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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]
  • Risk factors of intrauterine fetal death: a case control study at the
           maternity of Yaoundé Central Hospital

    • Authors: Romaric Joel Tetsiguia Momo, Jeanne Hortence Fouedjio, Florent Ymélé Fouelifack, Robinson Enow Mbu
      Pages: 2149 - 2154
      Abstract: Background: Intrauterine fetal death (IUFD) is the death before the beginning of the work of the fetus from the 28th week of pregnancy or a fetus of weight greater than or equal to 1000g. It occurs in 98% in poor countries, particularly in sub-Saharan Africa. The aim of this study was to identify the risk factors for IUFD in low-income countries.Methods: All the women with preeclampsia from 30 weeks onwards were enrolled in the study. The umblical artery (UA) Systolic-diastolic (S/D) ratio >2 standard deviation (SD) or UA-pulsatility index (PI) and UA-resistive index (RI) >2 SD were taken as abnormal. The middle cerebral artery (MCA) was visualised and cerebroumblical PI ratio calculated. MCA-RI<2SD was taken as abnormal.Results: Independent risk factors for IUFD are age over 30 years (ORa = 2.1, P = 0.052), (ORa = 2.4497, p = 0.01), household occupation (ORa = 2.0097, p = 0.0282), hypertension disorders (ORa = 2.11, p = 0.0176), antepartal haemorrhage (ORa = 3.9635, p = 0.000), multiparity (ORa = 13.3089, p = 0.0056).Conclusions: The main risk factors for IUFD identified in our study are maternal age greater than 30 years, hypertension, antepartal haemorrhage, multiparity, and the household profession. Any pregnant woman who has one of these factors should be follow-up closely during pregnancy with a weekly assessment of fetal well-being by the 28th week.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192406
      Issue No: Vol. 8, No. 6 (2019)
  • Study of blood component therapy in obstetrics

    • Authors: Nidhi Pancholi
      Pages: 2155 - 2158
      Abstract: Background: Blood transfusion is a life saving measure. Various pregnancy complications and disorders of labor present as risk factors for extra blood loss during pregnancy and cause severe hemodynamic instability. This along with complications due to abortion (spontaneous or induced) and ruptured ectopic pregnancy show up as conditions needing transfusion in the day-to-day practice of obstetrics. In a country like India, limited and fixed resources of blood, forces us to titrate the use of blood and its components. Normally, blood loss during birth is well-tolerated because of changes during pregnancy.Methods: This is a retrospective observational study done at tertiary care hospital. This study is based on study of indoor patients admitted during one year duration. Detailed history and all necessary investigations were carried out. Details regarding blood transfusion were taken indication of blood transfusion, number and type of unit transfused, number of patients given blood components, indications where single unit was transfused. Analysis of the data was done.Results: Anemia followed by antepartum hemorrhage followed by postpartum hemorrhage was the major cause for blood and blood product transfusion. Approximately 60% patients required two units of PCV (Packed Cell Volume) transfusion. Anemia in pregnancy was the major cause of single unit PCV transfusion.Conclusions: A proper knowledge for blood and blood product transfusion is needed to make it available for people who are actually in need and also to decrease the economic burden. Measures to prevent anemia should be implemented. Active management of third stage of labour (AMTSL) should be done to avoid postpartum hemorrhage. Single unit transfusion should be avoided.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192101
      Issue No: Vol. 8, No. 6 (2019)
  • The relationship between pregnancy weight gain and birth weight of new

    • Authors: Bharat Kumar Bilwal, Apurva Garg
      Pages: 2159 - 2162
      Abstract: Background: Maternal weight gain is one of the most important independent predictors of infant birth weight.  It is stated that under nutrition during pregnancy and low birth weight increase the risk for diabetes and cardiovascular disease in adulthood. Normal weight gain of pregnancy 11kg weight gain should be according to pre-pregnancy BMI.  Patients with BMI > 25 should gain weight of 7kg patient with normal BMI should gain 11kg weights.Methods: This is a hospital based prospective study and was conducted in the Department of Obstetrics and Gynaecology, RNT Medical college Udaipur from November 2018 to March 2019  to find association between maternal weight gain and birth weight. Exclusion criteria included congenital malformations, multiple pregnancy, polyhydraminos, preeclampsia, diabetes, cardiovascular, kidney disease, RH negative pregnancy. Results were calculated by percentage.Results: excessive weight gain during pregnancy increases baby weight. Out of total 100 cases, 88 (88%) cases are Hindus and 12 (12%) cases are Muslims. Out of total 100 cases 72 cases (72%) belong to urban, 28 (28%) belong to Rural area. Out of 100 patients 32 patients gain weight less than 11kg among which 16 newborn have weight less than 2.5kg, 68 patients have weight gain more than 11kg and 67 have baby weight more than 2.5kg.Conclusions: Excessive maternal weight gain during pregnancy increases birth weight. In view of the apparent association between high birth weight and adult adiposity, an advantageous time to initiate obesity prevention efforts may be during pregnancy.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192161
      Issue No: Vol. 8, No. 6 (2019)
  • Correlation of Pap smear and colposcopic findings in relation to
           histopathological findings among women attending a tertiary care hospital:
           a two year study

    • Authors: Jyothi Gandavaram, Bindu Reddy Pamulapati
      Pages: 2163 - 2168
      Abstract: Background: Cervical malignancy is ranked second among the malignancies in females with breast carcinoma the first. Screening for cervical cancer by conventional cytology and supported by colposcopy and histopathology can easily identify the premalignant lesions and also other non-invasive inflammatory lesions of the cervix. Objective of this study was to find the correlation of Pap smear, colposcopic findings and colposcopic guide biopsy in evaluation of cervical lesions in women and to analyze the various risk factorsMethods: A prospective study for two years was conducted by department of obstetrics among women aged from 20-60 years. Socio demographic data, clinical history and examination were done and findings noted. Pap smear, colposcopy and colposcopic guided biopsy was done and findings were noted and analyzed foe sensitivity, specificity and compared with Pap smear.Results: In present study sensitivity of Pap smear for detecting lesions above LSIL was 28%, specificity 99.32%, PPV was 93.47%, negative predictive value 76.21% and accuracy of Pap smear was 78%. The sensitivity of colposcopy in detection of low grade lesions and above came out to be 80.2%, specificity 82.14%, positive predictive value 66.78%, negative predictive value 86.78% and accuracy of colposcopy was 84.65%.The incidence of preinvasive lesions (LSIL and HSIL) was 33.6% with LSIL (19.2%) and HSIL (14.4%) and of invasive lesions was 9.6%.Conclusions: This study suggests that accuracy of detection of cervical abnormalities is higher when cytology, colposcopic biopsy and colposcopy are used complimentarily in diagnosis of cervical lesions. Colposcopy eliminates the need for repeated follow up as in Pap smear which has low sensitivity.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192132
      Issue No: Vol. 8, No. 6 (2019)
  • Study of fetomaternal outcome in second stage caesarean section

    • Authors: Kamal D. Goswami, Manisha M. Parmar, Avnika N. Kunjadiya
      Pages: 2169 - 2171
      Abstract: Background: The incidence of second stage caesarean section is more in developing countries. Caesarean sections done at full cervical dilatation with impacted fetal head are difficult and associated with an increased incidence of maternal and fetal complications.Methods: This was prospective observational study conducted at a tertiary teaching institute. All second stage caesarean sections performed between September 2017 to August 2018 were analysed in terms of incidence, indications of caesarean-section, intra-operative  and postoperative complications, maternal and fetal outcome.Results: During the study period there were total 7270 deliveries. Out of this 1884 deliveries were done by caesarean section. Out of them 50 were 2nd stage caesarean sections contributing to 2.65% of total sections. Patwardhan method was used in 50% cases for deliveryof deeply engaged head. Intra-operative complications were higher in terms of atonic pph (8%), extension of uterine incision (16%), in 3 cases bladder injury was noticed. Obstetric hysterectomy was required  in 4% cases. 14% cases had postoperative febrile illness and 8% cases had wound infection. 44% babies required NICU admissions and neonatal death was 18%.Conclusions: Caesarean section in the 2nd stage of labour is associated with significantly increased maternal morbidity. Neonatal morbidity and mortality also increases. A proper judgement is required by a skilled obstetrician to take a decision for caesarean section at full cervical dilatation.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192129
      Issue No: Vol. 8, No. 6 (2019)
  • Bone mineral changes during pregnancy: a cross-sectional study

    • Authors: Ritu Sharma, Deepali Garg, Huma Khan
      Pages: 2172 - 2177
      Abstract: Background: Changes in bone mineral density during pregnancy are not widely studied because of the risk of radiation hazard to the fetus. But newer technology like DEXA has made it possible to measure bone density accurately with low dose radiations which are safe even during pregnancy. The aim of this study was to evaluate the changes in maternal bone turnover markers and bone mineral content at forearm during pregnancy.Methods: A total of 32 pregnant women with singleton pregnancy of more than thirty five weeks gestational age and thirty non-pregnant, non-lactating women as controls were recruited. Baseline blood investigations, serum calcium, serum alkaline phosphatase and DEXA of the forearm at ultra-distal, mid radius and proximal 1/3rd of radius were done at the time of recruitment into the study.Results: Bone mineral density of forearm of pregnancy group was compared with non-pregnant, non-lactating control group to see the effect of pregnancy. Bone turnover markers like serum calcium and serum ALP were also compared among pregnancy group and controls. The mean bone mineral density of controls at ultra-distal radius was 0.437±0.058g/cm2, while in pregnant women it was 0.431±0.58g/cm2 that was not statistically significant. Bone mineral density at mid radius in control was 0.599±0.051g/cm2 and in pregnant women it was 0.597±0.048 g/cm2 with no significant difference. BMD at proximal 1/3rd radius in controls was 0.670±0.36 g/cm2 as compared to pregnant women where it was 0.660±0.036 g/cm2 without any statistical significance. Total BMD at forearm in control and pregnant women was 0.586±0.035 and 0.582±0.036 respectively and again there was no statistically significant difference.Conclusions: There is no significant impact of pregnancy on bone mineral density of forearm. Although more bone areas need to be investigated for the further confirmation.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192159
      Issue No: Vol. 8, No. 6 (2019)
  • Induction of labor in women with unfavourable cervix: comparison of
           efficacy of intracervical Foley catheter with PGE2 gel

    • Authors: Shilpa Gupta, Bhumika Kagathray
      Pages: 2178 - 2182
      Abstract: Background: The aim of our study was to compare the efficacy, safety and patient’s satisfaction of intracervical Foley catheter with intracervical dinoprostone gel (PGE2 gel) for cervical ripening for successful induction of labor.Methods: Prospective study was conducted in Department of Obstetrics and Gynaecology, M P Shah Medical College, Jamnagar, Gujarat. 317 women with term pregnancy with bishop score of less than 4 with various indications for induction were included. Intracervical foley catheter was kept in 162 women for cervical ripening (group A) while intracervical PGE2 gel was kept in rest 155 women (group B).  The change in the bishop score, progress of labor, adverse effects and outcome of labor along with the patient’s satisfaction were assessed.Results: With regard to the obstetrical parameters, the two groups were comparable with respect to maternal age, gestational age, parity, indication for induction and initial bishop score. At 12 hours, both the groups showed significant improvement in bishop score, 5.2±1.81 and 4.8±1.76 in Foley catheter and PGE2 gel respectively. Mean induction to delivery interval was 18.8±5.5 in group A and 17.9±5.3 in group B, which was statistically insignificant.  No significant differences in side effects, mode of delivery and APGAR score were noted in both the groups. However, the incidence of hyperstimulation and tachysystole was higher in PGE2 gel group.Conclusions: This study shows that both Foley catheter and dinoprostone gel appear to be equally effective agents for cervical ripening. Infect foley catheter is cheap, causes less fetal distress and is safer than PGE2 gel.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192166
      Issue No: Vol. 8, No. 6 (2019)
  • Can perineal tear be predicted by severity of striae gravidarum score'

    • Authors: Nidhi Patel, Nilesh Shah, Gaurav Desai
      Pages: 2183 - 2187
      Abstract: Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from  1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192160
      Issue No: Vol. 8, No. 6 (2019)
  • Study of the magnitude of premenstrual syndrome in a tertiary care
           institute in Pondicherry, India

    • Authors: Jessy Varghese, Vijaya Koothan, V. Sujaritha
      Pages: 2188 - 2192
      Abstract: Background: Premenstrual syndrome is cyclical physical and behavioural symptoms that appear in days preceding menstruation and interfere with work or life style followed by a symptom free interval. The common affective and somatic symptoms seen are mood swings, irritability, anxiety, breast tenderness, weight gain and abdominal bloating. The present study was done to detect premenstrual syndrome and encourage students to seek treatment which would improve quality of life both socially and academically.Methods: A cross-sectional study was conducted over a period of three months from November 2018 to January 2019 among medical students in a tertiary care institute in Pondicherry. A detailed questionnaire regarding premenstrual symptoms and screening for depression was obtained from all study subjects. Diagnosis of premenstrual syndrome was done if there were at least one affective symptom like mood swings, insomnia, anxiety and one somatic symptom like abdominal bloating, breast complaints and weight gain.Results: Total of 207 students were screened out of whom 155 (74.87%) students were found to have premenstrual syndrome. 41 students did not have the same, 11 students were excluded as they were having endocrine disorders like polycystic ovarian syndrome and thyroid abnormalities. 60.6% had mild 38.4% moderate 4.5% had severe premenstrual syndrome. Commonest symptoms were mood swings 81.9% followed by anxiety 80% and fatigue 71.6% breast complaints and joint pains were seen in 71% equally so also abdominal bloating and weight gain which was seen in 67%. Depression was found in 52.9% of the students.Conclusions: Premenstrual syndrome is prevalent among medical students commonly and detecting it and encouraging students to seek treatment will help them perform better socially and academically.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192130
      Issue No: Vol. 8, No. 6 (2019)
  • Evaluation of urgent caesarian according to colour code at the
           Befelatanana University Hospital Centre of Obstetric Gynecology in
           Antananarivo Madagascar

    • Authors: Randriamahavonjy Romuald, Rakotozanany Besaina, Ibrahim Housni, Rakotonirina Martial, Rakotoson Koloina Tiphaine, Hery Rakotovao Andrianampanalirivo
      Pages: 2193 - 2201
      Abstract: Background: Color code was described for the first time in 2003 was described for the first time in 2003 by since and al. The objective of this study was to accomplish urgent caesarian sections according to color code over delays indications-births (DIN) in Motherhood Befelatanana, Antananarivo, Madagascar.Methods: It was about a longitudinal prospective, analytical study of caesarian sections performed in emergency in CHUGOB going from June 1st till December 31st, 2017.Results:
      Authors took a census 193 caesarian sections of emergency. Among these patients 28 (14.50%) had a caesarian section encode red, 42 (21.76%) an orange code and 123 (63.73%) a green code. The medium age of the patients was of 26.4 years and that of the gestation was of 37SA and 6 days. The delay indication-birth (DIN) medium was of 102.9 minutes for red code, 99.7 minutes for orange code and 75 minutes for green code.Conclusions:
      Authors could not attain DIN of 30 minutes shape in international recommendations.
      Authors must improve the delay indication entered in the surgical unit by reinforcing knowledge of the agents of support on the management of emergency obstetrical. The possibility of leading to a very quick birth is an indisputable progress in obstetrics but she should not make forget risks inherent in such procedure.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192407
      Issue No: Vol. 8, No. 6 (2019)
  • Hysterosalpingogram in evaluation of primary and secondary infertility: a
           two year study at a tertiary care hospital of South India

    • Authors: Gurram Swetha Reddy, Gandavaram Jyothi
      Pages: 2202 - 2207
      Abstract: Background: Infertility globally is a raising threat and problem associated with significant social and psychological problem. Infertility currently affects about 10 to 14 percent of the Indian population, with higher rates in urban areas where one out of six couples is impacted. Patency of the tubes, structure of uterus and cervix can be visualized by hysterosalpingogram which is a simple safer inexpensive investigation of choice in cases of infertility. Objective of this study was to study the role of hysterosalpingography (HSG) in cases of primary and secondary infertility and to observe the structural abnormalities of cervix, uterus and fallopian tubes.Methods: A two year prospective study was conducted on cases of primary and secondary infertility attending the OPD of infertility clinic. HSG was performed on the subjects included in study and findings were noted. Analysis was done by Microsoft excel spread sheet.Results: A total of 286 cases with 11.19% of primary infertility and 88.81% of secondary infertility evaluated by HSG. Mean age of the study group was 35.16±2.8 years. 74.83% had abnormal findings, with 20.28% having normal uterine cavity with uterine filling defect being the common abnormality. Two congenital anomalies of uterus were noted. Tubal occlusion was seen in 8.39% right and 9.09% left cases. Hydrosalpinx was observed in 7.69% of right and 9.79% of left cases.Conclusions: To conclude, women presenting with infertility should be evaluated for tubal pathology. The tubal pathologies like occlusion or hydrosalpinx may be due to infections or post surgical sequelae. HSG remains one of the diagnostic backbone in infertility even availability of new modalities.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192164
      Issue No: Vol. 8, No. 6 (2019)
  • Knowledge, attitude, and practice of contraception among women attending a
           tertiary care hospital

    • Authors: Alpana Agrawal, Rashmi Saxena, Manisha Gupta, Neelima Agarwal, Divya Shubham, Anuradha Tyagi
      Pages: 2208 - 2214
      Abstract: Background: This study was carried out to assess the knowledge, attitude and practice of contraceptive methods among women attending a tertiary care hospital, to know the influence of various factors on use of contraceptives and to identify the reasons for not using contraception.Methods: A cross sectional, observational study was conducted in Obstetrics OPD, Santosh Medical College, Ghaziabad. 408 married women of reproductive age group (15-45 years), randomly selected, were interviewed with the help of a predesigned questionnaire to elicit information regarding their demographic profile, knowledge, attitude and practice of contraception.Results: In our study 73.3% women interviewed were aware about family planning methods.  Awareness was lowest among adolescents less than 20 years of age (28%) and highest among 31-35 yr age group (84.1%). The main source of knowledge was “friends/relatives” (37.8%) and mass media (26.8%). Awareness was high in Para-1 (96.5%), higher SES (97.4%), with higher education (90.7%), in working women (80.4%), women living in nuclear families (80.2%) and Hindu females (73.7%).  But in spite of high level of awareness, contraception usage was less (54.4%), the main reason being fear and misconceptions regarding contraceptives.Conclusions: It can be concluded that high level of knowledge and awareness does not match with contraceptive usage rate. Converting family planning knowledge into practice is the real challenge for India. Hence, we recommend sustained efforts to increase awareness and motivation for contraceptive use through more information, education and communication with the reproductive age couples, and improved social and welfare services.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192408
      Issue No: Vol. 8, No. 6 (2019)
  • Impact of different grades of anaemia severity during pregnancy on
           maternal and neonatal outcomes: a prospective study

    • Authors: Sonia Dahiya, Nisha Malik, Kiran Pandey, Renu Gupta, Vanamail Perumal, Vikram Singh
      Pages: 2215 - 2220
      Abstract: Background: Anaemia in pregnancy is a universal health problem that may cause a number of obstetrical and neonatal complications. This prospective observational study aims to evaluate and compare maternal and neonatal outcomes in different grades of anaemia severity.Methods: A total of 400 pregnant women with anaemia in third trimester were classified into three groups according to haemoglobin (Hb) levels-group I with Hb:10-10.9 g/dl, group II with Hb:7-9.9g/dl and group III with Hb<7 g/dl. Maternal and neonatal outcomes of women with different severity of anaemia were analyzed and compared. Two groups means were compared by Student’s t-independent test and more than two groups means by one way analysis of variance test followed by post-hoc pairwise comparison using Bonferroni test.Results: The prevalence of anaemia in the study population was 35.2%. Mild, moderate and severe anaemia were found in 58% (n=232), 29.0% (n=116) and 13% (n=52) women respectively. A statistically significant difference in maternal outcomes such as Preterm labor (p=0.001), Prelabor premature rupture of membranes (p=0.044), Intrauterine growth restriction (p=0.002) and postpartum hemorrhage (p=0.001) was observed amongst the three groups. Cardiac failure occurred in 26.9% (n=14) and mortality in 13.4% (n=7) women with severe anaemia. Amongst the neonatal morbidities, the rate of low birth weight, preterm birth, respiratory distress syndrome, septicaemia, pneumonitis and jaundice revealed an increasing trend with rising severity of anaemia which was statistically significant.Conclusions: Targeted interventions addressing early detection and appropriate treatment in early pregnancy can prevent and avoid dismal maternal and neonatal consequences.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192409
      Issue No: Vol. 8, No. 6 (2019)
  • A study of efficacy of oral iron and intravenous iron sucrose in the
           treatment of moderate anemia in pregnancy

    • Authors: Saloni M. Prajapati, Meha K. Patel
      Pages: 2221 - 2225
      Abstract: Background: Iron deficiency anaemia in pregnancy is a common medical problem throughout India with the burden of disease impacting on both mother and the newborn. It is also responsible for increased incidence of premature births, low birth weight babies and high perinatal mortality. Intravenous iron sucrose and oral iron therapy are the primary therapeutic modalities for management of iron deficiency anaemia during pregnancy, but its efficacy during pregnancy is still a matter of argument among healthcare personnel. Therefore the objective of this study is to compare the effect of oral iron and intravenous iron sucrose on hemoglobin and other blood indices among pregnant females with iron deficiency anemia.Methods: Randomized clinical trial was conducted among 400 females between 20 to 34 weeks gestation with iron deficiency anemia who were managed either with oral ferrous sulphate or intravenous iron sucrose therapy. Z test was used for statistical analysis for significance with 95% confidence interval. The hemoglobin and blood indices levels before and after initiating treatment in both groups were compared.Results: Intravenous and oral; both the treatments were associated with increment in hemoglobin but this rise was significantly more in the intravenous group than in oral. Comparing participants with low pretreatment hemoglobin among both groups, participants in the intravenous group were better benefited than oral due to respective treatment.Conclusions: Intravenous iron therapy is much effective in correcting iron deficiency anemia in pregnancy than oral iron therapy. It restores iron stores more promptly. Also intravenous iron is better tolerated compared to oral iron.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192163
      Issue No: Vol. 8, No. 6 (2019)
  • Weight gain and menstrual abnormalities between users of Depo-provera and

    • Authors: Yusuf Abisowo Oshodi, Joy Oyinyechi Agbara, Olamide O. Ade fashola, Fatimat Motunrayo Akinlusi, Haleema Folasade Olalere, Taiwo O. Kuye
      Pages: 2226 - 2231
      Abstract: Background: Progesterone only injectable contraceptive provides long acting contraception against unwanted pregnancy. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objective of this study was to compare the weight gain and pattern of menstrual abnormalities in users of Depot Medroxyprogesterone Acetate (DMPA) and Norethisterone Enanthate (Noristerat) in LASUTH.Methods: Retrospective comparative study conducted over a 3year period (January 2013 to December 2015) and involving 237 subjects who used injectable hormonal contraceptive (either DMPA or Noristerat). Case records of all the subjects were retrieved and information obtained on socio-demographic data, parity, previous contraceptive method and reason for discontinuation within one year of usage. Other information including subjects’ weight, menstrual cycle length and pattern, and side effects were collected at 3, 6 and 12 months for DMPA group and 2, 4 and 12 months interval for Noristerat group. Data obtained were analyzed using statistical packages for social sciences (version 19).Results: The combined mean age was 34.15±1.36 years. The mean weight at commencement was 68.16kg for DMPA and 66.61kg for Noristerat users while after a year, it significantly increased to 71.27kg for DMPA and 69.07kg for Noristerat users (P<0.05). No change in menstrual pattern was noted in 10% of DMPA and 7% of Noristerat users while 60% of DMPA and 57% of Noristerat had amenorrhoea by the end one year period. Five percent each of DMPA and Noristerat users perceived weight gain as problem significant enough to discontinue both methods respectively. Overall, 24% of DMPA and 19.1% of Noristerat users discontinued use after one year.Conclusions: There were significant weight gain between users of DMPA and Noristerat which was not considered a problem. Amenorrhoea was the commonest menstrual abnormality responsible for discontinuation of either method.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192131
      Issue No: Vol. 8, No. 6 (2019)
  • Demographics and follow up of post partum intra-uterine copper device in
           tertiary hospital in Delhi, India

    • Authors: Nidhi Garg, Bani Sarkar, Saloni Singla, Rajesh Kumar Meena
      Pages: 2232 - 2235
      Abstract: Background: Increasing unintended pregnancies in post partum females in our country warrants urgent attention towards prevalence and efficacy of contraceptives used. This study was done to determine the prevalence of PPIUCD and its follow up in patients attending tertiary hospital in New Delhi, India.Methods: Prospective study was carried in Department of Obstetrics and Gynecology, Dr. RML Hospital, New Delhi, India over a period of 1 year from July 2017 to July 2018. The awareness and prevalence of PPIUCD was assessed. At 6 week follow-up visit, women with PPIUCD were asked for symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed. All the data was recorded and assessed.Results: Out of 1478 deliveries, 1372 were eligible for PPIUCD. 335 patients got PPIUCD inserted. 295 patients were followed as 40 patients were lost to follow up. 79.3% women did not have any complaints. 11.8%, 1% and 7.4% women had only heavy menstrual bleeding, only lower abdominal pain and both symptoms respectively. Spontaneous expulsion rate was noted in one patient (0.3%) at 6 weeks. IUCD removal was done in 4 patients who had complaints of pain and heavy menstrual bleeding not conservatively managed.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. The benefits of contraception immediately after delivery outweigh disadvantage of complications. Antenatal counseling and follow up in hospitals need to be strengthened to increase awareness and acceptability of PPIUCD.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192410
      Issue No: Vol. 8, No. 6 (2019)
  • Evaluation of thyroid disorders in abnormal uterine bleeding

    • Authors: Bharat Kumar Bilwal, Apurva Garg
      Pages: 2236 - 2239
      Abstract: Background: Abnormal uterine bleeding (AUB) is a common clinical presentation in gynecology. Alteration in thyroid hormones level has been associated with menstrual disturbances. This study is aimed to know the prevalence of thyroid disorders amongst AUB patients and also the different patterns of menstrual abnormalities associated with thyroid disorders.Methods: 100 Patient of clinically diagnosed AUB were taken from gynecology OPD at RNT Medical College Udaipur from October 2019 to March 2019. All the patients from 19 to 45 age groups presenting with menstrual disturbances were tested for thyroid function by measuring ST3, ST4, and S.TSH. Statistical analysis done by percentage formula.Results: Out of 100 women of AUB, majority were in the age group of 31-40 years (38%). 44% presented with menorrhagia. 65% were euthyroid, 17% had subclinical hypothyroidism, 15% had overt hypothyroidism and 3% were diagnosed as hyperthyroid. Subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism were detected mostly in the age group of 31-40 years. The commonest bleeding abnormalities in hypothyroid patient were oligomenorrhoea while most of the hyperthyroid cases were having menorrhagia.Conclusions: The study concludes that biochemical evaluation of thyroid function is an easy, reliable method and should be made mandatory in all cases of AUB.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192162
      Issue No: Vol. 8, No. 6 (2019)
  • Frequency, risk factors and materno-foetal outcomes among cases of
           Placenta previa at a tertiary care hospital: a two year study

    • Authors: Pamulaparthi Bindu Reddy, Gurram Swetha Reddy
      Pages: 2240 - 2244
      Abstract: Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192165
      Issue No: Vol. 8, No. 6 (2019)
  • Identification of factors determining the initiation of breastfeeding in
           postnatal women in a tertiary care centre: an observational study

    • Authors: Manisha Gupta, Neelima Agarwal, Alpana Agrawal
      Pages: 2245 - 2250
      Abstract: Background: The WHO recommends that mothers worldwide to initiate breastfeeding within an hour of delivery to achieve optimal growth, development and health but the breastfeeding rates remain far below the recommended standards. The aim of this study was to find the prevalence of delay in initiation of breast feeding, to identify various factors which determine the initiation of breastfeeding and to correlate their association with delayed onset of breast feeding.Methods: Hundred and thirty six postnatal women, who delivered in Santosh Medical College and Hospital, Ghaziabad, were recruited in the study. They were interviewed after their informed consent using a pretested structured questionnaire. Socio-demographic and obstetric factors were compared between subjects who initiated breast feeding in less than and more than 1 hours. Frequencies were calculated for different variables. Data was statistically analyzed and p value of <0.05 was taken significant.Results: The prevalence of delay in initiation of breast feeding in our study was found to be 74.2% (n=101).The mean time of initiation of breast feeding was 18.43 hours. Significant association (p <0.05) was found in various sociodemographic, obstetrical and social factors.Conclusions: Identifying mothers at risk of delayed breastfeeding initiation should be the target for breastfeeding promotion during prenatal, antenatal as well as postnatal period. Public health officials and health care providers should consider interventions to promote and support early initiation of breast feeding.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192411
      Issue No: Vol. 8, No. 6 (2019)
  • Prevalence of depression and quality of life in polycystic ovary syndrome
           patients at a tertiary care hospital: a cross-sectional study

    • Authors: Radhika Gollapudi, Venu Madhavi Lanke, Manaswini Namilakoda
      Pages: 2251 - 2255
      Abstract: Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathy among women of reproductive age. Physical symptoms in PCOS cause depression and decrease the Quality of Life (QoL). The objective was to study the prevalence of depression in women suffering from PCOS and to assess its correlation with QoL.Methods: This was a cross sectional study conducted among one hundred patients diagnosed with PCOS. Women 18-40 years of age diagnosed with PCOS were included in the study. Patients with known psychiatric illness were excluded. Depression severity was assessed with Hamilton depression (HAM-D) scale. The quality of life (QoL) was assessed with Polycystic ovary syndrome questionnaire (PCOSQ). The data was analyzed using SPSS 20.0 for Windows.Results: The mean age and BMI was 25.64±3.25 years and 26.78±2.72 kg/m2 respectively. The mean depression score was 12.46±6.18. QoL domains showed that the lowest score was in the menstrual problem with a mean of 12.48±4.44 and the highest was in the emotional domain with a mean of 28.07±11.17. The negative correlations were between age and Hamilton score (p < 0.05). The Hamilton score was negatively correlated with the emotional score (p <0.01) and weight score was positively correlated with infertility score (p <0.01).Conclusions: PCOS was clearly associated with depression and reduced QoL. This should warrant health professionals to consider routine screening for depression and assess the impact of symptoms on their QoL to improve patient outcomes.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192412
      Issue No: Vol. 8, No. 6 (2019)
  • Manual vacuum aspiration: a safe and effective surgical management of
           early pregnancy loss

    • Authors: Aishah Azman, Noor Asikin Mohd Sakri, Nor Adibah Mohd Kusni, Nurul Hidayah Mansor, Zahar Azuar Zakaria
      Pages: 2256 - 2260
      Abstract: Background: Manual vacuum aspiration (MVA) is an alternative to the standard sharp uterine curettage, performed under local anaesthetic or sedation in the daycare setting. The objectives of this study were to assess the efficacy and safety of MVA, the pain perception and the factors related to it.Methods: This was a prospective observational study of 58 consecutive patients who had undergone Manual Vacuum Aspiration (MVA) in Early Pregnancy Assessment Clinic, Hospital Kemaman between January and December 2017. Data on the patients’ characteristics and the procedures were analysed.Results: The efficacy of the procedure was 96.5% (56/58) with no major complication recorded. Majority of the patients (91.3%) reported mild to moderate pain with 2/3 of them agreed to undergo MVA in the future and would recommend it to other patients. There was no significant difference in mean pain score between different groups of women (parity, education levels, occupations, previous uterine evacuation) or procedural techniques (analgesia, sedation, cervical block, cervical dilatation, procedure duration, number of aspiration passes).Conclusions: MVA is safe and well accepted procedure for out-patient surgical evacuation of early miscarriages.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192413
      Issue No: Vol. 8, No. 6 (2019)
  • Impact of changing life style on age of menarche

    • Authors: Kritika Upadhyay, Archana Dhok, Arpita Jaiswal
      Pages: 2261 - 2265
      Abstract: Background: Menarche marks the beginning of the reproductive phase in a woman’s life or the onset of puberty Menarche is said to be early when it begins before the age of 8 years in a girl’s life. Early menarche can turn up into many consequences. This can only be controlled by carefully exploring and analyzing the factors causing early menarche. This study aims to assess the impact of changing lifestyle on age of menarche.Methods: It is a prospective cross-sectional study, included 112 subjects in group I (girls had their menarche at the age of <11 years) and 88 subjects in group II (Girls had their menarche at the age between 12-14 years). A self-made questionnaire was used for collecting the data.Results: It is found that  80.32% girls from group I and 47.73% girls from group II consume junk food daily or 2-3 times per week. 66.07% girls from group I and 51.14% girls from group II play indoor games daily or 2-3 times per week. 52.86% girls from group I and 26.14% girls from group II go to hotel once a week and 57.14% girls from group I and 73.86% girls from group II go to hotel occasionally.Conclusions: Girls who are not much interested in playing outdoor games, more frequently go to hotel, eat more junk food and consume more amount of fats in the daily home-made food have a significant lowering in the age of menarche.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192414
      Issue No: Vol. 8, No. 6 (2019)
  • Indications and foeto-maternal outcome of emergency cesarean sections in
           rural Mewar region

    • Authors: Savitri Verma, Archana Bamniya
      Pages: 2266 - 2269
      Abstract: Background: In the 21st century caesarean section is the most common operation in modern obstetrics but its indications have been changed in elective and emergency cases. The aim of the present study was to find out the incidence, indication of caesarean, foeto-maternal outcome in patients who came in emergency from rural areas.Methods: This retrospective study was conducted at Pannadhai Mahila Hospital, R. N. T. Medical College, Udaipur from September 2017 to February 2018. All the women who were unbooked, belonged to rural Mewar region and underwent emergency caesarean section.Results: Total no. of deliveries conducted were 1560 in the emergency labour room out of which 462 were emergency caesarean sections. The mean age of the participants was 27 years. Foetal distress was the most common indication (17.75%) followed by prolonged labour/ failed induction 14.5%. Post-partum haemorrhage and adhesions were the commonly encountered complications.Conclusions: LSCS due to maternal and foetal indications is inevitable. Timely performed LSCS decreases the morbidity and mortality. The government of India has also taken initiative in making caesarean deliveries more acceptable, affordable to patients belonging to rural areas. The government is also enhancing primary and community health centers.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192415
      Issue No: Vol. 8, No. 6 (2019)
  • Thyroid function in abnormal uterine bleeding

    • Authors: Ruthvika Kundoor, Burri Sandhya Rani
      Pages: 2270 - 2274
      Abstract: Background: AUB is any abnormal uterine bleeding in the absence of any palpable pelvic pathology and demonstrable extra genital causes. AUB is responsible for 10% of gynaecological complaints. Thyroid hormone is very important to affect the menstrual pattern. The objective of this study was to evaluate thyroid function test in women with AUB and to assess the menstrual pattern in women with thyroid dysfunction.Methods: The present study was conducted in the Department of Obstetrics and Gynecology, Laxmi Narasimha Hospital, Hanamkonda, Hyderabad, Telangana, India 80 women of reproductive age group between 15-45 years women with menstrual disorders like menorrhagia, oligomenorrhea, hypomenorrhea, polymenorrhea, metrorrhagia, and amenorrhea. Quantitative determination of T3, T4, and TSH by CLIA estimated in autoanlyser.Results: About 80 women participated in the study in which Most of the subjects belong to 26-30 years of age group. Maximum patients i.e. 41 (51.2%) patients were para one to 2. Commonest cause bleeding pattern was menorrhagia 41.25%. 15 apparently normal patients with AUB belonged to the category of subclinical hypothyroidism (15%). Hormonal levels revealing profound hypothyroidism in patients without any symptoms was present in only 10% of cases. 2.5% of cases had hyperthyroidism though they were clinically normal. Patients who were sub-clinically hypothyroid were maximally presenting as polymenorrhoea (50%) and menorrhagia (12.1%) and only 6.27% of patients had oligomenorrhoea. Patients who were profound hypothyroid were predominantly having polymenorrhagia (83.3%) and (62.5%) of patients had oligomenorrhoea.Conclusions: So, biochemical evaluation of thyroid functioning should be made mandatory in all provisionally diagnosed cases of AUB to detect thyroid dysfunction.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192416
      Issue No: Vol. 8, No. 6 (2019)
  • Prospective study on outcome of post-partum intrauterine contraceptive
           device insertion at tertiary level rural health institute of Gujarat,

    • Authors: Shilpa N. Ninama, Tejas A. Shah, Mayur R. Gandhi
      Pages: 2275 - 2279
      Abstract: Background: This study was conducted to evaluate the acceptance, safety, efficacy, complications and expulsion rate of post-partum intrauterine contraceptive device (PPIUCD) insertion among post-partum pregnant women in a rural tertiary care center. Objective of this study was assessment of the efficacy and safety of post-partum IUCD insertion. Comparing the complications and client satisfaction in both groups (intra caesarean insertion versus vaginal route of insertion).Methods: This is a prospective study conducted at one of the rural tertiary care teaching institution. A total of 150 patients with caesarean or vaginal deliveries had PPIUCD insertions and they were followed up for a period of one year. The outcome measures analyzed were menstrual irregularities, vaginal discharge, pelvic infection and perforation and efficacy measures - failure, expulsion and removal. Data are expressed in frequency and percentage. Chi square test was used for comparison and P value <0.05 was considered significant.Results: The study shows that PPIUCD is an effective intervention in both caesarean and vaginal delivery with non-significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation and no significant risk of infection in either caesareans or delivery. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the caesarean group compared to vaginal insertion.Conclusions: PPIUCD is a safe, effective and long term reversible method of contraception and should be encouraged by public awareness and community acceptance.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192417
      Issue No: Vol. 8, No. 6 (2019)
  • A study for efficacy and safety of ferric carboxymaltose versus iron
           sucrose in iron deficiency anemia among pregnant women in tertiary care

    • Authors: Divyani Agrawal, Deepa Lokwani Masand
      Pages: 2280 - 2285
      Abstract: Background: Anemia is one of the common manageable problem among the pregnant women worldwide, which contributes to maternal and perinatal mortality. This study aims to compare the efficacy and safety of intravenous ferric carboxymaltose with intravenous iron sucrose in treating anemia during pregnancy. Objective of this study was to compare safety and efficacy of intravenous ferric carboxymaltose with intravenous ferric sucrose in iron deficiency anemia during pregnancy.Methods: It’s an interventional prospective study conducted in Department of Obstetrics and Gynecology at NIMS, Jaipur, Rajasthan, India constituting of 100 pregnant women. Group 1- 50 pregnant women were treated with intravenous ferric carboxymaltose and Group 2: 50 pregnant women were treated with intravenous iron sucrose. Hemoglobin and serum ferritin levels were measured pre and post treatment with parenteral iron therapy. The efficacy of intravenous ferric carboxymaltose in comparison to intravenous iron sucrose was assessed. The evaluation of safety and tolerance with the parenteral therapy was also performed.Results: Anemia during pregnancy was more prevalent among the reproductive age group and in multiparous women. The mean rise in the hemoglobin level with ferric carboxymaltose was 2.92 gm/dl and with that of iron, sucrose was 1.08 gm/dl. The man rise in the serum ferritin levels with ferric carboxymaltose was 64.97ng/ml and with iron sucrose was 31.64 ng/ml. Ferric carboxymaltose was observed to be safer with no adverse events in comparison to the Iron sucrose which was related with adverse events among 03 pregnant women.Conclusions: Intravenous ferric carboxymaltose was more efficacious and safer in comparison to intravenous iron sucrose among pregnant women. Hence, ferric carboxymaltose is the drug of choice in treatment of iron deficiency anemia during pregnancy.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192418
      Issue No: Vol. 8, No. 6 (2019)
  • Prevalence of female genital tract tuberculosis in suspected cases
           attending Gynecology OPD at tertiary centre by various diagnostic methods
           and comparative analysis

    • Authors: Diksha Sharma, Anju Depan, Kanti Yadav, Suchitra Narayan, Anubhav Sharma
      Pages: 2286 - 2292
      Abstract: Background: The genital tract tuberculosis is one of the most common causes of tubal factor infertility. This study was conducted to compare the results of different diagnostic methods used in screening for female genital tuberculosis in suspected cases attending Gynecology OPD at RMC, Ajmer.Methods: This prospective study was conducted in department of obstetrics and gynecology, J. L. N. Medical College, Ajmer, Rajasthan, for studying incidence of genital tuberculosis by various diagnostic methods (viz. AFB smear examination, AFB Lowenstein Jensen culture method, TB-PCR and CBNAAT).Results: Prevalence of genital TB was 5.5% in study population of 200 selected women meting the inclusion criteria. 72% women were in between 20-30 years age group. Oligomenorrhoea (24%) was found to be significant symptom with P value of <0.05. TBPCR and CBNAAT were found to be statistically significant with P value of <0.001 for diagnosing FGTTB.Conclusions: We concluded that genital tuberculosis is paucibacillary disease, TBPCR and CBNAAT appears to be rapid and sensitive diagnostic modality.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192419
      Issue No: Vol. 8, No. 6 (2019)
  • A prospective observational study involving three fixed infusion regimens
           of phenylephrine for hemodynamic support during spinal anaesthesia for
           caesarian delivery

    • Authors: Aymen Masood, Ajaiz Rasool, Aabid Hussain Mir, Waqurl Neesa, Ayaz Farooqi
      Pages: 2293 - 2301
      Abstract: Background: Spinal anaesthesia used in caesarian section is associated with hypotension which can have maternal and fetal side effects. To determine the efficacy and ideal dosing of Phenylephrine in attenuating the hypotensive episodes during caesarean section under spinal anaesthesia.Methods: 100 patients were allocated to four groups, placebo group (PE 0) and 3 fixed phenylephrine infusion regimens, phenylephrine 25 μg/min-1 (PE 25), phenylephrine 50 μg/min-1 (PE 50), and phenylephrine 75 μg/min-1 (PE 75). Blood pressure, heart rate were noted among primary variables and fetal parameters like umbilical blood pH and lactate were recorded as secondary parameters.Results: There was a significant reduction in heart rate with increasing the infusion dosage of phenylephrine, with a mean of 86.8 beats/min at the end of procedure in placebo group and 69.4 beats/min in 75 μg group (p value <0.001). There was significant statistical difference among systolic blood pressure in the four groups after 7 min of the procedure and p-value of <0.05 with better attenuation of hypotension in infusion groups as compared to placebo. Similarly there was significant statistical difference in diastolic blood pressure among the four groups after 8 min of the procedure with p values <0.05.Conclusions: Prophylactic phenylephrine infusions reduced the incidence and severity of maternal pre-delivery hypotension. Among the fixed rate phenylephrine infusion regimens investigated, infusion rates of 50 μg/min-1 were associated with greater maternal hemodynamic stability compared with 25 and 75 μg/min-1, with minimal side effects and intervention.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192420
      Issue No: Vol. 8, No. 6 (2019)
  • Prevalence of vitamin D deficiency in antenatal women

    • Authors: Anu Bala Chandel, Rita Mittal, Anoop Sharma, Shivika Mittal, Poonam Samyal
      Pages: 2302 - 2305
      Abstract: Background: Vitamin D has an increasingly recognised repertoire of non-classical actions, such as promoting insulin action and secretion, immune modulation and lung development. It therefore has the potential to influence many factors in the developing fetus. Several studies reported the relationship between maternal vitamin D deficiency and adverse maternal and fetal outcomes including gestational diabetes, preeclampsia, preterm labour, low birth weight and increased rate of caesarean section. The present study was undertaken to study the prevalence of vitamin D deficiency in antenatal women of Shimla, India.Methods: The study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru Hospital, Shimla, India over a period of 12 months. Six hundred women were included in the study.Results: Out of 600 subjects, 568 (94.67%) subjects had vitamin D deficiency and only 32 (5.33%) subjects had sufficient vitamin D levels. Vitamin D deficiency was more common in the vegetarians, dark skinned subjects and in those who were taking vitamin D supplements.Conclusions: It is concluded from this study that there is high prevalence of vitamin D deficiency in antenatal women of Shimla, India.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192421
      Issue No: Vol. 8, No. 6 (2019)
  • Effect of duration of pre-operative admission on surgical site infection
           in major abdominal surgeries: an observational study

    • Authors: Alka Shantiprakash Gupta, Arthika Shetty
      Pages: 2306 - 2314
      Abstract: Background: Surgical site infection (SSI) are second most common cause of mortality in surgical patient, situation has been further complicated by emergence of drug resistant strains. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stays, need for readmission, high end antibiotic treatment and re-surgery. The study was done to see if   incidence of SSI is decreased with decreased pre-operative admission time. Others factors associated with SSI were analysed including the microbiological spectrum.Methods: The study was an analytical, observational, case control study. Sixty (60) cases each of gynaecology and obstetrical post-operative patients who developed SSI within 30 days were taken as cases and who did not develop SSI were taken as controls and preoperative admission time was analysed in both cases and controls to observe if risk of surgical site infections decreases due to decreased exposure to nosocomial pathogens when the pre-operative admission time was less than 48 hours.Results: Author found that there was statistically significant difference in the time between surgery and admission in the gynaecological surgeries with p value 0.023, as compared to the obstetrics surgeries where there was no statistically significant difference. Common organism isolated was E. coli sensitive to gentamicin.Conclusions: From this study, it seems to be a good policy to evaluate the patient on OPD basis and admit them about 24 to 48 hours prior to the surgery rather them keeping them admitted for prolonged duration in wards for diagnostic evaluation. This prevents nosocomial contamination in the patient’s skin flora thereby preventing SSI. This practice not only conserves the hospital resources but also makes the patient turn over faster. Further this might in the long run reduce the antibiotic resistant hospital flora.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192422
      Issue No: Vol. 8, No. 6 (2019)
  • The effect of information, education and communication on knowledge and
           practice regarding prevention/treatment of iron deficiency anaemia among
           the antenatal women attending primary health centre in Puducherry, India:
           a randomised control study

    • Authors: Athul Chandran, Subashini M., Nina Kate
      Pages: 2315 - 2321
      Abstract: Background: IEC (Information, Education, and Communication) strategies may help pregnant women to prevent disease and to improve and maintain health. The present study was carried out with an aim to evaluate the effectiveness of IEC in improving the knowledge and practice regarding prevention/treatment of iron deficiency anaemia among the antenatal women attending Primary Health Centre in Puducherry.Methods: The present study was carried out in Puducherry, as a randomised control trial among antenatal mothers attending antenatal clinics in Primary Health Centre from February 2016 to August 2017. Block randomization technique was used to designate study participants into intervention and non-intervention groups. The minimum required sample size was calculated to be 84 in each group. Then intervention (Information, Education and Communication) was given to these antenatal women by using interpersonal communication methods, PowerPoint presentation and audio visual aids.Results: Correct responses to the questions were compared among the intervention and non intervention group in pre test and post test. It was noted that the proportion of correct responses were significantly higher among intervention group than that of non-intervention groups.Conclusions: Well planned and tailor made IEC material, acceptable by the regional population, by using various modes of interpersonal communication, improves the knowledge and practice of the antenatal mothers. It was also found that the haemoglobin levels of mothers in the intervention group were higher than the antenatal mothers who did not receive any IEC intervention.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192423
      Issue No: Vol. 8, No. 6 (2019)
  • Comparative study of efficiency of vaginal versus oral misoprostol along
           with mifepristone for first trimester medical termination of pregnancy

    • Authors: Latika R. Mehta, Grishma P. Agrawal
      Pages: 2322 - 2325
      Abstract: Background:
      Authors estimate that 15.6 million abortions (14.1 million-17.3 million) occurred in India in 2015. Incomplete abortion is a known disadvantage of medical method of abortion reported in 0.2-3% of cases. Though Misoprostol can be used with different routes including oral, sublingual and vaginal, few evidences are available in drug effectiveness as well as its related side effects when used through different routes and more so in India. The present study is aimed to compare the efficacy of misoprostal in first trimester abortion when taken vaginally as compared to orally. Thus, whichever route results in lower rates of incomplete abortions, can be employed in our health set up, minimizing the complications of failed first trimester MTP.Methods: An experimental study was conducted on 74 women seeking termination of pregnancy within 9 weeks of amenorrhea during the period of 9 months in a tertiary care institute. Tablet mifepristone 200 mg was given to all participants. After 48 hours, 37 women were given 800 mcg tablet of Misoprostol for oral consumption while other 37 women were given 800 mcg Misoprostol for self-administering vaginally. Abortion status and complications were checked.Results: The complete abortion rates in vaginal group and oral group were 97.3% and 86.49 % respectively. Satisfaction was more in case of vaginal misoprostol, while side effects were similar in both groups.Conclusions: Mifepristone with vaginal misoprostol was more effective as compared to oral misoprostol for first trimester abortion.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192424
      Issue No: Vol. 8, No. 6 (2019)
  • Clinical profile of patients with menorrhagia and its correlation with
           endometrial histopathology and sonographic features

    • Authors: Bikram Bhardwaj, S. K. Rath
      Pages: 2326 - 2332
      Abstract: Background: Menorrhagia is one of the most common gynecologic complaints in contemporary gynecology. It is defined as total blood loss exceeding 80 ml per cycle or menses lasting longer than 7 days. Current gynecological survey reports that 30% of all pre-menopausal women perceive their menses to be excessive. So, the main aim of this study was to correlate clinical profile of patients with menorrhagia, etiological factors of menorrhagia, endometrial patterns in cases of menorrhagia, sonography findings in these patients.Methods: This is a prospective study of 100 patients with complaints of menorrhagia that were randomly selected from out-patient department of a tertiary care hospital. In all cases of menorrhagia, detailed history followed by examination and a particular set of investigations including USG was done. All women were subjected to D and C and histo-pathological report taken into account. However all cases of Puberty menorrhagia were excluded from this study as D and C could not be done in them. Treatment was given depending upon cause/age/parity/ family/completion/patient’s desire.Results: AUB is the most common cause of menorrhagia in this study group (60%) with leiomyomas as the second commonest cause (24%). Other causes found were adenomyosis (8%), polyp (4%), IUCD (4%). Maximum cases of menorrhagia are in 40-50 years age group.Conclusions: To conclude AUB (60%) was the commonest cause of menorrhagia followed by leiomyomas (24%), adenomyosis (8%), IUCD (4%) and polyps (4%). Menorrhagia was most common in multiparous (78%) and peri-menopausal age group (40-49 years). Proliferative endometrium was most commonly observed histo-pathological pattern in 58% cases. Leiomyoma was the commonest sonological finding seen in 24% cases followed by adenomyosis in 8% cases.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192425
      Issue No: Vol. 8, No. 6 (2019)
  • Evaluation of partogram in 100 cases of both primi and multi gravida each,
           their outcome in labour and perinatal outcome

    • Authors: K. Sowmya Krishna, Rajshree Paladi
      Pages: 2333 - 2341
      Abstract: Background: the objective of this study was to study the utility of partogram in both primi and multi gravida and evaluate its role in preventing prolonged labour; assess the rate of cervical dilatation on admission, and to evaluate the maternal and perinatal outcome by comparing their partogram in labour.Methods: This observational prospective clinical study involved randomly selected 200 patients in labor divided into 2 groups of 100 each admitted in Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga. Modified WHO partogram was used. Statistical analysis done by Chi square test.Results: Mean age group in primi was 22.05 years with standard deviation of 2.38 years and in multi mean age group was 25.19 years with standard deviation of 3.09 years. Mean duration of active phase of labor in primi was 2 hrs 12 mins and in multi was 1 hours and 35 mins from time of admission into hospital. Mean duration of second stage of labor in primi was 57 mins and in multi was 35 mins. Out of 100 primi gravida 68% had NVD, 1% had outlet forceps. 13% had vacuum application and 18% underwent LSCS. Out of 100 multigravida 86% had NVD, 1% had outlet forceps, 7% had vacuum application and 6% underwent LSCS. In group A in primi 75% had NVD, 0% had forceps, 5% had vacuum application and 0% LSCS whereas in multi 93% had NVD and 7% had vaccum, NO forceps /LSCS. In group B, in primi 20% had NVD, 4% had forceps, 33% had vacuum application and 43% had LSCS whereas in multi 34% had NVD, 8% had forceps, 8% had vacuum application and 50% LSCS. In group C, in primi 100% had LSCS whereas in multi there were no NVD/Vaccum/ forceps/ LSCS cases. In primi 100% and in multi 96% had no maternal complications. In primi 96% and in multi 97% had no neonatal complications.Conclusions: The partogram is used to assess the labor progress and identify when intervention is necessary. This study showed that it can be highly effective in reducing complications from prolonged labor for both mother & neonate, in reducing operative intervention and improving their outcome.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192426
      Issue No: Vol. 8, No. 6 (2019)
  • Knowledge of Cancer cervix and its causative agents among HIV-infected and
           HIV-uninfected adolescent women in rural Medical College in Maharashtra,

    • Authors: Ravi M. Raval, Vaibhav B. Patil, Pradnya P. Thaware
      Pages: 2342 - 2347
      Abstract: Background: The aim of this study is to examine the knowledge of human papilloma virus (HPV) and cervical cancer among HIV-infected and HIV-uninfected female adolescents attending Antenatal OPD in Department of Obstetrics and Gynecology, Government Medical College, Miraj, Maharashtra, India.Methods: Subjects were recruited randomly from OPD attending patients.  A total of 30 subjects, 15 HIV-infected and 15 HIV-uninfected were selected via randomization and completed a measure of HPV knowledge, based on a previously validated instrument. The study took place in December 2017.Results: The overall mean score on the measure for all subjects was 43.3% (S.D. 10.9). There was no significant difference in HPV knowledge between the HIV-infected and HIV-uninfected groups. Based on results from a previous large-scale study using the same validated measure, this sample scored significantly worse on general HPV knowledge than samples from the other studies.Conclusions: Given the limited knowledge of HPV in this sample, there is greater need for education about the prevention of cervical cancer, specifically among high-risk adolescent women.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192427
      Issue No: Vol. 8, No. 6 (2019)
  • Role of vitamin D in prevention of adverse maternal and perinatal outcome:
           a randomized controlled trial

    • Authors: Sujatha M. S., Shruthi K. R., Neelaharika .
      Pages: 2348 - 2353
      Abstract: Background: Vitamin  D  deficiency  is  thought  to  be   common among  pregnant  women  and  is  associated  with  adverse  maternal  and  perinatal  outcome. Maternal  and foetal  outcome  in  pregnant  women  with  standard  obstetric  care  was compared with   women with  additional  vitamin D  supplementation.Methods: A randomized comparative  study  was  conducted  on  100  patients attending  the  antenatal  clinic at JSS Medical College and Hospital, Mysuru, Karnataka, India   who were randomly  grouped   into  group A (50 patients) who  received  standard  obstetric care  (500 mg calcium+200 IU vitamin D)  and  group  B (50 patients)  who  received  in  addition  to  standard  obstetric  care   supplementation  of   Vitamin  D  1000 IU/day starting  from  14  weeks  of  gestation  till  delivery.  Vitamin  D  levels  were assessed  in  both  the  groups  with  onset  of  labour  by  chemiluminescence immunoassay  and  obstetric  and  neonatal  outcomes  in  both  groups  were compared.Results: High  incidence  of vitamin  D  deficiency  (96%)  in  standard  care  group  compared  to  vitamin  D supplemented  group  ( p= <0.0001)  was  noted. The  study  showed  significant  reduction  in  risk  of  Preeclampsia (P=0.004),  GDM  (P= 0.02)  and  primary  caesarean  delivery  (0.008)  in  Vitamin  D  supplemented  group. Significantly  high  birth  weight  in  vitamin  D supplemented   group,  an  increase  in  320 grams  in  birth  weight  was  noted  (P <0.0001).Conclusions: There is a high incidence of subnormal vitamin D levels in antenatal women and is associated with maternal and neonatal adverse effects. Measuring Vitamin D levels and appropriate supplementation of higher dose of vitamin D is an effective strategy in prevention of adverse maternal and neonatal outcomes.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192428
      Issue No: Vol. 8, No. 6 (2019)
  • Prevalence of menstrual disorder among college girls and correlation with
           body mass index

    • Authors: Jeevitha K. J., Rajarajeswari S.
      Pages: 2354 - 2357
      Abstract: Background: Menstrual irregularity is the most common gynaecological disorder in all age group. Adolescence is a transitional period between childhood and adulthood and involves physical, biological and psychosexual changes and is characterized by hormonal changes. Aim of this study was to find out the prevalence of menstrual abnormality in college girls in Madurai and their association with their Body mass Index (BMI).Methods: A cross sectional study was conducted among 200 girls of age group 18-22 years in a college in Madurai after getting their consent from college authorities and students. All details regarding their age of menarche, type of menstrual disorder and their BMI, stress factors were collected. The results were compared using chi square test and the pattern of menstrual abnormality and its relation with BMI and with stress was obtained.Results: The average age of menarche was 13.38 years in our study, irregular cycle was present in 47.5%, dysmenorrhoea was the commonest disorder and accounts for 26% students requiring medical treatment. Underweight students have irregular cycles compared to other groups. Stress had a significant correlation with menstrual irregularity.Conclusions: Many students in our study was under obese category, lifestyle modification like regular exercise, avoiding junk food and promoting healthy eating habits should be emphasised among students to have a healthy life. Students should also be informed about menstruation, physiological changes and its importance.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192429
      Issue No: Vol. 8, No. 6 (2019)
  • First trimester uric acid level: a reliable marker for gestational
           diabetes mellitus

    • Authors: Suvarna Jyothi Ganta, Sunanda R. Kulkarni
      Pages: 2358 - 2362
      Abstract: Background: The prevalence of diabetes mellitus (DM) is increasing worldwide and more in developing countries like India. The diabetic epidemic experienced in India can be due to strong genetic factors coupled with increasing urbanization, sedentary lifestyle, changes in the dietary patterns and increasing obesity. Indians are at an 11-fold increased risk of developing gestational glucose intolerance and hence universal screening is essential. Uric acid is a known marker of oxidative stress. Hyperuricemia in early pregnancy may be an indicator of the existing metabolic disturbance which can hinder the maternal physiological adaptations generally seen in pregnancy thus making the pregnant women more vulnerable to the development of gestational diabetes mellitus. The objective of this study was to investigate the association between elevated uric acid levels in the first trimester of pregnancy with gestational diabetes.Methods: This prospective observational study was conducted in Chinmaya mission hospital, Bangalore from June 2016 to March 2017 (10 months). Three hundred and twelve (312) pregnant women of gestational age less than 12 weeks who attended the OBG outpatient department within this time of period for regular antenatal check-up were enrolled in the study. Along with the other antenatal investigations serum uric acid levels were estimated before 12 weeks and also between 24-28 weeks. At 24-28 weeks screening for GDM was done by OGCT using 75 gms of glucose (IADPISG criteria). Other parameters like age, parity, BMI, family history of diabetes was noted and compared.Results: In our study, among the 312 pregnant women, 88 (28%) developed GDM. Of these 74 Women (84%) with GDM had uric acid levels above 3.5 mg/dl and 14 women (15.9%) with GDM had uric acid levels below 3.5 mg/dl. Women with higher BMI showed high uric acid levels.Conclusions: Elevated serum uric acid in the first trimester has a significant correlation with development of GDM. In present study; the cut-off level of maternal serum uric acid of 3.5 mg/dl in the first trimester appears to have a good sensitivity and specificity in identifying those patients who are most likely to develop GDM later in pregnancy.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192430
      Issue No: Vol. 8, No. 6 (2019)
  • Role of endometriosis fertility index system in predicting non-IVF
           conception in patients with surgically documented endometriosis

    • Authors: Fessy Louis T., Deepa Naveen, Ramesh P., Parasuram Gopinath, Gopinathan K. K.
      Pages: 2363 - 2367
      Abstract: Background: Endometriosis still remains an enigmatic disease. There are important reasons to stage endometriosis and to prognosticate the chances of pregnancy after a surgical management. The currently used revised AFS system has poor correlation with pregnancy rate. A scoring system-Endometriosis fertility index (EFI) to prognosticate the outcome was proposed few years back. The objective was to assess the usefulness of the EFI system in predicting pregnancy in patients with surgically documented endometriosis who attempt Non-IVF conception.Methods: Retrospective data was collected from 77 subjects with endometriosis who underwent laparoscopy and had documented least function (LF) score and EFI score. All were followed up until 12 months for the occurrence of a non IVF pregnancy.Results: Our study showed that the pregnancy rate was clearly higher in those with high EFI scores than those with low scores. A score of less than 4 was associated with significantly lower pregnancy rates than those with score above 5 (n=26, pregnancy rate- 11.54%) vs. (n=51, pregnancy rate 50.1%); p = 0.001)). Similarly, the pregnancy rate was significantly lower in those with LF score 1-3 (21.2%) as opposed to those with higher LF scores (p =0.029). Also, sensitivity analysis showed that higher EFI score was significantly associated with higher LF score (P <0.001).Conclusions: EFI is a useful clinical tool that predicts pregnancy with reasonable accuracy after endometriosis surgery. Its use clearly provides reassurance to those patients with good prognosis.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192431
      Issue No: Vol. 8, No. 6 (2019)
  • Emergency obstretic hysterectomy: a retrospective study in a tertiary care

    • Authors: Vaishnavi Sanjay Shivade, Vaishali S. Vhawal, Manisha M. Laddad
      Pages: 2368 - 2371
      Abstract: Background: Obstetric hysterectomy remains a necessity in preventing maternal mortality in catastrophic rupture of the uterus or intractable postpartum hemorrhage when all the conservative management options fail. Uterine atony followed by abnormal placentation remains the primary indication of emergency obstratic hysterectomy worldwide. In majority of cases, anticipation, prompt resuscitation and earlier surgical intervention by skilled operator will reduce patient’s morbidity and mortality. The first successful operation was performed in 1876. The main objective of the study was to study frequency, indications and fetomaternal outcome of emergency obstetric hysterectomy in tertiary care center.Methods: Observational, retrospective and analytical study was done over 2 years from January 2017 to January 2019. A total of 11 cases of emergency obstretic hysterectomy (EOH) were recorded.Results: The overall incidence was 1.47 per 1000 deliveries. Atonic postpartum hemorrhage (54%) was the most common indication followed by placenta previa (18%) and placenta accreta (9%). Second gravida were mostly involved (45%) with previous LSCS (45%) as a common risk factor in commonest age group of 20-25 years (46%) amongst them. The most frequent squeal was disseminated intravascular coagulation (45%). Maternal mortality was nil while neonatal mortality being 9%. The decision of performing total or subtotal hysterectomy along with bilateral internal iliac ligation was influenced by patient’s condition.Conclusions: Emergency obstretic hysterectomy is the most demanding obstretic surgery performed in circumstances of life threatening hemorrhages where conservative surgical modalities fail and interventional radiology is not immediately available. Antenatal anticipation of the risk factors, involvement of experienced obstetrician at the early stage of management and prompt hystrectomy after adequate rescuitation will reduce fetomaternal mortality and morbidity.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192432
      Issue No: Vol. 8, No. 6 (2019)
  • Current practices in family planning: a population based study

    • Authors: Asmita Kaundal, Rohini Sehgal, Garima Kachhawa, Sunesh Kumar, Alka Kriplani, P. Vanamail
      Pages: 2372 - 2377
      Abstract: Background: To study the knowledge, current practices of family planning methods and acceptance post motivation.Methods: Cross-sectional study conducted at family planning OPD of AIIMS, New Delhi, India. A total of 1516 couples who came for MTP at any gestation couple were enquired about knowledge, currently used contraceptive method and reason for abortion. Couple was counseled and allowed to choose contraceptive method using cafeteria approach. Mean values of continuous data were tested using t-test/ANOVA. Categorial data were compared using chi-square/ Fischers exact test.Results: Mean±SD age of the women was 28.89±5.21 years with 9.98±4.56 weeks POG. Around 81% of women had one or more living children with 62.67% women with at least one abortion previously. Majority used male condoms (42.10%) followed by natural method (21.01%), Cu-T (3.80%), OCPs (1.65%), injectable (0.30%), I-pill (0.24%). Awareness was maximum for male condoms, Cu-T, OCPs, female sterilization (100%) and least for female condoms (20%) and LNG-IUS (8.46%). Contraceptive failure (68.90%), congenital abnormality in the fetus (22.40%), maternal disease (5.90%), rape (1.60%), completed family (0.80%) and not using any method (0.30%) were the reasons of abortion. Majority of abortions were in first trimester (70%). Post-motivation around 69.30% of the couples accepted some form of contraception. Female sterilization (32.50%) method accepted by the couples as compares to temporary methods (36.70%) such as Cu-T, OCPs, Injectables etc.Conclusions: Despite of awareness the family planning programme is unsuccessful largely due to inappropriate attitude. Behavioral modification and communication goes a long way to slove the problem.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192433
      Issue No: Vol. 8, No. 6 (2019)
  • Study of labetalol vs. methyldopa in treatment of pregnancy induced

    • Authors: Bhakti G. Gurjar, Samidha S. Malewar
      Pages: 2378 - 2383
      Abstract: Background: Hypertension is a common medical problem encountered during pregnancy and is associated with increased risk of adverse outcomes. Objective of this study was to compare efficacy and safety of Labetalol and Methyldopa in controlling blood pressure in patients with PIH and pre-eclampsia.Methods: A comparative, prospective observational, single centre study conducted from November 2015 to November 2017 in women with PIH at Indira Gandhi Government Medical College, Nagpur. Group A included 100 patients treated with Labetalol while Group B included 100 patients who were given Methyldopa. Response in lowering of BP was assessed over a period of 7 days.Results: Labetalol treated group of patients showed significant fall from 143.50±7.30mmHg/101.30±3.93 (sytolic/diastolic) on 1st day to 126.10±5.49 mmHg/87.40±5.62 mmHg (sytolic/diastolic) on day 7, while systolic/diastolic BP in methyldopa group on 1st day was 145.20±7.17 mmHg/101.60±4.20 mmHg which was reduced to 129.20±4.86 mmHg/90.50±3.30 mmHg on day 7. Author found that MAP in Labetalol group reduced from 115.226±4.17 mmHg to 100.17±4.43 mmHg on day 7 while in Methyldopa group had MAP on admission 115.99±4.38 mmHg and on day 7 it reduced to 103.27±2.99mmHg which is highly significant.Conclusions: Labetalol controls systolic and diastolic blood pressure more rapidly and effectively than Methyldopa. Safety profile and adverse effects of Labetalol and Methyldopa are similar to each other.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192434
      Issue No: Vol. 8, No. 6 (2019)
  • Efficacy of Mefipristone for induction of labour in late term pregnancy

    • Authors: Roopa N. K., Rekha N.
      Pages: 2384 - 2388
      Abstract: Background: Late-term pregnancy defined as one that has reached between 41 0/7 weeks and 41 6/7 weeks of gestation is associated with an increased maternal morbidity as well as an increased risk of fetal and neonatal mortality and morbidity. Mifepristone, an anti-glucocorticoid and antiprogesterone, though not an oxytocic increases uterine activity and causes cervical effacement and dilatation and improves the Bishop score without over/hyper stimulation of uterus. Increased maternal and fetal mortality from late term pregnancy could be prevented by induction of labour. The objective of this study was to know the efficacy of single dose of oral mifepristone in induction of labour in late term pregnancy and to assess the induction delivery interval in the study population.Methods: This was a prospective interventional study conducted in Department of Obstetrics and Gynaecology at BGS Global Institute of Medical Sciences, Bengaluru. 100 Women with late term pregnancy who fulfilled the inclusion and exclusion criteria were considered for the study after an informed written consent.Results: 73.5% (n=36) of multigravida and 80.4% (n=41) of prim gravida showed improvement in the Bishop score post induction with mifepristone and majority (89.79 % primigravida and 84.31% multigravida) of the study population had vaginal delivery. Multigravida (73.5%) had less induction delivery interval (less than 48hours) compared to primigravida (19.6%).Conclusions: Mifepristone, a progesterone antagonist causes a significant improvement in the Bishop’s score and is associated with an increased rate of vaginal deliveries.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192435
      Issue No: Vol. 8, No. 6 (2019)
  • Effectiveness of Cabergoline therapy in hyperprolactinemic infertility

    • Authors: Devdatt Laxman Pitale
      Pages: 2389 - 2392
      Abstract: Background: Hyperprolactinemia may be associated with ovulatory dysfunction and resultant subfertility. Hyperprolactinemia affects the pulsatile release of GnRH, which in turn impairs the secretion of FSH and LH. It may also affect the endocrine activity of ovarian follicles, resulting into luteal phase defect and ovulatory dysfunction. Hyperprolactinemia may be associated with infertility in up to one-third of women undergoing infertility workup. Women with hyperprolactinemia are generally treated with dopamine receptor agonists to reduce serum prolactin levels and regularisation of menses. The aim of this study was to study the effectiveness of cabergoline therapy in hyperprolactinaemic infertility.Methods: This prospective study was performed from June 2017 to July 2018 in women with Hyperprolactinemic infertility attending the infertility clinic at INHS Patanjali. In this study, 20 women with hyperprolactinemic infertility who satisfied the inclusion and exclusion criteria were started on four week cabergoline therapy. The effectiveness of therapy was evaluated on the basis of normalization of prolactin levels, regularization of menses, reduction in galactorrhea, successful conception and adverse effects if any.Results: The women on Cabergoline therapy showed marked improvement in menstrual irregularity, near normal prolactin levels and reduced galactorrhea. After the four week Cabergoline therapy the frequency of galactorrhea and irregular menses was reduced in 8 (80%) and 14 (93.3) per cent, of women respectively. Successful conception was achieved in 17 (85%) women after regularization of menses with no any major adverse effects.Conclusions: This study shows the effectiveness of cabergoline therapy both on lowering the serum prolactin levels and successful Conception with no any major adverse effects. Cabergoline therapy is a cost effective and safe option in hyperprolactinaemic infertility.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192436
      Issue No: Vol. 8, No. 6 (2019)
  • Association between clinical diagnosis of foetal distress with umbilical
           artery acidaemia at birth in women undergoing caesarean section for foetal

    • Authors: Garima Gandhi, Kavita Chandnani
      Pages: 2393 - 2399
      Abstract: Background: The risks of maternal morbidity and mortality associated with a caesarean section may not be reasonably justified by the degree of neonatal compromise at birth associated with caesarean section done for clinically diagnosed foetal distress. The aim was to study the association of clinical diagnosis of non-reassuring foetal status with umbilical artery acidaemia at birth in women undergoing caesarean section for foetal distress and to evaluate outcomes in neonates born by caesarean section performed for foetal distress.Methods: Prospective observational study of all the women undergoing emergency caesarean section for foetal distress at a tertiary care teaching facility over 2 months. Criteria for diagnosis of foetal distress were thick meconium stained liquor only or foetal heart rate abnormality with or without meconium stained liquor. Testing for pH was done on arterial blood drawn from umbilical cord at the time of birth. Acidaemia was defined as cord blood pH less than 7.2.  Severe acidaemia was defined as cord blood pH less than 7.0.Results: Cord blood pH was analysed in 110 caesareans done for foetal distress. Incidence of neonatal acidaemia at birth in study population was 53.6%.Conclusions: Much lower incidence of actual acidaemia and low Apgar scores in neonates born by caesarean section done for clinical diagnosis of foetal distress than previously reported indicate the need for more stringent criteria and more objective tests for diagnosis of foetal distress.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192437
      Issue No: Vol. 8, No. 6 (2019)
  • Comparative study of papanicolaou smear and colposcopy in the evaluation
           of cervical lesions

    • Authors: Priyanka Mohan, Lakshmidevi M., Shreedhar Venkatesh
      Pages: 2400 - 2405
      Abstract: Background: Cervical cancer is the third most common type of cancer among females. Study aims to critically evaluate the sensitivity and specificity of colposcopy versus papanicolaou (Pap) smear in the early detection of dysplasias. Its secondary objective to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.Methods: This was a tertiary care teaching hospital based, prospective, cross sectional study done in Department of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, conducted on 200 women attending Gynaecology OPD.Results: PAP smear was taken for all 200 patients. 73% of smear was found to be normal, 11% showed inflammatory atypia, 9% showed low grade squamous intraepithelial lesion (LSIL), 3.5% showed atypical squamous cells of undetermined significance (ASCUS) and 3.5% showed High Grade Squamous Intraepithelial Lesion (HSIL). Among the 200 cases studied, 38% (76/200) were diagnosed as colposcopically abnormal. Among the abnormal cases, AW areas were diagnosed in 4%. Punctate pattern of vessels was seen in 5% of women. Normal findings was present in 62%, Erosion cervix in 6%, inflammatory changes were seen in 6% and polyps were diagnosed in 7.5%, leucoplakia was found in 2% and unsatisfactory colposcopy finding was seen in 4% and underwent endocervical curettage. 32 cases out of 200 women were positive on Pap smear. 66 out of 200 women were positive on Biopsy. Pap smear was positive in 22 out of 66 biopsy proven positive cases.Conclusions: The commonest presenting complaint was vaginal discharge (182/200; 91% of the patients. the PAP smear  is found to have sensitivity of 33.33%  and specificity of 92.54%. colposcopy is found to have sensitivity of 81.82%  and specificity of 82.84%.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192438
      Issue No: Vol. 8, No. 6 (2019)
  • Abnormal uterine bleeding in women of peri-menopausal age: a retrospective

    • Authors: Rambabu Chennuru, Ramkumar Potnuru
      Pages: 2406 - 2409
      Abstract: Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of abnormal uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders.Methods: A retrospective study of randomly selected 200 cases of abnormal uterine bleeding between 40–55 years of age during January 2018 to January 2019, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months.Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 60% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (21%) uterus was most common. Maximum number of patients (75%) was treated surgically and 20% got medical treatment.Conclusions: Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192439
      Issue No: Vol. 8, No. 6 (2019)
  • Hysteroscopy: a boon in abnormal uterine bleeding

    • Authors: Grishma Kulkarni, Kunaal K. Shinde, Mayur Thosar
      Pages: 2410 - 2414
      Abstract: Background: Aim of the study was to analyze retrospectively the efficacy of hysteroscopy in the diagnosis of abnormal uterine bleeding (AUB).Methods: Eighty-six women in the reproductive and perimenopausal age group (20-50 years) visiting the gynaecology OPD from March 2018 to February 2019 with the complaints of abnormal uterine bleeding were enrolled in the study. All the patients who underwent hysteroscopic examination were subjected to endometrial curettage; which was sent for histopathological examination (HPE). The hysteroscopic findings were then corelated and compared with HPE.Results: Mean age of the patients was 37.2 years. Around 60.46% patients presented within six months of complaints. Clinically, 54.65% were diagnosed as menorrhagia, 37.2% as polymenorrhoea and 8.13% as intermenstrual bleeding. On hysteroscopy, 44.1% showed abnormal pathology. The positive findings including polyps (8.13%), calcification (3.48%), submucous myoma (12.79%), necrotic mass and forgotten IUCD (2.32%) and adhesions in one case. On the other hand, the findings of histopathology; 56 patients (65.11%) had normal / proliferative / atrophic endometrium, 17 (19.76%) had hyperplasia, 10 (11.62%) had polyps and 3 (3.48%) had calcified endometrium. There was no significant difference between two modalities for normal / proliferative / atrophic endometrium. The HPE diagnosed slightly higher patients of hyperplasia as compared to hysteroscopy. Hysteroscopy diagnosed a higher number of patients with submucous myoma and necrotic mass.Conclusions: Hysteroscopy provided additional visual information for some pathologies which otherwise would remain undiagnosed by HPE.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192440
      Issue No: Vol. 8, No. 6 (2019)
  • Place of the misoprostol in 600 µg in intrarectale in case of hemorrhage
           of the post partum by uterine atony at the Befelatanana University
           Hospital Centre of Obstetric Gynecology in Antananarivo, Madagascar

    • Authors: Rainibarijaona Lanto Nirina Aimé, Rakotonirina Andriamaro Martial, Ratsiatosika Andriamanetsiarivo Tanjona, Randriamahavonjy Romuald, Andriamihajason Lovamampionona, Hery Rakotovao Andrianampanalinarivo
      Pages: 2415 - 2420
      Abstract: Background: The hemorrhage of the post-partum (HPP) represents a major problem of public health because it hires the vital and obstetrical forecast of the mother in case of delay of taking care. Present study aims at assessing the effectiveness of the administration of 03 tablets of misoprostol in intra-rectal in the taking care of HPP by uterine atony and to determine the épidémio-clinical profile of HPP by atony.Methods:
      Authors performed a retrospective and descriptive study concerning the effectiveness of the misoprostol in the taking care of HPP by uterine atony. This study started from December 1st, 2016 till March 31st, 2017. The data processing was performed by Epi info 7 and Excel.Results: The rate of HPP represented 3.8% deliveries which 69.4% was due to uterine atony. HPP by uterine atony represented 2.60% deliveries. It happened at the women from 25 to 34 years old (46.16%), pauciparous (76.93%), with a lower working time at 8 hours (71.15%) and having performed at least 4 CPN (63.47%), giving of urgent babies with a medium weight of 3073.43 g. The administration of the misoprostol was efficient in 90.40% and we noticed no side effect or of serious complications during the taking care of HPP by uterine atony.Conclusions: HPP remains another major preoccupation of the obstetricians in our country because it is an emergency that can put into play the vital forecast and which requires a catch in quick load. The administration of 03 tablets (600 µg) of misoprostol in intra-rectal during HPP by uterine atony deserves its place in the armory of taking care because it is a sure method, efficient and easy to manipulate.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192441
      Issue No: Vol. 8, No. 6 (2019)
  • Comparing the degree of pelvic pain with the macroscopic features of

    • Authors: Tarini Sonwani, Ratna Biswas
      Pages: 2421 - 2424
      Abstract: Background: Endometriosis is considered as the chronic benign gynecologic disease which can cause chronic pelvic pain (CPP) and infertility. Endometriosis has affected almost 10% of the women of reproductive age.Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously.Results: Mean age of women with endometriosis was 30±5.75 years. Majority had superficial implants (30%), 6.66% had deep implants and 6.66% had combination of superficial and deep implants. There was no significant difference between implants and severity of pain (p=0.069). There was a significant association between severity of pain with obliteration of POD. Significant association was seen between deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration and severity of pain.Conclusions: Severity of pain was significantly associated with deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration. However, no association was obtained between severities of pain with superficial implants.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192442
      Issue No: Vol. 8, No. 6 (2019)
  • Causes and management of post-partum hemorrhage at tertiary care center,
           Rajasthan, India

    • Authors: Kamlesh Gora, Anju Depan, Kanti Yadav, Devendra Benwal
      Pages: 2425 - 2428
      Abstract: Background: PPH is responsible for 25% of all maternal deaths. In India, PPH incidence in India is 2%-4% following vaginal delivery and 6% following cesarean section. PPH as the important cause of 19.9% of maternal mortality in India. The objectives of the study were to study the incidence, risk factors, cause, morbidity and mortality pattern and management of PPH.Methods: This is a cross-sectional study conducted among 102 pregnant women selected by convenient sampling and admitted in labour room during the study period who will be deliver by vaginally or by caesarean section. The patient having PPH were divided into two groups: Group I: Patients having primary atonic PPH, Group II: Patients having traumatic PPH.Results: Mean age of participants was 33.6 and 32.9 years, 59.3 and 51.2 have ‘0’ parity, mean BMI 22.8 and 23.9 kg/m2, 34.6% and 17.1 babies were delivered by LSCS, 11.7% and 12.2% have history of PPH in the group of atonic and traumatic respectively. In the group of atonic PPH cases, 77.2%, 15.4%, 4.3% and 3.1% cases managed by the method of ‘Uterotonics +<2 blood transfusions’, ‘Uterotonics + >2blood transfusions’, ‘Perineal Tear Repair’ and ‘Surgical Intervention’ respectively. All the traumatic PPH cases (100.0%) were managed by ‘surgical intervention’.Conclusions: A multi-disciplinary approach include medical, mechanical, surgical and radiological is required in severe haemorrhage. Availability of blood and blood products is very crucial. Prediction and assessment of blood loss and timely identification of uterine atony are remaining the cornerstone for prompt and effective management of PPH.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192443
      Issue No: Vol. 8, No. 6 (2019)
  • The study of thyroid profile in abnormal uterine bleeding at tertiary care
           center, Rajasthan, India

    • Authors: Dinesh Gurjar, Purnima Pachori, Sandhya Chaudhary, Dharmendra Singh
      Pages: 2429 - 2433
      Abstract: Background: Hypothyroidism and Hyperthyroidism leads to menstrual irregularities. Females with thyroid gland abnormality have chances of reproductive abnormalities ranging from abnormal sexual development, menstrual irregularities, infertility and premature menopause. The objectives were to study the association between thyroid dysfunction and AUB in the reproductive age group (18-45 years), To study the thyroid abnormalities in different types of AUB in the reproductive age group, to establish if screening for thyroid abnormalities is justified using T3, T4 and TSH.Methods: This cross-sectional study conducted among 250 women with ‘abnormal uterine bleeding’ (AUB). Inclusion criteria for participants were females in the age group of 18-45 years, females presenting with abnormal uterine bleeding, with thyroid dysfunction, females who do not have signs of demonstrable pelvic pathologyincluding PID.Results: Majority of the patients belonged to the age group of 24 - 32 years i.e.56.8%, 9.2% cases were nullipara, 44.0% cases have menorrhagia, 32.2% have oliogomennorrhea, 19.6% have amenorrhea. Around 3.6% had Thyromegaly, 12.4% have weight gain in hypothyroidism, 28.4% have fatigue in hyperthyroidism, 6.8% cases have higher T4 level, 18.0% cases have higher TSH level.Conclusions: The risk of progression to overt hypothyroidism (about 5% per year) in patients with subclinical disease and the cost-benefit ratio also emphasises the need for selective screening. Early detection of subclinical disease by selective screening facilitates appropriate therapy early in the course of the disease.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192444
      Issue No: Vol. 8, No. 6 (2019)
  • Meconium stained liquor and fetal outcome: a hospital based follow up

    • Authors: P. Kalpana, A. Kavitha
      Pages: 2434 - 2439
      Abstract: Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192445
      Issue No: Vol. 8, No. 6 (2019)
  • The prospective study of laparoscopic finding in infertility cases

    • Authors: Shruti ., Sangeeta Sen
      Pages: 2440 - 2443
      Abstract: Background: Infertility is a global reproductive health issue that affects many individuals and family. The aim of the present study was to evaluate the laparoscopic finding in infertility cases.Methods: Present study is a prospective study on laparoscopic evaluation of female infertility at Panna Dhai Mahila Chikitsalaya, Udaipur, Rajasthan, India. This study was done for the duration of one year from January 2017 to December 2017. Present study included total 100 cases randomly selected attending OBG OPD with both primary and secondary infertility.Results: Out of 100 cases infertile women 62 cases (62%) were of primary infertility and 38 cases (38%) were of secondary infertility. The mean duration of infertility was 3.7 years. Laparoscopic finding were as follow 42% had polycystic ovaries, 33% women had tubal pathology diagnosed on laparoscopy in which 22 women had tubal blocks diagnosed on chromopertubation and among them 19 had cornual block and 3 had ampullary block ,11% uterine finding and 7 women had adhesions in the pouch of douglas and one women had obliterated. About 20 women (20%) conceived during the period of study. Seven women had post laparoscopic complication two women complained of shoulder pain and another four of abdominal pain post operatively.Conclusions: Laparoscopy is the gold standard for diagnosing tubal factors, peritoneal factors, endometriosis and adhesions, because no other imaging technique provides the same degree of sensitivity and specificity and it should be considered in infertility workup for early treatment decision.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192446
      Issue No: Vol. 8, No. 6 (2019)
  • The study of efficacy of injection iron sucrose in treatment of iron
           deficiency anemia in pregnancy

    • Authors: Akhileshwar Singh, Sanjay Singh, Anuj Sharma
      Pages: 2444 - 2448
      Abstract: Background: Iron deficiency is the most common cause of anaemia in pregnancy amounting to almost 50% of pregnant ladies in India. All pregnant women, irrespective of haemoglobin status, should receive prophylactic doses of iron from second trimester. Iron sucrose has an advantage of being cost effective and readily available. The objective of this was to study the efficacy of injection Iron Sucrose in treatment of iron deficiency anaemia in pregnancy.Methods: About106 patients were given in injection iron sucrose in pregnancy, who had intolerance to oral iron or were non-compliant, in pre calculated (Ganzoni’s formula) doses and were followed up with rise in hemoglobin and ferritin after 6 weeks and at term.Results: Statistically significant increase in hemoglobin levels was observed at 6 weeks after initiation of treatment (9.689±0.821 gm% vs 10.906±0.775 gm%) as well as at term (mean 10.981±0.690 gm%). The serum ferritin levels too increased significantly at term (26.7 ng/mL±12.92 vs 65.34 ng/mL±15.73).Conclusions: Present study demonstrates that iron sucrose is an excellent option to treat iron deficiency anemia in patients where oral iron therapy has either failed or not suitable. It significantly increases hemoglobin levels in the study population. It is readily available in the market and can be infused on an outpatient basis.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192447
      Issue No: Vol. 8, No. 6 (2019)
  • Evaluation of amniotic fluid volume and its relation to perinatal outcome

    • Authors: Richa Dwivedi, Anju Depan, Kanti Yadav, Meenakshi Samariya
      Pages: 2449 - 2452
      Abstract: Background: In pregnancy amniotic fluid surrounds the foetus and plays an important role in the development of fetus. From the very beginning of the formation of the extracoelomic cavity amniotic fluid can be detected. To evaluate the predictive value of amniotic fluid index (AFI) (<5) for adverse perinatal outcome in terms of cesarean section for fetal distress, birth weight, meconium staining, Apgar scores, and NICU admission at birth.Methods: This was a prospective study of 100 antenatal women visited RMC, Ajmer, Rajasthan, India during the year 2018 with gestational age >34 weeks. The women’s history, clinical examination recorded, and AFI were measured and the perinatal outcome was compared between two groups, i.e., AFI <5 and >5.Results: The cesarean section rate for fetal distress, low birth weight babies, <2.5 kg and meconium staining was higher in patients with oligohydramnios (p=0.012, 0.001, 0.00015 respectively). There was no significant difference in Apgar score at 5 min <7 (p=0.087) and NICU at birth between the two groups.Conclusions: Oligohydramnios has a significant correlation with cesarean section for fetal distress, low birth weight babies and NICU admission.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192448
      Issue No: Vol. 8, No. 6 (2019)
  • Association of occupational exposure on semen density in male industrial
           workers undergoing infertility treatment at tertiary care hospital

    • Authors: Leena Wadhwa, Ashish Fauzdar, Sanjana N. Wadhwa, Lata Singh, Sumit Chakravarti, Onkar Kaur
      Pages: 2453 - 2458
      Abstract: Background: Working with particular substances or under certain working situations may cause some workers to experience abnormalities in their sexual or reproductive health. Occupational exposures can lead to infertility, but the workers may not be aware of such problems. The purpose of the study was to determine the association between male infertility and occupation of industrial workers in organized sector.Methods: Prospective case-controlled study that included 136 industrial workers working in organized sector and attending infertility clinic for treatment. This study included male partners aged between 21-46 years with primary or secondary infertility and undertaking same occupation for at least last three months. Complete infertility workup of all male partners attending infertility clinic was done that included detailed history and information related to occupation. Routine semen parameters were evaluated according to the 2010 World Health Organization (WHO) criteria.Results: In the present study, significant semen abnormalities were observed in male partners with age more than 31 years and undertaking arduous jobs for more than 5 years (p <0.05) in study group (n=136) as compared to control group (n=62). The abnormal semen count were observed in 114 (83.2%) workers in the study group that included 43 (31.6%) with total sperm concentration (TSC) less than 10 million/ml and azoospermia in 44 (32.3%). Reduced motility (asthenozoo-spermia) was observed in majority 125 (91.9%) of male partners. The findings were significant (p <0.05) as compared to control group.Conclusions: Preventive measures in the workplace need to be established to reduce the effect of occupational hazards and its influence in the semen parameters ultimately leading to infertility.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192449
      Issue No: Vol. 8, No. 6 (2019)
  • Comparative study of intra and post-operative complications between total
           abdominal hysterectomy and laparoscopic assisted vaginal hysterectomy

    • Authors: S. Nithya Priya, S. Senthil Priya, S. Allirathnam, S. Nithya, R. Shankar
      Pages: 2459 - 2464
      Abstract: Background: Vaginal hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim was to compare the risks and complications of laparoscopy assisted vaginal hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.Methods: A retrospective observational study was conducted in the Gynaecology ward at Vinakaya Mission’s Kirupananda Variyar Medical College and Hospitals, Salem, Tamil Nadu, India. The data for the past 1-year record was taken for analysis. A total of 80 subjects were included in the study and were divided into two groups with 40 patients under TAH (total abdominal hysterectomy) group and 40 under LAVH (Laproscopic assisted vaginal hysterectomy) group. The primary outcome of the present analysis was incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of postoperative stay.Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (201 ml) compared to LAVH group (149.8 ml) and the difference was found to be statistically significant (p <0.05). Similarly, the duration of operative procedure was found to be less in LAVH group (57.9 mins) compared to TAH group (72.6 mins) and the difference was found to be statistically significant (p <0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the LAVH group and the difference was found to be statistically significant (p <0.05).Conclusions: LAVH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192450
      Issue No: Vol. 8, No. 6 (2019)
  • Study of diagnosis and management of ectopic pregnancy

    • Authors: Seema Patel, Ajesh Desai
      Pages: 2465 - 2470
      Abstract: Background: Diagnosis of ectopic pregnancy was frequently missed. Aim of the study was to determine the clinical presentation, and treatment associated with ectopic pregnancy.Methods: This is a prospective study which was carried out at Obstetrics and Gynaecology department, GMERS SOLA civil hospital from August 2017 to October 2018. Total 416 patients were admitted during study period out of them 50 patients diagnosed with ectopic pregnancy were enrolled in the study and information was collected and analysed.Results: 80% patients were between the age group of 21-30 years. 56% patients were nulliparous. Amenorrhea (92%) with lower abdominal pain (94%) is the most common presenting symptom. 26% of patients show typical triad of amenorrhea, abdominal pain and bleeding per vagina. UPT and USG were most commonly performed investigations. 96% cases showed UPT positive. 100% USG showed adnexal pathology. Serum beta-hCG was done in 37 patients as an aid for diagnosis and to decide the line of management. Conservative medical management with Injection MTX was done in 4 patients of which 1 patients required laparotomy later on. Surgical management was done in 90% of patients. Laparoscopic management was done in 54% of cases.Conclusions: Early diagnosis and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192451
      Issue No: Vol. 8, No. 6 (2019)
  • Level of serum uric acid in patients with preeclampsia compared to
           controls and its relation to feto-maternal outcome

    • Authors: Ramraj Meena, Purnima Pachori, Sandhya Chaudhary, Chandrakanta .
      Pages: 2471 - 2474
      Abstract: Background: Uric acid is the final product of the purine metabolism in humans. The two final reactions in its production which catalyze the conversion of hypoxanthine to xanthine and the latter to uric acid are catalyzed by the enzyme xanthine oxidoreductase. The role of uric acid in the progression of prediabetes to diabetes has been known. Serum uric acid has been shown to be associated with cardiovascular disease, hypertension, and chronic kidney disease. The present study was done to see the level of uric acid in preeclampsia and  healthy pregnant controls, to relate serum uric acid results to the severity of hypertension and its relation to fetomaternal outcome in patients attending OPD at RMC Ajmer.Methods: 100 cases of preeclampsia of age group between 20-40 year and gestational age ≥28 weeks and 100 normal healthy women with similar gestational age and age group were included in the study and maternal serum uric acid was estimated in both groups.Results: Mean serum uric acid levels in preeclampsia was 7.65±081 mg/dl and 3.21±072 mg/dl in control group. Perinatal complication was more in case group, 74 % were preterm compared to 11% in control group. Mean birth weight in study group was 2.07 kg, of which 24% babies were VLBW 52% were LBW, and 24% babies had normal birth weight, in control group mean birth weight was 2.82 kg. The difference was found to be statistically significant (p value 0.001). In the study group, the MSUA concentration is found higher in LBW and VLBW babies compared to normal birth weight babies.Conclusions: There is a positive correlation between SUA & severity of preeclampsia, and a significant adverse fetal outcome is observed with raised MSUA in preeclamptic patients.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192452
      Issue No: Vol. 8, No. 6 (2019)
  • Mammary lipofiling seen to the hospital complex of Dax

    • Authors: Rainibarijaona Lanto Nirina Aimé, Rakotonirina Andriamaro Martial, Rakotoarivony Valerie Kamary, Andriamihajason Lova, Housni Ibrahim, Eric Rousseau, Hery Rakotovao Andrianampanalinarivo
      Pages: 2475 - 2481
      Abstract: Background: Taken care therapeutics of breast cancer is in constant evolution. She links, according to the stadium of illness, a specific treatment of the cancer and mammary reconstruction which makes integral part of the treatment of breast cancer today. The lipofilling or lipostructure is one of the techniques used in mammary reconstruction.Methods: A descriptive retrospective study on lipofilling accomplished in Hospital complex of Dax, France from January 1st, 2016 till October 31st, 2017 was accomplished, to assess the rate of aesthetic and psychological satisfaction of the patients on the basis of breast Q, then to assess its effectiveness and its security. The statistical analysis was made with the software Excel of Microsoft Office 2007.Results:
      Authors could record 52 lipofillings at 40 patients among 1212 gynecological surgical operations is 4.29% surgical activities. 47 cases (90.38%) of lipofilling were accomplished at 35 patients after a surgery for breast cancer accomplishing a frequency of 3.87% of surgical activity. The women from 49 to 54 years old are the most concerned the median age of which was of 52 years (37 and 73 years) and the patients are still sexually active in 26 cases (74.29%). The mastectomy was practiced in 32 cases (91.45%). An immediate reconstruction was accomplished at 29 (82.86%) patients. The back big rag autologous was used in 22 cases (62.85%). In 33 cases (94.27%), the lipofilling was accomplished to supplement the reconstruction among which by the back big rag at 22 patients (62.5%) and by mammary prosthesis at 11 patients (31.42%). One took a sample in 32 cases of a volume from 400 to 700 ml of grease average of which was 456.38 ml (200-800 ml). A volume from 200 to 300 ml was injected at 17 patients (36.17%) with an average of 264.14 ml (100-600 ml). No repetition of the cancer was recorded during this study. A score of more than 60 was recorded in every domain for the valuation of satisfaction in more than 90% cases.Conclusions: With the evolution of the taking care of the cancers of breast, mammary reconstruction by lipofilling is a technology which goes know a big development. It is a new way of natural reconstruction at the mastectomy patients who wish, more and more a less aggressive surgical gesture with good result.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192453
      Issue No: Vol. 8, No. 6 (2019)
  • Breast feeding knowledge, attitude and perspective in immediate postnatal

    • Authors: Vishma H. Shetty
      Pages: 2482 - 2486
      Abstract: Background: The aim of the study is to understand the knowledge, attitude and practice of breastfeeding among postnatal mothers and optimize the breast feeding practices and overcome various factors that hinder and influence the full realization of benefits of breast feeding.Methods: The study was conducted in the postnatal ward of Rajarajeswari medical college and hospital, Bangalore. 500 postnatal mothers were included. A structured interview schedule was prepared to collect sociodemographic data, perceptions, knowledge, attitude and practices of mothers regarding breastfeeding. Data was collected by interviewing mothers (in their own language) using proforma.Results: About 100% of mothers and newborn infant have skin to skin contact within one hour of an uncomplicated vaginal delivery. Majority of the mothers knew about the importance of breast feeding for babies and herself. Only 17% of the mothers were working in our study and majority of them had resigned from their work as there was no option of maternity leave and baby friendly work environment at their working places. 69% intended to breastfeed up to 6 months. 23% mothers discarded colostrum and 11% gave prelacteal feeds to their babies.Conclusions: The mothers should be encouraged and reinforced about the benefits of breastfeeding for both baby and herself. The workplace condition has to be improved and make it more breast feeding friendly. The study also will assist the health care providers and community workers to understand the attitude and practice in the area and help them to prioritize and focus on these aspects and decrease the incidence of suboptimal feeding practices.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192454
      Issue No: Vol. 8, No. 6 (2019)
  • A study for evaluation of two protocols comprising of clomiphene citrate,
           human menopausal gonadotropin with or without follicle stimulating hormone
           for ovulation induction in patients with infertility for intrauterine

    • Authors: Ashok Verma, Shivani Sharma, Suresh Verma, Pankaj Sharma, Tenzin Tsamo Tenga, Indu Chauhan
      Pages: 2487 - 2492
      Abstract: Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle.  Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192455
      Issue No: Vol. 8, No. 6 (2019)
  • Condom catheter: a simple and efficacious alternative of hysterectomy in
           postpartum haemorrhage

    • Authors: Neeta Natu, Vandna Singh
      Pages: 2493 - 2498
      Abstract: Background: The aim of this study was to evaluate the effectiveness of the condom catheter in treating postpartum hemorrhage refractory to medical treatment.Methods: This prospective study included 21 women with postpartum hemorrhage treated with a condom catheter as a conservative therapeutic option.Results: The condom catheter was successful in controlling hemorrhage in 90.4% of the women. It was effective in all women with vaginal delivery (11 of 12) and highly effective in women with uterine atony who did not respond to medical uterotonic treatment (6 of 7 women).Conclusions: Its ease of use and high effectiveness make the condom catheter a useful approach for the conservative management of acute postpartum hemorrhage. This device reduces bleeding, shortens the hospital stay and avoids the need for surgical management.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192456
      Issue No: Vol. 8, No. 6 (2019)
  • Feto maternal outcome in obstructed labor: a tertiary centre study

    • Authors: Anshul Bansal, Ruchi Kalra
      Pages: 2499 - 2505
      Abstract: Background: The number of maternal deaths as a result of obstructed labor is 8% globally but this number varies in developing country, it ranges 4-70% of all maternal deaths and it is also associated to high perinatal mortality rate. Objective of the study was to find out the proportion of obstructed labour cases and their feto-maternal outcome during last 3 years at tertiary level institute.Methods: A cross sectional observation study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Centre Bhopal. All pregnant women presenting with obstructed labor who delivered at our hospital during last 3 years duration (January 2015 to December 2017) were studied for their feto -maternal outcome.Results: 53% cases had duration of trail more than 16 hours. 84% were referred from primary health centers of nearby rural areas. All  cases  of obstructed labor  delivered by cesarean section (100%). 44% were primigravida. 72% of cases had Cephalopelvic disproportion as the cause. 28% of cases had longer stay more than 7 days at hospital. 32% had  fever  during post operative period 12.5% cases had wound sepsis and 6% of cases required re-suturing of wound during post operative period. 72% baby's birth weight was between 3 to 3.4 kg. 94% of the babies survived where as 6% of babies were still birth. 16% of babies born to obstructed labor mother had APGAR less than 7 at 5 minutes of birth. 6% fetus were IUFD.Conclusions: Cephalopelvic disproportion was the most common cause for obstructed labor. Timely identification of prolonged labor and timely referral and management at place where operation theatre, NICU and blood bank facilities are available can save the life of both baby and mother.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192457
      Issue No: Vol. 8, No. 6 (2019)
  • Spectrum of vulvar lesions: patient’s anxiety, clinician’s concern and
           pathologist’s diagnostic challenge

    • Authors: Dharitri M. Bhat, Vrushali A. Mahajan, Dinkar T. Kumbhalkar, Waman K. Raut
      Pages: 2506 - 2514
      Abstract: Background: A wide variety of inflammatory, premalignant and malignant lesions can occur on the vulva. Some of the lesions are limited to the vulva, while some also involve other parts of the body. Although vulvar diseases can cause a significant issue in the patients, they are less commonly discussed than those of cervix, uterus and ovary. Most of the asymptomatic lesions remain un-noticed, and are seen during routine gynecological checkups. Common complaints in symptomatic lesions are lumps, discomfort, itching and pain. Since the symptoms are nonspecific; determining the location of the lesion can assist with the diagnosis. Being a genital part with skin covering on outer aspect and mucosal lining inside, it is associated with various dermatological, nutritional, and hormonal as well as sexually transmitted diseases. The present study thus was conducted to categorize vulvar lesions based on their histological diagnosis and also to study the morphological spectrum of precursor lesions for malignancy.Methods: Present study includes all types of vulvar lesions sent for pathological study in the Department of pathology, at GMC Nagpur over the period of one year.Results: Total 34 lesions were studied including a wide diagnostic range from inflammatory, dermatological to benign, premalignant and malignant. Inflammatory lesions including various infections and LSA (Lichen sclerosus atrophicus) were the most commonly seen lesions along with collection of neoplastic lesions.Conclusions: Proper diagnostic categorization of the lesions is essential for initiating therapy and reducing patient’s anxiety. Morphology of these lesions along with their diagnostic significance is discussed.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192458
      Issue No: Vol. 8, No. 6 (2019)
  • Comparative study on usefulness of modified WHO Partograph in management
           of labour at one of the rural teaching institutes of Gujarat, India

    • Authors: Shilpa N. Ninama, Mayur R. Gandhi
      Pages: 2515 - 2518
      Abstract: Background: Modified WHO Partograph is a simple, inexpensive pre-printed form on which labour observation are recorded. It generally comprises three sections of information: maternal condition, fetal condition and labor progress. To study on usefulness of Modified WHO Partograph in management of labour of low risk women, this indirectly improved maternal and perinatal outcome.Methods: In this study the progress of labour of 150 women with uncomplicated full term pregnancies with cephalic presentation in active labour was studied using modified WHO partograph. 150 historical matched controls comprising of low risk women who delivered without the use of partograph were identified from the labour register and their course of labour studied. The hospital records were studied to obtain the demographic variables. Maternal and perinatal outcome was analyzed for both cases and controls.Results: The emergency cesarean section rate was reduced from 38.7% in controls to 24.7% in cases and both are significant statistically. None of the cases had labour beyond 16 hours, thus indicating significant reduction in prolonged labour. Neonatal intensive care admissions decreased from 18.6% in controls to 6% in cases indicating an improved maternal and neonatal outcome.Conclusions: Modified WHO Partograph work as “early alarming warning system” which help in detecting delayed progress of labour which improves maternal as well as perinatal outcome.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192459
      Issue No: Vol. 8, No. 6 (2019)
  • Study of thyroid dysfunction in perimenopausal women with abnormal uterine

    • Authors: Velicheti Satya Sree, Gomathy E.
      Pages: 2519 - 2521
      Abstract: Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD.Methods: In the present study, Ninety patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients.Results: Among 90 patients, 22 patients were diagnosed as hypothyroidism and 9 as hyperthyroidism, women with AUB 59 (65.4%) were euthyroid. Among 31 women with thyroid abnormality, heavy menstrual bleeding was seen in 14 (45.1%) women, 11 (35.4%) had Polymenorrhagia, 6 (19.3%) had oligomenorrhea. The frequent menstrual abnormality in women with hypothyroidism (22 women) was heavy menstrual bleeding in 9 (40.9%) women, 5 (22.7%) had oligomenorrhea, 8 (36.3%) had Polymenorrhagia. Out of 9 women with hyperthyroidism, 3 (33.3%) had oligomenorrhoea, 4 (44.4%) had heavy menstrual bleeding, 2 (22.2%) had Polymenorrhagia.Conclusions: AUB might be because of structural or non-structural causes. Thyroid abnormalities may present in perimenopausal women with abnormal uterine bleeding, therefore proper identification of the cause of AUB is needed to give appropriate treatment to the patient. And to avoid unnecessary surgical intervention.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192460
      Issue No: Vol. 8, No. 6 (2019)
  • Serum urocortin in preterm labor is it an effective biomarker'

    • Authors: Nancy Mohamed Ali Rund
      Pages: 2522 - 2527
      Abstract: Background: Preterm labor classically defined as delivery before completed 37 gestational weeks. Urocortin a biomarker that have raised recent research interest is a 40-amino acid neuropeptide related to the corticotrophin-releasing factor molecular family. Interestingly urocortin is produced by gestational tissue such as amnion and chorion predictability of preterm labor by biomarker assay could enhance management levels particularly in cases of preterm labor that are considered a frequent clinical scenario in obstetric practice. Aim of the study was to assess and evaluate the serum levels of urocortin predictability capacity in cases that develop preterm labor.Methods: The current research clinical trial was conducted in a prospective way there was two research groups 60 study subjects had threatened preterm labor and 60 normal research study subjects that delivered at term. Comparative analysis was performed for urocortin assay conducted in both research groups in correlation to gathered clinical data obtained from both research groups.Results: Receiver operating characteristic curve (ROC) between preterm and term delivery research groups as regards plasma urocortin level (pg/ml) as a predictor of pre term delivery showing that a cut-off point level >101.3 pg/ml in which statistical sensitivity=88.33%, statistical specificity=75%, positive predictive value=77.9, negative predictive value=86.5.Conclusions: This research finding reveal that maternal serum urocortin is an effective biomarker in predictability of preterm labor; however future research studies should be multicentric in fashion putting in consideration the racial and ethnic differences besides the impact of BMI on maternal serum urocortin indices.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192461
      Issue No: Vol. 8, No. 6 (2019)
  • Maternal and perinatal outcome of Evan’s syndrome: a 5 years study
           in a tertiary care centre

    • Authors: Manjula S. K., Jasmine Deva Arul Selvi T., Vishnu Priya K. M. N.
      Pages: 2528 - 2532
      Abstract: Background: Evans syndrome is a rare autoimmune disorder characterized by simultaneous or sequential presence of a positive antiglobulin test, autoimmune haemolytic anemia (AIHA), and immune thrombocytopenia (ITP). It is characterised by frequent exacerbations and remissions within a chronic course. It was first described by Robert Evans in 1951.  Incidence of AIHA is 1 per 75 - 80,000 and ITP is 5.5 /100000 per general adult population.  Incidence of Evans syndrome is 1.8% to 10% of patients with ITP. Objective was to study the maternal and perinatal outcome of women with Evans syndrome (E).Methods: About 4 antenatal mothers were identified with Evans syndrome at St. Johns medical college and hospital, Bengaluru during the study period of 5 years from July 2013-July 2017. They were followed up during their antenatal, intra natal and postnatal period and outcomes were studied. All patients included in the study fulfilled the criteria for Evans syndrome.Results: There were 4 cases of Evans syndrome, with a total number of deliveries of 11859, during this 5 year study. Incidence was 0.09 per 1000 births. All patients presented with bleeding manifestations ranging from mucosal haemorrhage to subarachnoid haemorrhage (SAH) at the time of diagnosis. All patients were on treatment with either 1st or 2nd line of management with corticosteroids/ azathioprine. None had bleeding during pregnancy after the initiation of treatment. Patients had antenatal complications like preeclampsia 25%, IUGR 25%, oligohydraminos 50%, IUD 25%. 2 patients received platelet transfusions intrapartum. None had intrapartum or postpartum haemorrhage. There were no maternal and neonatal mortality.Conclusions: Evans syndrome in pregnancy is a rare condition and requires multi disciplinary approach involving specialists from obstetrics, neonatology, and hematology. Close maternal and fetal surveillance and management during pregnancy is essential to increase the possibility of a favourable pregnancy outcome in these women.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192462
      Issue No: Vol. 8, No. 6 (2019)
  • Attachment, perceived social support and mental health problems in women
           with primary infertility

    • Authors: Sadia Saleem, Namra S. Qureshi, Zahid Mahmood
      Pages: 2533 - 2540
      Abstract: Background: Infertility is one of the fastest growing concerns when it comes to reproductive health and most often, women get the blame. Consequently, females suffer from major psycho-social and emotional problems that may lead to serious mental health concerns.Methods: To fill the gap in literature, a cross-sectional research design was used to measure the attachment styles with spouse, perceived social support, and predict mental health problems in women attending infertility clinics with ages ranging from 19-45 (M 27.21, SD 4.79). Adult Attachment Questionnaire, Multidimensional Perceived Social Support, and Depression Anxiety Stress Scale were used among experimental subjects selected through purposive sampling technique.Results: About 32% women reported themselves as secure, 49% as ambivalent, and 19% as avoidant in their attachment style with spouse. The results revealed that a significant negative correlation exists between perceived social support and mental health problems among women with infertility. Moreover, women who identify their attachment pattern as Ambivalent perceive less social support and experience more mental health problems.Conclusions: Education is one of the strongest predictors of how likely infertility is to cause mental health issues while Attachment style is another strong indicator since infertile women with secure attachment pattern have fewer mental health problems. However, the sample size was modest to make any wide-scale assumptions, so further trials with larger participant pools must be performed. Additionally, future studies should include both rural and urban samples with different psychological variables to find the similarities and differences between various groups of people with diverse backgrounds.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192463
      Issue No: Vol. 8, No. 6 (2019)
  • Comparison of C-reactive proteins level in gestational hypertension and in
           normal pregnancy in 2nd and 3rd trimester and its correlation with
           maternal and foetal outcome

    • Authors: Rashmi Ranjan Rout, Meenakshi Mahalik
      Pages: 2541 - 2548
      Abstract: Background: Hypertensive pregnancy disorder covers a spectrum of clinical conditions namely preeclampsia, eclampsia, chronic hypertension and gestational hypertension. Impaired function of vascular endothelium in preeclampsia may cause abnormal immune activation causing release of inflammatory agents like cytokines, C-reactive proteins (CRP) etc. Aim of this study is to evaluate the CRP (Q) levels in gestational hypertension and in normal pregnancy in 2nd and 3rd trimester and its correlation with maternal and foetal outcome.Methods: Total 350 patients were involved in the study with 160 subjects in Study group meeting the eligibility criteria and 190 subjects in control group. All the cases were followed up during the rest part of their antenatal, labour and postpartum period for development of preeclampsia and eclampsia and their effect on mother and foetus.Results: In 2nd and 3rd trimester mean CRP level in study group was 10.01 mg/L and 10.28 mg/L compare to control group 1.85 mg/L and 3.06 mg/L respectively. Difference of mean CRP level was statistically significant (P value <0.001) in both 2nd and 3rd trimester. Gestational age at delivery and birth weight, Apgar score for baby was lower in study group as compared to control group. Maternal morbidity, maternal mortality, mode of delivery by caesarean section, IUD, still birth, preterm delivery, IUGR, baby with respiratory distress syndrome was significantly higher in study group.Conclusions: Increased serum CRP level can be used as a biomarker for identifying women at risk of preeclampsia and its complications along with adverse effect.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192464
      Issue No: Vol. 8, No. 6 (2019)
  • A molar pregnancy detected by following irregular vaginal bleeding after a
           first trimester evacuation: rare case report

    • Authors: Meena Bhati Salvi
      Pages: 2549 - 2552
      Abstract: In this case report summarizes the sequence of events that led to detection of a molar pregnancy missed by ultrasound and initial pathology examination. A 29 years old Asian nulliparous patient came to our clinic with missed period. On beta HCG she was 6 weeks pregnant. After 20 days she was diagnosed with 7 weeks missed abortion on ultrasound. surgical evacuation done for same. After 3 weeks she came with irregular vaginal bleeding. After physical and vaginal examination Beta HCG done, which was very high. On transvaginal ultrasound partial molar pregnancy was detected, so she was immediately admitted and repeat surgical evacuation was done. Histopathology report confirmed partial molar pregnancy which was not detected in previous report. She was regularly followed up with Beta HCG value up to 1 year which declined dramatically. Though molar pregnancy is rare, but it has the potential to develop into invasive mole, so any abnormal bleeding post evacuation should be followed up properly. Beta HCG values and histopathological evaluation is important for correct diagnosis and follow up.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192465
      Issue No: Vol. 8, No. 6 (2019)
  • Uterine Lipoleiomyoma: a rare variant of benign uterine neoplasm

    • Authors: Sunil V. Jagtap, Abhijit Phalke, Nitin S. Kshirsagar, Shubham S. Jagtap, Nitesh Nasre
      Pages: 2553 - 2555
      Abstract: The lipomatous tumors are very rare benign neoplasms of the uterus. Lipoleiomyoma is a benign tumor which is variant of leiomyoma. It has similar clinical course and presentation like uterine leiomyoma and is typically found in postmenopausal women.
      Authors report a case of 45 years female presented with a complaint of increased frequency of menstrual cycles and generalized weakness since 5- 6 months. On ultrasonography abdomen - pelvis a single large lobulated hyperechoic mass was noted in the fundal myometrium measuring 5 x 4.6 cm. The finding was suggestive of fibroid uterus. On histopathological examination showed variable proportions of lobules of mature adipocytes and interlacing bundles of benign smooth muscle cells which was diagnostic of lipoleiomyoma.
      Authors are presenting this case for its rarity, clinical presentation, imaging and histopathological finding with differential diagnosis.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192466
      Issue No: Vol. 8, No. 6 (2019)
  • An unusual case of delivery with central rupture of perineum and intact

    • Authors: Priyanka Mathe, Manisha Meena, Rekha Bharti
      Pages: 2556 - 2558
      Abstract: Most women experience some degree of tear during childbirth and in some these can be extensive. Obstetrics injuries contribute 0.5-15% of vaginal deliveries. Here authors present a case of 23-year-old primigravida who presented at Safdarjung hospital New Delhi, Delhi, India with complaint of pain in perineum and excessive bleeding per vaginum. On examination, introitus was intact and there was central rupture of perineum which involved anal sphincter proximally and rectal mucosa distally. Patient was shifted to operation theatre for exploration and repair. She received 2 units of blood transfusion, antibiotics and laxatives. Patient was discharged on post-operative day 5 in satisfactory condition. Thus, authors emphasise the need of institutional delivery and prevention of perineal injuries which would further obviate the need for surgical repair and associated morbidity. In present era of easy communication and transport we still receive cases of unsupervised deliveries which gives us a strong motive to spread awareness for antenatal visits and care among this population.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192467
      Issue No: Vol. 8, No. 6 (2019)
  • Idiopathic aplastic anemia: a rare case report in Jammu and Kashmir
           region, India

    • Authors: Smriti Sharma, Upma ., Deep Mani
      Pages: 2559 - 2562
      Abstract: Idiopathic aplastic anemia is a pancytopenia disorder that is a rare but life threatening for both mother and fetus during pregnancy. Association of aplastic anemia with pregnancy is unclear but considered to be interrelated. Bone marrow transplantation is the most effective treatment for adult aplastic anemia but is inadvisable to perform during pregnancy because of the teratogenic effect of immunosuppressive agents or radiation therapy to the growing fetus. Supportive care, withdrawal from offending drugs and involving erythrocytes and platelets transfusion is a promising way to save the life. Here author present a case report of 36-year-old lady with idiopathy aplastic anemia. In this case medical investigation revealed severe anemia of unknown origin. The patient was treated with hematinics, blood transfusion and glucocorticoids. A healthy baby was delivered without evidence of hemolysis at her eight month and one week of pregnancy, the patient recovered and discharged with normal incidence. Being a rare case, it becomes a necessity to report such life-threatening disorder and management. Moreover, to our knowledge this is the first case reported of its kind from Jammu and Kashmir Division of India.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192468
      Issue No: Vol. 8, No. 6 (2019)
  • Pregnancy in a rare case of Takayasu’s arteritis: a case report

    • Authors: Kushal Shah, Vaishali Korde Nayak
      Pages: 2563 - 2566
      Abstract: In Takayasu’s arteritis is a rare, chronic idiopathic vasculitis affecting aorta and its major branches, commonly seen in young women of Asian origin. Incidence is 2.6 cases/million/year. Female of reproductive age group are commonly affected. A 32-year female G3A2 with known case of Takayasu arteritis wanted to continue this pregnancy under tremandous social pressure and came for antenatal care at tertiary care hospital. As the pregnancy advanced, she developed uncontrolled hypertension and severe IUGR. At 30 weeks of gestation, elective LSCS had to be done in view of reduced fetal blood flow and severe growth restriction. She delivered male baby of 1 kg which was shifted to NICU. Patient required cardiac intensive care unit for first 48 hrs and later shifted to ward. Postoperative period was uneventful, and patient could be discharged on 8th day. Baby received intensive NICU care and discharged after 1 month with 2 kg weight. Pregnancy with takayasu arteritis requires a multipronged management from gynaecologist, cardiologist, cardiac anaesthetist and neonatologist for favourable maternal and fetal outcome.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192469
      Issue No: Vol. 8, No. 6 (2019)
  • A case report on ruptured interstitial ectopic pregnancy: diagnostic

    • Authors: Suman S. Sharma, A. V. Gokhale, Shonali Agrawal
      Pages: 2567 - 2570
      Abstract: The ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Interstitial ectopic pregnancies are gestations that implant within the proximal, intramural portion of the fallopian tubes with high vascularity. Ectopic pregnancy in the interstitial part of the fallopian tubes can be life-threatening considering the thin myometrial tissue surrounding the gestational sac and high vascularization which may result in catastrophic haemorrhage when interstitium is ruptured. Being a hazardous type of ectopic pregnancy, it becomes extremely important to diagnose and manage it. This condition presents a challenge for clinical as well as radiological diagnosis. Generally, a case of interstitial ectopic pregnancy has typical radiological features distinguishing it from other ectopic. The ultrasonographic finding of interstitial line has better sensitivity (80%) and specificity (98%) than eccentric gestational sac location (sensitivity, 40%; specificity, 88%) and myometrial thinning (sensitivity, 40%; specificity, 93%) for the diagnosis of interstitial ectopic pregnancy. Ultrasound is the mainstay of diagnosis, but magnetic resonance imaging can be helpful in unusual or complicated cases. Interstitial ectopic pregnancy rupturing into the leaves of broad ligament and creating a tamponade effect to alter the clinical presentation is a rare event which presents as a diagnostic challenge. Here authors present a case of ruptured interstitial ectopic pregnancy confined to the leaves of broad ligament, with atypical presentation and radiological features which led to difficulty in diagnosing the interstitial ectopic pregnancy. After laparoscopic confirmation of ruptured interstitial ectopic pregnancy, the patient was managed successfully by laparoscopic cornual resection.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192470
      Issue No: Vol. 8, No. 6 (2019)
  • Elevated serum CA 19-9 levels in dermoid cyst: a predictor of ovarian
           torsion and tissue necrosis'

    • Authors: Ruby Bhatia, Simmanjit Kaur, Sunita Mor, Naazbir Kaur, Ritika Gupta
      Pages: 2571 - 2573
      Abstract: Dermoid cyst (mature cystic teratoma) with well differentiated derivatives of all the three-germ cell layer is a benign tumour with ovaries being the commonest site. Dermoid cyst accounts for more than half of ovarian tumours in girls below 20 years of age. 80% of dermoid cyst are seen in reproductive age group between 20-40 years. Size of dermoid cyst usually varies between 5-10 cm and it may be bilateral in 10% of cases. Malignant transformation is very rare occurrence only in 1-3% cases, however torsion may occur in 15% of dermoid cyst. Carbohydrate antigen or cancer antigen 19-9 is usually raised in gastrointestinal tumours, pancreatic malignancy, pseudocyst of pancreas. However, it may be raised in some other malignancies and benign condition like torsion of dermoid cyst.
      Authors report an unusual case of torsion large dermoid cyst with tissue necrosis along with significantly elevates levels of serum CA 19-9. A 30-year-old P1L1 female presented with chief complaint of heaviness and pain lower abdomen and loss of five kilogram weight for last three months. A provisional diagnosis of dermoid was made. Serum CA 19-9 level were 1126 IU significantly raised. An exploratory laparotomy done under regional anaesthesia. A large demoid cyst 12*10 cm with torsion and areas of gangrene in ovarian tissue was seen replacing left ovary. Large and small intestine, stomach, pancreas were explored to rule out any pathology. Histopathology confirmed diagnosis of mature cystic teratoma. There was significant fall in serum Ca 19-9 levels to 247 U/ml two weeks after surgery and levels returned to normal limit six weeks after surgery.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192471
      Issue No: Vol. 8, No. 6 (2019)
  • Mifepristone as pre-induction cervical ripening agent in term pregnancy

    • Authors: Nikita Sharma, Seetesh Ghose, Setu Rathod
      Pages: 2574 - 2574
      Abstract: We hereby report the results of a prospective randomized study where we compared efficacy of mifepristone and prostaglandin (PGE2) gel for pre-induction cervical ripening.
      PubDate: 2019-05-28
      DOI: 10.18203/2320-1770.ijrcog20192472
      Issue No: Vol. 8, No. 6 (2019)
School of Mathematical and Computer Sciences
Heriot-Watt University
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