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Publisher: Medip Academy   (Total: 12 journals)   [Sort by number of followers]

Showing 1 - 12 of 12 Journals sorted alphabetically
Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 12)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 2)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 12  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Tranexamic acid in prevention of postpartum hemorrhage in elective
           cesarean section

    • Authors: Pravin Shah, Ajay Agrawal, Shailaja Chhetri, Pappu Rijal, Nisha K. Bhatta
      Pages: 372 - 376
      Abstract: Background: Postpartum hemorrhage is a common and occasionally life-threatening complication of labor. Cesarean section is associated with more blood loss in compared to vaginal delivery. Despite, there is a trend for increasing cesarean section rates in both developed and developing countries thereby increasing the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of intravenous Tranexamic acid on blood loss during and after elective cesarean section.Methods: This was a prospective, randomized controlled study with 160 eligible pregnant women of 37 or more period of gestation. They were all planned for elective cesarean section and were randomized into two groups either to receive 10ml (1gm) of Tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation.Results: The mean estimated blood loss was significantly lower in women treated with Tranexamic acid compared with women in the placebo group (392.13 ml±10.06 vs 498.69 ml±15.87, respectively; p<0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the Tranexamic acid group than in the control group (0.31±0.18 vs 0.79±0.23, respectively; p<0.001).Conclusions: Pre-operative use of Tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where postpartum hemorrhage is a major threat to the life of the mothers, it seems to be a promising option.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190017
      Issue No: Vol. 8, No. 2 (2019)
       
  • Risk factors and outcome analysis of post-partum haemorrhage in a tertiary
           care centre

    • Authors: Roopa Aravind K., Priya Shankar
      Pages: 377 - 379
      Abstract: Background: Maternal haemorrhage is the major cause of maternal mortality and morbidity all over the world and more so in developing countries. PPH is the commonest cause of maternal mortality in India. Identification of risk factors, early diagnosis and timely intervention can help in reducing maternal mortality and morbidity significantly. The aim of this study is to analyse the risk factors and causes and study the maternal and perinatal outcomes of PPH in North Karnataka.Methods: It is a retrospective study of 228 patients admitted with the diagnosis of PPH, at KIMS, Hubli during 2016.Results: Average age of the patients was 27 years. Commonest risk factor was PIH, followed by APH and prolonged labour. The commonest cause of PPH was atonicity followed by retained placenta. Majority of the patients recovered successfully with medical management. While 29 patients required Para cervical clamp. Sixteen patients underwent hysterectomy. Commonest complication was anaemia. Total maternal deaths were four; all of them were due to DIC, mostly due to late referrals.Conclusions: Maternal mortality and morbidity due to PPH can be reduced by encouraging regular anti natal visits, timely referral of high-risk patients, training of the health personals and timely intervention. Well stocked blood banks play an important role in management of PPH.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190033
      Issue No: Vol. 8, No. 2 (2019)
       
  • Correlation between changes in placental morphological features with
           abnormal Doppler flow in pregnancy induced hypertension

    • Authors: Vijay N. Gadhavi, Mansi K. Gadhavi, Manish Pandya
      Pages: 380 - 384
      Abstract: Background: Placenta is one of the most challenging organs; it is an instrument of transfer of essential elements, i.e. nutrients and oxygen from mother to fetus and waste product of metabolism in reverse manner.Methods: Cases of PIH between 20-36 weeks of gestation will be studied over a peri-od of 2 years having B.P ≥140/90mm Hg and protienuria ≥1+ in this prospective analytical study having color Doppler scanner with PI, RI of umbilical, uterine artery and middle cerebral artery PI along with placental morphological changes are observed.Results: In present study where, placental weight was <300g also has LBW babies born were higher 51(100%). In placental gross examination 58% infarction, 42% calcification and 48% retroplacental were found. among 58 samples with infarction 76%, 42 placentas had calcification 48% and among 49 samples retroplacental clots 61% were belonged to uterine artery PI >1 group. While 78% placental infarction, 57% calcification and 69% retroplacental clots be-longed to uterine artery RI > 0.6 group. Infarction were 77.50%, calcification were same as infarction 77.50% while retroplacental clots 80% in group having MCA PI <1.3 that were higher than group of cases having MCA PI >1.3.Conclusions: In recent years placenta has drawn attention as valuable indicator for maternal and fetal diseases in preeclampsia. Decreased circulation in placenta reflects on its morphological features and these changes causes alterations in Doppler flow velocities of uterine, umbilical and middle cerebral vessels pregnancy induced hyper-tension.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190259
      Issue No: Vol. 8, No. 2 (2019)
       
  • A descriptive study on histopathology of fallopian tube in neoplastic
           surface epithelial ovarian tumors

    • Authors: Ashna C. Manuel, Radhamani M. V., Priya V., Deepa S.
      Pages: 385 - 388
      Abstract: Background: The incidence of cancer is increasing day by day. Ovarian cancer ranks as the fifth leading cause of cancer related death among women worldwide. The cure rate of early stage disease is high. The accepted view is that ovarian cancer arises from ovarian surface epithelium. Recent evidence suggested that around sixty percentage of women without a genetic predisposition who developed sporadic ovarian cancer also have early tubal lesion and cancer. The present study aims to find out the histopathology of fallopian tube in neoplastic surface epithelial ovarian tumour.Methods: A descriptive study was conducted among hundred women who had undergone surgery for malignant and benign surface epithelial ovarian tumor from Govt. Medical College, Kottayam for one year from January-December 2017.Results: Fifty percent of the patients had malignant surface epithelial ovarian tumors.Conclusions: The risk factors of malignant surface epithelial ovarian tumors include age above fifty years and post-menopausal women. Whereas oral contraceptive pill use is a protective factor against malignant surface epithelial ovarian tumors. The fimbrial end of fallopian tube is the site of origin of malignancy in high grade ovarian epithelial carcinoma. So, prophylactic bilateral salpingectomy should be encouraged in all patients who have completed family and undergoing hysterectomy. This will reduce the morbidity and mortality due to ovarian carcinoma.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190044
      Issue No: Vol. 8, No. 2 (2019)
       
  • Maternal and perinatal outcome of oligohydramnios in term pregnancy in
           rural tertiary care centre

    • Authors: Swati Kagne, Sambhaji Chate
      Pages: 389 - 392
      Abstract: Background: Disorders of amniotic volume is one of the commonest obstetric problem. Amniotic fluid acts as cushion to the foetus allowing musculoskeletal development and also helps in the differentiation of lungs and gastrointestinal tract. Decreased amniotic fluid, known as oligohydramnios, is known to be associated with adverse perinatal outcome. The objective is to study the maternal and perinatal complications of oligohydramnios in term pregnancy.Methods: The present study was carried out in the Department of Obstetrics at rural tertiary care hospital in Maharashtra from February 2018 through October 2018. women with Oligohyamnios were studied for obstetrical and neonatal complications.Results: The incidence of oligohyamnios was 7.6% in present study. The mean age of the study population was 22.6±3.6 years. Induction of labour was required in 44 (61.11%) patients out of which 23 patients underwent emergency LSCS. Low birth weight (birth weight<2.5kg) was found in 14 (19.44%) babies with 11 babies having intrauterine growth restriction. 5-minute APGAR (appearance, pulse, grimace, activity, respiration) score was <7 in 13.88% babies. 16 babied needed NICU admission out of which 1 neonate died.Conclusions: Detection of oligohydramnios increases obstetrical interventions in term pregnancy.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190031
      Issue No: Vol. 8, No. 2 (2019)
       
  • Record based analysis of indications and complications of 500 cases of
           lower segment cesarean sections at a tertiary care hospital

    • Authors: Vaishali Chaurasia, Sushruta Shrivastava
      Pages: 393 - 397
      Abstract: Background: The drastically increasing rate of caesarean section is a topic of constant worry and analysis throughout the world. In order to understand the degree to which caesarean section may be preventable, it is important to know why caesarean section are performed. This study is aimed to find out the rate of caesarean section at our institute, various indications of the procedure and complications related to them.Methods: This study was carried out retrospectively in the department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal. Study period was from January 2017 to December 2017. 500 cases of lower segment cesarean section were studied including both elective and emergency caesarean sections. Statistical analysis of age, parity, period of gestation, indications of LSCS and complications was done.Results: The rate of caesarean section came out to be 47.7%, which is far above recommended. Majority of patients (81.6%) were in 21-30 years age group; while the number of primary and repeat caesarean section were comparable (40.8% and 59.2%respectively). Commonest indication was previous LSCS (31.6%) followed by fetal distress (21.6%). Surgical site infection was present in 4.6% cases whereas, post-partum hemorrhage occurred in 5.8% cases. Three patients underwent obstetric hysterectomy and two cases of maternal mortality were reported among post LSCS patients.Conclusions: Increasing rates of caesarean section has contributed to maternal morbidity along with financial burden. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit rate of caesarean section.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190003
      Issue No: Vol. 8, No. 2 (2019)
       
  • Diagnostic role of hysteroscopy in abnormal uterine bleeding: a
           comparative study of hysteroscopy findings with histopathology from
           Mysore, South India

    • Authors: Mamatha Shivanagappa, Vinutha K. Veerabhadrappa, Madhumitha Mahesh
      Pages: 398 - 401
      Abstract: Background: Dilatation and curettage has long been the diagnostic gold standard for abnormal uterine bleeding. However, even a trained gynecological curettes at best 70-80% of the endometrium. Hysteroscopy is gaining acceptability over other diagnostic technique like dilatation and curettage, hysterosalpingogram and ultrasound. The objective of this study is to find out the role of hysteroscopy in abnormal uterine bleeding and to compare hysteroscopy findings with histopathology.Methods: Fifty patients in perimenopausal age group with abnormal uterine bleeding attending JSS Medical College and Hospital Mysore, during the period 1999-2001 were studied by diagnostic hysteroscopy followed by dilatation and curettage.Results: Mean age of the study group was 44.3% years (±2.5 SD). Menorrhagia was the commonest symptom and was found in 68% of the patients. Diagnostic hysteroscopy identified 23 cases as Normal endometrium, 16 cases as endometrial hyperplasia, 3 cases as atrophic endometrium, 4 cases as endometrial polyp, 4 cases as fibroids. Compared with histopathological findings as definitive diagnosis, hysteroscopy correctly picked up 19 cases of (86.9%), normal endometrium, 12 cases of hyperplasia (75%), 3 cases of atrophic endometrium (100%), 4 cases of polyps (100%), and 4 cases of fibroid (100%).Conclusions: Hysteroscopy should be considered as a basic and essential diagnostic procedure in the diagnostic work up of abnormal uterine bleeding. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190034
      Issue No: Vol. 8, No. 2 (2019)
       
  • Are cesarean delivery rates and indications changing'

    • Authors: Jitendra D. Mane
      Pages: 402 - 405
      Abstract: Background: There seems to be gradual raising trend in cesarean deliveries over decades with associated decrease in perinatal mortality rate. This study was undertaken to compare the caesarean delivery (CS) rates along with its indications over the last decade and to examine whether it is changing.Methods: The aim is to compare the rate and indications of CS in a retrospective manner from the data collected between January 1 and December 31 in the year 2006, 2011, and 2016 in a zonal hospital. The rates and indications of CS were analyzed to find whether they are changing if yes which are the factors contributing for the same. Categorical variables were compared using chi-square test.Results: The CS rate showed an increasing trend from 26 % in 2006 to 27.6 % in 2011 to 32.4 % in 2016. Of the total CS, repeat CS rate was significantly increased from 76 (6.61%) in 2006 to 106 (10.34%) in 2011 to 128 (13.72%). Primary CS percent remained more or less same during the study period. Post cesarean pregnancy (p=0.00001) and fetal distress (p=0.012) showed significant rise as an indication for CS which were major contributor for rise in last decade while failed induction decreased.Conclusions: Over the decade there is increase in the total CS rate mainly attributable to repeat CS while post CS pregnancies and foetal distress were leading cause for CS. There is need for reducing primary CS along with increase in trial of labor after cesarean in properly selected women.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190018
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence of climacteric symptoms in menopausal and perimenopausal women

    • Authors: Achala Sahai Sharma, Zareena Khan
      Pages: 406 - 411
      Abstract: Background: With increasing life expectancy population of menopausal women is also rising and each woman is expected to spend almost 1/3rd of her life in this phase. Due to various factors the health issues of menopausal age group are still not completely understood and addressed. Further studies in this field are expected to enhance the understanding of the subject and improve the quality of life of elderly woman.Methods: A cross sectional analysis was done over a period of one year, 200 women between 40 to 65 years of age not taking HRT and not having any other medical illness were recruited. The data regarding demography and 21 climacteric symptoms in Greene’s Climacteric Scale was collected by interviewing the subjects. The prevalence of various menopausal symptoms and their severity were analyzed.Results: Mean age of study group (n=200) was 46.8 years with menopausal group (n=79) 50.18 years and perimenopausal group (n=121) 44.6 years. Out of all 84% subjects were illiterate. The most prevalent and severe symptom was muscle and joint pain. There was no significant difference in the mean number of climacteric symptoms in various demographic groups and between menopausal and perimenopausal group.Conclusions: The climacteric symptoms do not appear to decrease in number or intensity after transition from perimenopause to menopause. Differences in sensitivity, literacy, social and cultural factors etc. among elderly women may be responsible for under reporting or differences in reporting. Exploring the issues of menopausal health and training of health personnel in this field may improve awareness of these women about various menopause related health issues and thus improve their quality of life.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190260
      Issue No: Vol. 8, No. 2 (2019)
       
  • Usefulness of Chlamydia serology in prediction of tubal factor infertility
           among infertile patients at Federal Medical Centre, Bida, North Central
           Nigeria

    • Authors: Lucky Amadi, Uchenna Onwudiegwu, Adebanjo B. Adeyemi, Chiemezie N. D. Nwachukwu, Afolabi B. Abiodun
      Pages: 412 - 419
      Abstract: Background: Infertility is a major public health problem in developing countries where pelvic inflammatory disease due mainly to Chlamydia trachomatis and Neisseria gonorrhea infection have been implicated. The role of Chlamydia serology in predicting tubal factor infertility (TFI) has been demonstrated by many researchers elsewhere. However, there are limited data in our environment. This prospective cross-sectional study aims to determine the usefulness of Chlamydia Serology as a screening tool for TFI at Federal Medical Centre, Bida, North Central Nigeria.Methods: 125 women with infertility who met the inclusion criteria were enrolled into the study. Relevant information on their socio-demographic characteristics, gynaecological symptoms and risks factors for infertility were obtained. Participants had Hysterosalpingography (HSG) as part of their fertility work-up while 5ml of venous blood was withdrawn to check for Immunoglobulin G antibody to Chlamydia trachomatis using rapid test kits. The HSG findings were correlated with the result of Chlamydia serology. Data was analyzed using the computer software, Statistical Package for Social Science (SPSS) version 20. The level of significance (p value) was set at 0.05.Results: A total of 120 infertile women completed the study, 5 had incomplete investigations and were excluded from the analysis. The prevalence of TFI was 47.5%, while that of positive chlamydia serology was 36.5%. The prevalence of chlamydial seropositivity was 59.6% for patients with TFI but 15.9% for non-TFI. There was a significant association between positive chlamydia serology and TFI p< 0.05. The study revealed moderate sensitivity 59.6%, and negative predictive value 69.7% but high specificity 84.1% and positive predictive value of 77.2%. In this study the odds for diagnosing tubal infertility was 7.8.Conclusions: Chlamydia serology is useful in predicting TFI and should be incorporated in the routine work up for infertility.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190261
      Issue No: Vol. 8, No. 2 (2019)
       
  • Evaluation of FMR1 gene mutations in Turkish women newly diagnosed with
           primary ovarian failure

    • Authors: Esma Sarıkaya, Aytekin Tokmak, Esra Şükran Çakar, Gürhan Güney, Neslihan Düzkale, Müzeyyen Gülnur Özakşit
      Pages: 420 - 424
      Abstract: Background: One of the known causes of ovarian dysfunction is fragile X mental retardation gene 1 (FMR1) premutation. The prevalence of FMR1 premutation in primary ovarian failure (POF) cases may differ between the studies due to some reasons including POF definition, definition of premutation, and determination of study population, ethnicity, genetic and environmental factors. In this study authors aimed to determine the prevalence of FMR1 mutations in patients who applied to present clinic and diagnosed as POF.Methods: This retrospective cohort study was conducted on 200 women who had been newly diagnosed with POF in present clinic between 2013 and 2014. The presence of cytogenetic fragility was firstly investigated in all patients by using the lymphocyte culture method, and molecular analysis of the FMR1 gene was then performed. Genomic DNA’s of cases were isolated using standard protocols, followed by polymerase chain reaction amplification with an appropriate program. Fragment analysis of the amplification products were performed by agarose gel electrophoresis.Results: Cytogenetic analysis results in 200 cases were numerically and structurally normal in all patients, and as a result of molecular genetic analysis of FMR1 gene; 1 (0.5%) patient had complete mutation and 9 (4.5%) patients had premutation carriage.Conclusions: FMR1 gene mutations are common in women with POF. These mutations should be investigated in all patients presenting with POF, particularly in cases with early onset and family history of POF, and also genetic counseling should be given to those patients.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190262
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence of various dermatoses in pregnancy at a tertiary care centre in
           Moradabad, Uttar Pradesh, India: an observational study

    • Authors: Shruti Uniyal, Ritika Agarwal, Nupur Nandi, Pulkit Jain
      Pages: 425 - 432
      Abstract: Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190263
      Issue No: Vol. 8, No. 2 (2019)
       
  • Analysis of caesarean sections according to modified Robson’s ten group
           classification system at a tertiary care centre in Western India

    • Authors: Priyanka D. Jogia, Kaushik K. Lodhiya
      Pages: 433 - 439
      Abstract: Background: The increasing trends for Caesarean section (CS) in India and worldwide have been a cause of concern. The aim is to compare and analyse CS rates across the globe, WHO recommends the Robson’s ten group classification system (TGCS). This will help to target appropriate group of women for reduction of overall CS rates.Methods: This was a retrospective study design using hospital records for women delivered in December 2017. Data was entered and analysed using excel 2007 and presented using modified Robson’s ten group classification system.Results: Out of total 650 women delivered during the study period, 184 (28.3%) delivered by CS. Group 1 and group 2 included a total of 49.53% women in the present study. The CS rates varied from 100% in group 5 (previous CS), group 7 (breech, multiparous) and group 9 (abnormal lie) to as low as 0.9% in group 3. The present study highlights that group 5 i.e. women with previous CS, contributed maximum (37%) to the overall surgical deliveries with group 2 being the second largest contributor (21%).Conclusions: The findings of the study indicate that group 5-women with prior CS and group 2-women with induced labour contributed maximum to overall CS rates. TOLAC should be a routine and not optional. Simultaneously Judicious selection of women for induction, strict implementation of induction protocols to decrease the cases of failed inductions will also reduce primary CS. To monitor the CS rates and take appropriate actions it is recommended that Robson’s TGCS be used continuously in all health institutions.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190264
      Issue No: Vol. 8, No. 2 (2019)
       
  • Mullerian ductal anomalies and its outcome

    • Authors: Rupa C. Vyas, Ashleta M. Moghariya, Sapana R. Shah, Purvi M. Parikh, Prachi M. Shelat
      Pages: 440 - 444
      Abstract: Background: The aim is to study various investigative modalities to diagnose Mullerian anomalies and to evaluate the reproductive outcome that occurs as a result of malformation of genital tract.Methods: A prospective study of reproductive anomalies and its outcome was performed by using data from women with congenital anomalies attended in OPD either with complains or for operative treatment or incidental diagnosis during caesarean section, manual removal of placenta, during laparoscopy or laparotomy at tertiary care center. Total 70 women with different types of congenital anomalies were included in study. Out of them gynecological cases (27) were diagnosed on basis of clinical examination and other diagnostic aids while Mullerian anomalies in obstetric cases (43) were observed and their outcomes were studied.Results: Most common utero-vaginal anomaly seen in present study was septate uterus with 18 (25.7%) cases, followed by bicornuate uterus with 13 (18.6%) cases. Most common presenting symptom is primary amenorrhea 21 (30%) followed by cyclical abdominal pain 11 (15.7). HSG, USG are the primary tools to detect genital tract anomalies. Surgical correction was required in 47.1% patients.Conclusions: Present study shows prevalence of congenital malformation of female reproductive tract is 0.17% at our tertiary care center. Utero-vaginal anomalies are a morphologically diverse group of developmental disorders. Establishing an accurate diagnosis is essential for planning treatment and management strategies. The surgical approach for correction of utero-vaginal anomalies is specific to the type of malformation and may vary in a specific group.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190265
      Issue No: Vol. 8, No. 2 (2019)
       
  • Retrospective analysis of efficacy of washed husband semen IUI for
           oligoasthenoteratospermia in an urban centre

    • Authors: Shanthi Sivaraman, Georgy Joy Eralil
      Pages: 445 - 452
      Abstract: Background: The true incidence of male subfertility is unknown due to great variability in the prevalence of subfertility. Artificial insemination with husband’s semen is the most widely used treatment for male infertility, usually presumed because of oligospermia, and for what is called ‘mucus hostility’ when there is failure of sperm penetration of cervical mucus despite normal seminal analysis.Methods: The study was conducted in 438 couples with male factor infertility at the ARTC (artificial reproductive technique centre) of Sri Ramakrishna Hospital, Coimbatore. Results of at least two seminograms (based on WHO norms) were used to primarily classify males into three categories-oligozoospermic, asthenozoo spermic and oligoasthenoteratospermic. The media used were the Earle’s Balanced Salt Solution (EBSS), Ham’s F10 and Medicult. EBSS and Ham’s F10 were obtained as “readymade” solutions from Sigma, USA. Medicult was imported from Denmark. EBSS and Ham’s F10 were supplemented with protein using FCS (Fetal cord Serum) or HEPES (4(2-hydroxyethyil)-1-piperazineethanesulfonic acid). Benzyl pencillin, 60mg per litre and Streptomycin, 50mg per litre were also to the media.Results: By the DMRT analysis of post wash count, the influence of the count below 5 million or above 20 million on the pregnancy rate was significant at all the levels of male factor.Conclusions: Considering the male factor, in cases of oligoasthenoteratospermia, IUI has a positive significant effect on the success rate of pregnancy at all three levels of the post wash sperm count.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190266
      Issue No: Vol. 8, No. 2 (2019)
       
  • Doppler patterns in growth restricted foetuses: determinants and outcome
           in a tertiary hospital in South Kerala, India

    • Authors: Heera T. Shenoy, Sheela Shenoy, Sonia X. James
      Pages: 453 - 461
      Abstract: Background: Foetal growth restriction refers to a condition in which the foetus is unable to achieve its genetically determined growth potential. Doppler velocimetry in FGR not only decides the optimum time of delivery but also the optimum mode of delivery and so authors evaluated the Doppler patterns in growth restricted fetuses.Methods: Nested case-control study conducted among normal and abnormal Doppler groups at a tertiary care teaching hospital in the year 2017.Results: Among 82 growth restricted foetuses, 54 of them had normal Doppler patterns (65.85%) and 28 had abnormal Doppler patterns (34.15%).13(46.5%) had umbilical S/D elevation,2 (7.14%) had AEDV,1(3.57%) with REDV and 12 (42.8%) with CPR<1. Mean maternal age was slightly higher in the abnormal Doppler group. FGR babies with abnormal velocity waveforms had shorter diagnosis to delivery interval than those with normal Doppler and decision for delivery was taken at a lower gestational age. (p value-0.001). Mothers of FGR babies with abnormal Doppler studies underwent emergency caesarean section for non-reassuring foetal heart patterns. (p value-0.001) The mean birth weight was higher (2201.80gm) in Doppler normal FGR and it was 1929.46grams in abnormal umbilical Doppler group and 1363.33gm in AREDV (pvalue-0.001). Growth restricted with normal Doppler had shorter NICU stays than with abnormalities (p value-0.003). Term FGR went home early than early preterm. (p value-0.001).Conclusions: Growth restricted foetuses with normal umbilical velocimetry are at a lower risk than those with abnormal velocimetry in terms of prolonged diagnosis-delivery interval and shorter NICU days. The need for neonatal resuscitation at birth was more in babies with abnormal Doppler velocimetry and absent diastole /reversed diastolic flow of umbilical artery velocimetry.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190267
      Issue No: Vol. 8, No. 2 (2019)
       
  • Study on breastfeeding practices among rural women in the field practice
           areas of a tertiary care teaching hospital

    • Authors: Noopur S. Nagar, Ebbie Thomas, Shashwat S. Nagar, Naresh R. Godara
      Pages: 462 - 466
      Abstract: Background: Breastfeeding is one of the most important determinants of child survival, birth spacing, and prevention of childhood infections. The beneficial effects of breastfeeding depend on breastfeeding initiation, its duration, and the age at which the breast-fed child is weaned. Data from NFHS-4 suggest that in India, in Gujarat where only 56% of infants are exclusively breastfed and 50% of infants are initiated with breastfeeding within one hour of birth. This study was planned to identify the gaps in breastfeeding practices so that necessary interventions can be designed and thereby implemented. The objective is to study the breastfeeding practices of mothers having children below 2 years of age in the field practice areas of the medical college and to associate the findings of these practices with the socio-demographic characteristics of the population.Methods: The study conducted was a community based cross-sectional one in the six villages of RHTC of PIMSR. The study was conducted by surveying a total of 204 mothers to study their breastfeeding practices which were categorized into ‘good’ and “not so good’ practices. From this the total score was calculated and associated with socio-demographic variables.Results: Majority of the mothers were in the age group 18-22 and educated up to ‘primary’ and most of them were from social class IV and V. Only 23% of the mothers had adequate knowledge of exclusive breastfeeding. About 70% practiced both early initiation of breastfeeding and feeding colostrum whereas nearly 80% practiced exclusive breastfeeding.Conclusions: It is concluded from the study that even though the practice of breastfeeding was found quite good, the gaps in the knowledge and practice must be addressed through health education and support through peer and health groups. Documenting the success stories will go a long way for community education and behavioral change in communication at the community level for adequate breastfeeding practices.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190268
      Issue No: Vol. 8, No. 2 (2019)
       
  • Pregnancy outcome with hepatitis E infection

    • Authors: Niranjan M. Mayadeo, Sachi N. Shah
      Pages: 467 - 473
      Abstract: Background: Hepatitis E is usually a self-limited viral infection in men and non-pregnant women, but during pregnancy it is associated with high maternal and perinatal mortality. This needs to be studied for early diagnosis and better management.Methods: The study commenced after the approval of Institutional Ethics Committee. This was a retrospective cum prospective observational study conducted in the Department of Obstetrics and Gynaecology and Department of Medical Intensive Care Unit in present tertiary care hospital between February 2012 and July 2017. An analysis of 120 cases was made over a period of five years.Results: In this study the incidence of pregnant patients with hepatitis E was 3.09 per 1000 deliveries. It was found that majority of the patients which were diagnosed with hepatitis E were young and belonged to the age group of 21-25 years. Most of the affected patients were primigravida with increasing severity of the disease in their third trimester. The maternal morbidity was 51% with a mortality rate of 20%. The percentage of still birth was 25.64% with increased incidence of preterm deliveries and poor perinatal outcome.Conclusions: Early diagnosis and rapid management of the complications such as correction of abnormal coagulation and supportive management is the best treatment available at present. ICU admission and with strict maternal and foetal monitoring can help improve the outcome and thereby reducing the maternal and perinatal mortality.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190269
      Issue No: Vol. 8, No. 2 (2019)
       
  • Maternal and neonatal outcomes in pregnancies complicated by maternal
           obesity

    • Authors: Sudha Menon, Sivaprasad K.
      Pages: 474 - 478
      Abstract: Background: Maternal obesity imparts elevated maternal and neo natal adverse outcomes. Aim of the study was to evaluate and analyse the maternal and neonatal outcomes in obese mothers.Methods: This was a prospective case control study in a tertiary care high risk referral center. Antenatal women with first trimester Body mass index (BMI) of more than 30 Kg/m2 constituted the cases and those antenatal women with BMI <25 Kg/m2 formed the controls.Results: Mean age was slightly more (28.6±4.3 years vs 26.3±3.6 years: P<0.0001) in the obese group. Obese women were significantly more likely to have  of gestational diabetes (OR 5.2, 95% CI 3.2-8.7 P<0.00001), gestational hypertension (Or 3.5, 95% CI 2.1-5.9 P<0.0001) , induction of labour (OR 2.5, 95% CI 1.8-3.6 P<0.0001), failed induction of labour (OR 2.4, 95% CI 1.3-4.2 P=0.003), Preeclampsia (OR 2.8, 95% CI 1.6-4.9 P=0.0002), Caesarian section (Or 4.0, 95% CI 2.9-5.9 P<0.0001) and Postpartum hemorrhage (OR 4.0,95% CI 1.1-14.3 P=0.034), prolonged hospital stay (OR 12.8, 95% CI 7.7-21.1 P<0.0001)  and adverse neonatal outcomes such as low(<7) Apgar (OR 3.2, 95% CI 1.1-10.0 P=0.03), Large for gestational age babies (OR 3.1, 95% Cl 2.1-4.5 P<0.0001) and transfer to new born nursery (OR 3.4, 95% CI 2.3 -5.2 P<0.0001).Conclusions: Maternal obesity in pregnancy is high risk and has many adverse maternal and neonatal outcomes warranting specialized antenatal, intranatal and post-natal care.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190270
      Issue No: Vol. 8, No. 2 (2019)
       
  • Serum anti-Mullerian hormone and homocysteine in premenopausal females
           with and without cardiovascular disease

    • Authors: Huma Khan, Madhur M. Gupta
      Pages: 479 - 482
      Abstract: Background: The objective of this study is to assess the association of anti-Mullerian hormone (AMH) and homocysteine (Hcy) levels in premenopausal females with and without cardiovascular disease.Methods: A case control study was conducted in premenopausal, menopausal and normal fertile females (n=30) with and without cardiovascular disease in a tertiary care hospital and research centre in central India. Fasting sample obtained was assessed for AMH and Hcy levels. Results were compared and data was analyzed.Results: The levels of AMH and Hcy were significantly altered in premenopausal and menopausal females as compared to normal fertile females. Moreover, there was a weak correlation when intergroup comparison was made between the parameters in females with and without cardiovascular disease.Conclusions: A prospective study with a larger sample size to assess levels of AMH need to be performed to provide insight in premenopausal females for the early detection cardiovascular disease.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190271
      Issue No: Vol. 8, No. 2 (2019)
       
  • Predictive value of changes in the serum CA-125 levels in patients
           undergoing interval debulking surgery after neoadjuvant chemotherapy in
           advanced epithelial ovarian carcinoma

    • Authors: Sonia Batra, Ruchi Arora, Kalpana Dave
      Pages: 483 - 487
      Abstract: Background: The objective of this study is to evaluate the predictive value of serum CA-125 changes in the management of patients undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in advanced epithelial ovarian carcinoma (EOC).Methods: A retrospective hospital-based study of patients with advanced epithelial ovarian cancers (stage III and IV) was conducted at Department of Obstetrics and Gynecology in Gujarat Cancer and Research Institute, Ahmedabad, for two years. Total 50 patients were treated with NACT followed by surgical cytoreduction and followed up till August 2010. Response to NACT, optimal cytoreduction rate and overall response rate were analyzed.CA 125 levels before (baseline) and after NACT were analyzed.Results: Out of 50, there were 43 patients (86%) with stage III disease and 7 (14%) with stage IV disease. Maximum 37(74%) patients had CA 125 levels >500 on presentation while none of the patients had baseline CA125 levels in the normal range (<35). Range of baseline CA 125 was 164-5394.All patients were given NACT and after NACT, out of 50 patients, 22(44%) patients had CA 125 values within the normal range (<35) while 23(46%) had values between 35 and 100. Thus, statistically significant difference (Z = 6.154, P<0.0001) was found between CA 125 level before and after NACT. Out of 45 patients with CA 125 <100, 35(77.8%) underwent optimal cytoreduction.Conclusions: Baseline (prechemotherapy) serum CA-125 levels are powerful indicators of the presence and extent of spread of disease while CA-125 level particularly <100U/ml after NACT strongly predicts optimal cytoreduction in advanced epithelial ovarian cancers.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190272
      Issue No: Vol. 8, No. 2 (2019)
       
  • A clinical study on the analysis of caesarean section rates using
           Robson’s ten group classification in a tertiary care hospital

    • Authors: Priya Shankar, Madhu J., Vinay Raju
      Pages: 488 - 491
      Abstract: Background: Auditing c section rates can be done using Robson’s classification which in turn helps achieve a uniform basis for comparison across centers and across various countries.Methods: A retrospective analysis was done in a tertiary care hospital in north Karnataka KIMS, over a period of 6 months May 2017 to October 2017. All cases of LSCS done during this period were classified according to Robson’s classification and analyzed.Results: Out of 5080 overall deliveries 1876 delivered by cesarean section attributing to 36.76% cesarean section rate. Highest contribution was from group 5 (36%) and group 2 (19.24%).Conclusions: Robson’s classification helps to identify and analyze the group that contribute to the most to overall cesarean section rate and this helps us to modify strategies and interventions to optimize cesarean section rate.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190032
      Issue No: Vol. 8, No. 2 (2019)
       
  • Kidney length, a visceral parameter predicts foetal age between 24 to 40
           weeks of gestation

    • Authors: Sunanda Bharatnur, Samantha Dawson, Shripad Hebbar
      Pages: 492 - 497
      Abstract: Background: Accurate estimation of gestational age is important in providing appropriate antenatal care. Recent evidence suggests that weightage should also be given to kidney length in addition to standard biometric parameters in determining the duration of pregnancy by ultrasound.Methods: In a single centre, prospective cross-sectional study was done in 120 pregnant women. In addition to standard biometric parameters, kidney length was also measured between 24 to 40 weeks at two-week intervals. A total of 240 renal vertical measurements were done and average of right and left renal lengths was taken as a final kidney length. Descriptive analysis was carried out to find the mean and standard deviations for each variable. Regression analysis was carried for each variable either singly or in combinations and Pearson regression coefficients was used to find the association between gestational age and various foetal parameters and to determine which of the regression model gives the best fit for prediction of gestational age.Results: Foetal kidney length progressively increased throughout the gestation (from 23.2 mm at 24 weeks to 40.1 mm at 40 weeks). The regression formula using only kidney length as an independent variable (gestational age=2.195±0.942 X kidney length) had high degree of correlation (R2 0.97, p<0.001, SE of prediction 4.7±3.9), which was superior to other prediction models using standard biometric parameters. In multiple regression models using several conventional parameters, when femur length was added in a stepwise manner, there was significant improvement in forecasting gestational age.Conclusions: Present study showed that foetal kidney length is a reliable indicator of gestational age between 24 to 40 weeks of pregnancy and may be of utility in pregnancies with wrong dates, non-availability of dating scan and women who have conceived during lactational period.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190273
      Issue No: Vol. 8, No. 2 (2019)
       
  • A comparative study of sublingual versus oral misoprostol following oral
           mifepristone for second trimester termination of pregnancy

    • Authors: Ruchi Gupta, Krishna Priya Banerjee, Reena Pant
      Pages: 498 - 502
      Abstract: Background: The objective of this study is to assess the effectualness and safety of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy.Methods: This institution based contingent study was conducted on 220 women requesting for mid-trimester termination of pregnancy between 12-20 weeks with legal indication as per Govt. MTP act. After excluding the women as per exclusion criteria, they were randomly allocated into two groups (Group A Sublingual, Group B Oral), the women received 200 mg oral mifepristone followed by sublingual or oral misoprostol 400µg three hourly for a maximum of 5 doses 48 hours later. The course of misoprostol was reiterated if women failed to abort in 24 hours.Results: The mean induction-abortion interval of Group-A and Group -B was 4.02±1.39 hours and 6.44±1.79 hours respectively. The mean dose of misoprostol in Group–A and Group-B was 680±220.4µg and 1003.6±274.9µg. Hence mean Induction-abortion interval and dose were shortened in  Group-A as compare to Group-B (p <0.05). There was 100% success rate noticed via both routes. Evacuation was done in 4 (3.64%) women in Group-B as compare to only 1 (0.91%) in Group-A . The acceptability was significantly more in Group-B (100%) as compare Group-A (52.73%), probably because of unpleasant taste of sublingual misoprostol. All side effects (Nausea, pain, headache, and diarrhea) were common in both the Groups, only fever was significantly more common in sublingual group as compare to oral group (p<0.05).Conclusions: From present study authors conclude that, sublingual misoprostol when combined with mifepristone is effective for medical abortion in second trimester in terms of effectualness, endurability and success rate than oral route.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190274
      Issue No: Vol. 8, No. 2 (2019)
       
  • Clinical versus ultrasonographic fetal weight estimation and its
           correlation with actual birth weight

    • Authors: Ashwini Ingale, Shweta Avinash Khade, Sneha Shirodkar
      Pages: 503 - 512
      Abstract: Background: This is a prospective study was conducted at Obstetrics and Gynecology department, tertiary care Hospital, to compare the accuracy of clinical and ultrasonographic estimation of fetal weight at term with actual birth weight.Methods: The present study is a prospective comparative study of fetal weight estimation in Antenatal women with term gestation (37week to 42week of gestation) singleton pregnancy with vertex presentation, who had gestational age confirmed by dates and ultrasound scanning of< 22weeks admitted in tertiary care center from March 2016 to November 2016. Patients with Polyhydramnios, oligohydramnios, Antepartum hemorrhage, Congenital anomalies of fetus, Obese (Body mass index >30 kilogram/meter2) are excluded from the study. Estimation of fetal weight is done by clinical method and ultrasonography. Birth weight after delivery was recorded in grams by electronic weighing machine and tabulated.Results: Clinical as well as ultrasonography estimates observed to be strongly correlate with actual birth weight. Both the methods had more sensitivity in birth weight range 2500-4000gm than <2500g and >4000g. The overall mean absolute percentage error of the clinical method (7.2±7.7) was smaller than that of the sonographic method (16.2±11.1). In low birth-weight (<2,500g) group, mean absolute percentage error was 9.0±11.3 with USG and same with clinical was 11.7±9.0. No statistically significant difference was observed.Conclusions: The present study concludes that clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation.Clinical palpation should be considered as diagnostic tool for FWE and is equally reliable even when done by trained medical person. It is cheap and easy to teach. The need is to practically apply this method in obstetrics and guide the management decisions.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190275
      Issue No: Vol. 8, No. 2 (2019)
       
  • Association of serum neutrophil gelatinase associated lipocalin (NGAL)
           levels with preeclampsia

    • Authors: M. Dhivya, Chippy Tess Mathew, G. Jeyachandran
      Pages: 513 - 518
      Abstract: Background: Preeclampsia is a systemic disorder that affects multiple organs and is characterized by the new onset of hypertension and proteinuria or end-organ dysfunction or both in the second half of pregnancy. NGAL is a 25-KDa protein of the lipocalin family and is considered to be a novel biomarker for ischemic injury. The objective of this study is to compare the levels of serum NGAL in preeclamptic patients and gestational age matched normotensive controls.Methods: The study design is case control study in which pregnant women with preeclampsia (n=40) are selected as cases. Cases were selected from pregnant women attending OG-OPD and IP satisfying the inclusion criteria and not coming under exclusion criteria. 0.5ml of blood was collected in vacutainers and was centrifuged at 3500rpm for 10 minutes. The serum thus separated was aliquoted into smaller plain containers and stored at -20 degree Celsius for analysis. The urine sample was also collected. Controls were also selected from the OP patients.Results: In present study, the serum NGAL ranged from 40-900ng/ml in cases and from 110-795ng/ml in controls. There is no difference in NGAL between cases and control. The correlation coefficients between the NGAL levels and other parameters like maternal age, gestational age, systolic Blood pressure, diastolic Blood pressure, uric acid levels, urine PCR are also not statistically significant.Conclusions: Serum NGAL levels are not significantly elevated in patients with preeclampsia when compared with the normotensive controls and also there is no significant correlation between serum NGAL levels and other assessed parameters.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190276
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence and awareness of osteopenia in perimenopausal women in Navi
           Mumbai, Maharashtra, India

    • Authors: Ajay Dodeja, Anushka Makhija, Ashita Rane, Meeta Dodeja
      Pages: 519 - 523
      Abstract: Background: Osteopenia is considered as precursor of osteoporosis. Osteoporosis is a major public health problem associated with substantial morbidity and socio-economic burden worldwide. Osteopenia occurs more frequently in most menopausal women. Early detection of the same can be beneficial to control prevalence of osteoporosis and also to reduce the fracture rates.Methods: A cross-sectional quantitative study using DEXA (Dual Energy X-ray Absorptiometry) was conducted on 80 women. A self-structured questionnaire was used to evaluate the level of awareness among the study subjects. The data was analyzed using statistical tests such as Chi-Square test for association. The level of significance was set at 5%.Results: The prevalence of osteopenia in the studied population was 63.75%. The mean age was recorded to be 40.35 years. The mean age of women with menopause in this study is 50.62 years. Out of the 51(63.75%) women diagnosed with osteopenia, 5.9% were underweight, 33.3% were normal and 49% were obese. Of the diseased, 37.3% experienced adequate amount sunlight exposure required while 62.7% did not. Out of the 80 women interviewed 43.75% were aware about osteopenia, its causes and complications; which 56.25% were unaware about the same.Conclusions: Women were screened for osteopenia with the help of DEXA scan according to the (World Health Organization) WHO, T-Score criteria-which may go undiagnosed otherwise and may experience the risk and complications of osteoporosis.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190277
      Issue No: Vol. 8, No. 2 (2019)
       
  • Predictors and symptomatic burden of uterine fibroids among women in
           South-Eastern India: a cross-sectional survey analysis

    • Authors: Dharitri Swain, Chanchal Yadav, Jyoti Kumari, Monika Rani, Priyanka Daunrai Rongmei, Sehaj Kaur Khurana
      Pages: 524 - 530
      Abstract: Background: Uterine fibroid is the most common pelvic tumor in women of reproductive age and are asymptomatic in at least 50% of affected women. Various risk factors are associated with development of uterine fibroids during this reproductive age. The present study established various associated risk factors increases the prevalence of uterine fibroid among reproductive age group and clinical symptoms burden of diagnosed case.Methods: A cross sectional study design was used to collect samples for a period of six months in an OPD basis. Purposive sampling technique was used to select the 362 sample of reproductive age group (15-45 years) women in a tertiary care hospital, Southeastern India. Women diagnosed with uterine fibroid by ultrasonography were included as cases. Symptomatic features and associated risk factors of UF were collected through structure interview schedule.Results: Point prevalence of uterine fibroid among women in reproductive age group during the period of six months was 20%. Majority of them were in the age group of 30-39 years. Demographic factor such as overweight and obesity and consume dairy products daily has increased the prevalence of UF, whereas use of oral contraceptive pills and normal BMI had inverse relationship with UF risk. Most of the cases reported of having menstrual disturbances like heavy bleeding, passes blood clots during menstruation, prolonged period, urinary symptoms and pressure symptoms were considered independent predicting factors for the occurrence of uterine fibroid.Conclusions: Uterine fibroid is more prevalent among women of reproductive age causing various bleeding and renal symptoms that can have negative impact on quality of women’s life.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190278
      Issue No: Vol. 8, No. 2 (2019)
       
  • Retrospective study to find predictive factors of scar dehiscence in
           previous caesarean section to prevent maternal and perinatal morbidity and
           mortality

    • Authors: Natasha Tyagi, Manju Prabhakar, Smita Tyagi
      Pages: 531 - 535
      Abstract: Background: Uterine scar dehiscence is a complication in which scar tissue remaining from previous C-section is disrupted and separated. Its incidence ranges between 0.2%-4.3% of all pregnancies with previous caesarean. It is asymptomatic in 48% of patients and thus is a serious complication because if not predicted it can lead to uterine rupture.Methods: Patients included in the study were of previous caesarean who were taken for repeat caesarean and scar dehiscence was not predicted preoperatively but seen intra-operatively. History, symptoms, signs and radiological investigations were interpreted to find out single or multiple factors responsible for scar dehiscence.Results: Incidence of scar dehiscence was found to be 8.3% .Scar dehiscence was detected in 55% of cases who were gravida 3 and above, all patients with intraoperative scar tenderness, 35% of patients with scar thickness ˂2mm, 70% cases with POG 37-40 weeks, 65% of patients with interpregnancy interval˂18 months,86.6% of patients with scar dehiscence had baby birth weight ˃3kg.Conclusions:
      Authors concluded that a single factor which has maximum predictive value for scar dehiscence is scar tenderness.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190279
      Issue No: Vol. 8, No. 2 (2019)
       
  • Efficacy of low dose magnesium sulphate regime and Pritchard’s regime in
           controlling of eclamptic convulsion and prevention of recurrence

    • Authors: Suryaprakash Jagdevappa Karande, Archana S. Shah
      Pages: 536 - 542
      Abstract: Background: Eclampsia is defined as the onset of convulsions or coma during pregnancy or in post-partum period in a patient who has signs and symptoms of pre-eclampsia. It is life threatening emergency that continues to be a major cause of serious maternal morbidity and mortality also along with high perinatal mortality and morbidity. The present study undertaken to determine the efficacy of low dose magnesium sulphate regime and Pritchard’s regime in controlling eclamptic convulsion and prevention of recurrence of convulsion.Methods: Out of total 60 patients enrolled in the study; 30 were given low dose magnesium sulphate regime and remaining 30 with Pritchard’s regime. Selection of patients was done with simple random sampling. Relevant history was obtained from the patient, if conscious, or from the relatives. Through clinical examination was done and blood samples were collected for investigations after securing IV line.Results: There was insignificant difference regarding type of eclampsia in both groups. Recurrence of convulsion in Pritchard’s regime group was 6.67% and in Low dose regime group found to be 10% but this was statistically insignificant. Total dose of magnesium sulphate required in Low dose regime group was less than that required for Pritchard’s regime.Conclusions: Low dose magnesium sulphate Regime proved equally effective as that of Pritchard’s regime in control of convulsion in spite of less amount of drug and comparatively low serum magnesium levels and hence there is hardly any fear of intoxicator.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190280
      Issue No: Vol. 8, No. 2 (2019)
       
  • Screening and diagnosis of gestational diabetes mellitus by IADPSG
           criteria

    • Authors: Gunjan Chaudhary, Chita Raghunandan, Kanika Chopra
      Pages: 543 - 547
      Abstract: Background: GDM is a complex clinical entity and its screening, diagnosis, and management warrants attention. With this issue in mind, we aimed to study the prevalence of gestational diabetes mellitus in the antenatal group of patients attending tertiary hospital in New Delhi and its association with maternal outcome.Methods: 300 pregnant patients were enrolled in the first trimester and RBS (random blood sugar) was done. Those who had RBS >200mg/dl were labelled as overt diabetes and excluded from the study. The patients who were screened negative in phase 1 of screening were subjected to the next phase of screening at 24-28 weeks of gestation with 2-hour 75g OGTT using IADPSG criteria. Those who were diagnosed as GDM were followed in the antepartum, intrapartum and postpartum period.Results: The prevalence of overt diabetes and GDM in the study population is 1.33% and 13.33%. The prevalence of gestational hypertension, pre-eclampsia, chronic hypertension, polyhydramnios was 15%, 5%, 5%, 7.5% respectively. Normal and instrumental vaginal delivery was in 50 %, 5% patients respectively and 45 % had the caesarean section.Conclusions: The single step OGTT with lower threshold value cut-offs and single abnormal value for the diagnosis of GDM as advocated by IADPSG seem to be effective as it helps to screen and diagnose GDM at the same time as a single step procedure and thus more cost-effective.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190281
      Issue No: Vol. 8, No. 2 (2019)
       
  • Maternofetal outcomes in early versus late onset pre-eclampsia: a
           comparative study

    • Authors: Poornima Shankar, Kavitha Karthikeyan, Amrita Priscilla Nalini, Sindhura M., Gowtham Kim
      Pages: 548 - 551
      Abstract: Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190282
      Issue No: Vol. 8, No. 2 (2019)
       
  • Obstetrical outcome in gestational diabetes mellitus: a retrospective
           study

    • Authors: Anitha Aldur Manjappa, Maya Menon, Aruna Bholenath Patil
      Pages: 552 - 559
      Abstract: Background: Gestational diabetes mellitus (GDM) is associated with adverse maternal and fetal outcomes. Majority of the maternal complications associated with GDM have been decreasing nowadays, however the relative risk of development of perinatal complications remain higher in women with hyper glycaemia.Methods: This retrospective study was conducted among 286 delivered pregnant women. The pregnant women were diagnosed as GDM by DIPSI diagnostic criterion. The study was performed to find the association of various risk factors with GDM occurrence and to assess the obstetrical outcome in the GDM and normoglycaemic women.Results: Out of the 286 women, the proportion of women affected with GDM was 20.6%. The onset of GDM was more common among women between 25-30year (62.7%). GDM onset is increased when they had previous history of GDM and family history of diabetes.  The obstetric complications were less common among GDM women (23.72%). GDM women had increased rate of caesarean delivery (69.5%) and induction of labour (42.4%). The neonatal complications were more common among GDM neonates (57.62%). The proportion of occurrence of congenital anomalies and macrosomia (>3.5kg) was similar among both groups.Conclusions: Risk factors associated with GDM onset such as previous history of GDM and family history of diabetes are significant risk factors. Advanced age, increasing parity and occurrence of abortions were not associated with GDM onset.  With good glycaemic control the obstetrical complications and macrosomia are preventable. Rate of Induction of labour, caesarean delivery and neonatal morbidity remains higher among GDM women.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190283
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence and determinants of caesarean section in a rural tertiary
           teaching hospital: a 6-year retrospective study

    • Authors: Ke Manga Reddy, Lakshmi Sailaja P., Shiva Charana Kodimala, Poojitha Pathakamudi, Kalpana Betha
      Pages: 560 - 565
      Abstract: Background: Caesarean section is the most commonly performed surgery in obstetrics and there is a rise in caesarean section rates in recent times. This study was undertaken to know the changing trends in caesarean section rate in a rural hospital and to examine the indications contributing to it. The objective of the present study was to know the prevalence and changing trends in caesarean section over the last 6 years (April 2012-March 2018).Methods: Demographic data for all the deliveries, mode of delivery and indications of caesarean sections performed from April 2012 to March 2018 that occurred at MIMS were collected in a retrospective manner.Results: Among a total of 12,522 women delivered during the study period of 6 years, 44.93%, 48.49%, 48.41%, 50.9%, 45.48% and 49.62% were delivered by caesarean section during 2012-2013, 2013-2014, 2014-2015, 2015-2016, 2016-2017 and 2017-2018 respectively. Increase in repeat caesarean section is the primary reason for these increased rates followed by fetal distress. There is a rise in the repeat caesarean section from 44.36% in 2012-2013 to 55.67% in 2016-2017 and 47% in 2017-2018. Whereas primary caesarean section rate reduced from 55.63% in 2012-2013 to 44.32% in 2016-2017 and 53% in 2017-2018.Conclusions: As repeat caesarean section and fetal distress are the most common causes of caesarean section we need to address these to bring down the caesarean section rate.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190284
      Issue No: Vol. 8, No. 2 (2019)
       
  • An observational study to compare between conventional condom balloon
           catheter with CG balloon

    • Authors: Somila Xess, Preeti Baghel
      Pages: 566 - 569
      Abstract: Background: Postpartum haemorrhage (PPH) is a life-threatening complication of delivery. The most common cause of PPH is uterine atony. Intrauterine balloon tamponade has been suggested as an effective, easily administered minimally invasive treatment option to control uterine bleeding while preserving the mother’s ability to bear additional children.Methods: Twenty women with normal vaginal delivery were studied over a period of six months, 10 were inserted conventional balloon tamponade and rest 10 were inserted CG balloon and outcome studied in terms of time to assemble, leakage, expulsion, lumen occlusion, volume of fluid used, time to arrest bleeding, cost, drainage port, inflation deflation interval.Results: Most of the women were para 4 or more, unbooked belonging to age group of 20-30. Mean time to assemble Condom balloon tamponade was 1.8min   and that in CG balloon was 1.2 minute. There was leakage and expulsion in two and lumen occlusion in three in the conventional balloon catheter. In the second group there was  no leakage ,lumen occlusion  or expulsion . There is uterine drainage port present in CG balloon which is characteristic of it which helps in determining the actual blood loss in real time. The inflation deflation interval and mean volume of fluid are almost same in both the groups.Conclusions: Both conventional balloon and CG balloon are effective and lifesaving in low resource setting with few advantages of CG balloon over conventional balloon tamponade.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190285
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence and predictors of metabolic syndrome with comparison of
           myoinositol and metformin in PCOS women

    • Authors: Rupali Modak, Dilip Kumar Biswas, Amitava Pal, Tapan Kumar Mandal
      Pages: 570 - 575
      Abstract: Background: The objective is to determine the prevalence of metabolic syndrome (MBS) and the effects of insulin sensitizers to improve the clinical and hormonal milieu for better reproductive outcome in PCOS women.Methods: This prospective cross-sectional study was conducted on 50 PCOS women and 50 age matched control to determine the prevalence of the MBS in two tertiary hospitals over one year. Diagnosis of PCOS was based on at least two of ESHRE/ASRM criteria and diagnosis of MBS was based on at least three of NCEPATPIII criteria. Patients already diagnosed as PCOS were treated with insulin sensitizers myoionositol and metformin which were compared.Results: The study revealed that the prevalence of MBS was 40 % (20/50) nearly 4-fold higher than that of control groups. Among PCOS women, the most prevalent MBS factors were high BMI (52%) and low serum HDL-C (42%). The least prevalent factor was high fasting serum glucose level (16%). The resumption of spontaneous regular menstrual cycle and pregnancy rate in infertile groups of PCOS patients with myoionositol and metformin were 61% vs. 26% and 50% vs.91% respectively. The myoionositol group did not require any extra ovulating agents for pregnancy, while 7 out of 11 patients in metfromin group needed clomiphen citrate for ovulation induction to achieve pregnancy.  With myoinositol there is significant reduction of weight, BMI, LH/FSH ratio and fasting insulin level; whereas metformin shows decrement of weight and BMI only.Conclusions: The prevalence of MBS in PCOS is nearly 4 times in present study and there is significant improvement of symptom profile, weight, BMI and change of hormonal pattern in myoinositol group.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190286
      Issue No: Vol. 8, No. 2 (2019)
       
  • Maternal outcome in term premature rupture of membranes

    • Authors: Amulya MN., Ashwini MS.
      Pages: 576 - 579
      Abstract: Background: Rupture of Fetal membranes before the onset of labour is called PROM. Premature rupture of membrane (PROM) is associated with various complications. The present study is undertaken to study the maternal morbidity in term PROM.Methods: A prospective cross-sectional study was conducted at Vijaynagar institute of medical science Ballari for a period of one year by Department of Obstetrics and Gynecology from November 2016 to October 2017.  120 cases of spontaneous rupture of membranes with term gestation with confirmed PROM were selected.Results: PROM was common in age group of 20-29 years (80%), and common in primigravida. Study showed majority of them belongs to low socioeconomic status (80%) , 13.33% belonged  to middle socioeconomic status and 6.66% belonged to higher socioeconomic status. In present study, it is observed that 27.05% cases  went  into  spontaneous labour and delivered normally, 56.50% cases delivered by induction and  20% cases  were delivered by LSCS. The rate of maternal morbidity was 16.6%,  which includes febrile morbidity accounting to maximum with 9.6% followed by wound infection 3.33% and others were PPH(1.66%)and puerperal sepsis (each 1.66%).Conclusions: The rate of maternal morbidity was 16.6% and no maternal death observed. Hence an appropriate and accurate diagnosis of PROM is essential for favorable outcome in pregnancy and reduces the maternal morbidity.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190287
      Issue No: Vol. 8, No. 2 (2019)
       
  • Comparison of prophylactic versus regular use of antibiotics in elective
           major obstetrical and gynecological surgeries

    • Authors: Ramya Sreevarshni Shunmugha Sundharam, Hiremath P. B., Sankareswari R.
      Pages: 580 - 585
      Abstract: Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190288
      Issue No: Vol. 8, No. 2 (2019)
       
  • Incidence and risk factors of gestational diabetes mellitus in antenatal
           mothers in Goa, India

    • Authors: Rini R. Naik, Guruprasad Pednekar, Jagadish Cacodcar
      Pages: 586 - 590
      Abstract: Background: Gestational Diabetes Mellitus (GDM) accounts for almost 90% of all pregnancies complicated by diabetes. Its prevalence in the Indian population ranges from 5.5% to 11.5 %.Methods: The present study was undertaken to assess the incidence of GDM among antenatal mothers admitted in Goa Medical College for a period of 18 months and also to study the risk factors associated with GDM amongst such cases.Results: Present study revealed that among 7717 antenatal mothers who were admitted and delivered in our Hospital, 424 women were diagnosed with GDM. Of these women diagnosed with GDM, almost one third were in the age group of 31- 35 years (35.8%); 56.2 % of these women were multigravidas. Advancing maternal age, rising parity, obesity, family history of Diabetes Mellitus (DM) and past history of GDM were among the risk factors found to be significantly associated with GDM.Conclusions: The incidence of GDM in present study population was 5.49%. Advancing maternal age, maternal obesity, family history of DM and past history of GDM were found to be important determinants of GDM.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190289
      Issue No: Vol. 8, No. 2 (2019)
       
  • A prospective randomized comparative study of Misoprostol and balloon
           tamponade using condom catheter to prevent postpartum hemorrhage at M. Y.
           H., Indore, India in vaginal delivered patients

    • Authors: Sumitra Yadav, Anjali Malhotra
      Pages: 591 - 596
      Abstract: Background: PPH is responsible for quarter of maternal deaths occurring worldwide and its incidence is increasing in developed world. According to Confidential Enquiries into Maternal and Child Health (CEMACH) report obstetric hemorrhage occurs in around3.7 per 1000 births. The objective of the study is that it was a prospective randomized comparative study of misoprostol and balloon tamponade via condom catheter to prevent postpartum hemorrhage in normal delivered patients at MYH.Methods: A sample size of 200 normal delivered patients between age group 18 and 45 years is chosen with excessive bleeding after third stage of labour and after administration of oxytocics. These 200 patients are divided into two groups: First group receiving Misoprostol and applying condom catheter in other group. Both groups are evaluated for PPH.Results: It was found that CG balloon condom catheter was a much better and more effective alternative in controlling PPH than Misoprostol as the failure rate with CG balloon condom catheter were  much less than that  with misoprostol. Due to its cost effectiveness and being easily available at primary health center and due to absence of any drug reactions and easy technique of formation makes it a better modality in controlling PPH even at PHC.Conclusions: Patients with condom catheter in situ must show better result than patients receiving misoprostol.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190290
      Issue No: Vol. 8, No. 2 (2019)
       
  • Effect of transdermal nitroglycerin patch on severe preeclamptic women
           with abnormal Doppler indices

    • Authors: El-Sayed S. El-Ebshehy, Ahmed M. Hagras, Amr T. Elbadry, Ahmed M. Awara
      Pages: 597 - 603
      Abstract: Background: The aim is to evaluate the effect of maternal transdermal nitro-glycerine patch administration on blood flow resistance on maternal uterine artery, fetal umbilical and middle cerebral arteries in patients with severe pre-eclampsia in early gestational age (24 weeks to 33 weeks) associated with abnormal Doppler indices (placental insufficiency) and also its effect on maternal mean arterial blood pressure.Methods: This is a prospective interventional clinical trial conducted on (50) pregnant women with singleton pregnancy diagnosed with severe pre-eclampsia admitted in high-risk pregnancy unit at the Department of Obstetrics  in Tanta University Hospitals, A 50-mg transdermal GTN patch (Novartis Pharma) was applied to the abdominal skin, releasing nitroglycerin at a rate of 0.4 mg/h. Doppler ultrasonography and measurement of maternal blood pressure were performed before application of transdermal GTN patch, after 4 hours of application, after 24 hours and after 48 hours.Results: the application of a 50-mg transdermal GTN patch to the maternal abdomen was associated with a significant decline in the PI of the uteroplacental and fetoplacental blood flow. No change was observed in the PI of the cerebral circulation. And also, there was a significant decrease in maternal blood pressure (MAP).Conclusions: Nitroderm patch (nitric oxide donors) may be used as initial therapy in cases of severe preeclampsia complicated by placental insufficiency in the form of abnormal Doppler indices.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190291
      Issue No: Vol. 8, No. 2 (2019)
       
  • Clinical study on postpartum eclampsia

    • Authors: Madhu J., Priya Shankar
      Pages: 604 - 607
      Abstract: Background: Eclampsia constitutes one of the deadly triad along with malnutrition and anemia which authors encounter in the present tertiary hospital Karnataka Institute of Medical Sciences, Hubli. This study was done to study the epidemiological factors associated with postpartum eclampsia, correlation with neuroimaging and the maternal outcome. The objective of the present study was retrospective study of postpartum eclampsia over a period of 22 months.Methods: A retrospective study conducted over a period 22 months from June 2015 to March 2017 in a tertiary care hospital, Karnataka Institute of Medical Sciences, Hubli. Case records of all postpartum eclampsia patients admitted during the period were analyzed.Results: This study showed that incidence of postpartum eclampsia in our hospital was 1.4%. It is more common in age group of 20-25 years, more common in primipara  (67.24%), commonest mode of delivery was vaginal route (86.2%), the occurrence of convulsion was more common within 24hrs after delivery. Most common CT scan finding was normal study (51.72%) followed by cerebral infarct (15.5%), cerebral edema (13.72%), PRES (10.34%). There were no cases of maternal mortality due to postpartum eclampsia during study period.Conclusions: Eclampsia still remains a major cause of maternal morbidity, CT scan of brain gives valuable intracerebral information, and aids in a better management.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190048
      Issue No: Vol. 8, No. 2 (2019)
       
  • The prediction of pregnancy induced hypertension from umbilical and
           uterine Doppler flow study

    • Authors: Vijay N. Gadhavi, Mansi K. Gadhavi, Manish Pandya
      Pages: 608 - 612
      Abstract: Background: Hypertensive disorder along with hemorrhage and infection contribute greatly to maternal mortality and morbidity. Pregnancy induced hypertension remains among the most significant and intriguing unsolved problems in obstetrics.Methods: In this prospective analytical study investigations and color doppler findings 0f umbilical artery PI, RI and end diastolic flow in same, uterine PI, RI and persistent diastolic notch in uterine artery recorded. Total 100 Cases of PIH between 20-36 weeks of gestation in 2 years with B.P ≥ 140/90 mm hg and protienuria ≥ 1+ were observed.Results: In this study, out of 100 cases, there were 58 cases of mild PIH (58%) and 42 cases of severe PIH (42%). Umbilical artery PI was elevated in 43(43.0%) patients and was normal in  57(57.0%) patients. Umbilical  artery RI was more than and equal to 0.7 in 77 patients  (77%) and was below of 0.7 in 23 (23%) pa-tients.9(9.0%)  fetuses showed  absence  and  14 (14.0%) fetus  had  reversal and 46 (46.0%) had reduced  end diastolic umbilical artery flow with total 69 out of 100  fetuses  having  abnormal  waveforms.65 (65%)  mothers  had  an  elevated  uterine  artery  PI   and  35(35%)  patients   had  normal uterine  artery PI. in observation 69 (69%)  patients  were  having  RI more  than 0.6, while 31 (31%) were having less than 0.6 out of 100 patients. In this study, 65 (65.0%) women were having persistent diastolic notch.Conclusions: This study was to evaluate arterial flow velocities as a predictor of impending pregnancy induced hypertension with raised RI and PI along with umbilical ab-sent or reverse end diastolic flow velocities and elevated RI and PI in the presence of a diastolic notch are considered as abnormal uterine doppler findings doppler finding with unfavorable outcome.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190292
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence of teenage pregnancy and pregnancy outcome at a rural teaching
           hospital in India

    • Authors: Okram Sarda Devi, Ke Manga Reddy, B. Sree Chaitanya Naga Samyukta, P. Sadvika, Kalpana Betha
      Pages: 613 - 616
      Abstract: Background: Teenage pregnancy accounts for 11% of births worldwide and 95% of these occur in low middle income countries. Pregnancy and its complications are leading cause of death among these girls. This study was done to know the prevalence and to determine whether teenage mothers are at risk of adverse pregnancy outcome.Methods: A retrospective study was conducted at a tertiary teaching hospital, India between July 2015 to Dec, 2017. All teenage mothers delivered after 28 weeks of gestation were included. Women with Diabetes mellitus, renal disease, thyroid disorders were excluded. Demographic data, maternal complications like anaemia, hypertensive disorders of pregnancy, preterm birth, mode of delivery, low birth weight, NICU admissions, stillbirth and early neonatal death were recorded.Results: In the present study, the prevalence was 7% which is less than that of other studies. Incidence of caesarean-Section in the present study was 31%. Amongst the complications oligohydramnious was found to be significantly associated with teenage pregnancy. NICU admissions were needed for 43% of the cases and 31% were LBW.Conclusions: High NICU admission and high LBW in newborns of teenage mothers were noted in the current study. Hence, there is urgent need to focus on the teenage pregnancy.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190293
      Issue No: Vol. 8, No. 2 (2019)
       
  • Amino acid infusion in oligohydromnios and increase in AFI and impact on
           perinatal outcome

    • Authors: Isha Sunil, Chejerla Sunitha, Harkirat Kaur
      Pages: 617 - 620
      Abstract: Background: Decreased amniotic fluid is related to adverse maternal and perinatal outcomes. The purpose of this study was to evaluate the role of amino acid infusion in patients of oligohydromnios and compare the perinatal outcome in the two groups.Methods: This study was conducted in the Department of Obstetrics and Gynaecology, ASCOMS Hospital, Jammu for a period of one year from October 2017 to September 2018. A total of 50 women with AFI <8 cm were enrolled in the study . They were divided into two groups of 25 each. Group A were given amino acid infusion and Group B were not given any intervention. These were compared for increase in AFI and perinatal outcome.Results: In the present study, the gain in AFI in Group A was 2.32 ± 0.67 and in group B was 1.32 ± 1.03 which was statistically significant. The perinatal outcome was better Group A compared to Group B with decreased incidence of meconium stained liquor, low birth weight, low APGAR scores and NICU admissions and increase in vaginal deliveries as compared to caesarean sections.Conclusions: The present study suggests that parentral transfusion of amino acid in cases of oligohydromnios significantly increases the AFI of the patient and decreases the incidence of caesarean sections, meconium stained liquor, low APGAR scores and NICU admissions.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190294
      Issue No: Vol. 8, No. 2 (2019)
       
  • Use of non-pneumatic anti shock garment in hemorrhagic shock

    • Authors: Vidyadhar B. Bangal, Satyajit Gavhane, Sonal Raut, Ujwala Thorat
      Pages: 621 - 627
      Abstract: Background: Non-pneumatic anti-shock garment (NASG) is a first-aid device that reverses hypovolemic shock and decreases obstetric haemorrhage. It consists of articulated neoprene segments that close tightly with Velcro, shunting blood from the lower body to the core organs, elevating blood pressure and increasing preload and cardiac output. The use of an NASG can stabilize a patient while awaiting transport, during transport, or during delays in receiving care at referral facilities.Methods: A prospective observational study of use of non-pneumatic anti shock garment (NASG) in cases with obstetric hemorrhagic shock was carried out at a tertiary referral center. As soon as severe shock was recognized in the hospital, the anti-shock garment was placed. Data on various parameters related to use of NASG was collected and interpreted to draw conclusions.Results: NASG was used in 25 cases of hemorrhagic shock during one-year period. Post-partum hemorrhage (36%) was the commonest indication for NASG use, followed by ruptured tubal ectopic pregnancy (28%). It was observed that 68% and 32 % of women had shock index of 1-1.5 and above 1.5 respectively at the time of application of NASG. The shock index rapidly improved to 0.5-0.9 in 92% and 1-1.5 in 8 percent of cases respectively after the application of NASG. The NASG was mainly used in labour room (40%) and emergency department (36%).  NASG was applied by nurses and doctors together in 64% of cases. NASG was kept for a period 24 hours in 92% cases. The survival rate was 96% following use of NASG.Conclusions: NASG is a temporizing alternative measure in hemorrhagic shock management that shows a trend to reduce hemorrhage related deaths and severe morbidities. NASG should be made available at all health facilities that deal with high risk pregnancies and deliveries.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190295
      Issue No: Vol. 8, No. 2 (2019)
       
  • Role of transvaginal ultrasonographic cervical assessment in predicting
           the outcome of induction of labor

    • Authors: Kiran Aggarwal, Anita Yadav
      Pages: 628 - 636
      Abstract: Background: Induction of labor is the most common intervention in modern obstetrics. The pre-induction ‘favourability’ of the cervix as assessed by the bishop score is very subjective. Transvaginal sonography appears to be a feasible alternative to the traditional bishop’s score. Aim of this study, was to compare cervical assessment by transvaginal sonography and digital examination in prediction of outcome of labor induction.Methods: Three hundred women at term with maternal and foetal indications for labor induction were included in the study. Modified Bishop score was assessed by digital examination and the cervical length was measured by Transvaginal sonography (TVS). Successful labor induction was taken as a vaginal delivery within 24 hours from the start of induction. Data were analyzed using SPSS for Windows 15.0.Results: Labour induction was successful in 81.33% of patients. Mean cervical length by digital examination was 2.6 cm, whereas the mean sonographic cervical length was 3.4cm. There was a significant difference of 0.8cm in mean cervical length measured by two methods (P=0.01). The best cut off point for predicting successful induction of labor was ≤3.4cm for sonographic cervical length (sensitivity 0.82, specificity 0.87, positive predictive value 0.77 and negative predictive value 0.25). The best cut off point for Modified Bishop score was 2 (sensitivity 0.95, specificity 0.93). The ROC curve showed that compared to TVS cervical length, Modified Bishop score was the best parameter for predicting successful induction of labor.Conclusions: Transvaginal sonographic cervical length measurement can be used as an adjunct tool to the traditional Bishop score for predicting successful labor induction in high risk pregnancies.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190296
      Issue No: Vol. 8, No. 2 (2019)
       
  • Comparison of Amsel’s criteria and Nugent’s criteria for diagnosis of
           bacterial vaginosis in tertiary care centre

    • Authors: Romi Bansal, Priyanka Garg, Aastha Garg
      Pages: 637 - 640
      Abstract: Background: Bacterial vaginosis is an imbalance in the ecology of the normal vaginal flora which is characterized by depletion of lactobacilli, and proliferation of anaerobic bacteria. It most often manifests clinically as a vaginal pH of > 4.5, presence of thin whitish homogenous vaginal discharge, detection of “clue” cells and presence of an amine odour after the addition of 10 percent potassium hydroxide. These anaerobic bacteria through specific products stimulate the decidual tissue causing an increase of cytokine level, release of phospholipase A2 and prostaglandins leading to preterm labor, premature rupture of membranes, chorioamnionitis and development of PID following abortion. To compare Amsel Criteria and Nugent Criteria for diagnosis of bacterial vaginosis.Methods: A cross sectional study involving 260 patients with preterm and term labour was conducted at a tertiary care hospital in North India. BV was determined to be present or absent on the basis of Amsel’s criteria and Nugent’s criteria. Pearson’s chi-square test was used to demonstrate the difference between both groups with respect to various categorical data.Results: Amsel’s criteria and Nugent’s criteria were reliable diagnostic methods. As compared to Nugent scoring system, Amsel’s criteria had sensitivity of 75%, specificity of 95%, positive predictive value of 90% and negative predictive value of 86%.Conclusions: Although the Amsel’s criteria is a convenient and inexpensive method of diagnosing bacterial vaginosis, it is not always reliable. Nugent’s criteria is considered as a gold standard for the diagnosis of bacterial vaginosis but it requires an experienced slide reader and considerable time and skill. If lab equipment is not available as in many developing countries, the diagnosis of BV can be simplified by using a combination of any two Amsel’s criteria like vaginal pH and whiff test which had highest sensitivity and specificity (90.19% and 97.78%) respectively as seen in present study.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190297
      Issue No: Vol. 8, No. 2 (2019)
       
  • Third stage of labour: expectant versus active management-a comparative
           study in local low risk population

    • Authors: Kavita A. Chandnani, Deepti D. Sharma
      Pages: 641 - 646
      Abstract: Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. These deaths have a major impact on the lives and health of the families affected. Thus, anticipation as well as proper management of 3rd stage of labour is mandatory. The objective of this study was to compare expectant and active management of third stage of labour in preventing post-partum blood loss and having impact on prevention of maternal mortality in local population. Advantages and disadvantages of both techniques might be over estimated.Methods: Prospective comparative study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 200 laboring women admitted directly or from OPD to labour room for expected vaginal delivery. They were randomly allocated to group A (expectant management) and group B (active management). Labour progress was charted on partograph and interventions recorded. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for descriptive variables were calculated and appropriate statistical tests applied to determine significance.Results: Average PPBL (post-partum blood loss) was 360.5ml in group A as compared to 290.6ml in group B. 12 patients in group A had blood loss more than 500ml while none in group B. 66% cases in group B had duration of third stage of labour less than 5 min as compared to only 22% in group A. the mean duration of third stage was 13.46±8.3 in group A while 5.32±3.05 in group B. these differences were statistically significant.Conclusions: Active management of the third stage of labour is associated with less blood loss as well as a shorter duration of third stage compared with expectant management. It is reasonable to advocate this regime.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190298
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prevalence of vulvovaginal candidiasis in females in the reproductive age
           group

    • Authors: Meena Salvi
      Pages: 647 - 651
      Abstract: Background: Vulvovaginal candidiasis (VVC) is a common infection among reproductive age group females. The objective of present study is to determine the prevalence of vulvovaginal candidiasis, its distribution and association of risk factors among reproductive age group females, attending the outpatient department of obstetrics and gynaecology of our Prime Medical Centre, Sharjah attached with Prime Hospital, Dubai, United Arab Emirates (UAE).Methods: It was cross-sectional descriptive study over a period of six months. Patients who came to our outpatient department with complains of vaginal discharge and itching in reproductive age group were included in this study. Patients characteristics i.e. age, parity, risk factors like diabetes, pregnancy, use of oral contraceptive pills (OCPills) and intrauterine contraceptive device (IUCD) were noted. High vaginal swabs (HVS) were collected and sent for culture. Candida positive cases were noted, and results were analyzed.Results: A total of 224 high vaginal swabs were collected. Prevalence of vulvovaginal candidiasis was found to be 31.6%. It was found more in 26-30 years age group and multiparous women. Previous history of candidiasis and diabetes were the commonest risk factors. Frequency of C. albicans was more (76.05%) than non-albicans candida (23.94%).Conclusions: Present study concluded that vulvovaginal candidiasis is more prevalent in reproductive age group females, therefore a routine high vaginal swab culture must be performed in every woman presenting with vaginal discharge and itching for correct diagnosis. Women should be educated on clinical symptoms.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190299
      Issue No: Vol. 8, No. 2 (2019)
       
  • Early stage cervical cancer with negative pelvic lymph nodes: morbidity
           and survival patterns following radical hysterectomy and postoperative
           adjuvant radiotherapy

    • Authors: Ruchi S. Arora, Shilpa M. Patel, Ava D. Desai, Meeta M. Makand
      Pages: 652 - 657
      Abstract: Background: The objective of the present study was to optimize the role of adjuvant radiotherapy in lymph node negative cervical cancer treated with radical hysterectomy and pelvic lymph node dissection, and to analyse patterns of failure and complication following surgery and radiotherapy in same patients.Methods: This is retrospective analysis of 98 patients of cancer cervix FIGO Stage IB; IIA treated with radical hysterectomy with bilateral lymphadenectomy and adjuvant radiotherapy between the years 2000 and 2007at our hospital. Among all node negative patients who were operated during this period 97 patients were high risk. [High risk-Two or more of following risk factors: primary tumor size >4 cm, cervical stromal invasion ≥1/2, lymph-vascular space invasion, Unfavorable histology,>].Results: Median follow up: 79 months [6 months to 109 months], Recurrence rate: 13.26% [2 Pelvic and 11 distant recurrence] Pelvic control rate: 98 %Radiotherapy Complications: 4 % [Grade 3-4].Conclusions: Adjuvant radiotherapy following radical hysterectomy in high risk node negative early cervical cancer is effective treatment. It reduces pelvic recurrence with acceptable morbidity.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190300
      Issue No: Vol. 8, No. 2 (2019)
       
  • Risk factors and outcome of placenta previa: accrete in a tertiary health
           care center of Punjab, India

    • Authors: Davinder Pal, Nisha Bhagat, Ritu Arora
      Pages: 658 - 664
      Abstract: Background: The aim of this study was to identify and evaluate risk factors associated with placenta accrete (PA) and its clinical outcome.Methods: A descriptive, case control study was conducted in department of obstetrics and gynecology, GMC Amritsar in which authors retrospectively reviewed data of 180 patients of placenta previa (PP) over 5 years, categorized as PA (cases; n=23) or no PA (control; n=157). Furthermore, these groups were compared as to maternal demographics, intrapartum and postpartum complications and neonatal outcomes. Stepwise logistic regression analysis was done to evaluate the extent to which exposure variable contributed to the incidence of PA including advanced maternal age (AMA), parity, location of placenta and previous caesarian section (CS).  Primary aim was to identify and quantify the various risk factors of PA and secondary aim measured incidences of PP, PA and fetomaternal outcome.Results: The cumulative incidence of PA over 5 years was 2.98 per 1000 deliveries. Accrete rate increased with number of CSs at 4.76% in patients with no previous CS versus 45.94% in ≥1 CS (p < 0.003). Anterior PP (AOR 10.128  CI 2.406 -42.632; p <0.001) and number of previous CSs (AOR 36.405, 95% CI 2.743 -483.24, p =0.006) were significant risk factors for PA. AMA (OR >30 years: 4.326 95% CI 0.724 -25.856; p =0.108), parity (AOR 1 vs 0: 2.526 95% CI 0.242-26.41; p=0.439), prior uterine curettage (AOR ≥1 vs 0: 11.143 95% CI 0.522-9.726; p=0.278) although had association with PA but was not statistical significant. Caesarian hysterectomy was done in 95.65% patients of PA while only 1 patient of PP required hysterectomy (p<0.001). Neonatal outcome was similar in both groups.Conclusions: Prior caesarian and anterior PP emerged out as significant predictors of PA. Other risk factors like AMA, multiparous, history of prior uterine curettage, central PP have incremental risk of having PA and such patients should be managed diligently to lower feto-maternal morbidities and mortalities. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190301
      Issue No: Vol. 8, No. 2 (2019)
       
  • A study on fetal outcome in patients with oligohydramnios

    • Authors: Rooplekha Chauhan, Sonal Sahni, Akanksha Dubey
      Pages: 665 - 671
      Abstract: Background: There is an association between oligohydramnios and intrauterine growth restriction as well as increased perinatal mortality. Amniotic fluid provides a protected environment for the growing fetus, moderating the fetus against mechanical and biological injury. The objective of the present study was to study the fetal outcome in patients with oligohydramnios between 20 to 42 weeks of pregnancy.Methods: Prospective study of 87 pregnancies with oligohydramnios was carried in Department of Obstetrics and Gynaecology, NSCB Medical College, Jabalpur from 1st March 2016 to 31stMarch 2017. All women enrolled for the study were subjected to history taking, clinical examination and amniotic fluid index estimation.Results: Rate of caesarean section was higher in patients with oligohydramnios and higher number of neonates were admitted to the NICU amongst the patients of oligohydramnios.Conclusions: Oligohydramnios has a significant correlation with adverse perinatal outcome.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190302
      Issue No: Vol. 8, No. 2 (2019)
       
  • Elevated progesterone level and its consequences on IVF

    • Authors: Sankar Kumar Das, Priyanka Roy, Krishna Kalita
      Pages: 672 - 676
      Abstract: Background: Understanding of the embryo-endometrium dialogue is still far from being understood. During conventional in vitro fertilization cycles, progesterone elevation on the day of human chorionic gonadotropin administration refers to rising progesterone levels in the absence of either premature or a luteinizing hormone surge. Most research have reported that elevated progesterone had an adverse impact on the endometrial environment of fresh cycles, leading to a decrease in pregnancy rates.Methods: The current study was undertaken at Swagat hospital and research Centre, Bongaigaon, Assam (India). Fifty patients undergoing in vitro fertilization (IVF) were selected for the study. Baseline estimation of follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH), (estrogen) E2 and (transvaginal sonography) TVS was done. The patients were grouped on the basis of their progesterone levels on the day of hCG trigger, with the cutoff for defining premature progesterone rise being (progesterone) P4≥ 3ng/ml. Final oocyte maturation was induced with hCG. Oocyte retrieval was performed 34-36 h after hCG. Two to three embryos of day 3 cleavage stage were transferred under TVS guidance. The parameters obtained from each cycle were recorded. Statistical analysis was performed. Probability (P) value <0.05 was considered statistically significant. A sonographic confirmation of pregnancy was performed 2 weeks after β-hCG positive.Results: On dividing the patients into two groups, based on the cut off of P4 as 3ng/ml, it was observed that the no of cases that conceived was significantly higher in the subjects whose P4 level was less than or equal to 3ng/ml than the subjects whose P4 level was more than 3ng/ml.Conclusions: Elevated P4 i.e. Progesterone level just before trigger is a reflection of endometrial maturity that can cause disparity between endometrial and embryonic ageing and therefore hamper implantation or cause failure in assisted reproductive technology (ART).
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190303
      Issue No: Vol. 8, No. 2 (2019)
       
  • Predictive value of uterine artery: peak systolic velocity on the day of
           trigger for clinical pregnancy rate in infertile women

    • Authors: Karishma Makhija, Deepti Shrivasatava, M. Tiwari
      Pages: 677 - 681
      Abstract: Background: The purpose of the study is to evaluate the role of uterine artery blood flow parameter measured by uterine artery two-dimensional (2D) power coloured doppler (PCD) ultrasound in predicting fertility outcomes in women undergoing ART treatment.Methods: It is prospective observational study. Total of 60 patients were included  of receiving infertility treatment in the age group20-40 years. 20 patients were selected for timed intercourse , 20 patients were selected for intrauterine insemination , 20 patients were selected for invitro fertilization. Transvaginalsonography will be done on the day of trigger by BHCG , UA PSV were measured,  and endometrial blood flow will be assessed. Predictivity of pregnancy rate  will be looked after by 3 ways: BHCG values  , UPT, Gestational sac  on USG.Results: In TI/IUI/IVF cycles the Doppler parameter PSV of uterine artery (23.08+/-3.39 vs 20.37-/+5.43) in pregnant vs non-pregnant group did not differ significantly. The mean PSV   of UA shows no significant difference women who were became pregnant during treatment and the women who were not became pregnant.Conclusions: With help of Doppler parameter imaging of women undergoing infertility it was found that UA PSV is non-significant to decide the prediction of pregnancy outcome.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190304
      Issue No: Vol. 8, No. 2 (2019)
       
  • Comparative clinical study of laparoscopic assisted vaginal hysterectomy
           and non-descent vaginal hysterectomy

    • Authors: Shobha S. Shiragur, B. Rajammal
      Pages: 682 - 686
      Abstract: Background: Laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly becoming popular. It's really a technique made to replace abdominal hysterectomy. The need of the hour is the minimal invasive surgery, early discharge from the hospital, early resumption of work, avoidance of disfiguring scar on the abdomen and cost-effectiveness of the procedure which are as important as cure of the disease. The objective of this study is to compare the effectiveness and safety of laparoscopic and vaginal hysterectomies for non-descent uteri (NDVH).Methods: The study was undertaken in the department of obstetrics and gynecology, Amrita Institute of Medical Sciences, Kochi for the period of one year. About 50 women in each group undergoing LAVH and NDVH for benign pelvic conditions were studied preoperatively, intra-operatively and post-operatively in detail for indications, operative time, intraoperative blood loss, duration of stay in hospital.Results: The mean operative time in LAVH was 240.6 minutes and in NDVH 168.3 minutes. Minimum duration of stay was in LAVH 3 days and in NDVH 4 days. Mean duration of stay in both groups was 6.4 days. Maximum duration of stay-15 days in both groups.Conclusions: LAVH is a better approach for a larger uterus whereas NDVH is preferable for a small uterus, not only for shorter operative time and minimal wound, but also for much lower costs.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190305
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prospective study of maternal perception of decreased fetal movement in
           third trimester and evaluation of its correlation with perinatal
           compromise

    • Authors: Nupur Nandi, Ritika Agarwal
      Pages: 687 - 691
      Abstract: Background: Intrauterine fetal movements are sign of fetal life and well being. Perception of decreased fetal movements by the expecting mother is a common concern for both the mother and her obstetrician. Inadequate evaluation of reported decreased fetal movements may lead to catastrophic perinatal outcome. These necessitates us to identify the mothers perceiving decreased fetal movements, evaluating them to identify any risk factor, and follow up them to know the correlation with perinatal outcome.Methods: Antenatal mothers with singleton pregnancy at third trimester are recruited from OPD/ Emergency of Obstetrics and Gynaecology departments of Teerthankar Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India. Both case and control group comprise of 80 mothers matched by demographic profile, with perception of decreased fetal movements only in case group. They were evaluated thoroughly to identify risk factor if any and were followed up till delivery to know the perinatal outcome.Results: Majority of women reporting reduced fetal movements were between 20-30 years of age group (73%), Primigravida (80%), 72.5% were at term pregnancy. Common (46%) pattern of decreased movements was both in frequency and as well as intensity. 62% women with decreased fetal movements had anteriorly placed placenta.  In the study group, 48.75% women were identified with risk factor, and association of more than one antenatal risk factor was significantly high (p value 0.0026). LBW was more common (21.25%), many neonates were associated with low Apgar score in the study group.Conclusions: Pregnant mothers reported with decreased fetal movement in third trimester should be evaluated adequately for identification of risk factors, as well as for fetal surveillance. Record of fetal movement for 2 hours while the mother is in rest, Cardiotocography, elaborative USG, BPP should be monitored to have good perinatal outcome by providing timely intervention.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190306
      Issue No: Vol. 8, No. 2 (2019)
       
  • Clinical presentation and outcome of ectopic pregnancies in a tertiary
           care rural hospital

    • Authors: Indu Verma, Punya Priya, Charvi Chugh, Harsharan Kaur, Dinesh Sood
      Pages: 692 - 696
      Abstract: Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190307
      Issue No: Vol. 8, No. 2 (2019)
       
  • Comparison of iron carboxy maltose and iron sucrose in pregnant females

    • Authors: Isha Sunil, Prabhjit Kour, Mitali Sharma
      Pages: 697 - 701
      Abstract: Background: Maternal anaemia is a common problem worldwide. The aim of this study is to compare the efficacy and safety of FCM vs iron sucrose for correction of iron deficiency during pregnancy.Methods: This study was conducted in Swasthya healthcare, Jammu for a period of ten months from Sep 2017 to June 2018. A total of 100 women with Hb 7-9.9g% enrolled. They were divided into two groups of 50 each. Group A were given Iron Carboxy maltose and Group B were given Iron Sucrose. These were compared for their efficacy and safety.Results: In the present study, the rise in mean hemoglobin at 4 weeks in Group A was 1.79±0.47 and 1.06±0.11 in Group B which was highly significant (p-value<0.0001). Rise in mean serum ferritin level at 4 weeks in Group A was 123.80±16.03 and in Group B was 84.78±10.53. Statistically, this rise was also highly significant (p<0.0001). In present study, adverse reactions were observed in 34% patients in Group A, while in Group B it was observed in 52% patients.Conclusions: Iron carboxy maltose shows higher rise in hemoglobin and ferritin levels as compared to Iron Sucrose and incidence of adverse effects is also comparatively lower in the former.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190308
      Issue No: Vol. 8, No. 2 (2019)
       
  • Effect of Myoinositol and Metformin in combination on clinical and
           hormonal profile in patients of polycystic ovarian syndrome

    • Authors: Tripti Nagaria, Arpita Mohapatra, Jyoti Jaiswal
      Pages: 702 - 709
      Abstract: Background: Polycystic ovarian syndrome (PCOS) also known as hyperandrogenic anovulation syndrome or Stein – Leventhal syndrome is an endocrine disorder, characterized by anovulation, oligomenorrhea, amenorrhea, features of androgenic hormone excess (hirsutism, acne, alopecia, seborrhea) and insulin resistance. The global prevalence ranges from 2.2% to 26%. Methods: A prospective observational study was conducted from December 2015 to December 2016 in Department of Obstetrics and Gynecology at Pt. Jawahar Lal Nehru Memorial medical college and associated Dr. Bhim Rao Ambedkar memorial hospital, Raipur (C.G.) after obtaining permission of ethical committee of the institute to evaluate the effect of myoinositol and metformin on clinical profile in patients of polycystic ovarian syndrome. 70 women were included in the study who received a combination of myoinositol 600mg and metformin 500mg (twice a day) for 3 months for the management of PCOS. Prior to the start of the therapy, a detailed history and baseline investigations were recorded. Cases were reassessed at the end of three months of therapy for evaluation of change in clinical and hormonal profile.Results: 90.09% (63/70) cases showed improvement in the menstrual complaints. Spontaneous onset of menses occurred in all the cases presented with amenorrhea, in nearly 90% within 2 months of start of treatment. Regularization of cycles was observed in nearly 50% of patients with infrequent menses. Amongst all the cases with cutaneous manifestations, maximum improvement was seen in cases of acne (4/6) i.e. 66.66%. 25% (5/20) patients with infertility conceived during the study period.Conclusions: Myoinositol with metformin in combination has resulted in significant improvement in the clinical profile with reduction in individual drug dosage in cases with PCOS.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190309
      Issue No: Vol. 8, No. 2 (2019)
       
  • Uterine atony risk factor after vaginal delivery in a tertiary hospital in
           Antananarivo, Madagascar

    • Authors: Tanjona A. Ratsiatosika, Randriamahavonjy Romuald, Rainibarijaona A. Lantonirina, Housni I. A., Rakotonirina A. Martial, Said Ismael Mhoudine, Rakotonirina Ando-Miora, Andrianampanalinarivo H. Rakotovao
      Pages: 710 - 716
      Abstract: Background: Postpartum hemorrhage is the leading cause of maternal death in developing countries. Uterine atony is the cause in 80% of cases. Through this study, we want to determine risk factors for uterine atony after vaginal delivery route with oxytocin-mediated delivery.Methods: This is a retrospective case-control study ranging from January 1st 2017 to June 31st 2018 at the Befelatanana University Hospital Centre of Gynecology-Obstetrics. The cases consisted of patients who had spontaneous vaginal delivery in the centre and had uterine atony.
      Authors studied maternal, obstetrical, neonatal parameters.
      Authors used the R software for the statistical analysis of the results.Results: We found 40 cases of uterine atony out of 5421 deliveries with a prevalence of 0,73%. The average age was 27.73 years old±6.46 years old (p=0.113). The average parity was 2.67±1.62 (p=0.22). The total duration of labor was 6.88±2.95 hours (p=0.0187). The average duration of rupture of the membrane was 5.80±11.90 hours (0.003376). We found as risk factor of uterine atony the increase in oxytocin infusion rate during labor (OR=18.67, 95% CI 2.21-157.57), the artificial rupture of membranes (OR=5, 27, 95% CI 2.11-13.19), artificial induction of labor (OR=7.08, 95% CI 2.06-24.28) and labor over six hours (OR=2.53, 95% CI) % 1.18-5.47). In univariate analysis, premature delivery and a hypotrophic fetus were a factor risk of uterine atony (OR=3.07, 95% CI 1.27-7.44 and OR=3.43 95% CI 1.48-8.09 respectively) but this risk is not statistically significant in multivariate analysis with logistic regression (OR=1.27, 95% CI 0.40-3.84 and OR=2.19 95% CI 0.77-6.22). The main treatment was uterotonic drug use (72.5%).
      Authors identified seven cases of haemostasis hysterectomy and two cases of maternal death.Conclusions: Present study confirms risk factors for uterine atony already known as prolonged labor and increased oxytocic infusion rate. Unrecognized factors have been identified as a risk factor for uterine atony such as the duration of rupture of the membranes and artificial rupture of the membranes. A minimal inflammation hypothesis that reduces susceptibility to oxytocin may explain this association. Knowing these factors would reduce the occurrence of uterine atony to reduce maternal mortality.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190310
      Issue No: Vol. 8, No. 2 (2019)
       
  • Study of maternal and fetal outcome in HIV positive women on HAART therapy
           in a tertiary hospital

    • Authors: Priya Shankar, Madhu J.
      Pages: 717 - 720
      Abstract: Background: India has the third largest population of HIV. Moving from single dose nevirapine in labor to use of HAART treatment for all pregnant women and the outcome of the same was the subject of present study.Methods: Retrospective study of HIV positive pregnant women on HAART treatment admitted in labor room at Karnataka institute of medical sciences from June 2015 to December 2016. A retrospective analytical study of 93 women with HIV positive status on HAART therapy admitted in labor at KIMS was done by collecting data from case records. Baby follow up details were collected from ART center, KIMS.Results: Parameters studied were maternal and fetal outcomes. Maternal outcome in terms of mode of delivery, morbidity and mortality and fetal outcomes in terms of APGAR at birth, weight of the baby, NICU admission, incidence of meconium, still birth and intrauterine fetal demise, follow up of the babies at 6 weeks, 6 Months and 18 Months for seropositivity.Conclusions: HAART in pregnant women significantly improved the maternal and fetal outcomes.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190311
      Issue No: Vol. 8, No. 2 (2019)
       
  • Predictors of maternal outcome in women on mechanical ventilation in an
           obstetric intensive care unit: an observational study

    • Authors: Tanu Soni, Priyadarshini Tiwari
      Pages: 721 - 728
      Abstract: Background: Present study was designed to note the indications for and the complications and outcome of women on mechanical ventilation in our obstetric intensive care unit, and in addition to look for the applicability and correlation of Sequential Organ Failure Assessment (SOFA) scores for the prediction of outcome in these women.Methods: A prospective observational study was conducted in the obstetric intensive care unit of our teaching hospital which included all women requiring mechanical ventilation in the study period. The diagnosis of the woman on admission, the clinical course and outcome along with total maximum sequential organ failure assessment (SOFA) score and SOFA score for each system were noted. Women were divided into two groups, survivors and non-survivors. Student t test and chi square test were used for analysis.Results: The foremost indication for mechanical ventilation was hypertension in pregnancy namely eclampsia and pre-eclampsia, followed by obstetric hemorrhage and then by hepatic failure. Maternal mortality rose significantly as the number of days of mechanical ventilation increased (p value <0.05). The total SOFA score correlated highly significantly with the outcome (p<0.0001).Conclusions: In women with eclampsia and pre-eclampsia suffering from respiratory failure, survival is inversely correlated with the number of days of mechanical ventilation. The total SOFA score is highly predictive of the woman’s outcome and all individual organ system scores also significantly correlate with outcome except for the score of coagulation system.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190312
      Issue No: Vol. 8, No. 2 (2019)
       
  • Role of low dose Magnesium sulphate in eclampsia

    • Authors: Kajal Sinha, Shail K. Sinha
      Pages: 729 - 733
      Abstract: Background: Eclampsia is one of the challenging medical complications seen during pregnancy. With the use of magnesium sulphate for control of convulsion in eclampsia, it can be managed effectively.Methods: This is a prospective study done in a tertiary care hospital. Considering low body mass index of patients of developing area, authors had used low dose regime of magnesium sulphate. 100 patients had been enrolled for low dose magnesium sulphate regime after categorizing patients as per inclusion and exclusion criteria. The primary outcome to be measured was recurrence of fits in any patients who received low dose magnesium sulphate. The secondary outcome measured were development of any toxicity, level of serum magnesium level, maternal and perinatal outcome.Results: It was observed that 93% of the patients responded to low dose regime. 7% developed  recurrence of fits for that additional dose of 2 gram of 20% magnesium sulphate was given to the patients. Not even a single patient developed signs of toxicity. 94% and 95% of the patients acquired therapeutic level of serum magnesium at 4 hours and 10 hours of magnesium sulphate administration, respectively. Maternal mortality was 5% and perinatal mortality was 24.4%.Conclusions: Low dose of magnesium sulphate can prevent and treat eclampsia. Low dose regimen also reduces incidence of toxicity with improved maternal and perinatal outcome.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190313
      Issue No: Vol. 8, No. 2 (2019)
       
  • Prolapse in pregnancy

    • Authors: Indrani Dutta, Jacinta Minz
      Pages: 734 - 737
      Abstract: Presentation of uterine prolapse is a normal event in a pregnant woman which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of uterus vary from minor cervical infection to spontaneous abortion to preterm labour, maternal and fetal mortality, acute retention of urine and urinary tract infection.
      Authors of this paper have studied a case of a pregnant lady who presented to the emergency department with prolapse and her line of management which was executed. This was a case report study and management were done as per standard obstetrical guidelines. Patient was counselled at the time of discharge. Implementation of conservative treatment modalities throughout pregnancy with prolapse and their application in accordance of severity of uterine prolapse and patient’s preference may be sufficient to achieve an uneventful pregnancy, normal and spontaneous vaginal delivery. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190047
      Issue No: Vol. 8, No. 2 (2019)
       
  • Recurrent decidual cast with membranous dysmenorrhea

    • Authors: Jyoti ., Suman Kumari, Devender Kumar, Pratiksha Gupta, Nupur Gupta, Anand Kumar
      Pages: 738 - 740
      Abstract: Decidual cast is the entire sloughed endometrium that takes the form of the endometrial cavity. It causes membranous dysmenorrhea because the intact cast passes through an undiluted cervix. It may be associated with ectopic pregnancy, incomplete abortion, non-pregnant state with use of progesterone, Depot medroxyprogesterone acetate (DMPA), rarely with oral contraceptive pills.
      Authors are reporting a case of recurrent decidual caste formation with membranous dysmenorrhoea in 33 years old women P3L3 who was on norethisterone acetate treatment for a typical uterine bleed (AUB). She presented with heavy menstrual bleeding with severe dysmenorrhea in Gynae causality of ESI Basaidarapur medical college, Delhi. She expelled decidual caste and required therapeutic Dilation and Curettage (D and C) to control bleeding per vaginum. Her histopathology report showed marked decidua like change of the stroma but no villi suggestive of endometrial caste.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190080
      Issue No: Vol. 8, No. 2 (2019)
       
  • Hereditary angioedema caused by C1-esterase inhibitor deficiency: a case
           report with literature-based analysis

    • Authors: Sufia Athar, Noureddine Korichi, Yousra Shehada Siam
      Pages: 741 - 743
      Abstract: Hereditary angioedema (HAE) caused by C1-esterase inhibitor deficiency is an autosomal-dominant disease caused by a mutation in the C1-inhibitor gene. It is a rare disease that is often worsened during pregnancy and childbirth. HAE, though uncommon but if untreated it may lead to maternal death.  The case report presents the successful management of a 24 years old, G2P1, with hereditary angioedema caused by C1-esterase inhibitor deficiency. This patient was managed with a multidisciplinary approach by an obstetrician, an immunologist, an anaesthesiologist and a pediatrician. She had an uneventful antenatal period, labor was induced. She had precipitate delivery and soon after delivery had a flare up of the disease. It was successfully managed with fresh frozen plasma and close observation. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190314
      Issue No: Vol. 8, No. 2 (2019)
       
  • A novel approach for laparoscopic retrieval of dermoid cyst

    • Authors: Nitin H. Shah, Aditi V. Joshi, Sunita Mourya
      Pages: 744 - 746
      Abstract: A dermoid cyst is a germ cell tumour, benign in nature and common in young women under the age of 30. They are usually asymptomatic and often detected incidentally on imaging. Resection of the cyst is important owing to complications like torsion or malignancy. Laparoscopic surgery is the modality of choice in today’s era. However, rupture of the cyst during laparoscopic retrieval is any surgeon’s nightmare. Hence, good surgical skill and a reliable method of retrieval are of prime importance here.
      Authors present a novel method of dermoid extraction done laparoscopically with a sterile urine collection (urobag) bag. This is an easy and simple method which decreases the rate of spillage owing to the strength of the bag.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190315
      Issue No: Vol. 8, No. 2 (2019)
       
  • Capillary haemangioma of fallopian tube: a rare but dangerous incidental
           finding

    • Authors: Shakti Kumar Yadav, Mishika Bhoj, Sudha Salhan, Namrata Sarin, Sompal Singh
      Pages: 747 - 750
      Abstract: Haemangiomas are tumors of vascular origin. They are frequently observed in soft tissue and skin. Vascular tumors of female pelvic organs are extremely rare. Although, majority of these lesions are detected incidentally, they can mimic various benign and malignant lesions clinically and radiologically. Fallopian tube capillary haemangioma is very rare benign neoplasm. Only one case of capillary haemangioma of fallopian tube has been reported. A 44-year-old female with menorrhagia, underwent hysterectomy with bilateral salpingoopherectomy. Both the fallopian tubes were grossly unremarkable. Microscopic examination revealed a well circumscribed vascular neoplasm, consistent with capillary haemangioma, CD34 immunostaining highlighted the vascular endothelium.  Although benign in nature, haemangioma of the fallopian tube can present with complications. Rupture of the haemangioma can be lethal when present with hemoperitoneum.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190316
      Issue No: Vol. 8, No. 2 (2019)
       
  • Broad ligament ectopic pregnancy: a dilemma to diagnose

    • Authors: Namrata Saxena, Neeta Bansal, Pradeep Singhal, Monika Ramola
      Pages: 751 - 753
      Abstract: Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis, but definitive diagnosis is made only during surgery.
      Authors are reporting a case of 30 years female G3P1L1A1 seven weeks pregnancy with previous lower segment cesarean section and previous history of right sided salpingectomy with no complaints. Ultrasound was advised to know the location of sac this time, in which, she was diagnosed as a case right sided unruptured live ovarian ectopic pregnancy. On examination, signs and symptoms of ectopic pregnancy were absent. On laparoscopy, she was diagnosed as a case of right sided live unruptured broad ligament ectopic pregnancy as her right ovary was absent because of previous surgery.  With advances in sonography and laparoscopic skills, more cases can be diagnosed in the first trimester and can be safely managed laparoscopically. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190317
      Issue No: Vol. 8, No. 2 (2019)
       
  • Severe PID with sub-acute intestinal obstruction during third trimester of
           pregnancy: a rare presentation

    • Authors: Pesona Grace Lucksom, Annet Thatal, Patrika Rai, Spruha Navinbhai Thakkar, Kapil Singh Niranjan
      Pages: 754 - 757
      Abstract: Pelvic inflammatory disease (PID) during late pregnancy is rare.
      Authors report a case of severe PID manifesting as subacute intestinal obstruction at early third trimester of pregnancy. A 26 years woman at 28 weeks of gestation was admitted in OBG department of Central Referral Hospital (CRH), Sikkim for evaluation of pain in left hypochondrium with tachycardia and mild rise in temperature. Her WBC was 26,900/cmm while urine and blood cultures were sterile. USG showed single live gestation of 27weeks 3days with a heterogeneous mass suggestive of degenerative fibroid. She had recurrent episodes of subacute intestinal obstructions. Her condition deteriorated, hence, elective caesarean with exploratory laparotomy was done. Single live baby was delivered after which abdominal exploration revealed purulent ascites with multiple pockets of pus. Omental cake along with the bowel was adhered to the fundus of uterus. There was no area of perforation in the gut. Bilateral adnexa were adherent to the pre-sacral region which was densely adhered to underlying great vessels. Post operatively antibiotic to cover the anaerobic bacteria were given to which she responded. Baby died after 4 days of birth due to sepsis. One week after discharge she was readmitted with left sided pleural effusion which responded to antibiotics. PID should be considered a cause of abdominal pain and rise in temperature in pregnancy, as early diagnosis can be managed conservatively with antibiotics thus decreasing maternal and perinatal morbidity and mortality.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190318
      Issue No: Vol. 8, No. 2 (2019)
       
  • Thanatophoric dysplasia: a case report

    • Authors: Uruj Jahan, Astha Sharma, Neena Gupta, Shruti Gupta, Fatima Usmani, Ankita Rajput
      Pages: 758 - 761
      Abstract: Thanatophoric Dysplasia (TD) is a congenital, sporadic and most lethal skeletal dysplasia caused by new mutation in FGFR3 gene.
      Authors report such a rare case of a term alive baby with dysmorphic features, born to an unbooked, 40 years old G4P3+0 with non-consanguineous marriage; admitted at 9 months of gestation to present hospital with complain of pain abdomen for 2 days. Patient delivered a term female baby of vaginally which had delayed cry after birth, Admitted in NICU immediately with respiratory distress. The baby looked dysmorphic and suggested TD as most likely diagnosis. The case is being reported for its rarity and for high importance of early booking and anomaly scan. Early diagnosis is important since it provides alternative options of termination of pregnancy when an affected foetus is detected.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190319
      Issue No: Vol. 8, No. 2 (2019)
       
  • A large fibroma polyp of labia majora

    • Authors: Aman Deep Raj, Murali Mohan Soma, S. P. Khajuria
      Pages: 762 - 765
      Abstract: Fibroepithelial stromal polyps are benign proliferations which are usually polypoid or pedunculated, and less than 5cm in size. They are generally single lesions but can be multiple during pregnancy. They can be polypoid or pedunculated and are usually solitary. Symptoms usually include bleeding, discharge and general discomfort with sensation of a mass. They typically have a central fibrovascular core and contain stellate and multinucleated stromal cells which are best seen beneath the surface epithelium. True myxoid stroma is absent. Although vulvovaginal fibroepithelial stromal polyps are well documented, a giant variant such as the one authors report here is rather rare. To the knowledge, present case is the largest fibroepithelial stromal polyp compared to others reported in the literature.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190320
      Issue No: Vol. 8, No. 2 (2019)
       
  • ABO incompatibility: its impact on pregnancy and neonate

    • Authors: U. Nagashree, Swetha P., Sumana Manohar, Latha Kanchi Parthasarathy
      Pages: 766 - 768
      Abstract: ABO incompatibility is one of the most common cause of haemolytic disease of fetus and new-born (HDFN). The expression of ABO incompatibility in most of the cases is mild due to the lower expression of A and B Antigens on fetal red cells. ABO incompatibility has affected the first pregnancy and is milder in the subsequent pregnancies.  However, we describe this case with unusually severe form of ABO incompatibility which had an effect not only in her first pregnancy but also in all her subsequent pregnancies, evident as recurrent abortions and both her neonates developed pathological jaundice requiring exchange transfusion. It also emphasizes the fact that ABO incompatibility is not always a benign condition and should be considered in all babies whose mothers have O blood group, even in the presence of a negative DAT. Anticipation of ABO incompatibility not only in the first pregnancy but also in the subsequent pregnancies is necessary. Early diagnosis with cord blood bilirubin can prevent neonatal morbidity. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190321
      Issue No: Vol. 8, No. 2 (2019)
       
  • Post hysterectomy fallopian tube prolapse: a rare case

    • Authors: Priya S., Sarojamma C., Sailakshmi M. P. A.
      Pages: 769 - 771
      Abstract: Fallopian tube prolapse into the vaginal vault is a very complication of hysterectomy where the adnexa is preserved. The overall occurrence after all routes of hysterectomy is 0.01-0.05%. Several factors have been suggested to contribute to the condition such as vault hematoma, improper closure of vault, early resumption of sexual activity. Due to the misdiagnosis, there is often delay in the diagnosis and its management. The only means of definitive diagnosis is histopathology. A 30-year-old P2l2 presented to us after 3 years of post-hysterectomy with abdominal pain and bleeding pv on and off. On examination prolapsed fallopian tube was found in the vaginal vault on speculum. Biopsy was done in the outside hospital and was confirmed to be the tube. Patient underwent combined laparoscopic and vaginal method. Vaginal excision of the tube was done. Prevention by prophylactic salpingectomy and by suturing the adnexa high up in the pelvis in abdominal hysterectomy.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190322
      Issue No: Vol. 8, No. 2 (2019)
       
  • Huge cervical pedunculated leiomyoma with uterine prolapse: a case report

    • Authors: Shweta Avinash Khade, Balaji Jadhav, Rohini Raut
      Pages: 772 - 775
      Abstract: Leiomyoma uterus is the most common benign solid tumor in female. Most of it situated in the body of the uterus.  cervical myoma account 3%-8% of uterine myoma. Cervical myoma can frequently cause diagnostic dilemmas. Pedunculated cervical myoma can arise from the endocervical canal or from the uterine cavity and protrude through the cervix, may become necrotic, infected and gangrenous due to inadequate blood circulation through a long pedicle or if the pedicle of leiomyoma twists. This can cause menometrorrhagia, recurrent vaginal discharge leading to anemia and sepsis. A case of huge pedunculated cervical leiomyoma has been reported here. A 40 years old female, para 4, with menometrorrhagia, excessive vaginal discharge and severe anemia with haemoglobin 5gm% and challenging huge cervical pedunculated leiomyoma of size 13cm*9cm*9cm prolapsed outside introitus which is congested necrotic, infected causing uterine prolapse with bilateral hydroureter and hydronephrosis. Patient underwent bilateral internal iliac artery ligation and fibroid excision followed by total abdominal hysterectomy with bilateral salpingectomy after tracing both ureters.  Post-operative period was uneventful. Histopathology was confirmatory of leiomyoma.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190323
      Issue No: Vol. 8, No. 2 (2019)
       
  • Para vaginal dermoid cyst: a rare occurrence

    • Authors: Ruby Bhatia, Manjit Kaur Mohi, Anju Gupta, Sonia Goyal
      Pages: 776 - 778
      Abstract: Dermoid cyst (cystic teratoma) showing well differentiated derivatives of all three germs cell layers is a benign germ cell tumour. Ovaries remain the commonest site. Paravaginal dermoid cyst is a rare occurrence. Pre-operative diagnosis is usually difficult in majority of cases. They constitute less than 4% of all extragonadal teratomas. A 28-year old, P2L2 female presented with paravaginal cyst, 10×10cms, non-tender, soft swelling, cystic in consistency occupying posterior and left part of rectovaginal septum. Trans vaginal excision of cyst under regional anaesthesia done. Cyst was ruptured while excision showing putty material with tuft of hairs. A retrospective diagnosis of mature teratoma/paravaginal dermoid cyst was made on histopathological examination. Paravaginal dermoid cyst, a benign cystic teratoma is a very rare occurrence. Transvaginal excision of dermoid cyst under anaesthesia remains treatment of choice. Retrospective diagnosis on histopathological examination remains confirmatory as it may be missed on sonography if teeth are not present in dermoid cyst. 
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190324
      Issue No: Vol. 8, No. 2 (2019)
       
  • Management of cervical heterotopic pregnancy with inevitable miscarriage

    • Authors: Shyamala R., Saranya Srikumar, Radhamany K.
      Pages: 779 - 782
      Abstract: The objective is to report a case of successful treatment of heterotopic cervical pregnancy resulting from IVF–ICSI conception. Case report from Amrita Institute of Medical sciences: a tertiary care referral hospital. A 47-year-old Primigravida, diagnosed with heterotopic cervical pregnancy at 6 weeks of gestation, presented with significant first trimester vaginal bleeding. Under IV sedation, Transvaginal ligation of descending cervical branches of the uterine arteries arrested the bleeding. The cervical pregnancy was successfully aborted with minimal bleeding and the intrauterine pregnancy was successfully maintained till 32 weeks, after which she required emergency preterm LSCS in view of Severe preeclampsia superimposed on chronic hypertension a non-reassuring non-stress test (NST). The intervention applied maybe used in treatment of heterotopic cervical pregnancy in a low resource setting to control the bleeding.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190325
      Issue No: Vol. 8, No. 2 (2019)
       
  • Endoscopy in the management of a rudimentary non-communicating functional
           horn

    • Authors: Nitin H. Shah, Aditi V. Joshi, Sunita Mourya
      Pages: 783 - 786
      Abstract: Mullerian anomalies are developmental malformations of the female reproductive tract, often diagnosed late. They are classified into numerous types like a septate uterus, bicornuate or unicornuate uterus etc. A rudimentary non-communicating functional horn is a rare variant of a unicornuate uterus. It may present with a wide spectrum of symptoms like severe dysmenorrhea, infertility, lump in abdomen or rarely maybe diagnosed with a ruptured ectopic in the horn. The diagnosis of this entity is a difficult and challenging.
      Authors present a case of a young adolescent diagnosed with this Mullerian anomaly, the role of hysteroscopy in confirmation of diagnosis and the management of the patient by laparoscopy successfully. The patient was completely relieved of her symptoms post-surgery.
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190326
      Issue No: Vol. 8, No. 2 (2019)
       
  • The risk factors and preventive measures for the recurrence of endometrial
           polyps

    • Authors: Nitisha Doobaly, Xiuli Wang, Minjuan Lin, Shu Zhu, Xia Wang
      Pages: 787 - 791
      Abstract: Endometrial polyps (EPs) are a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data. Endometrial polyp recurrence remains a concern with recurrence rates of 2.5% to 43.6%. As such, it is critical to identify the risk factors and the preventive measures for endometrial recurrence, especially in reproductive-age women desiring future conception, to aid in clinical counselling and decision making. The recurrence of EPs is related to estrogen stimulation and endometrial hyperplasia. The progesterone-containing drugs are currently the most commonly used method to prevent the recurrence of EPs. In this article, authors aim to discuss the high-risk factors of EPs recurrence and the preventive measures for EPs recurrence. The preventive measures will focus on the combined oral contraceptives (COCs) and the levonorgestrel-releasing intrauterine system (LNG-IUS).
      PubDate: 2019-01-25
      DOI: 10.18203/2320-1770.ijrcog20190327
      Issue No: Vol. 8, No. 2 (2019)
       
 
 
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