
      Abstract: Background: This study was carried out to evaluate cases of unhealthy cervix by using Pap (Papanicolaou) smear, colposcopy and cervical biopsy and to arrive at a definitive diagnosis. It correlated the findings of Pap smear, colposcopy and histopathology. It is important to strictly implement the screening program and spread awareness of the disease symptoms and its management to reduce the overall incidence of morbidity and mortality reported due to cervical cancer.Methods: A total 120 patients satisfying the inclusion/exclusion criteria were recruited for the study and informed consent was taken from all the participants. Pap smear was taken for all the cases. Then cases were subjected to colposcopy followed by biopsy. All the findings were correlated and analyzed. The findings of Pap smear and colposcopy were correlated with the gold standard of histopathology.Results: The sensitivity and specificity of Pap smear and colposcopy with respect to cervical biopsy were 53.1% and 98.7%, 87.87% and 72.72% respectively. Colposcopy had higher sensitivity and lower specificity than Pap smear for screening of cancer cervix.Conclusions: Cervical cancer is one of the preventable and highly curable conditions when diagnosed in the precancerous stage. The incidence of deaths resulting from cervical cancer can be brought down with adequate cervical cancer screening. Colposcopy and colposcopy directed biopsy should be done along with Pap smear in screening for early detection of cervical cancer since the accuracy of detection of cervical abnormalities is higher when these two methods are used complementarily.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196001
      Issue No: Vol. 9, No. 1 (2019)
       
  • Effect of first trimester maternal serum pregnancy associated plasma
           protein: a level on fetomaternal outcome

    • Authors: Shilpi Singh, Pushpa Singh
      Pages: 87 - 93
      Abstract: Background: Serum pregnancy-associated plasma protein-A (PAPP-A) levels fluctuate in continuation with the pregnancy and thus become an important standalone marker in monitoring the adverse outcomes that may occur in pregnancy.Methods: A prospective observational study was conducted in the department of obstetrics and gynaecology. A total of 240 pregnant women in their first trimester were included in the study. Serum PAPP-A levels were measured at 11-13+6week of gestation and were evaluated with respect to the feto-maternal outcome. The data was entered in MS excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0.Results: The mean age of the study population was 27 years. Among the maternal pregnancy parameters, PIH, pre-term labor and Emergency LSCS were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, P<0.05. All the fetal outcome measures: IUGR, IUD, low birth weight, SGA babies, prematurity and NICU admissions, were significantly associated with low (<0.5 MoM) Serum PAPP-A levels, p <0.05.Conclusions: Serum PAPP-A in the early pregnancy showed significant correlation with feto-maternal outcome. Thus, it has the potential to be used as a prognostic factor and in the management of adverse outcomes by increasing surveillance for pregnant women with high-risk factors.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196002
      Issue No: Vol. 9, No. 1 (2019)
       
  • Effects of clomiphene citrate on seminal parameters in idiopathic
           oligospermia: a single blinded prospective randomized controlled trial

    • Authors: Apurba Mandal, Shibram Chattopadhyay, Chandan Sasmal, Tapan Kumar Maiti, Shritanu Bhattacharyya
      Pages: 94 - 98
      Abstract: Background: About 15% married couples face problem of infertility of which male factor is implicated in 20% of them. In about 30% infertile men no causative factor is found and the condition is termed “Idiopathic”. They are often treated by empirical medications or Assisted Reproductive Technologies (ART) although success in few; our present study is carried on effects of clomephene citrate on seminal parameters in idiopathic oligospermia.Methods: This single blinded prospective randomized controlled trial was conducted at the infertility clinic with 200 idiopathic oligospermic men (sperm count <15 millions/ ml of ejaculate) after fulfilling inclusion and exclusion criteria and were alternately allocated into two equal groups - “Group C” receiving clomephene citrate tablets and “ Group P” receiving placebo after concealment. Semen analysis data were collected at baseline and every month and three months of completion of treatment and were summarized by routine descriptive statistical analysis.Results: The demographic characteristics like mean age is comparative in both groups but duration of infertility of >2 years is more in group C than group p (4.3±3.06 versus 4.1±2.57). The semen volume, spermatozoa count, sperm motility and not normal form are all increased after three months of treatment in group C as are biochemical parameters like total testosterone and serum FSH, LH and as also pregnancy rate (22% versus 4%).Conclusions: This study showed clomiphene citrate treatment protocol is inexpensive, relatively safe and easy to administer and improves semen volume, sperm count and sperm motility but not sperm morphology by increasing serum testosterone, FSH and LH in male and resulting in improved pregnancy rate in female partners.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196003
      Issue No: Vol. 9, No. 1 (2019)
       
  • Stings of the missing string: missing Copper T thread

    • Authors: Ketaki K. Junnare, Saloni Sawaskar, G. S. Shekhawat
      Pages: 99 - 103
      Abstract: Background: Missing CuT thread is a worrisome complaint for a woman. The string may be curled in or the Cu T might have expelled or migrated.Methods: It was a retrospective study.
      Authors collected the data between January 2017 to December 2017. Data was collected from OPD, OT register and Indoor patient record file. The objective was to ascertain the symptomatology, type of insertion, investigations and mode of retrieval of CuT.Results: There were 63 cases of missing CuT thread, out of which, 42 were postpartum. 33 patients were asymptomatic. Irregular vaginal bleeding (19 patients) was commonest complaint, followed by abdominal pain (10 patients). Pregnancy was detected in one patient. Transvaginal ultrasonography (TVS) detected intrauterine location of CuT in 60 cases. X-ray abdomen erect was needed in 3 cases, which detected intra-abdominal migration of CuT in two cases. CuT was expelled in third case. In 31 patients, CuT was removed by artery forceps in OPD. In 17 cases, hysteroscopic Copper T removal was needed. Two cases with migrated CuT underwent laparoscopy for retrieval of CuT. One patient had to be converted to laparotomy to rule out bowel injury.Conclusions: Missing CuT thread is commonest with postpartum IUCD. TVS should be first investigation in missing CuT thread. X-ray abdomen is needed only if CuT is not visualized on TVS. Hysteroscopy can be used in patients where CuT retrieval with artery forceps fails. Laparoscopy and laparotomy may be required in migrated CuT cases.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196004
      Issue No: Vol. 9, No. 1 (2019)
       
  • The impact of maternal obesity on maternal and fetal outcome

    • Authors: Esther Kamalarani A., Ramyajothi ., Ramalakshmi S.
      Pages: 104 - 109
      Abstract: Background: Obesity continues to be a global health concern. Although the increasing obesity rates in developed countries has slowed down in the past 10 years, obesity rates in developing countries continue to increase, as much as three times in some developing countries over the past 30 years. The aim of the study was to determine the adverse effects of obesity in pregnancy and maternal and fetal outcome.Methods: In all patients, a detailed history was taken and examinations and investigations were carried out.  Based on BMI (body mass index), patients were divided into 2 groups. Group 1 = patients with BMI >30 kg/m2 and Group 2 = patients with BMI <30 kg /m2.Results: In our study, comparing pregnant mothers with BMI >30 kg/m2 and normal BMI, authors found that the prevalence of maternal and fetal complications was higher in the obese group. Prevalence of antenatal complications like gestational hypertension, preeclampsia, imminent eclampsia and gestational diabetes mellitus requiring control with insulin was higher in obese women.Conclusions: Obesity is associated with increased adverse effects on pregnancy and its outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196005
      Issue No: Vol. 9, No. 1 (2019)
       
  • Why women with advanced carcinoma cervix do not seek medical help early: a
           tertiary hospital based Indian study

    • Authors: Aastha Raheja, Krishna Agarwal, Anoosha K. Ravi
      Pages: 110 - 112
      Abstract: Background: Cervical cancer is a disease which claims maximum number of deaths in developing countries. Objective of this study was to understand the reason for delayed approach to medical help in women with advanced carcinoma cervix.Methods: It was a cross-sectional study. Information obtained from women with carcinoma cervix clinical stage IIb and above with proven histopathological diagnosis was recorded in the predetermined format.Results: Almost all the subjects were illiterate and were from lower socioeconomic strata and rural areas. None of them knew about the disease and its symptomatology. About 82% of the patients were symptomatic since 5-10 years however took no medical care during the period and 2/3rd of them even did not reveal their problem to any of the family members. About 79% of the subjects had never used any contraception and none had knowledge about its role in preventing infection. Majority of them (98%) had no idea about the role of PAP smear in screening carcinoma cervix. All of them said if they had knowledge about the disease, they would have sought medical help much earlier.Conclusions: The most important reason for delayed approach in our study was found to be lack of knowledge about the disease. Therefore, till such time that we have national screening program in place, these women who are at high risk of developing carcinoma of cervix should be targeted and educated through mass media so that these women could seek medical help in early stages.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196006
      Issue No: Vol. 9, No. 1 (2019)
       
  • Acute kidney injury in obstetrics: a five-year study in a tertiary centre

    • Authors: Sushma H. Papegowda, Pratima K. Devi, Ranjit L. Singh, Agalya Muruganadam, Zikpuii L. Tochhawng
      Pages: 113 - 119
      Abstract: Background: Pregnancy Related Acute Kidney Injury (PRAKI) is a major cause of maternal and foetal morbidity and mortality in developing countries. The incidence has declined due to improvements in reproductive health but it is still associated with significant perinatal mortality and maternal morbidity. It may be due to decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions encountered during pregnancy. Our study aims at determining the predisposing factors and causes of AKI during pregnancy and its impact on maternal and foetal outcome.Methods: A retrospective cohort study over a period of 5 years was conducted on pregnant women with AKI as per inclusion and exclusion criteria. The detailed history, events, mode of delivery, cause leading to AKI, management, hospital stay, maternal and foetal outcome were studied in detail and evaluated. These patients were classified according to RIFLE criteria and were followed up for hospital stay and residual morbidities.Results: The incidence of PRAKI in the study was 0.07% (36 out of 50,735 deliveries) and among obstetric ICU patients, it was 6.8%. Most of the majority of the cases were unbooked (66.7%) and multipara (61.1%). Maternal morbidity was seen in 66.7% and mortality was 27.8%. Poor foetal outcome was seen in 44.4%.Conclusions: Haemorrhage is the most common cause of PRAKI, followed by toxaemia of pregnancy and sepsis. Early detection and meticulous management of haemorrhage, hypertension and sepsis reduce the incidence of PRAKI and associated maternal mortality.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196007
      Issue No: Vol. 9, No. 1 (2019)
       
  • A clinical study of association of genital tuberculosis with infertility
           in a tertiary centre of Jharkhand, India

    • Authors: Samarina Kamal, Vandita Singh, Shashibala Singh
      Pages: 120 - 125
      Abstract: Background: The worldwide incidence of GTB is approximately 5- 10% in infertile women. It varies from as low as 0.69% in some developed countries to as high as 19% in India. It is diagnosed by culture of the tubercle bacillus from tissue sampled from the genital tract is the yardstick for diagnosis and remains the gold standard.Methods: A prospective study was carried out between January 2012 and January 2015 on 100 women presenting with infertility.Results: A total (27%) women were diagnosed as genital tuberculosis by combination of hystero laparoscopic findings, histopathological and endometrial DNA-PCR technique confirmation. Of these (40.62%) had secondary infertility and remaining (59.38%) had primary infertility. (15.62%) were previously diagnosed with pulmonary or extra pulmonary tuberculosis and had completed a full course of Anti-tubercular treatment as per WHO CAT 1 regime.Conclusions: Therefore, in countries where TB is endemic, early and aggressive strategies should be pursued to diagnose and treat TB.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196008
      Issue No: Vol. 9, No. 1 (2019)
       
  • Clinical pattern and presentation of abnormal uterine bleeding

    • Authors: Sarala V., Ushadevi Gopalan
      Pages: 126 - 128
      Abstract: Background: Abnormal uterine bleeding (AUB) is a very common debilitating gynecological condition among women of the reproductive age group. This diagnosis is given to women in whom no clear etiology is identified. It can occur in ovulatory and anovulatory cycle. It influences the physical, emotional, sexual and professional life of a woman. This study was carried out to evaluate the clinical profile of abnormal uterine bleeding.Methods: This cross-sectional study was carried out among 350 patients who were clinically diagnosed with AUB for a period of one year from April 2018 to March 2019. Patients with uterine polyp, adenomyosis, Leiomyoma, malignancies and with various coagulopathies were excluded from the study by physical examination, ultrasound, histopathology and blood test. The remaining 280 patients between the ages 20-60 years were selected for clinical classification of AUB.Results: Majority of the participants were in the age group of 41-50 years (60%). AUB is most commonly seen in multiparous women (48.92%). The prominent bleeding pattern seen was menorrhagia (52.2%).Conclusions: Menorrhagia is the most common form of AUB and there is a need to prevent the consequences of menorrhagia by way of creating awareness among the women, and by early diagnosis and clinical management of complications.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195587
      Issue No: Vol. 9, No. 1 (2019)
       
  • A prospective study of maternal factors and perinatal outcome of preterm
           birth

    • Authors: Kavita Dudhrejia, Zalak V. Karena, Rahul P. Patel
      Pages: 129 - 133
      Abstract: Background: Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality, henceforth being a major concern for the obstetricians and paediatricians as well being a major health care issue. Preventing and treating the associated risk factors could play a major role in curbing the perinatal morbidity and mortality.Methods: A total 100 women with preterm labour or an indicated preterm termination of pregnancy were enrolled in the study. They were evaluated by history taking, clinical examination, and ultrasonography. Corticosteroids were given to all the patients. Maternal risk factors, obstetric outcome and perinatal outcome till discharge were studied.Results: Of the 100 women studied, mean age of the cases was 27 years, 60% of the cases belonged to lower socio-economic class, 74% of the cases were under 55 kgs weight group and 77% of cases were anaemic. 34% cases were below 34 weeks of gestation, 58% were multigravida, and 2% grand multipara with 35% labour being induced labour because of presence of various risk factors such as preterm premature rupture of membranes (PPROM), pre-eclampsia, eclampsia and chorioamnionitis. 6% cases had multiple pregnancies and 8% had history of preterm delivery in previous pregnancy. Out of 107 babies, 73% neonates required neonatal intensive care unit (NICU) admission and there was 12.14% neonatal mortality rate.Conclusions: Anaemia, malnutrition, infection, high order pregnancy are the preventable causes of preterm birth which can be prevented, screened and treated by specialised antenatal programs.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195571
      Issue No: Vol. 9, No. 1 (2019)
       
  • Vaginal deliveries in a tertiary centre: a current profile

    • Authors: D. M. Christe, D. Tamilselvi, S. Surya, S. Shobha, C. Ponnuraja
      Pages: 134 - 139
      Abstract: Background: A normal delivery is what every woman wishes to have. The objective of this study was to find out the maternal and neonatal outcome and background characteristics of women delivering vaginally in a tertiary care center in Chennai, South India.Methods: For this one-year study, with power above 80%, Parturition records were selected by computerized random numbers, for a calculated sample size. Salient demographic features such as age, residential background and religion were noted. Details of obstetric history, past and current, delivery and baby details and admission to NICU were analyzed. Acceptance of postpartum contraception was noted.Results: A total of 338 women delivered vaginally. Majority of 63%, were from urban background. Late referrals were 19.2% of women,38.5% women had antenatal complications. Primigravida were 49.7%. Nearly 91.4% of women delivered naturally. Previous pregnancy loss was noted in 14.8%. Term deliveries were in 72% of women, and 2.7% of women delivered twins. Average birth weight among primi was 2.5kg and in multi it was 2.8 kg. There were no maternal deaths. Perinatal deaths of 2.96%, of which 90% were preterm births, and all among babies with birth weight below 1.5 kg.Conclusions: The larger majority of 91.4% of women had natural vaginal delivery. Primigravida were 49.7%, and 63% were from urban background. Antenatal complications, obstetric, medical or other complications were noted in 38.5 % of women. Most often observed complications were Gestational hypertension, Gestational diabetes, and Hypothyroidism. NICU care was required for 18% of babies. Preterm births were16.6%. Perinatal deaths were seen in 2.96% of babies. There were no maternal deaths.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196009
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study of spot urine protein: creatinine ratio as an alternative to 24
           hours proteinuria for the diagnosis of pre-eclampsia

    • Authors: Ruma Sarkar, Shilpi Rawat, Neela Rai Sharma, Harish Chandra Tiwari
      Pages: 140 - 144
      Abstract: Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsiaMethods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.                                 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196010
      Issue No: Vol. 9, No. 1 (2019)
       
  • Incidence of maternal near-miss events in a tertiary care hospital of
           Gujarat, India

    • Authors: Vijay Kansara, Disha Vaja, Ajesh Desai
      Pages: 145 - 150
      Abstract: Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.Methods: A facility-based cross-sectional study was conducted in the department of obstetrics and gynecology in GMERS medical college and hospital, Sola, Ahmedabad from January 1, 2019 to August 31, 2019. All maternal near-miss cases admitted to the hospital during the study period were recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant’s record.Results: During the period of study, 3235 deliveries were done at the institution while 16 cases of near-miss were identified. The prevalence of near-miss case in this study was 0.5%. Near-miss per 1000 delivery was 5%. Maternal death to near miss ratio was 1:2.67. The leading causes of maternal near miss were hypertensive disorders (62%) and haemorrhage (32%) The morbidity was high in un-booked cases.Conclusions: Maternal near miss is good alternative indicator of health care system. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196011
      Issue No: Vol. 9, No. 1 (2019)
       
  • Uterine rupture: a preventable obstetric catastrophe

    • Authors: Bina M. Raval, Apoorva G. Patil, Parav D. Shah
      Pages: 151 - 155
      Abstract: Background: Maternal health has long been acknowledged to be the cornerstone in public health. The objective of this study was to determine the incidence, etiology, risk factors, complications, treatment strategies, maternal and fetal outcome associated with uterine rupture and to determine how to decrease the maternal morbidity and mortality pertaining to it, as it is indeed a preventable obstetric catastrophe!Methods: This is a retrospective study which was carried out in our institute. Analysis of 45 cases of uterine rupture including scar dehiscence, registered/emergency, rupture occurring in the antepartum or intrapartum period, irrespective of previous vaginal or cesarean delivery was done between July 2017 to June 2019 out of 16,330 deliveries. None of the cases were excluded. Statistical analysis was done comparing the mortality in general population and study population and it was determined that it contributes to the maternal mortality significantly hence making it essential to promptly diagnose and treat the cases.Results: The incidence of rupture of uterus is average 0.27% (1 in 362). Out of 45 cases 9 (20%) were registered, and 36 (80%) were referred patients. The 20-30 years age group is the most vulnerable. Scarred uterus undergoing rupture were 34 (75.55%) as compared to rupture in intact uterus which were 11 (24.44%). The commonest modality of treatment used is suturing of tear which was done in 34 (75.55%) followed by total hysterectomy. There were 2 maternal deaths giving maternal mortality rate of 4.44% and perinatal mortality occurred in 18 (40%) cases.Conclusions: Uterine rupture is a dire emergency with a high incidence of maternal and fetal morbidity and mortality. Skilled attendance with accessible obstetric care, focused antenatal care, strict intrapartum monitoring and good surgical approach are key elements for the prevention and management of uterine rupture.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196012
      Issue No: Vol. 9, No. 1 (2019)
       
  • Diagnostic dilemmas of an eccentrically located gestation sac: role of 3D
           ultrasound

    • Authors: Selvaraj Ravi Lakshmy, Thasleem Ziyaulla, Shobana Umapathy
      Pages: 156 - 164
      Abstract: Background: Differential diagnosis of an eccentrically located sac includes interstitial pregnancy, true cornual pregnancy and angular pregnancy which may all look similar on 2D (two dimensional) ultrasound. Interstitial pregnancy is associated with a higher maternal mortality and needs to be differentiated from true cornual pregnancy and angular pregnancy. This paper is an illustration of the role of 3D (three dimensional) ultrasound in differential diagnosis and management of the three entities.Methods: 2D and 3D ultrasound findings were analyzed in 10 cases of eccentrically located sac. The role of 3D ultrasound in differentiating the three entities had been evaluated.Results: The presence of an eccentrically located gestation sac with incomplete or asymmetric myometrial tissue less than 5 mm in thickness on 2D and the coronal sections obtained from 3D scans were used for diagnosis of interstitial pregnancy in three cases. 2 cases of angular pregnancy were diagnosed based on the finding of sac located in one of the lateral angles of the uterus with broad based connection to the endometrium. 2 cases of cornual pregnancy one intrauterine in a bicornuate uterus and the other in a rudimentary horn has been described. One heterotopic pregnancy and two other cases where a cornual fibroid mimics interstitial pregnancy is also illustrated.Conclusions: The role of 3D ultrasound in differentiating the three entities and the key findings in obtaining the precise diagnosis are emphasized. Routine usage of 3D ultrasound in all cases of eccentrically located gestational sac is recommended.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196013
      Issue No: Vol. 9, No. 1 (2019)
       
  • Evaluation of vitamin D levels in term pregnancy and its obstetric outcome
           in Indian women

    • Authors: Shilpa S. Ciryam, Munikrishna M., Dayanand C. D.
      Pages: 165 - 172
      Abstract: Background: Vitamin D deficiency is currently a global pandemic affecting all age groups. Vitamin D is considered a fundamental hormone in calcium homeostasis and bone health. Risk of vitamin D deficiency increases during pregnancy due to increased maternal and fetal demands and altered vitamin D metabolism. Recently, maternal vitamin D deficiency has been linked to adverse pregnancy outcomes, including preeclampsia, gestational diabetes, fetal growth restriction and preterm birth. Adequate vitamin D status appears to be relevant to health at all ages, and even in prenatal life.Methods: This is a cross sectional, observational study conducted in the department of obstetrics and gynaecology at R. L. Jalappa Hospital. A total number of 160 subjects were included. 5 ml of venous blood was collected and was centrifuged at 3000 rpm and stored at - 80°C till analysis. Analysis of 25-hydroxy Vitamin D was done using ELISA.Results: Majority of the subjects were vitamin D deficient (81.87%) and 12.5% were vitamin D insufficient and only 5.63% were vitamin D sufficient. The prevalence of vitamin D deficiency was more among primigravidas (85.6%) and was associated with higher rates of caesarean section (92.4%). High prevalence of vitamin D deficiency was seen in lower middle socioeconomic class (62.5%). Maternal vitamin D deficiency was associated low birth weight of neonates (100%).Conclusions: In this study it was concluded that majority of subjects were vitamin D deficient and belonged to lower middle socioeconomic class. Majority of this subjects who underwent caesarean section were vitamin D deficient. Vitamin D deficiency was associated only with low birth weight of neonates and no other adverse obstetric outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196014
      Issue No: Vol. 9, No. 1 (2019)
       
  • Clinical study on presentation and management of ectopic pregnancies in a
           tertiary care centre

    • Authors: Anjum Ara, Indu Chawla, Rasika Agarwal, Bangali Manjhi
      Pages: 173 - 178
      Abstract: Background: Ectopic pregnancy means pregnancy outside the normal uterine cavity. It is the leading cause of maternal morbidity and mortality in first trimester. Early diagnosis and timely intervention can significantly improve the outcomes.Methods: Retrospective observational study done in the department of obstetrics and gynecology ABVIMS and Dr. RML hospital, New Delhi from January 2016 to March 2019. Case records of 76 patients of confirmed ectopic pregnancy were retrieved and studied from the medical record section. The main aims were to see the clinical presentation, mode of diagnosis, predisposing risk factors; treatments offered and associated morbidity and mortality.Results: The incidence of ectopic pregnancy in present study was 1.7%, highest in 21 to 30 years age multiparous patients. 85.1% presented as acute emergencies, 75% patients had classic triad of amenorrhea, pain and bleeding. Pain was the commonest symptom in 96.1%. The commonest clinical sign was adnexal mass and tenderness. Ultrasound findings had adnexal mass in 98.7% and free fluid in 84.7% cases with empty uterus in 100%. 90.7 % case were tubal ectopic and 69.73 % were ruptured. Surgery was the main treatment modality in 96.0% cases. Salpingectomy was the commonest surgery in 80.25%. There was 0% mortality and 78.9% cases required blood transfusions, 44.7% patients had no known risk factors whereas some of the common identifiable risk factors were history of previous abortion, previous pelvic surgeries and pelvic inflammatory disease.Conclusions: ABVIMS and Dr. RML hospital is a tertiary care center so majority of patients with ectopic pregnancies presented late, as such surgery was the main treatment modality but there was 0% mortality in our study. Conservative treatments such as laparoscopy and medical management can also be offered to hemodynamically stable patients.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196015
      Issue No: Vol. 9, No. 1 (2019)
       
  • A comparative study of saline infusion sonohysterography and
           hysterosalpingography for evaluation of female infertility

    • Authors: Riya Bhattacharya, A. C. Ramesh
      Pages: 179 - 183
      Abstract: Background: Infertility is a complex disorder with significant psychological and emotional impact. It affects 10-15% of couples in the reproductive age group. Hence, evaluation of female genital tract is an important part of workup of an infertile woman. The most commonly used methods are hysterosalpingography which exposes the patient to ionizing radiation and laparoscopy which is invasive. This calls for the need of a low risk method that would be suited for ambulatory application. Saline infusion sonohysterography is a cost-effective, safe, non-invasive and a rapid procedure to visualize the female pelvic organ in evaluation of infertility. The objective of this study was to compare diagnostic accuracy of saline infusion sonography (SIS) over conventional hysterosalingography (HSG) for evaluation of female infertility.Methods: Total 50 patients who presented to the gynecology OPD between 2018 to September 2019 for evaluation of infertility were included for the study. The results of the two procedures were compared.Results: For evaluation of uterine cavity, SIS had a sensitivity of 95%, specificity of 100%, PPV of 100%, NPV 75% and a sensitivity of 100%, specificity of 100%, PPV of 91%, NPV of 100% for tubal patency as compared to HSG.Conclusions: For evaluation of uterine cavity, SIS had a sensitivity of 95%, specificity of 100%, PPV of 100%, NPV 75% and a sensitivity of 100%, specificity of 100%, PPV of 91%, NPV of 100% for tubal patency as compared to HSG.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196016
      Issue No: Vol. 9, No. 1 (2019)
       
  • Correlation of maternal age with birth weight: need to reemphasize

    • Authors: Suyash Goel, Roshni Abichandani
      Pages: 184 - 186
      Abstract: Background: Women at both ends of the reproductive age spectrum have unique outcomes which needs to be considered. Adolescents are at increased risk for anaemia, preterm delivery, fetal growth restriction and preeclampsia. The maternal mortality rate is higher on extremes of the age. However, there is marked variability of the birth wt even with in the age group from 19-35 years of age. The present study was conducted with an objective to assess the correlation of Maternal age with birth weight.Methods: A total of 135 women between age 19-35 years were considered who had delivered at term (n=135) and women with any risk factors were excluded. Women were divided in three groups with age <25 years, 26-30 years and >30 years. Both primigravida and multigravida women were included without considering the mode of delivery.Results: According to birth weight, 113 cases had their birth weight >2.5 kg and out of them 43, 56 and 14 cases belonged to age group <25, 26-30 and >30 years respectively while only 22 cases had their birth weight <2.5 kg and out of them 9, 8 and 5 cases had their age group <25, 26-30 and >30 years. Mean birth weight in age group <25 years was 2.96±0.46 kg, in age group 26-30 years, it was 3.19±0.47 kg and in age group >30 years it was 2.79±0.54. On applying ANOVA test, the difference was found statistically significant (p<0.01).Conclusions: The variation in birth weight with respect to maternal age is significant. Limitation of this study was group comprising of 135 women.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196017
      Issue No: Vol. 9, No. 1 (2019)
       
  • Accuracy of transvaginal sonography in evaluation of abnormal uterine
           bleeding in perimenopausal women

    • Authors: Nicole Sequeira, Shannon Fernandes
      Pages: 187 - 193
      Abstract: Background: AUB is a commonly encountered complaint in peri- and postmenopausal women visiting OBG OPDs and accounts for about 70% of all gynaecological complaints. Key to management depends on the cause of AUB. Protocol has changed over the years from performing investigations randomly to a condition specific approach. This study aims to evaluate and compare the efficacy of transvaginal sonography and hysteroscopy in perimenopausal women with AUB and note its relation with histopathology.Methods: A prospective study was conducted on 103 women of 40-55 years presenting to the OBG OPD of Father Muller Medical College Hospital, Mangalore. All patients underwent a transvaginal scan to note the endometrial thickness followed by a hysteroscopy and biopsy. Endometrium was sent for histopathology. Findings of these modalities were correlated.Results: The diagnostic value of transvaginal sonography in relation to histopathology had a sensitivity and specificity of 33.33% and 95.95% for atrophic endometrium, 52.5% and 62.9% for proliferative, 29.41% and 79.41% for secretory, and 55.55% and 74.19% for hyperplastic. When compared to histopathology, hysteroscopy had a sensitivity and specificity of 100% and 92.3% for atrophic, 26.19% and 96.96% for proliferative, 27.07% and 98.59% for secretory, and 100% and 64.94% for hyperplastic endometrium. It had a sensitivity of 77.77% and a specificity of 92.92% for endometrial polyps. Agreement between TVS and histopathology based on kappa co-efficient was fair for atrophic endometrium but poor for proliferative, secretory and hyperplastic endometrium. Agreement between hysteroscopy and histopathology was moderate for atrophic endometrium and for endometrial polyps. It was fair for proliferative, secretory and hyperplastic endometrium.Conclusions: TVS seems to be a good initial method for evaluation of AUB. However, a subsequent hysteroscopy with biopsy is advisable to evaluate the cause of AUB.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196018
      Issue No: Vol. 9, No. 1 (2019)
       
  • Maternal and perinatal outcome in pregnant women with hypertensive
           disorders: a population-based study

    • Authors: S. Shruthi, G. Thenmozhi
      Pages: 194 - 199
      Abstract: Background: Hypertension during pregnancy is one of the well-known complications of dating from ancient times. It remains as one of the leading causes of maternal mortality and morbidity through its myriad complications. To study the risk factors, prevalence and epidemiological parameters of antenatal mothers presenting with hypertension during pregnancy.Methods: This study was on hypertensive disorders of pregnancy including mild, severe preeclampsia, eclampsia, and chronic hypertension at Chengalpattu Medical College Hospital, Chengalpattu in a period of 1st year from October 2016 to September 2017.Results: Out of 450 hypertensive pregnancies, the majority were severe preeclampsia (39.6%). There were 78 women with gestational hypertension (17.3%), 125 women with mild preeclampsia (27.8%), 178 women with severe preeclampsia (39.6%), 64 women with eclampsia out of which 52 were AP eclampsia (11.6%), 1 case was IP eclampsia (0.2%) and 11 women were PP eclampsia (2.4%). 5 women were chronic hypertensives (1.1%)Conclusions: Complications can affect all maternal systems including central nervous system, renal system, and hematological systems. Apart from these, the fetus also faces the brunt of insult. Fetal complications include prematurity, low birth weight, stillbirths, intrauterine deaths, and intrauterine growth restrictions. However, such vast complications can be prevented by simple blood pressure monitoring and proper antenatal mother follow-up.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196019
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study on correlation between laterality of placenta on mid trimester
           ultrasonography and perinatal outcome

    • Authors: Avik Ghosh, Mrinalkanti Ghosh
      Pages: 200 - 204
      Abstract: Background: Fetus is dependent on placenta for supply of nutrients from mother. Objective of this study was to assess the relationship between laterality of placenta by mid-trimester ultrasonography and perinatal outcome.Methods: It was a prospective observational study conducted between June 2016 to June 2017 at Burdwan Medical College, West Bengal. Participants were uncomplicated pregnant women having 18-24 weeks gestation attending antenatal clinics and admitted in ward who underwent obstetric sonography including placental localization. Women were observed till delivery. Analysis was done for site of implantation of placenta and its correlation with perinatal outcome.Results: Total of 300 women considered for the study, 195/300 (65%) had central implantation of placenta and 105/300 (35%) had lateral type of placentation. There were 4 IUFDs (1.33%); 2 (1.03) with central placenta and 2 (1.9) with lateral placenta. Among 31 (10.33%) IUGR babies 13 (6.67%) were associated with central and 18 (17.14%) with lateral placenta. Among 27 LBW babies 16 (8.21%) were related to central placenta and 11 (10.48%) were related to lateral placenta. Among 57 SNCU admissions 26 (13.33%) were related to central placenta and 31 (29.52%) were related to lateral placenta. Average birth-weight is 2.6±0.31 kg and 2.51±0.26 kg, respectively for central and lateral placenta.Conclusions: Laterally located placenta is associated with relatively poor perinatal outcome compared to central placenta with increased rates of IUGR, IUFD and LBW babies.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196020
      Issue No: Vol. 9, No. 1 (2019)
       
  • Towards optimizing caesarean section: a five-year review of caesarean
           sections at a Southern Nigeria hospital

    • Authors: Nkencho Osegi, Olakunle I. Makinde
      Pages: 205 - 211
      Abstract: Background: Monitoring caesarean sections at hospital level is essential to reduce unnecessary caesarean sections while still ensuring adequate access to caesarean section. This study was conducted to determine the caesarean section rate and indications for caesarean section at the study centre and provide objective data for institutional interventions towards reducing unnecessary caesarean sections in the centre.Methods: A retrospective descriptive study of patients that had caesarean sections between 1st January 2013 and 31st December 2017 at the Federal Medical Centre, Yenagoa, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 22.Results: There were 5,793 deliveries and 1,654 were by caesarean section. The average caesarean section rate was 28.6%. The leading indications for caesarean section were cephalopelvic disproportion (26.6%), previous cesarean section (18.2%), suspected fetal distress (11.2%), severe preeclampsia/eclampsia (7.9%), obstructed labour (6%), and breech presentation (5.9%).Conclusions: The 28.6% caesarean section rate in this study falls within a widely varied rate across Nigeria at hospital level but is comparable to rates within the south-south geopolitical zone of Nigeria. The leading indications for caesarean section are modifiable, thus there is room for institutional intervention to reduce unnecessary caesarean sections. Collaborative research between institutions is required to assess peculiar regional determinants of caesarean section towards developing suitable interventions to reduce unnecessary caesarean sections regionally.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196021
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of ectopic pregnancy in a tertiary care centre

    • Authors: Nitesh Meena, Radheshyam Bairwa, Savitri Sharma
      Pages: 212 - 215
      Abstract: Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196022
      Issue No: Vol. 9, No. 1 (2019)
       
  • The burden of caesarean section and its determinants from a tertiary care
           hospital, Thrissur, Kerala, India

    • Authors: Merin Baby, Sruthi M. V.
      Pages: 216 - 220
      Abstract: Background: Caesarean section is a surgical procedure done when vaginal delivery is contraindicated. The prevalence of caesarean section in Kerala showing an increasing trend. Even though the caesarean section is an emergency lifesaving procedure, various other factors like socio-demographic determinants, economic factors and patient’s or clinician’s preferences also influence this increasing trend. The present study was undertaken to compare the various determinants of caesarean section with normal delivery from a tertiary care hospital in Thrissur district.Methods: A hospital-based case control study was done taking mothers who had undergone caesarean section as cases and mothers who had undergone normal delivery as controls during two-month period. The sample size was calculated using the formulae: (Zα + Zβ)2x2xPQ/d2, and the calculated sample size was 88. The various determinants used were socio-demographic, obstetrics and cultural determinants.Results: In this study, it was found that the most common indications for C-section were previous C-section, PPROM and foetal distress. There was a statistically significant association between obstetrics determinants like complications during pregnancy, number of USG taken, period of gestation with mode of delivery. The present study also shows that mothers with educational status up to graduate/PG have lesser incidence of caesarean section. There was a statistically significant association between delivery date close to holidays/festival days and C-section.Conclusions: It is necessary to have health awareness sessions to pregnant mothers about the complication of pregnancy, benefits of normal delivery and complications of C-sections in-order to reduce the patients’ preference for C-section.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196023
      Issue No: Vol. 9, No. 1 (2019)
       
  • Incidence and determinant of eclampsia and its associated complication in
           tertiary care hospital of Gujarat, India

    • Authors: Chirag Banker, Latika Mehta
      Pages: 221 - 224
      Abstract: Background: Eclampsia is one of common cause of maternal mortality in developing country like India. It can be detected and prevented if early ANC care is properly done. Mainstay of management in case of eclampsia is early delivery to improve the prognosis in terms of reducing maternal and perinatal morbidity and mortality.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, at tertiary care centre in the state of Gujarat, for a period of two years from July 2012 to June 2014. With purposive sampling method all patients admitted with complain of eclampsia is included in study. Details are taken in predesigned, pre-validated and prescribed proforma.Results: Hospital based incidence of eclampsia in our study is 1.11%. Majority of the patient were unbooked. Eclampsia is a disease of young primigravida, specifically teenage primigravida. Seventy-five percentage of eclampsia cases occurred in the antenatal period, 14% in intranatal period and 11% in the postnatal period.Conclusions: In developing countries like India still eclampsia is major problem. Good antenatal care with increased antenatal visits may help in reducing the incidence. Increased incidence among young primigravida and low socio-economic status group provides the target group for medical measures.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196024
      Issue No: Vol. 9, No. 1 (2019)
       
  • Maternal-fetal prognosis of obstetric emergencies at the maternity ward of
           the Mamou regional hospital

    • Authors: B. A. Diallo, O. H. Bah, M. S. Barry, I. Conté
      Pages: 225 - 229
      Abstract: Background: Pregnant women may be at risk of unpredictable obstetric complications such as: bleeding, dystocia, acute fetal suffering, pre-eclampsia and eclampsia. This maternal-fetal prognosis of obstetric emergencies is influenced by factors that are most often related to complications that alter the course or outcome of a pregnancy and require prompt care. The objectives of this study are to analyze the factors that influence the maternal-fetal prognosis of obstetric emergencies; determine their frequency, describe the clinical profiles of patients and evaluate the maternal-fetal prognosis.Methods: The study was conducted at the Mamou Regional Hospital. It was a 6-month quantitative, descriptive and analytical study, from July 1st to December 31st, 2016, including all parturient women whose term is greater than or equal to 28 weeks of amenorrhoea.Results: The study covered 377 obstetric emergencies out of a total of 1273 deliveries, or 29.61%. Factors influencing the prognosis were: young age, parity, unfavorable socio-economic conditions and difficult baseline conditions. The main obstetric emergencies recorded were acute fetal suffering, disproportion and narrowed pelvis. The dominant mode of delivery was caesarean section with a frequency of 89.65%. Maternal lethality is 3.44% and fetal lethality is 5.14%.Conclusions: Obstetric emergency is a frequent situation where better management would improve the prognosis of the mother and fetus.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195646
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of sociodemographic profile, maternal, fetal outcome in preeclamptic
           and eclamptic women: a prospective study

    • Authors: Vedavathi ., Rajeev Sood
      Pages: 230 - 235
      Abstract: Background: Preeclampsia is pregnancy specific disease, lead to maternal, perinatal morbidity and mortality. This study is conducted to identify the socio demographic profile of subjects suffering from preeclampsia and its effect on maternal and fetal health.Methods: This prospective study was conducted at department of obstetrics and gynecology, Kamla Nehru State Hospital, Shimla, in this, 100 preeclamptic women were included. Preeclampsia was diagnosed with blood pressure of ≥140/90 mmHg noted for the first-time during pregnancy, after 20 wks of gestation and proteinuria. Demographic details were collected. Investigations i.e. hemogram, liver and renal function tests, coagulation profile and fundoscopy were done. Maternal and perinatal outcomes were recorded.Results: In this study, majority of the subjects were primigravida 65. In this, 11 subjects had systolic blood pressure of 140-159 mmHg and 89 subjects had systolic blood pressure of > 160 mmHg. 25 subjects had diastolic blood pressure of 90-109 mmHg and 75 subjects had diastolic blood pressure of > 110 mmHg. In this, 82 subjects had warning symptoms, mainly headache 49. 14 subjects showed hypertensive changes in fundus. Unfavorable Bishop Score, observed in 86 subjects and 78 subjects were induced after controlling blood pressure. Majority of subjects had vaginal delivery 73. Majority of the subjects had deranged liver function 61. Maternal morbidity was reported in 54 subjects. Intrauterine death reported in 14 subjects. Birth weight was < 2.5 kg was observed in 70 babies. Out of 74 live births, 53 neonates required admission in NICU and 16 neonates died in NICU.Conclusions: It may be concluded that, maternal and neonatal morbidity and mortality can be reduced by early identification of risk factors and timely intervention is the hall mark in preventing the maternal and perinatal morbidity and mortality.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196025
      Issue No: Vol. 9, No. 1 (2019)
       
  • Prevalence of hypertensive disorders of pregnancy and its maternal outcome
           in a tertiary care hospital, Salem, Tamil Nadu, India

    • Authors: Subha Sivagami Sengodan, Sreeprathi N.
      Pages: 236 - 239
      Abstract: Background: Hypertensive disorders complicate 5-10% of all pregnancies and together forms the deadly triad- along with hemorrhage and heart disease that contributes greatly to maternal morbidity and mortality. Objective of this study was to determine the prevalence of hypertensive disorders of pregnancy and its maternal complications in patients attending obstetrics and gynaecology department, Government Mohan Kumaramangalam Medical College Hospital, Salem.Methods: This is a prospective study conducted from August 2018 to July 2019 in the department of obstetrics and gynaecology. Patients diagnosed with hypertensive disorders of pregnancy was evaluated and data were collected.Results: A total of 19,383 pregnant women visited obstetrics and gynaecology department over a period of one year, out of which 2028 were diagnosed with hypertensive disorders of pregnancy. Hence the prevalence of hypertensive disorders in pregnancy is 10.4%. Among 2028 hypertensive disorder cases, Gestational hypertension were 962 cases (47.4%), pre-eclampsia 661 cases (32.6%), chronic hypertension 166 cases (8.2%) and pre-eclampsia superimposed on chronic hypertension 239 cases (11.8%). The prevalence was highest among primigravida (54%) compared to multigravida (46%). Hypertensive disorders were highest among the age group of 18-22 years in our study. Most common maternal complication in our study was HELLP syndrome.Conclusions: Prevalence of hypertensive disorders was high in our study. Early detection and timely intervention decrease the maternal complications.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196026
      Issue No: Vol. 9, No. 1 (2019)
       
  • Induction of labour at term: 25 mcg 2 hourly oral misoprostol or 6 hourly
           intracervical cerviprime, safety and efficacy

    • Authors: Indrani Mukhopadhyay, Dishant Sisodia
      Pages: 240 - 246
      Abstract: Background: There are various methods for induction of labour, both mechanical and pharmacological. Prostaglandins in induction have been commonly used. Studies have been done using vaginal and sublingual use of misoprostol. This study analyses efficacy of both oral misoprostol used in low frequent doses as per FIGO 2017 guidelines and intracervical prostaglandins for induction of labour.Methods: A total 159 consecutive pregnant term mothers with singleton pregnancy, intact membranes and unfavorable cervix were subdivided into two subgroups, first subgroup was administered 25 mcg oral misoprostol at 2 hourly interval and those in subgroup B were given intracervical PGE2. Both these subgroups were prospectively followed to assess efficacy in induction of labour at term and outcome in foetus and mother. Statistical analysis was done using chi square test.Results: It was found that the induction to delivery interval was significantly lesser in the cerviprime group (19.31 hours) compared to the misoprostol group (25.19 hours). However, there was no significant difference in the rate of vaginal delivery and mean duration of labour, rates of caesarean section, maternal and neonatal complications in both the groups. More women in the cerviprime group required augmentation with oxytocin. However, on comparing the cost of induction as per the mean doses used, the cost of induction with misoprostol was much lesser than that of cerviprime use.Conclusions: Oral use of Tab. misoprostol was not more efficacious than the use of cerviprime gel in induction of labour.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196027
      Issue No: Vol. 9, No. 1 (2019)
       
  • Effectiveness of kinesiotaping and Acu-TENS on maternal and neonatal
           outcomes in the first stage of labor among primigravidas

    • Authors: Roshini Rajappan, Shivaranjani Balamurugan, Karthikeyan Selvaganapathy
      Pages: 247 - 254
      Abstract: Background: The common reason for rise in elective Caesarean Section (CS) rate among primigravidas is maternal request due to labor pain fear. Many non-pharmacological pain relief strategies are available to help women cope with labor pain, providing a positive and satisfactory birth experience. The objective of this study was to evaluate effects of KT and Acu-TENS on maternal and neonatal outcomes in primigravidas.Methods: 40 full-term primigravidas with an age range of 20-40 years were enrolled into the study by convenience sampling method and divided into 2 groups. Group A received KT and Group B received Acu-TENS. Both groups received breathing exercises. Pain assessment at various cervical dilatation levels were carried out for all participants before and after treatment using Visual Analogue Scale (VAS). Duration of active phase in first stage labor, mode of delivery and neonatal well-being were measured following delivery.Results: Group A experienced VAS score reduction significantly more than Group B, p=0.004; <0.05. There was no significant change in active phase duration of first stage labor between Group A and Group B, p=0.319; >0.05. CS rate was increased in Group A [35% (7/20)] than in Group B [25% (5/20)], but neonatal outcomes were not different.Conclusions: This study proves that KT produced significantly better pain relief than Acu-TENS in first stage labor among primigravidas. Acu-TENS showed reduction in active phase duration of first stage labor than KT. Both interventions can safely be used non-invasively for labor pain relief.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196028
      Issue No: Vol. 9, No. 1 (2019)
       
  • Spontaneous pregnancy rate after saline infusion sonogram treat done under
           high pressure

    • Authors: Suzan Samir Elsharkawy
      Pages: 255 - 260
      Abstract: Background: Failure to achieve conception after 12 months of regular unprotected intercourse is defined as infertility. The aim of this study was evaluating SIS done under high pressure (SIStreat) as a treatment procedure, for relieving simple tubal obstruction and on cumulative pregnancy rate in infertile women.Methods: A prospective, interventional trial was done (October 2017 - November 2018) on 106 eligible women. All patients performed SIS. Patient with tubes patent under low pressure were assigned as control group, the rest of them were subjected to SIStreat, this group was farther divided into Group 2-a (patent under high pressure) and Group 2-b (occluded under high pressure). All patients had regular intercourse for 6 months. Pregnancy was confirmed by serum B-HCG.Results: we compared patients who performed conventional SIS (n = 100 cases) to patients who performed SIStreat afterwards (n = 84) according to the number of patent tubes. There was a high statistically significant difference in favor of SIStreat group (p < 0.001). Also, there was no significant difference in pregnancy rate between control group 62.5% and Group 2-a 45.7% (p = 0.226).Conclusions: SIStreat is a whole new procedure for opening fallopian tubes (diagnosed occluded by SIS). Patients who were successfully treated by SIStreat had cumulative pregnancy rate comparable to patients who were diagnosed to have patent tubes using conventional SIS.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196029
      Issue No: Vol. 9, No. 1 (2019)
       
  • Analysis of transfusion of blood and blood products and their utilization
           pattern at department of obstetrics of tertiary care hospital

    • Authors: Dipti C. Vasava, Rajal V. Thaker, Aditi A. Tyagi, Foram P. Patel
      Pages: 261 - 265
      Abstract: Background: In developing countries, nutritional anaemia and obstetric complications are leading causes of transfusion of blood and blood products. The study was aimed to analyse utilization pattern and to identify the indications of transfusion of blood and blood products in obstetrics and to study outcome and management of pregnancy in patients who required blood and/or blood products.Methods: This retrospective study was carried out at department of obstetrics of tertiary care teaching hospital from September 2018 to November 2018 and data was collected from all patients who had received transfusion of blood and/or blood products for any obstetric cause.Results: A total of 164(6.8%) patients received blood and blood products transfusion. Department of obstetrics utilized maximum units of blood and FFP whereas PRC utilization was second highest. There were 62(37.8%) of patients who had not taken any antenatal care, whereas 64(39.0%) patients had less than 4 antenatal visits. Three most common indications for transfusion of blood and blood products were 63.4% in nutritional anaemia, 17.1% in obstetric haemorrhage and 11.6% in first trimester complications.Conclusions: Three most common indications for transfusion were nutritional anaemia, obstetric haemorrhage and first trimester complications. Majority of patients had inadequate or no antenatal care. Early and regular antenatal care, early diagnosis and management of high-risk pregnancies and obstetric complications, institutional delivery can reduce the rate of transfusion of blood and blood products.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196030
      Issue No: Vol. 9, No. 1 (2019)
       
  • Prevalence and risk factor analysis for post-partum depression in women: a
           cross-sectional study at tertiary care centre

    • Authors: Kanchan Rani, Nupur Nandi, Seema Singh Parmar, Priyanka Rathore
      Pages: 266 - 269
      Abstract: Background: Postpartum depression (PPD) is non-psychotic depressive episode that occurs between postpartum to fourteen months of childhood. It has adverse effect on mother and child health. Aim of this study was to analyze prevalence and risk factors for postpartum depression at tertiary care centre.Methods: This cross-sectional study was done in obstetrics and gynaecology department where 175 women between 10 days to 1 year of delivery were assessed using Edinberg postpartum depression scale. A score of 10 or more were taken as sign of postpartum depression. Various socio-demographic and obstetrics variables were assessed using SPSS (Statistical Package for the Social Sciences).Results: Prevalence of PPD was found in 11.4% patients. Common risk factors associated were intrauterine death (IUD) or early neonatal death, postpartum complications and lack of family support.Conclusions: Postpartum is common among postnatal women and is associated with various factors which can be modified. So early detection of associated risk factors is needed for early intervention and prevents its impact on mother and child health. 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196031
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of maternal serum lipid profile and apolipoprotein a levels and its
           correlation with fetal growth restriction

    • Authors: Akoijam Tamphasana Devi, Reena Yadav, Amita Yadav, Yanglem Ajitkumar Singh
      Pages: 270 - 273
      Abstract: Background: This study was aimed to estimate maternal serum lipid profile and apolipoprotein A levels in pregnancies complicated with FGR and to compare the levels with the levels in normal pregnancies.Methods: A prospective observational study was conducted in Lady Hardinge Medical College, New Delhi, in a study group consisting of 30 pregnant women at gestation 32-34 weeks with ultrasound diagnosed FGR and control group consisting of 30 age and gestation matched uncomplicated pregnant women. Maternal serum lipid profile and apolipoprotein A levels were measured and compared between the two groups.Results: Total serum cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and Apolipoprotein A were significantly lower in FGR group compared to normal controls. Mean±SD of total cholesterol was found to be 199.17±49.06 mg/dl in cases and 244.10±53.17 mg/dl in controls. Mean±SD of triglyceride was 200.53±60.25 mg/dl in cases compared to 304.13±69.12 mg/dl in controls. Mean±SD of LDL-Cholesterol was 98.19±37.91 mg/dl in cases and 127.07±47.84 mg/dl in controls. Mean±SD of VLDL-cholesterol was 40.11±12.05 mg/dl in cases and 60.83±13.82 mg/dl in controls. Mean±SD of Apolipoprotein A was 147.71±16.40 mg/dl in cases compared to 163.30±16.07 mg/dl in controls. HDL-cholesterol did not change significantly as its mean±SD was 60.87±15.18 mg/dl in FGR group and 56.20±16.07 mg/dl in control group.Conclusions: The decreased levels of total cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and apolipoprotein A levels may be used as biochemical marker for detection of FGR.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196032
      Issue No: Vol. 9, No. 1 (2019)
       
  • Comparison of ambulatory blood pressure monitoring and self-blood pressure
           monitoring for diagnosing white coat hypertension amongst pregnant women

    • Authors: Sandeep Sood, Sirisha Anne, Kuldeep Kumar Ashta, Ravi Kumar
      Pages: 274 - 278
      Abstract: Background: White coat hypertension (WCH) is a common and well recognized phenomenon. It is also very prevalent amongst pregnant women and is often diagnosed as chronic/ gestational hypertension leading to unnecessary medications during pregnancy. ABPM is the gold standard for diagnosis of WCH. SBPM is an easy effective and reliable method to measure blood pressure but its efficacy needs to be tested and compared with ABPM in cases of WCH. It is important to compare the two methods in assessing WCH so SBPM can be utilized in cases of WCH, if found useful and efficacious.Methods: All pregnant women who presented to the ANC were screened for hypertension. Those who were diagnosed to be hypertensive in antenatal clinic and these patients were then admitted for ambulatory blood pressure monitoring (ABPM) for 24 hours and SBPM on 6 hourly bases for 5 days.Results: The ABPM and SBPB readings were noted, tabulated and compared. It was found that the prevalence of ‘WCH’ in this study using ABPM and SBPM were 47.368% (27/54) and 45.614% (26/54) respectively.Conclusions: The results in diagnosing WCH using ABPM and SBPM were comparable.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196033
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of perinatal outcomes in normal and borderline oligamnios

    • Authors: Divya R. Prasad, Neelima V. Nair
      Pages: 279 - 282
      Abstract: Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196034
      Issue No: Vol. 9, No. 1 (2019)
       
  • Diagnostic accuracy of ultrasonography with laparoscopy for assessment of
           benign adnexal masses

    • Authors: Vinita Sarbhai, Medha Yadav
      Pages: 283 - 287
      Abstract: Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196035
      Issue No: Vol. 9, No. 1 (2019)
       
  • Trends of caesarean section: an analytical overview of indications

    • Authors: Shruti A. Gavhane, Shilpa N. Chaudhari
      Pages: 288 - 293
      Abstract: Background: Caesarean section is one of the commonly performed surgical procedures in obstetrics. An increasing trend has been observed in both primary and repeat caesarean sections. The reasons for its increase are multifaceted. So, this study was carried out to compare the rates of caesarean delivery and to analyse various indications contributing to it.Methods: This retrospective study was conducted over a period of three year from 1st January 2016 to 31st December 2018 at the department of obstetrics and gynaecology, tertiary care hospital Pune, Maharashtra, India. All caesarean delivery (primary and repeat) taken place during the study period. The rate and indications of caesarean section was calculated over the study period to find out the trends in caesarean delivery. The data so collected was presented with graphical representation. Statistical analysis was performed with SPSS software and t-test was used for continuous data and pearson chi square test for discrete data.Results: There were a total of 12373 deliveries during the study period out of which, 3701 had delivered via Caesarean Section. So, the rate of caesarean section in the study was found to be 29.91%.Conclusions: Being a tertiary care hospital, a high rate of caesarean deliveries was observed, Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit caesarean section rates.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196036
      Issue No: Vol. 9, No. 1 (2019)
       
  • Complications and pregnancy outcome in women with preeclampsia and
           eclampsia

    • Authors: G. Thiripurasundari, D. M. Christe, S. Shobha, V. Sangeetha, Suganya Sevugaperumal
      Pages: 294 - 299
      Abstract: Background: One of the complications of pregnancy which till today challenges the obstetrician is preeclampsia and its severe form of eclampsia. Objective of this study was to find out the complications and outcome of pregnant women with preeclampsia and eclampsia admitted in a tertiary referral center.Methods: Case records, in labor room, were scrutinized to find out the number and the outcome of pregnancy, in women admitted with preeclampsia or eclampsia in the year 2018.Results: Pregnant women admitted with preeclampsia or eclampsia numbered 2511 and, 109 women developed complications. Maternal complications, were more often seen in mothers, (62.4%) of female babies. Only 37.6% of mothers of male babies developed complications. Complications seen were Renal complications in 34.8%, Hematological complications in 33%, Neurological complications in 25.6%, Pulmonary complications in 16.5%, ophthalmological complications in 11% and Sepsis in 6.4% and MODS in 10%. Of total maternal deaths, 34% was caused by complications of preeclampsia or eclampsia. Major cause of maternal death was MODS and Pulmonary complications. Nearly, 62.3% of babies born had birth weight of 1.8 kg and nearly one-third of babies (26.6%) were dead born.Conclusions: The incidence of preeclampsia and eclampsia in our referral center for the year 2018 was 15%, and 4.3% of women developed complications, and 6% died, making preeclampsia and eclampsia the causative factor for 34% of total maternal deaths. Major maternal complications were Renal, Hematological, Neurological, Pulmonary and MODS. Complications of preeclampsia were more often present in 62.4% mothers of female babies in contrast to 37.6% of mothers of male babies. Nearly one-third of babies (26.6%) were dead born.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196037
      Issue No: Vol. 9, No. 1 (2019)
       
  • A prospective study on maternal near miss cases at a tertiary care
           hospital

    • Authors: Karuna Kanta Das, Sasindra Kumar Das, Dhritimala Das
      Pages: 300 - 304
      Abstract: Background: Pregnant women’s health status is not only reflected by mortality indicators alone hence the concept of Severe Acute Maternal Morbidity (SAMM) is appropriate for present health providing system. It helps to evaluate the quality of obstetric care in a particular institute. The main objectives of the study were to find a) Incidence of MNMM; b) Disorders underlying MNMM; c) Socio-demographic variables among MNMM; d) Facilities and skills needed to handle these near miss situations.Methods: A prospective hospital-based study was conducted in the department of obstetrics and gynaecology, Gauhati Medical College and Hospital, Guwahati during the period 1st June 2018 to 31st May 2019. Cases were identified based on maternal near miss operational guidelines December 2014.Results: Out of 16222 live births, 241 near miss cases were identified during the study. The maternal near miss incidence ratio is 14.86 per 1000 live births. The maternal near miss to maternal mortality ratio is 2.025. Most common cause of MNMM is hemorrhage (48.54%) followed by hypertension (19.5%), anemia (13.28%), sepsis (10.37%), cardiac dysfunction (6.2%), liver dysfunction (0.83%), renal dysfunction (0.83%) and respiratory dysfunction (0.41%).Conclusions: The large magnitude of MNM cases may be attributed to improper management of obstetric emergencies at the referring hospitals, poor referral practices, inefficient transport system, limited availability of blood products and poor utilization of health care services at the peripheral hospitals. In our tertiary center, with the help of multidisciplinary action to all the near miss cases we can reduce maternal mortality to a great extent.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196038
      Issue No: Vol. 9, No. 1 (2019)
       
  • Prophylactic amnioinfusion in oligohydramnios

    • Authors: Dhiviya Narbhavi T., Cicily T. J., Kala B. S.
      Pages: 305 - 312
      Abstract: Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196039
      Issue No: Vol. 9, No. 1 (2019)
       
  • Obstetrics outcome in pregnant women with cardiac disease in tertiary care
           center, Dehradun, India

    • Authors: Prachi Singh, Namrata Saxena, Vineeta Gupta, Neeta Bansal, Yashika Pehal
      Pages: 313 - 317
      Abstract: Background: Incidence of heart disease in pregnancy is about 1%. Pregnant patient with cardiac disease can present with lot of challenges for the obstetrician, paediatrician and the cardiologist. With improvement in diagnostic, medical, surgical management, more patient with cardiac diseases especially congenital are able to reach reproductive age. Therefore, still a cardiac disease remains a significant cause of maternal death. Maternal and fetal prognosis both is affected by the care given and the skills used in the treatment of the individual patient. Hospital has resulted in majority of cardiac disease patient being managed in a tertiary care center and this provide an opportunity to report on clinical experiences of pregnancy with cardiac disease, their management and obstetrical outcomes.Methods: This was a retrospective study, with all the patients detailed demographic information, diagnosis, course in the hospital, management, maternal and fetal outcome was obtained from the medical records and files.Results: Incidence of cardiac disease was found to be 0.7%, 47% of pregnant women fell in age group of 26-30 years, 38.2% were primigravida, only 23.53% were booked, and half of them belonged to NYHA II class. 73.5% had Rheumatic heart disease and the most common obstetrics complications were preterm labor and anemia. LSCS was done in 29.4% cases and 38.2% of the newborns were premature.Conclusions: Prematurity anaemia, IUGR, are the common obstetrical complication in pregnant patient with cardiac disease which can be taken care with increased awareness and pre-conceptional counselling especially in patient with congenital heart disease. For optimization of maternal and neonatal outcomes in these patients, dedicated team of obstetrician, fetal medicine specialist, pediatricians, cardiologist and anesthesiologist is the prime requirement.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196040
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study on feto-maternal outcome of intra hepatic cholestasis of pregnancy

    • Authors: Binay Mitra, Debkalyan Maji, D. S. Borse
      Pages: 318 - 322
      Abstract: Background: Intrahepatic cholestasis of pregnancy is one kind of the hepatic disorder which is unique to pregnancy. It is associated with many adverse pregnancy outcomes if doesn’t intervened at right time. It requires adequate clinico-biochemical correlation during management.Methods: A prospective observational study was conducted at multispecialty government zonal hospital. Total 137 IHCP patients were managed during the study period from 01 Jan 2017 to 30 Jun 2019. Incidence and pregnancy outcome in form of several maternal and fetal factors were analysed by appropriate statistical test using spps software version 20.0.Results: During the study period total 4872 patients were undergoing delivery and 137 patients were diagnosed with IHCP. The incidence of IHCP was 2.81%. Majority of cases 75 out 137 (54.74%) were nulligravida. Total 29.92% (41/137) cases were underwent LSCS delivery and of this 21.17% (29/137) were primary caesarean delivery. There were three still birth noted in IHCP study population. Total 28 cases (20.44%) of IHCP were presented with preterm labour. And NICU admissions of the study population were 32 new born babies (23.36%). 2.18% case of still birth was noted among study population.Conclusions: IHCP causes significant maternal and neonatal morbidity and is major contributor of preterm delivery, caesarean delivery, meconium stained liquor and NICU admission.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196041
      Issue No: Vol. 9, No. 1 (2019)
       
  • Accuracy and reliability of ultrasound estimation of fetal weight in women
           with a singleton term pregnancy

    • Authors: Reena Sharma, Rohit Bhoil, Poojan Dogra, Sushruti Kaushal, Ajay Sharma
      Pages: 323 - 327
      Abstract: Background: Prenatal estimation of birth-weight is of utmost importance to predict the mode of delivery. This is also an important parameter of antenatal care. This study was conducted to evaluate the accuracy of estimated fetal weight by ultrasound, compared with actual birth weight.Methods: This was a prospective and comparative study comprising 110 pregnant women at term. Patients who had their sonography done within 7 days from date of delivery were included. Fetal weight was estimated by Hadlock 2 formula, the software of which was preinstalled in ultrasound-machine. The estimated fetal weight was compared to the post-delivery birth-weight. The Pearson's correlation coefficient was used and the accuracy of sonographic fetal weight estimation was evaluated using mean error, mean absolute error, mean percentage error, mean absolute percentage error and proportion of estimates within 10% of actual birth weight.Results: Mean estimated and actual birth weights were 3120.8±349.4 gm and 3088.2±404.5 g respectively. There was strong positive correlation between estimated fetal weight and actual birth weight (r = 0.58, p<0.001). The mean percentage error and mean absolute percentage error of ultrasound fetal weight estimations were 1.96±11.8% and 8.7±8.2% respectively. The percentage of estimates within ±10% of the actual birth weight was found to be 67.3%. In 23% of the cases, ultrasound overestimated the birth weight. In 13% of the cases, ultrasound underestimated the birth weight.Conclusions: There was strong positive correlation between actual and sonographically estimated fetal weight. So, ultrasonography can be considered as useful tool for estimating the fetal weight for improving the perinatal outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196042
      Issue No: Vol. 9, No. 1 (2019)
       
  • Role of pelvic and para-aortic lymphadenectomy in epithelial ovarian
           cancers

    • Authors: Pankush Gupta, Sunesh Kumar, Seema Singhal, Jyoti Meena, Sandeep Mathur, Lalit Kumar
      Pages: 328 - 334
      Abstract: Background: Lymphadenectomy in epithelial ovarian cancers has remained a controversial subject. Lack of robust evidence on survival benefits and surgical morbidity associated questions its role in the era of adjuvant chemotherapy. The present study assessed pelvic and para-aortic lymph node removal in epithelial ovarian cancer in Indian women and tried to find clinicopathological correlation of nodal involvement and postoperative implications of lymphadenectomy.Methods: Thirty patients with diagnosis of epithelial ovarian cancer posted for primary debulking surgery were recruited and underwent staging laparotomy along with pelvic and para-aortic lymphadenectomy. Nodal involvement was confirmed on histopathology and various parameters which could predict nodal metastasis were assessed. Patients were followed up for 12 months post-surgery.Results: Nodal yield was ten for pelvic and four for paraaortic nodes. Pelvic node involvement was seen in 26.6% (8/30) of the patients and para-aortic in 15% (3/20) of the patients. Serous histology, higher grade, stage 3 and above, positive peritoneal cytology, omental involvement showed a higher lymph node involvement though not statistically significant. Para-aortic lymphadenectomy was associated with increased operating time, blood loss and longer hospital stay.Conclusions: Lymphadenectomy increases morbidity and decision should be based on predictors of nodal involvement.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196043
      Issue No: Vol. 9, No. 1 (2019)
       
  • Healthcare workers’ knowledge and attitude towards prompt referral of
           women with postpartum haemorrhage in Nigeria: a community-based study

    • Authors: Adekemi Eunice Olowokere, Aanuoluwapo Omobolanle Olajubu, Ifeoluwa Eunice Ayeni, Olayinka Olaitan Aremu
      Pages: 335 - 341
      Abstract: Background: Postpartum Haemorrhage (PPH) is a major contributor to maternal mortality in developing countries most especially in the rural areas where Emergency Obstetric Care (EmOC) are not available. Delay in referring women from rural health facilities to settings where EmOC services are available have been reported. This study assessed community-based healthcare workers’ (CHWs) knowledge and attitude towards the prevention, early recognition and prompt referral of women with Post-Partum Haemorrhage (PPH) for Emergency Obstetric Care (EmOC).Methods: Descriptive cross-sectional design was used. Structured questionnaire was used to collect data from 200 CHWs recruited from community-based healthcare. Data analysis was done in SPSS version 20 at significance level of 0.05.Results: Findings show that 86.5% (n=173) of the respondents had good knowledge while 12% (n=24) and 1.5% (n=3) had moderate and poor knowledge respectively. Negative attitude towards prompt referral of women affected with PPH was found among 51% (n=102) of the respondents. Unavailability of blood drapes to estimate blood loss [χ2 (1, n=200) = 4.51, p=0.03], lack of ambulance [χ2 (1, n=200) = 4.46, p=0.03], and poor state of the roads [χ2 (1, n=200) = 4.44, p=0.03] were factors linked to poor attitude of CHWs towards prompt referral of affected women.Conclusions: The study concluded that there is a need for intervention that can help improve community healthcare workers’ attitude towards prompt referral of women affected with postpartum haemorrhage. There is also a need for general overhaul of community-based facilities to effectively support prompt referral.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196044
      Issue No: Vol. 9, No. 1 (2019)
       
  • Tramadol versus placebo for labor analgesia in low risk women: a
           randomized controlled trial

    • Authors: Aastha Raheja, Krishna Agarwal, Rini Pachori, Gauri Gandhi
      Pages: 342 - 347
      Abstract: Background: In low- and middle-income countries epidural analgesia is generally not available and practically no form of labor analgesia is given to the majority of the parturient. The purpose of study was to evaluate the safety and efficacy of tramadol as a labor analgesic during first stage of labor.Methods: Pregnant women admitted in the labor room satisfying the eligibility criteria were randomized to receive intramuscular injection of either 100 mg tramadol or 2 ml distilled water. Visual analogue score (VAS) was assessed at the beginning and every hour till 4 hours. Pain satisfaction, duration of second stage of labor, fetal heart rate, mode of delivery, and any maternal side effects of the study drug were recorded. Neonatal evaluation using Apgar score at 1 and 5 minutes was done. For statistical analysis Student t-test, Chi Square test and Fisher’s exact test were used.Results: Total of 86 women were included in the study. The VAS scores were significantly lower in the tramadol group at 1, 2 and 3 hours after the administration. Pain relief satisfaction was significantly higher in the tramadol group. Rate of cervical dilatation, duration of the second and the third stage, need for instrumental delivery or lower segment caesarean section, rate of fetal distress and Apgar score at one and five minutes were comparable in both the groups. Nausea was significantly higher in tramadol group.Conclusions: Tramadol is a safe and efficacious drug which is inexpensive, easily available and easy to administer with few minor side effects. It can be used as a labour analgesic as an alternative to epidural analgesia in settings where epidural analgesia is not available. Trial registration: Clinicaltrials.gov PRS registration number: NCT02999594. 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196045
      Issue No: Vol. 9, No. 1 (2019)
       
  • Study of choices of contraception in postpartum women in a tertiary care
           institute in Mumbai, Maharashtra, India

    • Authors: Aliya Farogh, Tushar Palve
      Pages: 348 - 351
      Abstract: Background: This modern era talks about women strength and empowerment where they are working either equally or one step ahead of men. However, a fall back in making decisions for contraception use and family planning can still be observed. It is most frequently seen among women belonging to some village as they are exposed to a minimal health care. Keeping this in mind, this crucial period was considered as opportunity to test the issue regarding the various choices of contraception available. Objective of this study was to find out the criteria and methods of contraception selected by women in the postpartum period.Methods: A cross-sectional study in the department of obstetrics and gynaecology was conducted over a period of 11/2 years in which a total of 150 postpartum women were interrogated and counselled regarding various methods of contraception.Results: The contraceptive methods most commonly selected in postpartum period are PPIUCD, Barrier, tubal ligation and injectable contraception of which condom is the most common method adopted. The important factors responsible for the choice of contraception include parity, breast- feeding, education and socio-economic status of the women.Conclusions: Postpartum period is particularly important for initiating contraception as the largest proportion with unmet need of contraception is found among those in their first year after child birth. In order to space birth in a healthy manner postpartum contraception should be emphasized upon.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196046
      Issue No: Vol. 9, No. 1 (2019)
       
  • Manfort, a blend from plant extracts used for infertility treatment and
           improvement of testicular histology

    • Authors: Mahmoud Elnahas Hussein
      Pages: 352 - 357
      Abstract: Background: Flavonoids and polyphenols are groups of natural substances have variable phenolic configurations, many benefits as anti-inflammatory and anti-oxidants, and have many protective roles against male reproductive system disorders. Objective of this study was to study the safety as well as the efficacy of a blend from some plants extracts with precise ratios and rich with flavonoids and polyphenols named in this study as “Manfort” on the safety, fertility, and testicular histology in the male mice.Methods: Firstly, some mice were used to evaluate the safety of Manfort and the levels of the testosterone in the serum of the treated animals with Manfort using biochemical analysis. Also, the efficacy of the Manfort on the histological architectures of the treated testis was evaluated using histological techniques.Results: The mice treated with Manfort did not show any signs of mortality, toxicities and blood contents changes. Furthermore, testosterone levels in the serum elevated after administration with Manfort twice a day for 21 days compared with the non-treated mice. Additionally, the histological structures of the testis improved in the mice treated with Manfort compared with that in the non-treated animals.Conclusions: In general flavonoids and polyphenols, which were found in the Manfort diet in a large amount, have important role in as antioxidant, anti-inflammatory and improve the fertility in the male mice. In the future these data might be very important to manufacture a drug composed from safe natural products for infertility and intractable diseases treatment.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196047
      Issue No: Vol. 9, No. 1 (2019)
       
  • Posterior reversible encephalopathy syndrome in preeclampsia

    • Authors: Uma Thombarapu, Aruna Devi Dwarampudi, Prabha Devi Kodey
      Pages: 358 - 363
      Abstract: Background: Posterior reversible encephalopathy is a clinico-radiological syndrome marked by headache, altered mental status, seizures, visual disturbances, and extensive white-matter changes, also known as hyper perfusion encephalopathy, brain capillary leak syndrome, and hypertensive encephalopathy. This syndrome was a possible consequence of several medical conditions but especially in pregnancy it is associated with pre-eclampsia and eclampsia. Objective of this study was to know the incidence and analyze the clinical features, biochemical, and radiological abnormalities in posterior reversible encephalopathy syndrome (PRES) as a complication of preeclampsia.Methods: This was a one-year cross-sectional analytical study conducted at NRI general hospital, Chinakakani, Guntur of patients with the diagnosis of PRES. Data was obtained from medical records and analyzed them in terms of mean for continuous variables and percentages for categorical data.Results: Total no of patients diagnosed as PRES were 16 out of 127 patients of preeclampsia. Among them, 14 presented with eclampsia, and two presented with severe preeclampsia and imminent symptoms of eclampsia. Headache was the most common symptom (100%). PRES occurred at a peak SBP of ≥160 mmHg in 75% cases and peak DBP of ≥110 mmHg in 50% cases. Serum lactate dehydrogenase (LDH) level was ≥600 in 56.25% and serum uric acid level ≥6 in 50% of patients of PRES. The drug of choice was magnesium sulfate.Conclusions: Neuroimaging abnormality is a definitive component in the diagnosis of PRES. These cerebral abnormalities are vital components in the pathogenesis of eclampsia. Considerable number of patients of preeclampsia might develop PRES even without eclampsia, with mild elevation in BP, serum LDH, and serum uric acid levels.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196048
      Issue No: Vol. 9, No. 1 (2019)
       
  • An empirical study on maternal and perinatal outcome of placenta
           previa-risk factors, morbidity and mortality in JNIMS, Imphal, India

    • Authors: Haripriya Devi Sanglakpam, Indrakumar Singh Ng.
      Pages: 364 - 370
      Abstract: Background: The observational study to analyse the maternal and perinatal outcome in pregnancies complicated with placental previa evaluating the potential risk factor, associated with morbidity and mortality.Methods: The study was a prospective longitudinal comprising of all the pregnant women after 28 week of gestation irrespective of gravid and parity that attended or admitted in the department of obstetrics and gynaecology, JNIMS, diagnosed as having placental previa by transabdominal ultrasonography and conducted for the period of 20 months i.e. from October 2017 to June 2019 analyzing 54 cases of placenta previa.Results: During this period there were total of 9967 deliveries with incidence of placenta previa being 0.54% in JNIMS, Porompat. The estimated risk factors out of total 54 cases were 20-30 (52%) years by age group, 25 (46%) gravida, 18 (32%) parity, 36 low lying placenta and 11 cases (20%) preterm.Conclusions: Highest levels of placenta previa are associated with poor maternal and perinatal outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196049
      Issue No: Vol. 9, No. 1 (2019)
       
  • First and second trimester bleeding and pregnancy outcome: a prospective
           study in a tertiary government hospital

    • Authors: Chaithra M., Anitha G. S., Sukanya Suresh, Savitha C.
      Pages: 371 - 374
      Abstract: Background: Bleeding in first and second trimester of pregnancy is one of the common complications of pregnancy. there is evidence from various prospective and retrospective studies that first and second trimester vaginal bleeding which continue with pregnancy is associated with adverse pregnancy outcome, including preterm delivery, low birth weight babies, perinatal death and congenital anomalies. Objective of this study was to know the outcome of pregnancies who have bleeding in first and second trimester of pregnancy.Methods: This study was prospective study done in the department of obstetrics and gynaecology, Vanivilas Hospital, Bangalore from September 2018 to August 2019.Results: This study concludes that I trimester vaginal bleeding are at increased risk of abortion than in II trimester vaginal bleeding. Risk of placenta previa was more in II trimester vaginal bleeding than in I trimester vaginal bleeding.Conclusions: This study concludes that I trimester vaginal bleeding are at increased risk of abortion than in II trimester vaginal bleeding. Risk of placenta previa was more in II trimester vaginal bleeding than in I trimester vaginal bleeding. Bleeding in I trimester and II trimester call for special attention in view of increased risk of preterm birth and perinatal death. Recognition of these association will be useful for detection and follow up of pregnancies being at high risk.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196050
      Issue No: Vol. 9, No. 1 (2019)
       
  • The retina in hypertensive disorders of pregnancy: a study of the
           prevalence and association with severity of disease in a tertiary referral
           centre in India

    • Authors: Jasmine C. Sharma, Bithi Choudhary, Laxmi Maru, Poonam Mathur
      Pages: 375 - 382
      Abstract: Background: Hypertensive disorders of pregnancy remains to be a major cause of maternal and fetal morbidity and mortality. The retina offers the unique opportunity to directly observe changes in the vasculature due to preeclampsia. Fundoscopy can be used to prognosticate and assess the severity of disease and offer an optimum time of delivery to improve fetomaternal outcome. There are limited number of studies from northern India assessing the relationship between hypertensive disorders of pregnancy and retinopathy. This study was undertaken to bridge this gap.Methods: This was an observational cohort study undertaken in a tertiary hospital, 225 patients of preeclampsia coming to the department were identified and a structured proforma used to gather relevant information. All patients underwent fundoscopy and were classified into groups on the basis of fundal grade observed. The groups were compared in terms of clinicodemographic variables. Appropriate statistical tests were applied.Results: A total 68% patients had retinal changes of which the most common grade was grade 1 There was a significant rise in the mean systolic and diastolic blood pressure with increasing grade of fundal change. The (p-value 0.001). 65.5% of patients of preeclampsia without severe features (i.e. mild cases) had no retinopathy. None of these patients had grade 3 or 4 changes. In the patients of preeclampsia with severe features, 88.9% cases had varying degrees of retinopathy.Conclusions: As severity of preeclampsia increases, incidence of retinopathy also increases. Fundoscopy is a useful diagnostic aid and should be done to optimize fetomaternal outcome.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196051
      Issue No: Vol. 9, No. 1 (2019)
       
  • Parturient satisfaction with labour epidural and factors affecting
           

    • Authors: Leah Raju George, Thenmozhi Mani, Ekta Rai
      Pages: 383 - 388
      Abstract: Background: Labour analgesia though widely practised is still not routinely administered to all parturients in India. We conducted this historical observational cross-sectional study to assess parturient knowledge and factors affecting satisfaction in those who received epidural labour analgesia; aiming at improving the services.Methods: All parturients requesting epidural labour analgesia have the catheter sited and the drug administered as per institutional protocols. A feedback form is given to these parturients, postnatally. The form consists of questions regarding her knowledge of and experience with labour analgesia, including her satisfaction score on a scale of 0 to 10. Author collected these forms and analyzed them along with information from the labour epidural register and the discharge summary.Results: The mean satisfaction score was 7.1 (SD- 2.28). 46 parturients (31.08%) had ‘low satisfaction’ (<7 score) and 102 parturients (68.9%) had ‘high satisfaction’ (≥7 score). The timing of initiation of epidural analgesia within the parturients expectations and adequate analgesia were two factors that were found to affect satisfaction scores, with statistically significant values (p=0.002 and p=0.006 respectively). Those with a very short or very long duration of labour analgesia, were more likely to give less satisfaction scores (p=0.023 and p=0.002). Only 30% of parturients had heard of labour analgesia in the past.Conclusions: In this setting good analgesia and receiving it on time are of utmost importance in those receiving epidural labor analgesia, emphasising the need for adequate analgesia and prompt initiation of the same.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196052
      Issue No: Vol. 9, No. 1 (2019)
       
  • Prevalence and characteristics of accidental perineal tears during
           childbirth in a communal medical center in Guinea-Conakry: a
           cross-sectional study

    • Authors: Oumou Hawa Bah, Boubacar Alpha Diallo, Aboubacar Fode Momo Soumah, Boubacar Siddi Diallo
      Pages: 389 - 393
      Abstract: Background: Prevalence studies are still rare in sub-Saharan Africa on perineal tears. We conducted this cross-sectional study in a communal hospital in Guinea-Conakry, with the objective of this study was to determining the prevalence and characteristics of post-obstetric perineal lesions.Methods: All deliveries between March 1st and August 31st, 2014 were reviewed. We included in the analysis all the single deliveries with perineal tears. The Anglo-Saxon classification of perineal tears was used.Results: The prevalence of perineal tears was 5.7% with 5.4% benign lesions and 0.3% severe lesions. We did not register 4th degree lesions. The average age of parturient was 22 years. The majority (96.6%) of parturient had a history of genital mutilation and perineal scarring (60.3%).Conclusions: This prevalence appear low compared to those reported in other studies in Africa and point to the need for more sophisticated studies to have a better estimate of the prevalence of perineal tears in Guinea-Conakry.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196053
      Issue No: Vol. 9, No. 1 (2019)
       
  • A study of clinical characteristics and outcome of obstetric patients in
           intensive care and high dependency unit of a tertiary centre of Jharkhand,
           India

    • Authors: Samarina Kamal, Vandita Singh, Shashibala Singh
      Pages: 394 - 399
      Abstract: Background: Few women during their pregnancy, labour and postnatal period require critical care related to the pregnancy itself, aggravation of a pre-existing illness and complications of the delivery. Pregnant patients account for a small number of ICU admission - 2-10% two main indications for admission are hypertensive disorders (17.2%-46%) and massive haemorrhage (10%-32.8%). The primary objective of the present study was to review the characteristics of the obstetric patients admitted to our ICU over a 2-year period.Methods: It was a prospective study conducted over 50 patients in high dependency and intensive care unit at Alam hospital over a period of 2 years (October 2014 to October 2016).Results: During the study period a total of 50 obstetric patients were transferred to the intensive care unit (ICU). Antenatal care played significant role in the obstetric outcome. 84% of patients transferred to the ICU during the study period had inadequate or no antenatal care, while 8% were booked in their pregnancy and had adequate antenatal care. ICU interventions included mechanical ventilation used in 20(40%) patients, blood and blood product transfusion in 35(70%) patients’ inotropes in 20 patients (40%) antihypertensive therapy in 20 patients (40%), arterial embolization in 2(4%) patients. Maternal mortality was seen in 10 patients (20%).Conclusions: There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196054
      Issue No: Vol. 9, No. 1 (2019)
       
  • Sirenomelia with Potter syndrome: a case report and review of literature

    • Authors: Amrita Singh, Anupma Kumari
      Pages: 400 - 403
      Abstract: Sirenomelia or mermaid syndrome is a rare congenital anomaly characterized by variable degree of fusion of lower extremities. Awareness to this rare condition is important for prenatal diagnosis and prognosticating the fetus. The exact etiopathogenesis is still an area of research. Two pathogenic hypotheses are the vascular steal hypothesis and the defective blastogenesis hypothesis with exceptions reported in literature.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195588
      Issue No: Vol. 9, No. 1 (2019)
       
  • About a uni-cervical unicorn uterus case with vaginal septum

    • Authors: Mapatano Shalamba E., Kalala Kanyinda L., Kiminyi Kalunga M., Nyakio Ngeleza O., Kanku Tudiakwile L., Mukwege Mukengere D.
      Pages: 404 - 408
      Abstract: The unicorn uterus is a common uterine malformation after septate uteri, accounting for 30 to 50% of cases. We report a case of unicorn uterus with an associated vaginal septum discovered during the obstetrical examination of a consultant surgeon for hemorrhage, and exploration of the uterus revealed a uterus during a cesarean section. Maternal-fetal rescue for placenta previa. The interest of this case is to show the double embryological mechanism involved, unilateral aplasia of the muller ducts and the lack of resorption explaining this vaginal septum.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196055
      Issue No: Vol. 9, No. 1 (2019)
       
  • Arteriovenous uterine malformation: case report

    • Authors: Raúl D. Lara Sánchez, Alexander J. Rafaelano Miranda, Sara E. Hernandez Flores, Tania P. Alvarez, Jose M. Bizuet Cabrera, Angel Lemus Huerta
      Pages: 409 - 414
      Abstract: The case of a 49-year-old patient is reported, with a particular history of obstetric risk, who presented with severe transvaginal hemorrhage, was performed doppler arteriography and ultrasound, finding data suggestive of arteriovenous uterine malformation, surgery was decided due to heavy menstrual bleeding with anemia, the pathology report shows characteristics of an arteriovenous uterine malformation.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196056
      Issue No: Vol. 9, No. 1 (2019)
       
  • A rare case of dicephalic parapagus conjoined twins

    • Authors: Edouard N’Guessan, Roseline Kouame N’Guessan, Franck Gbeli, Privat Guie
      Pages: 415 - 417
      Abstract: Dicephalic parapagus are one of the rare forms of conjoined twins. Their prognosis is usually very poor. Early prenatal diagnosis of these serious congenital abnormalities remains a real challenge for health systems in the low-income countries. The late antenatal diagnosis of a case of this abnormality was presented. The diagnosis was made at the 33rd week on the only ultrasound performed during the pregnancy. The pregnancy was interrupted with the agreement of the couple and delivery was performed by caesarean section. 
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196057
      Issue No: Vol. 9, No. 1 (2019)
       
  • Suture granuloma masquerading as primary ovarian malignancy: a case report

    • Authors: Seetu Palo, Kanchana P. V. N.
      Pages: 418 - 420
      Abstract: Suture granuloma is an uncommon surgical complication comprising of foreign body granulomatous tissue reaction against the suture material. We present a case of ovarian suture granulomas in a 28-year-old female who was clinico-radiologically misdiagnosed as ovarian carcinoma. She presented with intermittent pelvic pain, on and off low-grade fever and menstrual irregularities for 6 months and had undergone laparoscopic tubectomy two years back. Ultrasonographic findings were suspicious of left ovarian malignancy. CA-125 levels were elevated (115 U/mL). Left oophoro-salpingectomy was performed and histopathological examination revealed multiple suture-related granulomas.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196058
      Issue No: Vol. 9, No. 1 (2019)
       
  • The inevitable and incidental caesarian myomectomy

    • Authors: Vinita Sarbhai
      Pages: 421 - 423
      Abstract: The management of fibroid encountered during caesarean remains controversial. The traditional approach has always been, not to perform myomectomy, because of the fear of haemorrhage due to increased vascularity and uterine atonicity of pregnant uterus and increased morbidity. Caesarean section was performed in 27-year G2P1 in view of previous LSCS, short inter-conception period, frank leaking and poor bishop score. After delivery of baby a fibroid of 6 cm by 5 cm was seen jutting out of left side of incision line. Myomectomy was performed, without any complication, as it was not possible to approximate the incision line without that. No excessive hemorrhage or postoperative complications were encountered.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196059
      Issue No: Vol. 9, No. 1 (2019)
       
  • Reproductive potential in a case of Mosaic Turners syndrome with 46XY
           karyotype

    • Authors: Geetha D. Balsarkar, Rachana D. Dalmia, Namita N. Raut
      Pages: 424 - 426
      Abstract: This article describes a case of 18year-old-female who presented with primary amenorrhea, phenotypic features of Turners syndrome, which was confirmed later by Karyotype to have mosaic 45XO(8)/46XY(22). She had delayed puberty and proved (hormonally) to have ovarian failure, with absent Mullerian structures (radiologically and laparoscopy).
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196060
      Issue No: Vol. 9, No. 1 (2019)
       
  • Breus’ mole/chorangiosis/chorangioma of the placenta: a dilemma with a
           rare fetal outcome report

    • Authors: Nitika Sobti, Ankita Chandna, Bhawna Narula
      Pages: 427 - 431
      Abstract: Massive Subchorionic Thrombohematoma (MST) is a rare condition in which there is a massive collection of blood between the placental membranes and uterine wall separating the villous chorionic plate from villous chorion. It is relatively rare and is poorly understood. Many theories have been proposed to explain the etiology of Breus mole; some suggest it is a fetal haemorrhage, while others claim it has a maternal-origin thrombosis of placental vessels. A 30-year-old healthy Indian pregnant woman was presented at Max Hospital, Shalimar Bagh Delhi, India, during her second pregnancy with a complaint of fever. On routine level-2 ultrasonography (USG) done at 18.6 weeks of gestation showed thick placenta. No fetal tumours or any other anomalies were noted on that scan which was followed by a detailed scan which confirmed a solitary mass arising from fetal side 103x64x82 mm S/O chorioangioma. Serial growth and doppler USG were conducted to monitor placental function, tumor characteristics and future anatomy. The subject received steroids to enhance fetal lungs maturation at Week 30, iron/calcium supplements, Ecosprin tablets, and progesterone support. At 32.5 weeks, the subject developed deranged sugars followed by gestational hypertension at 34.1 weeks. Ultrasonography also showed fetal growth restriction with large chorioangioma. The subject underwent a successful elective caesarean section at 34.4 weeks. On placental examination, 10 cm large mass encasing ¾ of the placenta was identified as a large subchorionic hematoma/chorioangioma (800 g). This study concludes that early identification of a large chorangioma aids in consequent fetal surveillance, management of maternal symptoms, and delivery planning discussions even if the pathological diagnosis turns out to be Breus’ mole with underlying chorangiosis postnatally.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196061
      Issue No: Vol. 9, No. 1 (2019)
       
  • Huge Sertoli-Leydig cell tumor: a rare case report

    • Authors: Mridula Raghav, Ashok R. Anand
      Pages: 432 - 436
      Abstract: Sertoli-Leydig cell tumors (SLCTs), constitute less than 0.5% of all ovarian tumors. SLCT are rare after menopause (less than10%), 75 years, unmarried, postmenopausal since 30 years, presented with complaints of abdominal swelling. On examination, abdominal mass of 36 weeks, hard, immobile felt. Ultrasonography of abdomen showed lobulated solid cystic lesion of size 22 x 15 x 27 cms with bilateral ovaries not separately visualized. Moderate free fluid in the abdomen, suggestive of malignant neoplastic etiology. CECT Abdomen + pelvis suggestive of primary ovarian malignancy with omental deposits and pelvic adenopathy. CA 125- 415.1 Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with huge tumour mass excision (weight 5.25 kg) with umbilical hernia repair. Frozen section suggestive of a huge mass of 30 x 20 x 15 cm, multilobulated, yellowish white tan in colour, solid-cystic in consistency, seen arising from right ovary. Omentum appears normal. Histopathology report s/o- Moderately differentiated Sertoli Leydig cell tumor. Reporting the first, this huge, in this age group with atypical presentation.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196062
      Issue No: Vol. 9, No. 1 (2019)
       
  • Giant angioleiomyoma of uterus masquerading as ovarian tumour: a case
           report

    • Authors: Purnima Bhandari, Anil C. Humane, Vaishali S. Deshmukh
      Pages: 437 - 439
      Abstract: Angioleiomyoma is a rare benign tumour of uterus. We are presenting an unusual case of 45-year-old female with 11 kg giant angioleiomyoma of uterus which was masquerading as ovarian tumour on imaging. Exploratory laparotomy was done which was suggestive of huge lobulated mass arising from the uterus. Hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination of specimen was suggestive of uterine subserosal and broad ligament angioleiomyoma of cavernous type. This case is being reported because of its rarity and challenges in diagnosis and management.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196063
      Issue No: Vol. 9, No. 1 (2019)
       
  • Successful outcome in a perplexing case of Roberts uterus: a rare uterine
           anomaly, a rare case report with review of literature

    • Authors: Swati Singh, Renuka Malik, Pooja Gupta, Anjum Ara
      Pages: 440 - 443
      Abstract: Robert uterus is a rare Mullerian development anomaly with very few cases reports available. It presents with triad of morphologic features of - Blind hemi cavity with or without unilateral hematometra, contralateral unicornuate uterine cavity and normal uterine fundus with or without small external indentation. The major difficulty lies in making the diagnosis of Robert’s uterus. All the reported cases of Robert’s uterus have been managed differently according to patient’s complaints. A 25-year-old married female, resident of Agra presented to gynecology OPD of Dr RML Hospital and associated PGIMER in June 2013, with primary infertility and cyclical left sided dysmenorrhoea since menarche. Patient was consulting at her hometown Agra for 2 years and had an USG and MRI pelvis report of Feb. 2013 with her showing unicornuate uterus with rudimentary horn. Infertility investigations were done in our hospital. HSG report was of localized spill on right with left tubal block. Patient was posted for diagnostic hystero-laproscopy which was further followed by laprotomy, after which we could reach to a diagnosis of Robert uterus with non-communicating left cavity and with severe endometriosis. Patient needed a second hysteroscopy for lysis of septum and subsequently conceived with IVF. She delivered a healthy male baby of 2.65 kg by elective LSCS at 37 weeks with associated breech presentation with gestational hypertension with severe IHCP on 20 June 2019. Paediatric surgeons and gynecologists should be aware of this rare atypical obstructive Mullerian malformation and its management to avoid inappropriate management delays in these patients. A timely diagnosis and definite treatment have a great impact on future reproductive and endocrine function.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196064
      Issue No: Vol. 9, No. 1 (2019)
       
  • Yolk sac count matters

    • Authors: Ashok K. Todani, Kiralata Todani
      Pages: 444 - 447
      Abstract: Yolk sac is the first anatomical structure identified within the gestational sac at 5+ weeks and is diagnostic of intrauterine pregnancy. It is attached through the yolk stalk with the intestinal cavity of the embryo and is supplied with blood vessels that transport nutritive yolk products to the developing embryo. It provides nutritive, metabolic, endocrine, immunological and haemopoietic functions. The poor quality and early regression of a yolk sac in presence of embryonic heart beats are more specific than the large size of a yolk sac in predicting pregnancy loss. Number of yolk sac is usually indicative of amnionicity, except in select reported cases of monoamniotic twins when two yolk sacs are present. Singleton pregnancies contain only one yolk sac as a rule. We have come across a case of elderly non-diabetic primi gravida where presence of one extra yolk sac has accelerated growth of single foetus by 8 days in early first trimester. We followed it up to 16 weeks of gestation when both yolk sacs disappeared. It was concluded that two yolk sacs conferred extra mileage of growth to the foetus due to doubled yolk sac functions, and this extra growth persisted throughout.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196065
      Issue No: Vol. 9, No. 1 (2019)
       
  • A rare case of fetus papyraceous presenting in monozygotic biamniotic
           twins

    • Authors: Lakshmi S., Rajkumar K.
      Pages: 448 - 449
      Abstract: Fetus papyraceous or compresses is characteristic of compressed mummified, parchment like remains of dead twin retained in utero after intrauterine death in the second trimester. It is an uncommon finding and we report in a G2P1L1 with 22 weeks with Monozygoticbiamniotic twins with fetus papyraceous stuck to left upper segment followed up to 36 weeks. The mother was advised regular antenatal visits and frequent feto-maternal monitoring was done. Patient delivered a single live baby and a placenta with mummified fetus within it. The incidence of fetus papyraceous is about 1 in 17000 to 1 in 20000 pregnancies. Early diagnosis of this condition helps in monitoring the surviving fetus.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196066
      Issue No: Vol. 9, No. 1 (2019)
       
  • Partially four-vessel umbilical cord: about a diagnosed case at Panzi
           hospital

    • Authors: Boengandi Walala D., Nyakio Ngeleza O., Mukanire Ntakwinja B., Katenga Bosunga G., Mukwege Mukengere D.
      Pages: 450 - 452
      Abstract: Umbilical cord malformations are described in the literature; and it's about the umbilical artery and the umbilical vein. There are sometimes cases of a single umbilical artery. In contrast, the number of vessels in the umbilical cord can increase by three to four. A supernumerary umbilical vein is particularly rare and is usually found in association with congenital anomalies; sometimes the supernumerary umbilical vein is associated with no malformation. We report a case of umbilical cord having a four-vessel part diagnosed at the maternity ward of Panzi Hospital, in the town of Bukavu, South Kivu, DR Congo.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196067
      Issue No: Vol. 9, No. 1 (2019)
       
  • Gestational diabetes mellitus causes dyslipidemia in late trimester: mini
           review

    • Authors: Poonguzhalai S., Kalyanikutty K. P.
      Pages: 453 - 457
      Abstract: The incidence of gestational diabetes mellitus (GDM) is increasing rapidly worldwide. Many women with gestational diabetes mellitus are likely to have type 2 diabetes. With the extensive management protocol for GDM we are able to obtain a good glycaemic control but still excess morbidity prevails among GDM pregnancy compared to normal pregnancy. This may be due to the dysfunction of lipid metabolism. Changes in carbohydrate and lipid metabolism occur during pregnancy to ensure a continuous supply of nutrients to the growing fetus despite intermittent maternal food intake. Exaggerated reduction in insulin sensitivity in the peripheral tissues combined with peripheral adipose tissue lipolysis in GDM pregnancy than normal pregnancy results in increased maternal lipoprotein concentrations and elevated lipoprotein triglyceride content. An altered lipid profile on the maternal side would modulate the quantity and quality of lipids being transferred to the fetus. Hypertriacylglycerolemia in gestational diabetes mellitus has been related to a significant risk of having neonates that are large for gestational age and it is considered as a major cause of preeclampsia in the late gestational age. So, the recent researchers emphasize on targeting lipid metabolism in pregnant women with GDM to avoid the adverse outcomes of pregnancy.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20195600
      Issue No: Vol. 9, No. 1 (2019)
       
  • Changes in the lifestyle and feeding habits that could improve the planet
           and human health: the reproductive case

    • Authors: Alejandra María Gómez Gutiérrez, Briana D. Gómez Ramírez, Walter D. Cardona Maya
      Pages: 458 - 460
      Abstract: There is a link between food systems, environment, and human health. According to the Food and Agriculture Organization of the United Nations-FAO, food production from animal and plant origin, using unsustainable agricultural practices with the excessive use of fertilizers, pesticides, fungicides, and herbicides have adverse effects on the environment and could contaminate water sources and even the soil.1 Also, the production of food from animal origin is one of those responsible for the emission of greenhouse gases, fresh water expenditure, and soil loss. Therefore, with the current food consumption and unsustainable human practices, the future of humanity will be uncertain.
      PubDate: 2019-12-26
      DOI: 10.18203/2320-1770.ijrcog20196068
      Issue No: Vol. 9, No. 1 (2019)
       
 
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