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

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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 3)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 5)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 13)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 3)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 13  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Prevalence of white coat hypertension amongst pregnant women admitted with
           high BP recordings in ante-natal clinic

    • Authors: Sandeep Sood, Kuldeep Kumar Ashta, Sirisha Anne, Ravi Kumar
      Pages: 4141 - 4145
      Abstract: Background: White coat hypertension (WCH) is a common and well recognized phenomenon with significant prevalence amongst all age groups. This is also quite prevalent in the pregnant women with an intermediate long term prognosis between hypertensive and normo-tensive individuals. It is important to assess the true prevalence WCH in pregnant women and to prevent unnecessary medications to them during pregnancy but at the same time to keep a timely follow up and a watchful eye on these patients to identify complications at the earliest. Study was conducted at a peripheral secondary level hospital with a small obstetrics and gynecology OPD and ward. 54 patients were diagnosed to be hypertensive in Antenatal Clinic.Methods: All pregnant women who presented to the ANC were screened for hypertension. Those who were diagnosed to be hypertensive in antenatal clinic and these patients were then admitted for Ambulatory Blood Pressure Monitoring (ABPM) for 24 hours.Results: The ABPM tracings were checked and tabulated to arrive at the final diagnosis after 24 hrs. The prevalence of ‘WCH’ in this study was 48.15% as 26/54 patients were found to have their average BP < 140/90 mmHg after measurement by ABPM over 24 hours so they were diagnosed as ‘White Coat Hypertension’ patients.Conclusions: Many women who come to ANC in the early pregnancy are diagnosed to have hypertension. WCH is a well known phenomenon in pregnancy. WCH must be ruled out prior to starting these patients on anti-hypertensive medications.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194836
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study of maternal risk factors and the perinatal outcome in meconium
           stained amniotic fluid in central referral hospital

    • Authors: Kapil Singh Niranjan, Pesona Grace Lucksom
      Pages: 4146 - 4154
      Abstract: Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194837
      Issue No: Vol. 8, No. 11 (2019)
       
  • Correlation between placental location and development of preeclampsia

    • Authors: Prashaant Uikey, Vaishali Gurwani, Megha Tajne
      Pages: 4155 - 4162
      Abstract: Background: Preeclampsia occurs in presence of placenta. Blood supply distribution within the uterus is not similar in central versus lateral sites implicating that, the site of placenta is likely to have a profound effect on the pregnancy outcome. In the light of these observations, a prospective study was designed to find out if the lateral location of placenta as seen by ultrasound between 18-24 weeks of gestation can be used to predict the development of preeclampsia.Methods: This prospective study was conducted in the department of Obstetrics and Gynaecology in IGGMC, Nagpur between January 2017 and June 2018. Pregnant women, with singleton pregnancy and without any risk factor, attending the antenatal clinic were subjected to USG between 18-24 weeks of gestation. Accordingly, patients were divided into 2 groups, 51 with lateral placenta and 51 with central placenta. All 102 women were followed till term. The end point of the study was development of preeclampsia i.e. BP >140/90 and urine albumin >300 mg in 24 hours sample. The data obtained was analysed using appropriate statistical tests.Results: Out of 102 patients, 80.9% were from lateral placenta group and only 19.1% were from central placenta. Sensitivity of this as screening test for preeclampsia was 80.9% while specificity was 58%, Odds ratio being 5.875. In predicting preeclampsia, lateral placenta had a meaningful effect with p value <0.001.Conclusions: Placental laterality, as determined by USG between 18-24 weeks of gestation, is a simple and cost-effective screening test for development of preeclampsia.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194838
      Issue No: Vol. 8, No. 11 (2019)
       
  • A prospective randomized controlled trial showing efficacy of luteal phase
           low molecular weight heparin in fresh non-donor IVF/ICSI cycles in women
           with previous implantation failures

    • Authors: Neeta Singh, Rohitha Cheluvaraju, Sunesh Kumar Jain
      Pages: 4163 - 4168
      Abstract: Background: Implantation failure is a major challenge in in-vitro fertilization (IVF) cycles. The present study was undertaken to determine the immunomodulatory effects of heparin in patients with previous implantation failures undergoing assisted reproductive techniques (ART).Methods: This was a prospective randomized controlled trial with sample size of 100 patients who had history of at least one previously failed IVF/ICSI. Study group of 50 patients received heparin and 50 patients in control group received routine luteal phase support.Results: Primary outcome of the study was implantation rate (IR) which was 11.03% in the study group was and 5.48% in the control group (p=0.08). Biochemical pregnancy rate and clinical pregnancy rate in the study group was 18% and 12% in the control group (p=0.401). Calculated live birth was 5.15% and 3.42% in the study and control groups respectively (p=0.562). 11 babies were taken home from the study group and 6 from the control group (p=0.18).Conclusions: The result of this pilot study showed relative increase in implantation rates (IR) suggesting beneficial effects of heparin in patients with repeated implantation failures. Although these changes are not statistically significant, the presence of an increasing trend in all the outcome parameters signify the possible benefits of heparin proving for the present study hypothesis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194839
      Issue No: Vol. 8, No. 11 (2019)
       
  • Semen analysis and sperm function parameters in patients with infertility
           in Navi Mumbai and Panvel region

    • Authors: Surekha Bhalekar, Shweta Ganorkar, Hemant Bhalekar, Prakash Roplekar
      Pages: 4169 - 4176
      Abstract: Background: Although semen analysis is routinely used to evaluate male partner in infertile couples, infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 8-12% of couples worldwide. Aim of the study was to study different semen parameters in male factor infertility (MFI) and thus increasing the awareness regarding same.Methods: This is cross sectional study conducted between period of September 2016 to December 2018. Semen of 150 patients were studied and results were analysed as per recent WHO (2010) criteria.Results: The present study included 150 patients whose age ranged from 24 to 51 years. Patients were divided into different age groups and sperm count was studied in each group. Abnormal sperm morphology was studied with respect to sperm head, neck, tail defects and combined defects. Sperm deformity index (SDI) and Teratozoospermic index (TZI) were calculated. Other parameters including semen volume, pH, liquefaction time, sperm vitality and motility were also studied which showed significant variations. Conclusions: Although semen analysis is first and most informative investigation for evaluation of male factor infertility, studying individual semen parameters and sperm function and increasing its awareness in general population especially in developing countries is equally important. Besides, it is necessary to acknowledge its limitation with respect to collection, processing, evaluation and biological variation of samples. Also, a normal semen analysis may not prove successful fertility potential of an individual.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194840
      Issue No: Vol. 8, No. 11 (2019)
       
  • Comparison between headfirst and tail-first direction of sperm for
           intracytoplasmic sperm injection

    • Authors: Pallop Pongsuthirak
      Pages: 4177 - 4181
      Abstract: Background: Intracytoplasmic sperm injection (ICSI) is used for assisted fertilization. Sperm can be injected headfirst and tail-first. This study aimed to investigate the effect of the headfirst or tail-first injection of sperm into the cytoplasm during ICSI on oocyte survival, fertilization, blastocyst development, implantation, and clinical pregnancy.Methods: A prospective study was carried out by enrolling 79 women who had undergone IVF with male factor infertility between September 2016 and June 2019. The sibling oocytes were randomly inseminated by headfirst ICSI (405 oocytes) and tail-first ICSI (393 oocytes). After fertilization, the embryos were cultured until blastocyst and single embryos were transferred under ultrasound guidance.Results: There was no difference in survival rates (98.8% versus 98.9%; p=0.551), fertilization rate (71.5% versus 74.8%; p=0.333), and formation of blastocysts (50.7% versus 51.2%; p=0.970) between headfirst and tail-first direction of sperm during ICSI. Implantation and clinical pregnancy were also not significantly different.Conclusions: The outcomes showed that the direction of sperm injection (headfirst and tail-first) had no significant effect on oocyte survival, fertilization, blastocyst development, implantation, and clinical pregnancy.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194601
      Issue No: Vol. 8, No. 11 (2019)
       
  • Role of diagnostic hysteroscopy in evaluation of postmenopausal bleeding

    • Authors: Nisha Solanki, Prashant Suryarao, Aditi Bhatnagar
      Pages: 4182 - 4186
      Abstract: Background: Postmenopausal bleeding is defined as permanent cessation of menstruation resulting from the loss of ovarian follicular activity. Incidence of abnormal uterine bleeding is 10% to 15% in postmenopausal bleeding. For evaluation of postmenopausal bleeding earlier dilatation and curettage was considered as gold standard which is a blind procedure, transvaginal sonography has improved the accuracy of endometrial morphology. Now the focus has shifted to hysteroscopic guided biopsy which is gold standard for evaluating postmenopausal bleeding it also has benefit of see and treat modality. The objective of this study was to study the significance of hysteroscopy in diagnosis of etiopathological factors of postmenopausal bleeding. To correlate the diagnosis by TVS, hysteroscopy and histopathological diagnosis.Methods: The study was conducted at Dr. D. Y. Patil Medical College and Hospital from June 2016 to September 2018. A total of 30 cases were evaluated. The commencement of the study was followed by approval of the institutional ethical committee.Results: In our study, 83.34% of patients with postmenopausal bleeding where in age group menopause is >55 years. 66.67% are overweight with BMI of 25-29.9. We evaluated the ET <4 mm, 4-12 mm, >12 mm thickness, 53.33% were between 4-12 mm of ET. In our study endometrial hyperplasia shows 30% in hysteroscopy, on HPE shows 33.33%, in atrophic endometrium 20% on HPE is also 20%, polyp shows 6.67% in both hysteroscopy and HPE, sub mucous myoma on both hysteroscopy and HPE shows 3.33% and Ca endometrium shows 3.33% in both hysteroscopy and HPE.Conclusions: Study of total 30 cases were conducted, by using Bettochi Office hysteroscope (2.9 mm). Sensitivity, specificity, positive predictive value and negative predictive value of hysteroscopy was calculated in each group of patients.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194640
      Issue No: Vol. 8, No. 11 (2019)
       
  • Study of pregnancy outcome in relation to first trimester body mass index

    • Authors: Prachi Srivastava, Hema Verma
      Pages: 4187 - 4190
      Abstract: Background: Early pregnancy body mass index (BMI) plays an important role in pregnancy outcome. Women with either low or high BMI have an adverse pregnancy outcome. American college of obstetricians and gynecologists (ACOG) recommends calculation of BMI for all pregnant women at their first visit. This study was conducted to assess maternal and fetal outcome in women based on first trimester BMI.Methods: This was a prospective observational study conducted in Department of Obstetrics and Gynecology of T. S. Misra Medical college and hospital, Lucknow from January 2018 to January 2019. Patients with singleton pregnancy booked in first trimester were included while women with multiple pregnancy, pre-existing medical conditions were excluded from the study. Proper history taking and examination was done, and patients divided into five groups as per guidelines of WHO and National Institute of Health Guidelines. Patients were followed up during entire antenatal period. Any maternal and fetal complications were recorded.Results: Incidence of anemia and intrauterine growth restriction (IUGR) was seen more in underweight patients. Postpartum hemorrhage (PIH), gestational diabetes and macrosomia was associated more with patients who were overweight or obese. There was significantly more incidence of lower (uterine) segment caesarean section (LSCS), instrumental delivery, wound sepsis and PPH in patients with higher BMI. SGA babies were seen more in patients with low BMI while large for gestational age (LGA) babies were seen more in patients with high BMI. More neonatal intensive care unit (NICU) admissions were seen in patients with low or high BMI.Conclusions: Complications during pregnancy and adverse pregnancy and neonatal complication was seen significantly more in patients on either side of BMI (underweight and obese). Hence it can be concluded that BMI of a patient directly affects pregnancy outcome.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194598
      Issue No: Vol. 8, No. 11 (2019)
       
  • Clinical study comparing outcome of post in vitro fertilisation triplet
           pregnancy reduced to twins versus non reduced in vitro fertilisation
           triplet pregnancies

    • Authors: Sanjay Kumar Sharma, Reema Kumar Bhatt, Anupam Kapur, Shakti Panda
      Pages: 4191 - 4195
      Abstract: Background: There has been an upsurge in the number of multiple pregnancies with its attributability to increasing use of artificial reproductive techniques. To study clinical outcome of post IVF triplet pregnancy reduced to twin pregnancies   compared to those without triplet reduction.Methods: Hospital designed comparative study. 31 subjects were studied for comparative study design with triplets obtained after infertility treatment (assisted post-IVF). Out of 31, 15 subjects were expectantly managed who refused reduction while 16 subjects chose reduction to twins. Outcomes like prematurity, complications in neonate, birth weight discordance, neonatal mortality and maternal complications were studied.Results: The fetal (triplet) reduction group was associated with significant (p<0.002) higher neonatal birth weight as compared to non-reduced group. The fetal reduction group had significantly lower incidence of prematurity and neonatal complications like hyperbilirubinemia, respiratory distress syndrome and neonatal sepsis. The maternal complications were also higher in nonreduced in terms of PPROM, gestational hypertension, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and gestational hypertension.Conclusions: It is indicated that the reduction of triplet to twins is effective considering more complications with non-reduced group and hence reduction improves favorable pregnancy outcomes.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194593
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study of fetomaternal outcome in induction of labour in third trimester
           oligohydramnios

    • Authors: Nalini Sharma, Hanslata Gehlot
      Pages: 4196 - 4203
      Abstract: Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194599
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study of Centchroman users with special reference to its contraceptive
           benefit

    • Authors: Goter Doke, Jyoti Kamda
      Pages: 4204 - 4207
      Abstract: Background: Centchroman (INN: Ormeloxifene), was developed at CDRI, Lucknow in 1967. This drug was finally approved and licensed in 1991 and launched as Saheli and Choice-7 for marketing in 1992. The Ministry of Health and Family Welfare, India has now introduced centchroman in national family planning programme under the trade name “Chhaya” from April 2016. Centchroman is a novel nonsteroidal contraceptive that inhibits the fertilised ovum from implantation and thus prevents pregnancy. The aim of this study was to assess the effectiveness, side effects, discontinuation rates and failure rate among the users of Centchroman (Chhaya).Methods: The retrospective study was conducted by reviewing the records of Centchroman (Chhaya) contraceptives acceptor over the period of one year from September 2017 to August 2018 in family welfare clinic of Department of Obstetrics and Gynecology at Tomo Riba Institute of Health and Medical Science, a tertiary level center in Naharlagun, Arunachal Pradesh, India.Results: A total of 146 women were evaluated for the study. Majority of the women were in the age group of 20-30 years (76.02%) with mean age of 26 years. Most of the centchroman acceptors were multipara (74.65%) and women in post-abortion (38.35%) and postpartum group (36.3%). Duration of use ranged from 3 months in 146 women to 12 months in 98 women. The discontinuation rate was 31.5%. The major menstrual complaint was delayed menstrual cycle in 15.06% women and irregular cycle in 10.95%. Of the 146 women in the study group, pregnancy occurred in 3 women. Pearl index calculated for centchroman was 2.05/HWY.Conclusions: Centchroman is a non-steroidal, non-hormonal oral contraceptive drug with good therapeutic efficacy and a favourable side effect profile. Centchroman has an important place in postpartum contraception due to its safety profile in breastfeeding women.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194594
      Issue No: Vol. 8, No. 11 (2019)
       
  • Transcervical resection of endometrium as a conservative management of
           dysfunctional uterine bleeding in premenopausal patients

    • Authors: Girish A. Pote, Namita Nandkumar Raut
      Pages: 4208 - 4212
      Abstract: Background: Dysfunctional uterine bleeding (DUB) affects 10% to 15% women of reproductive age group. A prospective observational study was performed to study the efficacy, rate of satisfaction and adverse effects of Transcervical resection of endometrium (TCRE) in the treatment of DUB in premenopausal women.Methods: 30 patients with DUB attending the hospital underwent TCRE and patients were followed up after 6 week, 3 months, 6 months up to 1 year and there bleeding score was calculated. Their response to treatment, complications and satisfaction rate were studied.Results: 43.3% of the women in this study were in the age group of 40-44 years. Post TCRE, 43.33% (n=13) had hypomenorrhea. 33.33% (n=10) had regular cycle, 13.33% (n=4) women had amenorrhea and 10% (n=3) had no response and underwent hysterectomy. 86.66% (n=26) women were satisfied with the treatment whereas 13.33% (n=4) were not satisfied. One patient had uterine perforation and serosal bowel injury due to extended cautery injury. Bleeding reduced considerably and a statistically significant (paired t-test, p-value <0.05) difference was observed in pre and post procedure (6 weeks, 3 months, 6 months and 1 year) bleeding scores.Conclusions: Considering advantages like shorter operative time, uterine conservation and early mobility TCRE is a procedure of choice in patients in whom hysterectomy is either technically difficult or medically contraindicated or in those who are not suitable for long term medical management.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194600
      Issue No: Vol. 8, No. 11 (2019)
       
  • Study of fetal 2D echo in pregnant women with diabetes and gestational
           diabetes mellitus

    • Authors: Priti A. Hatkar
      Pages: 4213 - 4218
      Abstract: Background: Diagnosis of diabetes in pregnancy is an important public health issue. Present study was done to study incidence of abnormal foetal 2D echocardiography in women with diabetes and gestational diabetes mellitus and to know their obstetric outcome.Methods: It is a prospective, observational study, which includes 80 patients. It was conducted at our tertiary care centre after the approval by ethics committee, and the results were analysed.Results: Out of 80 patients included, 77% women had GDM and rest 23% had DM. In this study, all patients had fetal 2D echocardiography done. 3 patients had report suggestive of congenital heart disease in the fetus. 1 of them was suggestive of TAPVC, 1 was suggestive of enlarged right atrium, 1 report was suggestive of VSD. Two of the abnormal fetal 2D echocardiography diagnosis of TAPVC and VSD was confirmed by neonatal 2D echo. One baby with Normal antenatal 2D echo had ASD on post-natal evaluation. The baby with antenataly enlarged right atrium had no cardiac anomaly on post-natal evaluation.Conclusions: Incidence of DM/GDM is increasing. As baby is likely to have congenital anomalies, out of which cardiac anomalies are most common, fetal echocardiography is a well-established, accurate, and safe method for diagnosing congenital heart disease. All the babies with abnormal fetal echocardiography need post-natal confirmation.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194612
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study of knowledge, attitude, practices of menstrual hygiene and its
           waste disposal management among adolescent schoolgirls of Gadag District
           of Karnataka, India

    • Authors: Anitha Dharana, Sapna Kale, Ramesh Mayappanavar
      Pages: 4219 - 4223
      Abstract: Background: Adolescence is a defining time in the development of a child that is characterized by rapid physical growth and neurological sculpting, the onset of puberty and sexual maturity. Pubescent girls from developing countries face several social stigma and cultural taboos while menstruation and during menstrual hygiene management. The present study was aimed to assess the knowledge of adolescent females regarding menstruation, their perception and hygiene practice regarding menstruation.Methods: A cross sectioned study for two months was conducted after ethical committee approval. Adolescent girl’s between 10-16 years were selected from schools and data was collected by interviewing the questions in a predesigned format. Data included sanitation status of the school, knowledge about menstruation, pre-menarche, menstrual practices and beliefs, and the effect of menstruation on school life. Data was represented using percentage and simple proportions, results were drawn to arrive at conclusions of study.Results: 1800 students were included, the mean age in the study was 13.2±1.2 years and 12 -14 years was maximum group.78.5% attained menarche by 13 years with 93% Hindus. 57.5% were unaware of knowledge and 88.6% acquired information from mother. Absenteeism from school was seen in 18.5% and 88% reported concentration problems. Dysmennorhoea was common (78%) and 45.61% visited physician. 78.7% of the participants use sanitary pads and 55% disposed by wrapping the pad in a newspaper and dumping in the dust bin.Conclusions: There is good amount of awareness about menstrual hygiene and menstrual waste disposal among schoolgirls in Gadag district. Problem of menstrual waste disposal can be addressed effectively by providing and improving sanitary facilities of toilets, water and power supply through combined effort of government interventions, school managements and proper health education of girls and parents.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194611
      Issue No: Vol. 8, No. 11 (2019)
       
  • Knowledge, attitude and practices about exclusive breastfeeding among
           antenatal women

    • Authors: Annal A. Vaidya, Himangi S. Warke
      Pages: 4224 - 4229
      Abstract: Background: Breastmilk is considered as one of the healthiest, nutrition-rich yet least expensive method of infant feeding. It is a universally accepted fact that breastmilk meets all the nutritional demands of the new-born. There are extensive benefits of breastfeeding for the new-born as well as for the nursing mother which have been documented from time to time.Methods: A multiple-choice questionnaire was used to interview the participants during data collection.Results: Using the IBM SPSS version 20 software, descriptive analysis of the categorical variables has been presented using frequency and percentage tables. Regarding the practices about breast feeding in primigravidas, their concepts about the same have been captured in this study.Conclusions: Though the knowledge about exclusive breast feeding was not extraordinary among the participants, they had a very favourable attitude towards the same. Almost all patients were also extremely receptive and inquisitive during the session for discussion about the same.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194610
      Issue No: Vol. 8, No. 11 (2019)
       
  • The socio-demographic profile of the acceptor of copper intrauterine
           device after medical termination of pregnancy in a tertiary care centre

    • Authors: Paresh Shyam, Mili Ronghangpi, Ram Chandra Rongphar
      Pages: 4230 - 4232
      Abstract: Background: India is going to be highest populous country within less than a decade. To stabilize population growth as well as to reduce maternal mortality and morbidity resulting from unwanted pregnancy, greater utilization of the spacing methods is essential. In spite of several decades of effort the popularity of Cu-T among the Indian woman is not high. Aim of the study was to find out the profile of the Cu-T acceptor after medical termination of pregnancy (MTP).Methods: It was a retrospective study. Socio-demographic data of the woman accepting Cu-IUCD after MTP was collected from family planning operation theatre record book.Results: The majority of the participants were from rural area. The mean age of the acceptor was 27.28±4.78. The maximum number of woman was para two 74 (44.3%). The number of woman with LCB 2 years or less than 2 years was 96 (57.5%) and that of woman with LCB more than two years was 71 (42.5%).Conclusions: A significant number of woman use Cu-T after a long gap of two years after last child birth. Woman found to be inclined to use Cu-T after having at least one male child.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194595
      Issue No: Vol. 8, No. 11 (2019)
       
  • A prospective study of comparison between transvaginal sonogram and
           histopathological examination in perimenopausal women with abnormal
           uterine bleeding

    • Authors: P. Rishma Priyanka, C. Rama Mani, A. Yamuna
      Pages: 4233 - 4237
      Abstract: Background: Abnormal uterine bleeding is one of the most frequently encountered conditions in gynaecology practice and forms about 10% of all gynaecological admissions, the main concern in perimenopausal bleeding is that the bleeding could be the only external manifestation of many hidden serious pathologies of uterine-cavity. The objective of this study was to compare the results of transvaginal sonography (TVS) and drug and cosmetic (D and C) with histopathological examination (HPE) report of hysterectomy specimen in perimenopausal women with AUB.Methods: A prospective comparative study where 100 perimenopausal women with AUB were subjected to TVS then D and C and then the results were compared with histopathological report of the hysterectomized specimen.Results: With an endometrial thickness less than or equal to 15 mm the histopathology report is normal endometrium. When the endometrial thickness more than or equal to 15 mm the histopathology report is hyperplasia or carcinoma. Findings of TVS correlated well with histopathological report after hysterectomy. 14 cases of adenomyosis, 16 cases of myomatous polyp, and 6 cases of endometrial polyp missed by dilatation and curettage.Conclusions: TVS is a simple, non-invasive test to indirectly visualize the endometrial cavity and is useful as a first step diagnostic procedure in the evaluation of perimenopausal bleeding. Dilatation and curettage lags in detecting adenomyosis, endometrial and myomatous polyps, When TVS combined with dilatation and curettage, it can supplement the shortcomings of dilatation and curettage.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194609
      Issue No: Vol. 8, No. 11 (2019)
       
  • A prospective study on the efficacy of Pipelle biopsy to diagnose
           endometrial pathology in patients with abnormal uterine bleeding

    • Authors: Sunitha Mary Mathew, Pramod Thomas
      Pages: 4238 - 4243
      Abstract: Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability.Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology.Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report.Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194608
      Issue No: Vol. 8, No. 11 (2019)
       
  • Blood transfusion needs among obstetric patients in a tertiary care
           hospital: a prospective observational study

    • Authors: Renuka ., Shridevi A. S., Gayathri L. Patil
      Pages: 4244 - 4249
      Abstract: Background: Pregnancy possess a special challenge as immune responses in pregnant and non-pregnant states are different. The objectives of this study were to analyze the various indications for blood and blood component transfusion in obstetric patients. To study the prevalence and indications for blood transfusion among obstetric patients. To evaluate the various risk factors among these women. To study the role of antenatal visits in patients requiring blood transfusionMethods: A prospective observational study will be undertaken over a period of one year from July 2018 to June 2019 in Department of Obstetrics and Gynecology at SSIMS and RC, Davangere. This study was conducted on pregnant women and immediate postpartum patients (up to 7 days after delivery) admitted in Department of Obstetrics and Gynecology and requiring blood and blood component therapy. Statistical analysis will be performed using Chi square test and Student’s t test.Results: During study period out of 5486 patients 543 patients required blood transfusion. The incidence of blood transfusion is 9.89%. The indications for blood and blood product transfusion observed in our study were anemia, obstetric hemorrhage, thrombocytopenia, disseminated intravascular coagulopathy, ruptured ectopic, incomplete abortion, complete abortion and hydatidiform mole. Anemia in pregnancy was the most common indication and was observed in 217 cases (39.96%) followed by postpartum hemorrhage, which was seen in 117 cases (21.54%). The incidence of transfusion reactions was 5.34% in our study.Conclusions: A proper knowledge of 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. Regular Antenatal checkups should be given more importance in order to maximize the hemoglobin level at the time of delivery and to screen out the high-risk patients. Active management of the third stage of labor is required to minimize the blood loss. Anemia followed by obstetric hemorrhage still persists to be a major cause for blood and blood product transfusion.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194597
      Issue No: Vol. 8, No. 11 (2019)
       
  • Identification of causative pathogen and its antibiotic sensitivity in
           cases of preterm premature rupture of membranes

    • Authors: Sai Prasanna Kandukuri, Ramamani Chadalawada, Bhavishya Gollapalli
      Pages: 4250 - 4253
      Abstract: Background: Pre-labor rupture of membranes is defined as amniotic membrane rupture before the onset of labor contractions, and if it happens before 37 weeks, it is called preterm premature rupture of membranes (PPROM). Several organisms commonly present in the vaginal tract are E.coli, Group-B streptococci, staphylococcus aureus, chlamydia trachomatis, Gardnerella vaginalis and Enterococcus faecalis which secrete proteases that degrade collagen thereby weakening  the fetal membranes leading to PPROM. Appropriate antibiotic therapy has a significant role in the prevention and treatment of maternal and neonatal complications.Methods: This was a prospective observational study done in the department of obstetrics and gynaecology, Narayana medical college, Nellore. Selectively 100 patients with complaint of PPROM admitted to labor room were included in the study. Diagnosis of membrane rupture was established by speculum examination, and high vaginal swabs are taken and sent to laboratory for identifying bacteria using gram staining and cultured in aerobic and anaerobic methods. Antimicrobial susceptibility testing of the organisms was performed by disk diffusion method by Kirby and Bauer.Results: Out of 100, high vaginal swabs had growth in 82 patients, and 18 were sterile. The repeatedly isolated organism in patients with PPROM is E.coli amounting 32%, followed by candidal species 20%. Staphylococci are scoring 11% and enterococci 8%. However, organisms like gardenella vaginalis and Group B streptococcus are least common with a score of 6% and 5% respectively. In this study, E.coli is highly sensitive to tigecycline, colistin 100% each and highly resistant to gentamycin and amikacin.Conclusions: In this study, E.coli is related to the maximum number of cases with preterm premature rupture of membranes. Appropriate use of antibiotics significantly lowers maternal morbidity and neonatal mortality.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194596
      Issue No: Vol. 8, No. 11 (2019)
       
  • Size of cervical lesion in locally advanced carcinoma cervix and response
           to neoadjuvant chemotherapy

    • Authors: Neetu Ahirwar
      Pages: 4254 - 4260
      Abstract: Background: Recently neoadjuvant chemotherapy has started being considered for advanced stage of carcinoma cervix. Drug delivery to pelvic tumour is optimal with neoadjuvant chemotherapy since tumour vascular supply has not been damaged by any previous pelvic interference. Tumor size and parametrial involvement have been reported to be important predictor of NACT response. Objective of this study was to find out association between size of cervical lesion in locally advanced carcinoma cervix and response to neoadjuvant chemotherapy.Methods: The present prospective cohort study was carried out in the Department of Obstetrics and Gynaecology with the collaboration of Department of Radiotherapy, Chhatrapati Shahuji Maharaj Medical University Lucknow for a period of 1-year august 2010 to august 2011. 26 patients with histologically proven locally advanced carcinoma cervix were studied. In all cases Cisplatin 75 mg/m2 and paclitaxel 135 mg/m2 on day one was given at 14 days interval up to maximum of three courses. Evaluation of operability status was done two weeks after second course of chemotherapy. Those found operable were taken up for radical hysterectomy and rest were given 3rd course of chemotherapy. After two weeks of 3rd course again operability assessment was done and patient was taken up either for surgery or radiotherapy.Results: It was observed that out of 14 patients who had tumour size <4 cm, 9 (64.2%) responded completely (CR), 2 (14.2%) responded partially and 3 (21.4%) responded as SD while in 12 patients with tumour size >4 cm, 4 (33.3%) responded completely (CR) and rest 8 (66.6%) response was partial (PR).Conclusions: Response to chemotherapy was modified by pre-treatment volume of the tumour.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194607
      Issue No: Vol. 8, No. 11 (2019)
       
  • Abnormal cardiotocographic findings and perinatal outcome: a prospective
           study

    • Authors: Maitrayee Sen, Sunita Samal, Sajal Datta, Melvin George
      Pages: 4261 - 4270
      Abstract: Background: CTG as an intrapartum fetal surveillance can be judged appropriately taking the abnormal features of CTG individually into account for decision making of early delivery to reduce the fetal and neonatal morbidity. Objectives of this study were to identify the fetuses at risk of developing hypoxia as evidenced by abnormal FHR pattern seen by CTG and to correlate the abnormal features with perinatal outcome and find out the most specific feature among all abnormal features of CTG in detecting the adverse perinatal outcome.Methods: This was an observational study where total of 249 uncomplicated pregnant patients in active labor were selected randomly and CTG were done for them. Progress of labor was recorded in partogram. Only pathological CTGs were considered for early decision of delivery by LSCS. After delivery Apgar score 1 min, 5 min, baby weight, colour of liquor, NICU admission and no of days of admission in NICU were recorded.Results: For liquor colour, variability and absence of acceleration were good screening heart rate features and baseline was considered the most specific feature. For all babies with poor Apgar score at 1 min, abnormal baseline was the most specific feature. For NICU admission, the abnormal baseline the most specific feature. Acceleration was found to be the most sensitive heart rate feature among all other heart rate features. Liquor colour had better sensitivity for detecting poor Apgar score at 1min and 5 min. There was increase rate of cesarean section and operative vaginal delivery.Conclusions: Abnormal intrapartum CTG features of an uncomplicated laboring mother >37 weeks can detect fetuses at distress with different specificities and sensitivities when considered individually and can reduce the perinatal morbidity.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194841
      Issue No: Vol. 8, No. 11 (2019)
       
  • African experience of hysterosalpingography abnormalities tubes management
           by laparoscopy in infertile women

    • Authors: Mohamed Fanny, Edele Aka, Perel Konan, Luc Olou, Abdoul K. Koffi, Stephane Adjoussou, Konan Seni, Apollinaire Horo, Mamourou Kone
      Pages: 4271 - 4275
      Abstract: Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194842
      Issue No: Vol. 8, No. 11 (2019)
       
  • Obstetric and neonatal outcomes of the pregnancies complicated with
           thrombocytopenia

    • Authors: Pratima Kumari, Saurabh V. Bhangale, Asmita N. Patil
      Pages: 4276 - 4284
      Abstract: Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194843
      Issue No: Vol. 8, No. 11 (2019)
       
  • Determinants of cervical cancer screening via Pap smear among female staff
           in a tertiary hospital in Niger-Delta of Nigeria

    • Authors: Peter A. Awoyesuku, Basil O. Altraide, Dagogo A. Mac Pepple
      Pages: 4285 - 4290
      Abstract: Background: Cervical cancer remains a leading cause of death among women in the developing world, with poor prognosis attributed to lack of awareness about the disease and its prevention. Hospital workers’ attitude and practice to such an issue might positively or negatively influence people they come into contact with. This study is to assess the determinants of cervical cancer screening via Pap smear among Female Staff in a Tertiary Hospital in Nigeria.Methods: A hospital-based cross-sectional study was conducted between September and November 2015. A structured self-administered questionnaire was used to collect data from 265 female hospital workers on socio-demographic characteristics (age, parity, educational level and occupational category) and awareness and utilization of Pap smear test. The data obtained were analyzed using SPSS version 20.0.Results: Of the 265 respondents, only 40 (15.1%) had Pap smear test done at least once previously. Bivariate analysis of socio-demographic factors and Pap smear test uptake among the respondents was statistically significant for younger maternal age ≤35 years, not being married, higher educational level, professional occupation category and awareness of Pap smear. However, only maternal age, marital status and awareness of Pap smear remain statistically significant after multivariate analysis.Conclusions: Uptake of Pap smear test as a screening test for cervical cancer is low among female hospital workers. Identified determinants of cervical cancer screening via Pap smear test were younger age ≤35 years, not being married, higher educational level, professional occupational category and awareness of Pap smear.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194844
      Issue No: Vol. 8, No. 11 (2019)
       
  • Fetal birth weight, a challenge to the mother and simplest marker for
           fetal maturity: a study in new rural hospital setup

    • Authors: Rajashree Dattatreya Nagarashi, Lakshmi Swapna Durvasula
      Pages: 4291 - 4297
      Abstract: Background: The birth weight is an important factor which the obstetricians have to give due importance when contemplating elective induction of labor before 40 completed weeks. It is a single most important determinant for survival, growth and development of infant. It reflects the health status of the mother during adolescence and pregnancy and also the quality of antenatal care. It is well known that there is a co-relation between weight of the fetus and the length of the gestation and other various factors. This study looks into the various factors influencing the fetal birth weight and length of gestation and what is its relative importance to the viability of developmental chances of premature infants and also infants born at term. Objective was to study the effect of various maternal factors like maternal age, parity, maternal weight, gestational age on fetal birth weight.Methods: 176 participants with term pregnancies were studied under three independent variables viz gestational age, maternal age and maternal weight that had effect on the fetal birth weight in two groups - primipara and multipara and reported by statistical analysis.Results: The independent variables gestational age and maternal weight showed a statistically significant correlation (p <0.05) with fetal birth weight in both the groups. Whereas the variable maternal age didn’t have any statistically significant effect (p >0.05) on the fetal birth weight in the study.Conclusions: Primipara had more pronounced correlation with fetal birth weight than multipara in the variable gestational age. The maternal weight affected fetal birth weight equally in both the groups. And maternal age had no effect on fetal birth weight in either groups.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194845
      Issue No: Vol. 8, No. 11 (2019)
       
  • Doppler predictors of perinatal outcome in intra-uterine growth retarded
           foetuses

    • Authors: Varshika Mahesh Hingorani, Dharita S. Shah, Madhura Ghate, Sachin Patel
      Pages: 4298 - 4302
      Abstract: Background: The study aims at early detection of intrauterine growth retarded fetuses which are at high risk of perinatal complications. It can help obstetricians take appropriate preventive steps and prevent serious perinatal complications.Methods: The study undertaken over 100 pregnant women with pregnancy induced hypertension between 28-36 weeks subjected to umbilical artery and uterine artery doppler. The outcome data including gestational age at birth, birth height, APGAR score, admission to NICU, need for positive pressure ventilation and neonatal mortality.Results: The study shows that 58% mothers with IUGR foetuses were primigravida; gestational age at delivery is 34.2 weeks and 82% of IUGR foetuses were delivered by C-section. Average birth weight of foetus with abnormal doppler was significantly lower and there was high incidence of NICU admission. The study also shows that oligohydroamnios was common with abnormal doppler group.Conclusions: Umbilical artery doppler velocity in addition to uterine artery velocity doppler should be considered as a primary tool for foetal surveillance in pregnancy induced hypertension patients and for planning management of IUGR foetuses.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194846
      Issue No: Vol. 8, No. 11 (2019)
       
  • Awareness of cervical cancer and practice of Papanicolou smears among
           adult women availing health services or visiting a rural maternity
           hospital, Ramnagara District, Karnataka, India

    • Authors: Chandralekha Kona, Merlyn Joseph, Jilshy Varghese, Mary Aksha, Anju Joseph, Ria Jose, Avita Rose Johnson
      Pages: 4303 - 4308
      Abstract: Background: Cervical cancer is a leading cause of cancer-related deaths among women worldwide. Almost 87% of cervical cancer deaths occur in low and middle-income countries. The study was conducted to assess the awareness of cervical cancer and practice of Papanicolou (Pap) smears among women availing health services or visiting a rural maternity hospital, Karnataka.Methods: A hospital-based cross-sectional study was conducted using a 50-item interview schedule. The interview was administered to women >18 years of age who availed services at the hospital and their caretakers.Results: Mean age of the 158 women interviewed was 32.68±13.7 years. Only 21% of women had heard about cervical cancer. Only 11.4% knew at least one symptom and 1.9% knew one risk factor of cervical cancer. Most of the women (99%) were not aware about prevention of cervical cancer. Only 4% of the women had heard about Pap smears and 3% of the women had undergone a Pap smear test.Conclusions: Women in our study had very poor awareness of cervical cancer and practice of Pap smears. Gainfully employed women (OR=32; 8.8-111.2) and women who reported cervical cancer among family members or friends (OR=116; 20.2-665.4).  were more likely to have heard about cervical cancer. This study indicates a need to increase the awareness on cervical cancer and its prevention especially regarding Pap smears among rural women in Karnataka.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194847
      Issue No: Vol. 8, No. 11 (2019)
       
  • Clinical profile and fetal outcome in women with preterm labor pains

    • Authors: Shweta Gupta, Sunil K. Juneja, Himanti Salhan, Parminder Sandhu
      Pages: 4309 - 4313
      Abstract: Background: Preterm labor is a potential cause of preterm birth. Certain demographic and presenting features in pregnant women may correlate to the severity of the problem and progression to delivery. The aim of the study was to find out the clinical profile and fetal outcome in women with preterm labor pains in a tertiary care hospital of North India.Methods: 83 women with preterm labor were included in the study. Antenatal corticosteroids and tocolytic therapy were given. Women who delivered preterm comprised of Group A and who delivered at term were Group B. Clinical profile and fetal outcome was compared and statistically analyzed.Results: 39 (47.0%) women had preterm delivery (Group A) and 44 (53.0%) women delivered at term (Group B). 23.1% women in group A and 4.5% in group B had a previous preterm birth (p=0.021). 16 (41%) women in group A and 4 (9.1%) in group B had a positive microbial growth on high vaginal swab (p=0.001). The odds of having a preterm birth with cervical length of <2 cm was calculated to be 5.281 (p=0.000). A statistically significant difference was observed in the mean birth weight, Apgar score and nursery admissions in both the groups (p=0.000).Conclusions: A prior history of preterm birth, a positive growth on high vaginal swab and a cervical length of less than 2 cm were found to be significantly associated with preterm birth.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194848
      Issue No: Vol. 8, No. 11 (2019)
       
  • Assessment of maternal serum β hCG level in pregnancy induced
           hypertension and normotensive patients and to correlate between the level
           of β hCG with the severity of pre-eclampsia and eclampsia

    • Authors: Kapil Dev, Anoop Sharma, Rajeev Sood
      Pages: 4314 - 4319
      Abstract: Background: Hypertensive disorders during pregnancy are one of the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Spectrum of this disease ranges from mildly elevated blood pressure with minimal clinical significance to severe hypertension with multi organ dysfunction. Pre-eclampsia complicates about 2-8% of all pregnancies. Pre-eclampsia incidence in India is about 8-10%. Various studies have depicted that, there is a strict relationship between PIH and elevated serum β-hCG level.Methods: This one-year prospective case control study toteled 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum βhCG levels were estimated by chemiluminescent microparticle immunoassay. Statistical analysis of data was done by student’s t-test and p-value.Results: The mean β hCG level in PIH patients was found to 36851.59 mIU/ml with standard deviation of 22916.58 while the mean β hCG in normotensive patient was 15433.26 mIU/ml with standard deviation of 6861.56. (p <0.001). The mean β hCG level in gestational hypertensive patients was 25206.19 mIU/ml with a standard deviation of 8696.9. The mean β hCG level in pre-eclamptic patients was 61697.67 mIU/ml with standard deviation of 18498.57. The mean β hCG level were 84106.38 mIU/ml with standard deviation of 11295.05 in the eclamptic patient. The above values were statistically significant (p <0.001).Conclusions: We concluded that there was a striking relation between the PIH including pre-eclampsia and eclampsia with the elevated serum βhCG level. Concluding that early detection of altered serum βhCG shell aid in better management of pre-eclampsia and eclampsia cases which would play a pivotal role in improving the maternal and fetal outcome.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194849
      Issue No: Vol. 8, No. 11 (2019)
       
  • Maternal and perinatal outcomes in women with first trimester vaginal
           bleeding

    • Authors: K. Suganya, Latha Maheswari Subbarayan
      Pages: 4320 - 4323
      Abstract: Background: First trimester bleeding is one of the common complications during pregnancy which affects almost 16-25% of all pregnancies. To evaluate and ascertain the adverse maternal and perinatal outcomes in pregnant women presenting with first trimester vaginal bleeding.Methods: Prospective case-control study. A case control study involving 60 pregnant women with vaginal bleeding in the first 13 weeks + 6 days of gestational age with 60 matched controls. The study period was from March 2015 to March 2016 and conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu.Results: The complications seen in the study group were: first trimester abortion (16.7%), second trimester abortion (6.7%), preterm labour (25%), abruption (6.7%), neonatal intensive care admission (25%), ectopic (6.7%), IUGR (10%), IUD (1.7%) and PROM (8.3%). When compared with the parity matched controls there was statistically significant increase in first and second trimester abortions, preterm labour, abruption, NICU admission and ectopic pregnancy whereas there was no significant difference between the two groups with regard to intrauterine growth restriction (IUGR) and intrauterine death (IUD).Conclusions: Women with first trimester vaginal bleeding had several adverse outcomes in both the mother and the fetus, and it is very important to explain about the possibility of these outcomes and ensure proper follow up with close antenatal surveillance.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194850
      Issue No: Vol. 8, No. 11 (2019)
       
  • Early oncological outcomes and accuracy of risk stratification and
           tailoring surgical staging based on preoperative histology, Ca125 and MRI
           in endometrial cancer: a prospective cohort study

    • Authors: Jency Mathews, Seethal Abraham
      Pages: 4324 - 4331
      Abstract: Background: momentum to select patients who will benefit from the extensive procedures. However, the parameters used for risk stratification have variable accuracy outside of tertiary cancer centres. This study looks into the accuracy of risk stratification using preoperative histology, MRI and Ca 125 levels and the oncological outcomes after tailoring surgical staging based on the risk stratification by combining the three variables in a suburban centre with a growing cancer population.Methods: This prospective observational cohort study was undertaken in a suburban cancer center in Pushpagiri Medical College, Tiruvalla, Kerala between June 2014 and December 2018. All patients underwent surgical staging with hysterectomy and salpingo oophorectomy as the least procedure. Lymphadenectomy was tailored according to the preoperative risk grouping and changed only in the presence of gross findings at surgery. Adjuvant treatment and follow up data obtained and collected in Microsoft Excel and analysed using statistical software SPSS version 22.Results: Of 47 patients recruited for the study, 35 patients were available for final analysis. Preoperative histology was accurate in 73%. There was 20 % overestimation and 8% underestimation. Ca 125 levels were elevated in 15%.  MRI had an overall sensitivity of 74% and specificity of 60%. When MRI, Ca125 and histology were combined together, there was patients were deemed to be high risk. On final risk grouping, 9 patients were down staged and none were upstaged.Conclusions: Preoperative histology, MRI and ca 125 levels have moderate accuracy individually as preoperative risk determinates. The three parameters combined together show high specificity and PPV for preoperative risk stratification and the risk stratification has not been detrimental with respect to oncological outcomes of recurrence.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194851
      Issue No: Vol. 8, No. 11 (2019)
       
  • Needs, beliefs and barriers for contraceptive use among women in a low
           resource setting in Tamil Nadu: a qualitative study

    • Authors: Thacker S. Naveen, Sajitha M. F. Rahman, Pavan Mukherjee, Augustine ., Kirubah V. David, Ruby A. Pricilla
      Pages: 4332 - 4336
      Abstract: Background: The decline in fertility rate based on the National Health Profile is attributed to the choice of permanent sterilisation as the preferred method of contraception among Indian women. The uptake of spacing methods has declined over the years in many parts of India related to low awareness about options other than sterilisation. Hence understanding the needs, beliefs and barriers of women regarding contraceptive use can identify the factors behind their choice of contraceptive methods. This study aims to explore the needs, beliefs and barriers of women in using different methods of contraception in a low-resource area of urban Vellore, Tamil Nadu.Methods: A qualitative study was conducted in three underserved areas of urban Vellore served by the secondary care hospital of a private academic institution. A descriptive qualitative method was chosen. Focus group discussion was carried out among study participants. Thematic analysis was used to analyse data.Results: The need for contraceptive use was felt after completing the families determining the type of method chosen. Fear of impending side-effects of commonly available spacing methods of contraception limited their use. The results highlight the forceful use of intra-uterine device among study participants reflecting the incentive-based family planning services implemented in most Indian states.Conclusions: Our study reinforces that neither the availability of contraceptives nor forceful implementation of policies will increase the utilisation of contraceptives. There is a need for community-based education on the indications, types and side-effects of reversible methods of contraception.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194852
      Issue No: Vol. 8, No. 11 (2019)
       
  • The role of oral mifepristone in pre-induction cervical ripening at term

    • Authors: Uma H. Chourasia, Mudita Kamlesh Jain, Juzar I. Fidvi
      Pages: 4337 - 4340
      Abstract: Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194853
      Issue No: Vol. 8, No. 11 (2019)
       
  • Total laparoscopic hysterectomy: an experience at a tertiary care hospital

    • Authors: Fatma M. Rentiya, Ajesh N. Desai
      Pages: 4341 - 4345
      Abstract: Background: This study is aimed to review indications, demographic data of patients, clinical outcomes and safety of total laparoscopic hysterectomy.Methods: This is a prospective observational study of total 150 patients who underwent total laparoscopic hysterectomy (TLH) from 1st June 2017 to 30th November 2018 in GMERS Civil Hospital Sola.Results: ~45% patients were between 40-50 years age group; 60% patients had 2 or more deliveries; commonest indication was symptomatic adenomyosis ; uterine size in ~57% of patients were up to 6 weeks; duration of surgery in ~91% of patients <120 minutes; intraoperative blood loss in all cases <200ml; no intra-operative and postoperative complications were encountered.Conclusions: TLH is safe procedure with minimal blood loss, minimal postoperative pain and discomfort and shorter duration of hospital stay when performed via expert hands.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194854
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study on maternal and perinatal outcome of oligohydramnios in term low
           risk pregnancy

    • Authors: Sripreethika Rajavelu, Vinitra Dayalan, Surya S.
      Pages: 4346 - 4349
      Abstract: Background: Oligohydramnios is a frequent complication of pregnancy that is associated with increased perinatal morbidity and mortality. Once diagnosed; oligohydramnios should further lead to intensive fetal surveillance including ultrasound evaluation. The aim of the study was to determine obstetric outcome in term low risk pregnancy with AFI less than or equal to 5 and to assess whether antepartum oligohydramnios is associated with adverse perinatal outcome.Methods: 200 patients in third trimester in the hospital with evidence of oligohydramnios (AFI less than or equal to 5) were selected after satisfying inclusion and exclusion criteria and studied prospectively. Observations regarding the outcome of labour in form of maternal and perinatal parameters including AFI value, CTG features, mode of delivery, LSCS rate, meconium stained, APGAR score, birth weight and NICU admission were made.Results: Overall perinatal outcome with respect to CTG, 128 (64%) out of 200 patients had non-reactive CTG and only 72 (36%) had reactive CTG. 128 (64%) of non-reactive CTG delivered by LSCS, 72 (36%) delivered by labour natural. Nil labour natural in the subset of AFI 1 to 2, birth weight (<2.5 kg-8% and >2.5 kg-92%), Apgar score (<7 at 1-5 mins:18%), still birth (1%), meconium (58.5%), NICU admission (6%) and perinatal mortality (2%).Conclusions: AFI measurement of less than 5 cm detected after 37 completed weeks of gestation with a low risk pregnancy is found to be an indicator of adverse pregnancy outcome with higher fetal distress, meconium stained liquor and higher caesarean section rate. AFI assessment serves as an important tool and remains as an effective screening test in predicting fetal distress in labour that requires caesarean section.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194855
      Issue No: Vol. 8, No. 11 (2019)
       
  • Factors associated with removal of postpartum intrauterine contraceptive
           device among acceptors in rural areas of Nadia district, West Bengal: a
           case-control study

    • Authors: Jayita Pal, Jitu Sharma, Sankalpa Satapathy
      Pages: 4350 - 4357
      Abstract: Background: The unmet need for contraception remains high in the postpartum period. Postpartum intrauterine contraceptive device (PPIUCD), despite being an effective and well-suited contraceptive method for this period, many women discontinue its use due to various reasons just after a few days or weeks. The study aimed to identify the factors associated with the removal of the same.Methods: A community-based case-control study had been conducted in Nadia district of West Bengal. A multi-stage sampling technique had been applied to identify and interview the cases and controls with the help of a predesigned pretested semi-structured schedule.Results: The overall removal and expulsion rates were found to be quite high (21.5% and 16.3% respectively). Multivariate analysis revealed that acceptors belonging to joint family, educated only up to middle level, if place of delivery and insertion of PPIUCD was BPHC, the same had been inserted by nursing staff, experienced pain after insertion,  not given consent before insertion, not counselled ever on PPIUCD, not decided to accept PPIUCD before delivery, not satisfied with its use and undergone no follow up visit after its insertion, were having higher odds of removal of the same.Conclusions: Rigorous counselling during the antenatal period should be focused to achieve a declining trend regarding PPIUCD removal.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194856
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study to find the correlation between 24-hour urinary protein and spot
           urinary albumin to creatinine ratio and to determine the accuracy of spot
           urinary albumin to creatinine ratio as an indicator to detect proteinuria
           and its use as a rapid alternative test over 24-hour urinary protein in
           preeclamptic women

    • Authors: Sowmya Mahesh, Deepa Borgohain
      Pages: 4358 - 4365
      Abstract: Background: Preeclampsia is a multisystem endothelial disease leading to glomeruloendotheliosis with endothelial leak causing significant proteinuria. It is associated with high maternal and fetal risks and fetomaternal morbidity and mortality. Spot urinary albumin to creatinine ratio (ACR) leads to earlier detection of glomerular damage leading to prompt management of preeclamptic patients. To determine the accuracy of Spot Urinary ACR as an indicator to detect proteinuria and its use as a rapid alternative test over 24-hour urinary protein in women with Preeclampsia and to find the correlation between the two.Methods: Spot urinary ACR was measured in 70 consecutive patients with preeclampsia in Assam Medical College, Dibrugarh. The best cut-off value to differentiate between significant and insignificant proteinuria was calculated. The mean, standard deviation and range of various parameters were computed and various statistical tests were used. The Area under the curve and ROC curve were plotted.Results: The best cut-off value to differentiate significant and insignificant proteinuria was calculated as 291.9 mg/g beyond which adverse fetomaternal outcomes and complications were seen. The correlation coefficient between 24-hour urinary protein and spot urinary albumin to creatinine ratio was 0.922 highly significant. The area under the curve was found to be 0.98 with a standard error of 0.0155 which implied that the discriminant ability of spot urinary ACR to differentiate significant proteinuria from insignificant proteinuria in patients with preeclampsia was found to be 98%. Similar studies mentioned in the table below showed a good correlation between 24-hour urinary protein estimation and spot urinary ACR.Conclusions: Compared with 24-hour urinary protein excretion, spot urinary ACR is a simple and accurate indicator of significant proteinuria and helps to detect fetomaternal outcomes in preeclamptic women which may lead to prompt management to reduce fetomaternal complications.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194857
      Issue No: Vol. 8, No. 11 (2019)
       
  • Comparison of short and long co-incubation time of gametes for in vitro
           fertilization

    • Authors: Pallop Pongsuthirak
      Pages: 4366 - 4370
      Abstract: Background: The short and long co-incubation time of gametes for in vitro fertilization are still debatable issues. This study aims to investigate the effects of short and long co-incubation time of gametes on fertilization, polyspermy, embryonic developmental potential, and clinical outcomes.Methods: Sixty-five patients undergoing IVF treatment were invited to participate in the study between May 2017 and March 2019. Ovarian hyperstimulation was prescribed and oocytes were obtained by trans-vaginal aspiration under ultrasound guidance. Sibling oocytes were randomly allocated to short co-incubation for 4 hours (Group I) in 352 oocytes and long co-incubation for 16-18 hours in 363 oocytes (Group II). Rescue ICSI was carried out if total fertilization failure was documented. Fertilization, embryonic development, and pregnancy outcomes were determined.Results: No significant differences between short and long co-incubation were found in fertilization, polyspermy, cleavage, blastocyst, implantation, clinical pregnancy, and live birth rates.Conclusions: The present study showed that short co-incubation of gametes had no significant difference in fertilization, polyspermy, embryo development, and pregnancy outcomes when compared to long co-incubation. The short co-incubation with early cumulus cell removal and rescue ICSI may have the potential to help a couple who had total fertilization failure.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194548
      Issue No: Vol. 8, No. 11 (2019)
       
  • Magnitude of thyroid dysfunction among antenatal women attending tertiary
           care centre

    • Authors: Deepa Shanmugham, Deepak Kannan Saravanan, Priyanka Shah
      Pages: 4371 - 4375
      Abstract: Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194858
      Issue No: Vol. 8, No. 11 (2019)
       
  • The challenge of neuroimaging during pregnancy

    • Authors: Kariman Suel Ghazal, Abdul Rahman Shatila
      Pages: 4376 - 4382
      Abstract: Background: Central nervous system conditions may affect every aspect of female reproduction from fertility to lactation. The objective of this study was to examine the performance of computed tomography and magnetic resonance imaging in the diagnosis of maternal neurologic disorders and to examine the outcome of pregnancies complicated by abnormal neurologic imaging.Methods: Retrospective observational study of 20 parturients presenting with severe neurologic symptoms (January 2006 to January 2016).Results: Abnormal neuro-radiological findings were found. Only 10% of the computed tomography-scans were normal. Both magnetic resonance imaging and computed tomography that were performed in all cases showed cerebral edema (90%) with different degrees, thereby cerebral edema was the predominant lesion. Pertaining to its localization, 65% were localized in the parietal or occipital area, 10% in the paraventricular area, and 10% were diffused. Also, 35% showed intracerebral hemorrhage and 10% showed cerebellar hemorrhage. The incidence of neurological disorders in pregnancy and puerperium was high. Epilepsy and headache were the most common primary and secondary neurological disorders.Conclusions: The role of neuroimaging in diagnosing neurological disorders is crucial for prevention of severe complications.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194859
      Issue No: Vol. 8, No. 11 (2019)
       
  • Study of gynecological health of women with disabilities

    • Authors: Prajakta Ganesh Joshi, Ganesh Arun Joshi
      Pages: 4383 - 4386
      Abstract: Background: In routine gynaecological practice, women with disabilities are rarely seen. The available literature regarding gynaecological and obstetric issues of women with disabilities is scanty. Hence this study was designed on women with disabilities participating.Methods: History and examination findings regarding gynaecological problems of 30 participants were collected.Results: Results show that two third of the participants had normal menses while others had dysmenorrhea, oligomenorrhea, premenstrual syndrome, menorrhagia, infective vaginitis and urinary tract infection. 11 participants were married, out of which 2 had infertility. None of the participants had clinical findings suggestive of breast or cervical cancer. These findings are compared with available studies of similar type.Conclusions: This study concludes recommending the need of special camps for women with disabilities with Gynaecologist on the panel.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194860
      Issue No: Vol. 8, No. 11 (2019)
       
  • A prospective study of thyroid dysfunction in dysfunctional uterine
           bleeding

    • Authors: Chaithra M., Anitha G. S., Savitha C.
      Pages: 4387 - 4390
      Abstract: Background: Dysfunctional uterine bleeding is abnormal uterine bleeding in the absence of any palpable pelvic pathology and demonstrable extra genital causes. Thyroid dysfunction is the systemic disease most often associated with abnormal uterine bleeding. Aim was to evaluate thyroid function test in women with DUB; to assess bleeding pattern in thyroid dysfunction.Methods: Prospective observational study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from august 2018 to July 2019. Pre structured and predesigned proforma filled. All routine blood investigations including serum T3, T4, TSH, USG were advised. These patients were categorized as euthyroid, subclinical hypothyroid, hypothyroid or hyperthyroid based on thyroid profile.Results: 0.5% belonged to the age group of 31-40 years, prevalence of subclinical hypothyroidism is 11%, there were 5.5% of cases of hypothyroidism and 1.5% case of hyperthyroidism.Conclusions: Thyroid screening must be done mandatory for all the cases of DUB and prompt response to treatment with thyroxine would avoid unnecessary surgeries, hormonal treatment, and associated comorbities.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194861
      Issue No: Vol. 8, No. 11 (2019)
       
  • Fetal transverse cerebellar diameter measurement in intrauterine growth
           restriction: a more accurate parameter for gestational age assessment at
           term

    • Authors: Saroj Mourya, Harish Kumar Mourya, Vimla Jain, Manoj Verma
      Pages: 4391 - 4394
      Abstract: Background: Assessment of fetal gestational age (GA) is an essential part of obstetric USG. Accurate knowledge of fetal GA is important to facilitate the best possible prenatal care and successful pregnancy outcome.  For the estimation of GA the commonly used parameters in third trimester are:- BPD, HC, AC and FL. As all these parameters are affected by fetal growth disorders and fetal position. TCD can be used as another parameter for the estimation of GA in growth restricted fetuses.Methods: This study was conducted at Mahila Chikitsalaya Sanganeri Gate; SMS Medical College Jaipur from July 2005 to September 2006. A total of 80 pregnant women in third trimester with singleton pregnancy including 40 pregnant women with known cases of IUGR and 40 AGA fetuses were studied for TCD measure.Results: Correlation coefficient between TCD and gestational age was highly significant and no significant difference was found in TCD of AGA and IUGR fetuses.Conclusions: TCD measurement can be used as more reliable parameter for accurate estimation of gestational age in IUGR fetuses in third trimester.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194862
      Issue No: Vol. 8, No. 11 (2019)
       
  • Clinico epidemiological profile of abnormal uterine bleeding in
           reproductive womens: a cross sectional study

    • Authors: Neetu Singh, Mariyam Faruqi, Yashodhara Pradeep
      Pages: 4395 - 4399
      Abstract: Background: Abnormal uterine bleeding (AUB) is a common reason for women of all ages to consult their gynecologist and is one of the most common debilitating menstrual problems ending up in hysterectomy in developing countries. This study was done with the aim to observe the clinical and demographic profile of the patients and the pattern of AUB.Methods: It is an observational study, conducted in department of obstetrics and gynaecology, DR Rammanohar Lohia institute of medical sciences, Lucknow, Uttar Pradesh from August 2018 to July 2019. All patients in the reproductive age group with symptoms of abnormal uterine bleeding were included in the study.Results: Majority (37.50%) of the women were in the age group of 30-40 years. 71.66% were multiparous and maximum women (60%) were in normal BMI. 69.17% were belonging to middle class. Commonest presentation was menorrhagia (48.3%) followed by oligomenorrhoea (18.1%) followed by polymenorrhoea (17.27%).Conclusions: Excessive menstrual blood loss is a common reason for women to seek medical help and leads to large demands in health resources According to our study majority of the women with AUB were in the age group of 30-40 years, were multiparous with normal BMI belonging to middle class. Commonest presentation was menorrhagia. Following study highlights the clinical and epidemiological pattern of abnormal uterine bleeding of reproductive age group, which is crucial factor in management for these patients. In order to predict causal association, further more studies with larger sample size of higher level of evidence should be conduct to draw causal evidence.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194863
      Issue No: Vol. 8, No. 11 (2019)
       
  • Fetal growth in low-risk Indian population at a tertiary centre and its
           comparison with INTERGROWTH-21 standards: a prospective cohort study

    • Authors: Anoosha K. Ravi, Krishna Agarwal, Siddarth Ramji, Sreenivas Vishnubhatla
      Pages: 4400 - 4405
      Abstract: Background: The objective of this study was to compare the fetal growth pattern in low risk Indian population with the INTERGROWTH-21 standards.Methods: Low risk women were enrolled at 10 to 20 weeks of gestation and followed up until delivery. An experienced operator performed abdominal ultrasound every 5±1 week and measured biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) of the fetus. Newborn anthropometric measurements were taken within 12 hours of childbirth.Results: A total of 126 healthy women, enrolled at mean gestation of 16.8±1.6 weeks, completed the follow up until delivery. None of the participants developed any major obstetric or medical morbidity. The study subjects showed lower mean z scores for BPD (-0.7±1.3), HC (-0.4±1.3) and AC (-0.4±1.3) but a higher mean z-score for FL (0.3±1.7) as compared to INTERGROWTH-21 standards. From 1st through 5th visit, the z scores for BPD and HC improved whereas declined for AC and FL.Conclusions: The fetal growth in non-affluent healthy Indian women had a lower fetal growth compared to INTERGROWTH-21 standards.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194864
      Issue No: Vol. 8, No. 11 (2019)
       
  • Pregnancy outcomes of normal versus abnormal cardiotocography in a
           tertiary centre in Nepal

    • Authors: Mariyam Faruqi, Shailaja C. Shrestha, Rabindra D. Bhatta
      Pages: 4406 - 4413
      Abstract: Background: Pregnancy and childbirth is normal physiological process with great pathological potential. The obstetricians are more concerned with the early recognition of fetal distress during labour and such an adverse outcome should be detected at the earliest point of time by an effective surveillance method. Cardiotocography as a part of biophysical profile has become an established diagnostic tool for fetal surveillance. To compare early perinatal outcome of normal and abnormal cardiotocography in terms of APGAR scores, need for neonatal resuscitation, NICU admission, perinatal death and mode of delivery.Methods: It was a cross-sectional study. 200 nulliparous/multiparous women with singleton pregnancy in cephalic presentation at gestational age 37-42 weeks in latent stage of labor were enrolled in the study and subjected to admission test in left lateral position using fetal monitor. Baseline FHR and contraction pattern were determined for 20 minutes and classification of patients was done into normal, and suspicious or abnormal according to the FIGO guidelines 2015.Results: Low APGAR scores, rate of LSCS, need for neonatal resuscitation, neonatal admission were more in the abnormal cardiotocography group. Cardiotocography in the current study has high sensitivity and high negative predictive value for detecting fetal distress.Conclusions: From the analysis of this study, it would be safe to conclude that an ominous cardiotocography should be managed appropriately without delay and obstetrician should be vigilant in suspicious as well as in normal admission test group for timely intervention for bettering the neonatal outcome.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194865
      Issue No: Vol. 8, No. 11 (2019)
       
  • A study on awareness about temporary contraceptive methods among women in
           reproductive age group

    • Authors: Sharan Kumar Karthikeyan, Kohila Kalimuthu
      Pages: 4414 - 4418
      Abstract: Background: This study focuses on the awareness about temporary contraceptive methods among women in reproductive age group (15-45 years). The temporary contraceptive methods are barrier method, hormonal methods and intrauterine method. The need to study the awareness of temporary contraceptive among women is important to avoid Abortion, MTP and to reduce maternal mortality. The purpose of this study is to assess the awareness of temporary contraceptive methods among women within the reproductive age group of 15 to 45 years in the community. Explore women's understanding, interpretations of contraceptives. Suggestions to improve Birth control and enhance maternal, child health programmes.Methods: Cross-sectional descriptive study (samples were drawn from relevant population and studied once) conducted among the outpatients visiting the obstetrics and gynaecology department of Saveetha Medical College and Hospital. The study was conducted from 15th April 2019 to 14th July 2019 using pretested questionnaire by interview method.Results: The study shows 72% of women were aware of condoms and 92% of women were aware about sterilization method. 38% of the women who participated in the study belonged to the age group (36-45) and maximum usage of temporary contraceptives was found among this age group. We observe 56% of the women were aware that these contraceptives can be obtained at the government hospitals and 7% of the women were not aware where to get these services. 48% of the women got information about contraceptives from health personnel.Conclusions: The success of family planning programs can only be achieved by increasing the awareness of various contraceptives available. It is necessary that supplies of contraceptives are accessible, available and affordable to the general public with ease. Awareness can be improved by expanding health care facilities to peripheral areas.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194866
      Issue No: Vol. 8, No. 11 (2019)
       
  • The pattern of variations in the first trimester fetal heart rate in
           Indian population: a pilot study

    • Authors: Hethyshi R.
      Pages: 4419 - 4423
      Abstract: Background: Fetal heart rate is an indicator of fetal viability. During third trimester and labour the normal range of fetal heart rate is between 110-160 bpm as recommended by the international guidelines. Unlike this, the first trimester embryonic heart rate does not lie in the same range. During the first trimester the normal embryonic heart rate varies between each week of gestation, as determined by a few western studies. Indian studies on the same are not available. Objective of this study was to determine the trend of the fetal heart rate in first trimester of pregnancy in South Indian women.Methods: Transvaginal scan was done in 51 pregnant women with singleton pregnancy attending the antenatal clinic in a medical college hospital. Crown rump length and fetal heart rate were measured and plotted on a graph. Also, the fetal heart rate at different gestational age of our study was compared with the fetal heart rates at the same gestational age from the studies in the western population.Results: The range of fetal heart rate at different weeks of gestation was comparable to the heart rate variations as seen in the western population. The maximum heart rates at 9 weeks of gestation in our study was higher than the heart rate in the western population.Conclusions: Possibility of variation in the fetal heart rates in the first trimester in different populations cannot be ruled out until confirmed by studies with large sample size.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194867
      Issue No: Vol. 8, No. 11 (2019)
       
  • Evaluation of endometrial polymerase chain reaction in diagnosis of female
           genital tuberculosis

    • Authors: Manvi Dua, Kiran Pandey, Sangeeta Arya, Anil Verma
      Pages: 4424 - 4428
      Abstract: Background: Genital tuberculosis also known as tuberculous pelvic inflammatory disease can affect any age group, most common being reproductive women of 20-40 years. Clinical diagnosis of genital tuberculosis is a big challenge as the disease is either asymptomatic or has varied presentations. Conventional methods for diagnosis including AFB smear, endometrial histopathology and culture have limitations of low detection rate because of paucibacillary nature of disease. Laparoscopy generally detects macroscopic changes such as peritubal adhesions, tubercles and tubo-ovarian mass but it fails to diagnose disease at early stage. The objective of this study was to evaluate efficacy of TB DNA PCR in diagnosis of genital tuberculosis.Methods: A total of 127 patients (between 2013-2016) who presented in gynecologic OPD with symptoms suggestive of tuberculosis were included in the study. All patients were subjected to endometrial histopathology and TB DNA PCR of endometrial tissue and peritoneal fluid. Since there is no gold standard test available for diagnosis of genital tuberculosis, a diagnostic criteria was adopted in the study based on laparoscopic findings, clinical history and other investigations. Patients were divided in two groups. Group A included patients positive of tuberculosis based on diagnostic criteria. Group B included patients negative for tuberculosis based on diagnostic criteria.Results: In our study sensitivity of endometrial PCR, peritoneal PCR and endometrial histopathology were 73.8%,17.8% and 10.7% respectively. Endometrial histopathology and peritoneal fluid PCR was found to be highly specific (100%) while endometrial PCR was found to be 93% specific. Endometrial PCR although has highest sensitivity and specificity amongst the groups evaluated but high false negative rate was its major limitation.Conclusions: No single test fulfills all criteria to emerge as sole diagnostic test, hence a high degree of suspicion with a detailed history and investigating with a variety of tests is all that is required to diagnose geniatal tuberculosis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194868
      Issue No: Vol. 8, No. 11 (2019)
       
  • Laparoscopic management of cervical and endometrial cancer in Africa:
           experience of the National Hospital Centre of Pikine

    • Authors: Moussa Diallo, Abdoul Aziz Diouf, Aminata Niass, Astou Coly Niassy Diallo, Cyr Esperence Gombet, Magatte Mbaye, Babacar Biaye, Sophie Coulbary, Mori Niang, Codou Sene, Anna Dia, Alassane Diouf
      Pages: 4429 - 4434
      Abstract: Background: Laparotomy represents the standard historical surgical approach to these cancers. Process of treatment of benign adnexal pathologies to the emergence of a new pathway for the management of these cancerous pathologies.Methods: Our prospective study from December 2016 to December 2018 included 10 patients with early-stage uterine cancer and endometrial cancer confirmed by MRI. The characteristics of patients, their cancer, their intervention and morbidity were revealed.Results: Our results show that the average age of the patients was 63 years; There were 2 cases of cervical cancer and 8 cases of endometrial cancer. For cervical cancer, it was essentially squamous cell carcinoma; one patient was at stage Ia2 and the other at stage Ib1. For endometrial cancers, squamous cell carcinoma was 80%; 6 patients were in stage IB and 2 in stage IC. Of the 10 patients undergoing surgery, 9 had laparoscopic colpohysterectomy and lymphadectomy and one complementary laparoscopic lymphadenectomy. The average number of lymph nodes removed was 9 and no lymph node metastasis was found. In the immediate postoperative period, one patient had transient urinary incontinence and another had vaginal slice lymphorhea.Conclusions: The main interest of this practice is to be the least morbid possible for patients at the early stage. With our short experience, we obtained a reduction in operating time, a reduction in hospital stay, a decrease in the consumption of analgesics and antibiotics postoperatively and a reduction in per and postoperative complications.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194869
      Issue No: Vol. 8, No. 11 (2019)
       
  • Study of changes in non-stress test following antenatal corticosteroid
           therapy in preterm pregnancy

    • Authors: Renuka S., Sathiya S., Famida A. M., Vijayalakshmi K., Sailatha R.
      Pages: 4435 - 4439
      Abstract: Background: Preterm birth is the largest unsolved problem in obstetrics and the single most significant cause of neonatal morbidity and mortality. Preterm labour constitutes 5-10% of pregnancies and is the leading cause of neonatal morbidity and mortality worldwide. It is a major public health problem in terms of loss of life, long term disability (cerebral palsy, blindness, deafness, chronic lung disease). The objectives of this study were to determine whether antenatal corticosteroid administration affects the non-stress test. To evaluate the effect of antenatal steroid on foetal movements. To assess the incidence of respiratory distress syndrome and neonatal mortality after antenatal corticosteroid administration.Methods: All antenatal cases between 28-32 weeks of gestation judged to be at risk for preterm delivery attending the outpatient department or admitted in a tertiary care hospital, Tamil Nadu during the study period of 3 years.Results: The present study was undertaken to evaluate the NST for a period of 3 days following antenatal corticosteroid administration and to study the immediate changes in the mother and the foetus. We found out that there was a statistically significant change (p <0.01) in non-stress test when compared with the pre-betamethasone assay.Conclusions: Corticosteroids can cause metabolic alterations in mother, short- and long-term effect in the foetus.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194870
      Issue No: Vol. 8, No. 11 (2019)
       
  • Analysis of success of vaginal birth after cesarean in relation to
           indication of primary caesarean section: a tertiary care experience

    • Authors: Neha Gupta, Arpita De, Nidhi Gupta
      Pages: 4440 - 4443
      Abstract: Background: Apprehensions related to vaginal birth after caesarean (VBAC) has reduced rates of successful vaginal trials over last decade. The objective of this study was to identify the indications of first caesarean section that can lead to a successful trial of labour in subsequent pregnancy.Methods: Retrospective cohort study was done between November 2014 and October 2017. Data from the case records was analysed.Results: Study over 3 years from 2014 to 2017 revealed fetal distress (82.7%),  breech (72.2%), transverse lie (66.7%), antepartum haemorrhage (56.2%) and twins with first non-cephalic (57.9%) have successful outcome of VBAC whereas obstructed labour (19.2%) and failed induction (18.4%) in previous pregnancy have poor outcome for VBAC.Conclusions: Attempts to allow trial of labour after one previous caesarean section with fetal distress, malpresentation and twins as indications of caesarean in previous pregnancy are safe and should be encouraged.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194871
      Issue No: Vol. 8, No. 11 (2019)
       
  • Retrospective study to improve early initiation of breastfeeding in
           newborns

    • Authors: Joyce Jayaseelan, Anita Krishna Mohan
      Pages: 4444 - 4447
      Abstract: Background: Breast milk is the best nutrition to every new born baby. WHO recommends that all new-borns should be breastfed within one hour of birth and then on demand. Exclusive breast feeding i.e. avoiding any other feeds till 6 months of age, is best for the baby. Despite these guidelines, our national average of initiating breastfeeding within the first hour is less than 50% as per NFHS 2015-2016. The objective was to study the existing rate of early initiation of breast feeding in the study hospital.Methods: Retrospective data collection from 2015 to 2017 was used for this study. Mothers were educated about colostrum and benefits of early initiation of breastfeeding in their third trimester and during their baby shower.Results: Early initiation of breast feeding was successful among 2624 babies out of 2835 babies who were born in the study period.Conclusions: As compared to national averages, the study hospital had a superior percentage of babies being initiated early on breastfeeding. We need to educate and motivate the society to encourage exclusive breast feeding for all babies. Professional help in the form of dedicated lactation consultants of guidelines will help mothers to breast feed their babies sooner and for longer. Busting local myths and harmful practices is the need of the hour.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194872
      Issue No: Vol. 8, No. 11 (2019)
       
  • Levonorgesterel releasing intra uterine system in the control of heavy
           menstrual bleeding. Is it an alternative to hysterectomy'

    • Authors: Sobha S. Nair, Jayashree Nayar, Ann John Kurien, Isha Seth
      Pages: 4448 - 4452
      Abstract: Background: Heavy menstrual bleeding (HMB) affects 10 to 35% of women. Studies indicate LNG-IUS which releases controlled amounts of levonorgestrel (LNG) is effective in non- surgical treatment for HMB and has fewer side effects when compared to the conventional pharmacological agents. It also improves the quality of life. Levonorgesterel releasing intra uterine system can be an alternative to hysterectomy in the control of HMB.Methods: Retrospective study of 2 years in a tertiary care centre, Kochi. 170 women with abnormal uterine bleeding were enrolled in the study. Clinical examination, routine investigations and imaging was done.  Endometrial sampling done and followed with HPE reports in indicated cases.Results: Mean age was 41 years. 30.6% had menorrhagia. Adenomyosis in 44% and endometrial hyperplasia in 19. 4%. Lost follow up in 12.9% cases and expulsion in 3.6%. 4.1% were unsatisfied and had hysterectomy. The uterine width in adenomyosis was significantly reduced p <0.012. The mean ET in endometrial hyperplasia cases also significantly reduced with p <0.01. Satisfaction rate was 97%.Conclusions: LNG-IUS is having a high success rate in controlling menstrual symptoms, thereby improving the quality of life and avoiding hysterectomy in women with abnormal uterine bleeding. It is highly efficient in symptomatic relief of adenomyosis and reduction in the uterine volume (width). Endometrial hyperplasia showed complete regression with LNG-IUS.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194873
      Issue No: Vol. 8, No. 11 (2019)
       
  • Materanal and neonatal outcomes of triplet gestation in a tertiary care
           centre: a retrospective study

    • Authors: Neeraj Sharma, Deepika Kumari, Sonal Prasad, Akanksha Srivastava
      Pages: 4453 - 4456
      Abstract: Background: A significant rise in triplet pregnancy rate has occurred recently. This rise is of concern, as these infants are frequently reported as a risk factor of adverse outcome. The aim of this study was to retrospectively study the outcomes of triplet births.Methods: A retrospective study was undertaken to analyze the clinical data of all patients with triplet gestation admitted to the labour room of Dr. Baba Saheb Ambedkar Hospital, Delhi to study the maternal and fetal outcomes.
      Authors retrospectively observed and analyzed the database to examine triplet gestations delivered between January 2014 and December 2018.Results: Over the five-year study period, there were total 44,011 deliveries. Out of these, there were 35 (0.079%) triplet pregnancies. Of all the triplet pregnancies studied 80% resulted from ovulation induction and assisted reproductive technology. The mean gestational age at delivery was 31.6±3.0 weeks, and the mean birth weight was 1,594±460 gm. The most common maternal complications were Preterm labour in 32 pregnancies (92%), anemia in 17 (49%), pre-eclampsia in 11 (31%), post-partum hemorrhage in 8 (22%). Of the total deliveries neonatal complications included Respiratory distress syndrome in 44 (42.2%), Hyperbilirubinemia in 41 (39%), Intrauterine growth restriction in 19 (18.1%). The perinatal mortality rate was 10.5%.Conclusions: Higher order pregnancies are associated with maternal and neonatal complications. These high risk women need more care and the neonates require intensive care and monitoring after birth, most commonly due to prematurity and low birth weight.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194874
      Issue No: Vol. 8, No. 11 (2019)
       
  • Twin pregnancy, the study of maternal and perinatal outcome: what being a
           twin is like'

    • Authors: Smitha K., Jasiya Afreen M. H.
      Pages: 4457 - 4461
      Abstract: Background: Twin pregnancy is considered as a high-risk pregnancy due to associated high maternal and perinatal morbidity mortality in comparison with singleton pregnancy. The objectives of this study were to study the maternal and perinatal complications in twin pregnancies. To find out various factors that contribute to adverse perinatal outcome.Methods: This retrospective study was conducted at Kempegowda Institute of Medical Sciences Hospital, Bengaluru. 92 women with twin pregnancies admitted in KIMS Hospital from September 2014 to September 2018, both booked and referred patients were studied. Individual patient parameters like age, parity, gestational age, mode of delivery, maternal complications were tabulated. Neonatal morbidity and mortality were noted, data thus obtained was analysed and results studied.Results: In the study the incidence of twin pregnancies was more in second gravida (53%). 72% of the patients were admitted between 28-36 weeks of gestation with preterm labour (23%) as the main cause for admission. Anaemia (8.69%), hypertensive disorders of pregnancies (17.39%), PPROM (21%), single foetal demise (5%) and IUGR (5.4%) were the antenatal complications observed. Out of the 92 patients, 29 (35.4%) patients delivered by vaginal route whereas 53 (64.6%) had to undergo C-section. DCDA twin constituted 66% of twins in the study and mal presentation was the commonest indication for caesarean section (50%). Among the 164 babies out of 92 twin pregnancies 8 babies were still born and 12 babies died by the end of one week due to complications related to prematurity like hyaline membrane disease, IVH.Conclusions: Early detection of twin pregnancies and proper antenatal care reduces both maternal and perinatal complication thereby improving maternal and perinatal outcome.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194875
      Issue No: Vol. 8, No. 11 (2019)
       
  • Tamoxifen for treatment of abnormal uterine bleeding in etonorgstrel
           implant users: a randomized clinical trial

    • Authors: Ahmed N. Fetih, Ahmed M. Abbas, Fatma A. Kamel, Ihab H. El Nashar
      Pages: 4462 - 4467
      Abstract: Background: The current study aims to compare the use of tamoxifen and oral contraceptive pills in women using implanon and complain with irregular uterine bleeding.Methods: Women attended family planning clinic using implanon presented by bleeding were invited to participate in the study. They were randomized into two groups: Group A: 100 women received Tamoxifen 10 mg twice daily for 10 days taken at the onset of an episode of bleeding or spotting episode. Group B: 100 women received Combined oral contraceptive pills (microcept) once daily for 21 days take at the onset of an episode of bleeding or spotting episode.Results: No difference regarding the baseline criteria of both groups. No difference between both groups regarding the duration of irregular bleeding in the implanon users (p=0.090). Additionally, the number of bleeding days and spotting in the last month was similar in both groups (p=0.554). The percentage of women who stopped bleeding during the period of treatment is 84% in the tamoxifen group and 92% in the COCs group, but the COCs needs longer treatment time, where the mean of days required to stop bleeding is 5.03±1.8 days in the tamoxifen group and 6.5±2.5 in the COCs group. Headache and nausea were the most prominent adverse effects found in the COCs group (p=0.000).Conclusions: Oral administration of tamoxifen 10 mg twice daily for 10 days is effective on stopping bleeding attacks in implanon users.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194876
      Issue No: Vol. 8, No. 11 (2019)
       
  • Evaluation of caesarean section practices according to Robson's
           10-group classification at a level two maternity ward in Conakry, Guinea

    • Authors: Daniel W. A. Leno, Mamoudou E. Bah, Jerry C. Moumbagna, Tamba M. Millimouno, David Lamah, Alexandre Delamou, Telly Sy
      Pages: 4468 - 4473
      Abstract: Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194877
      Issue No: Vol. 8, No. 11 (2019)
       
  • Expression of Cyclin D1 in normal and hyperplastic endometrium

    • Authors: Parveen R. Kundu, Anjali Sindhu, Swaran Kaur, Amrita Kulhria, Ritika Hooda
      Pages: 4474 - 4478
      Abstract: Background: Endometrial hyperplasia is characterised by increased gland to stroma ratio with varying degree of atypia. Cyclin D1 is a protein playing important role during the G1→S phase transition in the cell cycle. The present study evaluated the expression of Cyclin D1 in normal and hyperplastic endometrium.Methods: A cross sectional study was conducted over a period of 1 year. We evaluated and compared the expression of Cyclin D1 in 56 endometrial samples including 24 cases of simple hyperplasia, 12 cases of complex hyperplasia and 10 cases each of secretory and proliferative endometrium.Results: A substantial increase in expression of Cyclin D1 was seen in hyperplastic endometrium compared to normal endometrium. Moreover, complex hyperplasia showed the maximum positivity for Cyclin D1.Conclusions: Cyclin D1 may play a stimulatory role in the proliferation of endometrial glands and hence may be involved in endometrial tumorigenesis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194878
      Issue No: Vol. 8, No. 11 (2019)
       
  • Predictors of poor maternal and perinatal outcome among singleton maternal
           delivery referral cases to the obstetrics unit of a tertiary health
           facility in Port Harcourt, Nigeria

    • Authors: Peter A. Awoyesuku, Dagogo A. Mac Pepple
      Pages: 4479 - 4484
      Abstract: Background: The high maternal and perinatal mortality rates in Nigeria continue to be issues of concern. That antenatal care improves both perinatal and maternal outcomes is now well established. The study seeks to identify the predictors of poor maternal and perinatal outcome among singleton maternal delivery cases referred to Rivers State University Teaching Hospital (RSUTH).Methods: A longitudinal study was employed; the patients referred to RSUTH were followed up to ascertain maternal and neonatal outcomes. A sample size of 460 was used. Selection of cases was done by systematic sampling. Data obtained in the study were demographic, obstetric and perinatal findings. Maternal and perinatal outcome were dichotomized into poor and good outcomes. Bivariate and multivariate analyses were performed using SPSS version 20.0.Results: A total of 460 cases were recruited. The mean age±SD was 28.7±4.6 years. There was poor maternal outcome in 65 (14.1%) and poor perinatal outcome in 291 (63.3%). There was one maternal death (rate 0.2%), perinatal mortality rate was 26.5%, low birth-weight rate was 6.3% and asphyxia rate was 23.3%. There is an association of multiparity and unbooked status with poor maternal outcome, while poor perinatal outcome was influenced by unbooked status.Conclusions: Perinatal and maternal mortality were high amongst all referral cases. There is a positive correlation of multiparity with poor maternal outcome and between unbooked status and an increased risk of both maternal and perinatal adverse outcomes.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194879
      Issue No: Vol. 8, No. 11 (2019)
       
  • Impact of severe anemia during pregnancy on maternal outcome

    • Authors: Smruthi C. Raj, Kruthika M. L., Vidhyasree S.
      Pages: 4485 - 4489
      Abstract: Background: Anemia is a global problem. Its prevalence in India is about 60%. Anemia directly or indirectly contributes to a significant proportion (40%) of maternal deaths in developing countries. The present study aimed to determine maternal outcome among pregnant women with severe anemia.Methods: This was a prospective study conducted in the department of obstetrics and gynecology, Mc Gann teaching district hospital, Shimoga, over a period six months i.e from January 2019 to June 2019. The study population included all pregnant women who were in their third trimester and with severe anemia (Hb%</=7g%) attending for routine care at our hospital. The interviews were conducted in regional language. The information collected was, social demographic characteristics, economic characteristics and reproductive health history. After the interviews, clinical examinations were conducted and clinical samples such as blood, urine and stool were collected to perform investigations.Results: A total of 94 study participants were included in the study. All study participants were belonged to the low socio-economic strata of the society. 68.1% of women in anemia group were from a rural background. Unbooked and referred cases constituted nearly 4/5th of all anemic subjects (84%). In study group, preponderance of illiteracy was reported and accounted for 60.64% followed by primary and secondary education 23.04% and 14.90% respectively. Common maternal complications noted in the severely anemic group was PPH (14.9%), post-partum febrile morbidity (5.3%), CCF (3.2%) and sepsis (4.2%) while in the control group only one woman had post-partum febrile morbidity.Conclusions: In our study, common maternal complications noted in the severely anemic group were post-partum hemorrhage, postpartum febrile morbidity, congestive cardiac failure and puerperal sepsis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194880
      Issue No: Vol. 8, No. 11 (2019)
       
  • Relationship of body mass index with bone mineral density in
           postmenopausal women: an Indian perspective

    • Authors: Avani Goyal, Veena Ganju Malla
      Pages: 4490 - 4495
      Abstract: Background: Osteoporosis is a common health problem that affects postmenopausal females, leading to increased susceptibility to fractures. Body mass index (BMI) has been shown to be an important predictor of bone mineral density (BMD) with increased body weight correlating with positive influence on bone metabolism. Low BMI predisposes postmenopausal females to rapid bone loss and low bone mass, crucial in the pathogenesis of osteoporosis. However, a specific BMI value chart to accurately predict osteoporosis remains to be fully established. The present study aimed to investigate the relationship of BMI and BMD in postmenopausal Indian females.Methods: 90 healthy postmenopausal females with 1-5 years of menopause were enrolled in the study. Subjects were categorized according to their BMI into normal, overweight and obese. BMD was assessed using dual energy X-ray absorptiometry (DEXA) scan at L1-L4 vertebrae and femoral neck and expressed as T-scores. Quantitative variables were compared using ANOVA/Kruskal Wallis Test.Results: Bone mineral density was significantly higher in the obese group as compared to normal BMI group at both lumbar spine (p=0.001) and femoral neck (p=0.001). BMD at lumbar spine was lower than that at femoral neck across all the three groups of BMI.Conclusions: BMI and body weight are important factors affecting BMD. Postmenopausal females with low BMI are more likely to have osteopenia and osteoporosis and are thus at an increased risk of pathological fractures. Routine BMD monitoring in postmenopausal females with low BMI may be necessary to initiate early clinical interventions for osteoporosis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194881
      Issue No: Vol. 8, No. 11 (2019)
       
  • Evaluation of endometrial thickness with transvaginal ultrasonography in
           perimenopausal women presenting with abnormal uterine bleeding and
           correlation with its histopathological findings

    • Authors: Noor Ayesha Begum, Lokesh Chandra H. C., Ravindra S. Pukale
      Pages: 4496 - 4502
      Abstract: Background: Abnormal uterine bleeding is the most common presenting menstrual complaint in women of perimenopausal age group. Most frequently used diagnostics tests to investigate the causes of abnormal bleeding are Transvaginal ultrasonography (TVS) and endometrial biopsy. Uterine curettage is an invasive procedure and is performed with anaesthesia. TVS is a non-invasive method that has been used to evaluate the endometrium and uterine cavity. The objectives of this study were to measure and evaluate the role and accuracy of endometrial thickness by transvaginal ultrasonography study to detect endometrial pathology in perimenopausal women presenting with Abnormal Uterine Bleeding. To correlate the transvaginal sonographic results with the Histopathological findings to discriminate normal from pathological endometrium.Methods: Prospective study including 150 perimenopausal women with abnormal uterine bleeding. Endometrial thickness was measured by TVS and then D and C was performed for all the patients.Results: Out of 150 women, 128 (85.3%) had normal and 22 (15%) had an abnormal endometrium. 43.3% were of 41-45 years and 65.3% patients presented with complaint of heavy menstrual bleeding. Majority of the patients in the study group were para 2 or more. Fibroid uterus (24%) was the commonest uterine pathology detected on TVS. 53.3% of patients had endometrial thickness in the range 10-14.9 mm. Most common finding on HPE was secretory endometrium (44.6%). Endometrial carcinoma was found in 3%. Endometrial thickness <14mm was associated with least abnormal endometrial pathology.Conclusions: Endometrial thickness of less than 14 mm need not be indicated for D and C in perimenopausal abnormal uterine bleeding. In perimenopausal women with AUB, TVS should be the investigation of choice due to its convenience, accuracy and non- invasiveness.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194882
      Issue No: Vol. 8, No. 11 (2019)
       
  • A clinical study of preterm labour

    • Authors: Prachi Patil, Richa Singh, Sriram Gopal
      Pages: 4503 - 4510
      Abstract: Background: There has been a rising incidence of preterm labour in India. Preterm labour poses greater risks of morbidity and mortality of the preterm neonates. Various factors contribute towards risk of preterm labour and its outcome. Addressing these factors appropriately improves the outcome in pregnant women.Methods: This prospective observational study was conducted in department of obstetrics and gynaecology from the period of July 2017 to July 2018.Results: The present study was in 98 patients admitted in our hospital with preterm labour. Clinical profile of those patients was studied. Statistically significant association was found between administration of antibiotics and tocolysis in prolongation of pregnancy (p value=0.00). There was an association found between gestational age at birth and immediate neonatal outcome (p value=0.00). Preterm labour was more common in multigravidae (62.4%) and women with cervical length less than 3 cm (85.17%).Conclusions: Preterm labour can be expected more commonly in multigravidae, pregnant women with cervical length less than 3 cm and in presence of high-risk factors. Anticipation of preterm labour, judicious use of antibiotics, tocolytics can improve the outcome of preterm labour.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194883
      Issue No: Vol. 8, No. 11 (2019)
       
  • Long term follow-up study for abdominal sacrocolpopexy/sacrohysteropexy

    • Authors: Sapna Puri, Rohini Jaggi, Isha Sunil
      Pages: 4511 - 4514
      Abstract: Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194884
      Issue No: Vol. 8, No. 11 (2019)
       
  • Prevalence of bacterial vaginosis among reproductive age group women in a
           tertiary care centre

    • Authors: Rema V. Nair, Raja Preethi, M. Vijayalekshmi
      Pages: 4515 - 4517
      Abstract: Background: Vaginal discharge in reproductive age poses a serious problem in the developing countries. Bacterial vaginosis also known as non-specific vaginitis is the most common cause of vaginal infections, detecting the organism at an early stage and initiating a proper treatment is very difficult in our country due to lack of awareness and proper follow-up. The disease manifests in the form of vaginal discharge with or without itching. It has a strong association with preterm labor, preterm premature rupture of membranes and low birth weight in pregnancy. The objective of this study was to find out the prevalence of bacterial vaginosis among the reproductive age group women, in a tertiary care centre.Methods: A cross sectional study was conducted among 150 women of the reproductive age group in the department of obstetrics and gynaecology Sree Mookambika Institute of Medical Sciences over a period of one month October 2018 the diagnosis was made with history and nugents scoring system.Results: Out of the total 150 women enrolled in the study 74 had positive results, 50% of them were of the age group 26-30.Conclusions: The study shows us the high prevalence of bacterial vaginosis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194885
      Issue No: Vol. 8, No. 11 (2019)
       
  • Assessment of risk factors for surgical site infection following caesarean
           section

    • Authors: Aditi Sangwan, Vani Malhotra
      Pages: 4518 - 4524
      Abstract: Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus.      Mean duration of resuturing was 17.42±6.98 days.  Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194886
      Issue No: Vol. 8, No. 11 (2019)
       
  • The study of role of HbA1c as a predictor of gestational diabetes mellitus

    • Authors: Nikita Shrivastava, Kanchan Durugkar, Pallavi Viswanadh, Himadri Bal
      Pages: 4525 - 4530
      Abstract: Background: India is the diabetic capital of the world and gestational diabetes mellitus contributes to a significant number of cases. Gestational diabetes mellitus is a common medical complication of pregnancy and may lead to serious consequences. Because of these reasons, it was felt that if there was a biomarker for predicting carbohydrate intolerance in pregnancy, it could help in earlier intervention and mitigate the consequences related to it. Hence, for this purpose, the role of HbA1c was studied as a predictor of gestational diabetes mellitus.Methods: This was a cross sectional study. Five hundred antenatal cases were considered for this study. All antenatal patients before 18 weeks of gestation attending antenatal clinic for the first time were selected and these patients were subjected to HbA1c followed by diabetes in pregnancy study group of India (DIPSI) test between 24-28 weeks and the results were analyzed to find any correlation between the two.Results: The main objective of the present study was to find whether HbA1c can be used as a predictor of gestational diabetes mellitus. In this study out of 500 women screened, 60 women turned out to have gestational diabetes mellitus. When comparing DIPSI positivity with various levels of HbA1c, it was found that maximum number of DIPSI positive patients (93.33%), had raised HbA1c levels.Conclusions: Maximum number of DIPSI positive cases had HbA1c level between 5.5 to 6 and this association was found to be statistically significant and a positive correlation was established between the two.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194887
      Issue No: Vol. 8, No. 11 (2019)
       
  • A root cause analysis of increasing caesarean section rates in a tertiary
           care private hospital in North India

    • Authors: Bela Makhija, Deepika Verma, Asif Mustafa
      Pages: 4531 - 4537
      Abstract: Background: Increase in the incidence of caesarean section is a matter of concern worldwide. Robson’s criteria which is universally accepted now as a way for calculating caesarean rates takes into account only the obstetrical consideration, however, it is noteworthy that many socioeconomic and cultural factors also have a role to play. This study takes into account both Robson’s criteria and common socio-cultural factors which lead to increased caesarean rates with an attempt to suggest ways to curtail this trend.Methods: The study was a hospital based cross-sectional study at a private tertiary care hospital in New Delhi. 1200 consecutive live births after 34 weeks of gestation were analysed over a period of one year.Results: LSCS was the most common mode of delivery 733 (61.1%). 329 (27.4%) had induced labour of which 260 (76.2%) had LSCS. 333 women had elective LSCS. Rates of CDMR were 185 (25.2%) which is very significant. As per Robson’s criteria maximum number of women (318) were in group 2, of which 226 (71.1%) underwent caesarean section.Conclusions: High caesarean rates can be attributed to a multitude of factors. Robson’s criteria are an effective way for analysis of obstetric indications. Other added factors include comorbidities, CDMR, fear of litigations, etc which were analysed.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194888
      Issue No: Vol. 8, No. 11 (2019)
       
  • Comparison of maternal and fetal morbidity between Patwardhan method of
           second stage lower segment caesarean section and conventional "push and
           pull" method

    • Authors: Kishorkumar Hol, Sneha Trivedi, Shruti Jaiswal, Sameer Popat Darawade
      Pages: 4538 - 4542
      Abstract: Background: To compare Maternal and fetal morbidity between Patwardhan method of second stage LSCS and conventional "push and pull" method.Methods: A retrospective study of all LSCS performed in second stage of labour consisted of all cases delivered by Patwardhan method compared with cases delivered by Push method during 3 years from January 2016 to December 2018 in Smt. Kashibai Navale Medical College Pune, Maharashtra, India.Results: A total of 89 patients underwent second stage LSCS from January 2016 to December 2018. A total of 37 patients were delivered by Patwardhan’s method and 52 patients were delivered by Push method. Uterine incision extension was more in the push and pull method when compared to Patwardhan technique. Same was true for the traumatic PPH blood transfusion which was significantly high in push and pull method as compared. Neonatal morbidity was significantly less in Patwardhan’s method as compared to Push method.Conclusions: As the maternal and fetal complications are seen to be considerably less in Patwardhan’s method than the conventional Push method our study concludes that Patwardhan’s method for delivering baby in second stage LSCS confers greater advantage.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194889
      Issue No: Vol. 8, No. 11 (2019)
       
  • Effect of single low dose intrathecal labor analgesia on maternal and
           fetal outcome

    • Authors: Poonam Samyal, Rama Thakur, Rohini Rao, Gian Chauhan, Sharad Kaushik, Anu B. Chandel
      Pages: 4543 - 4548
      Abstract: Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194890
      Issue No: Vol. 8, No. 11 (2019)
       
  • Comparative evaluation of different cost effective ovulation induction
           drugs and their effect on follicular growth, endometrial thickness and
           pregnancy outcome

    • Authors: Madhumithaa Narayanan, Uruj Jahaan, Neena Gupta
      Pages: 4549 - 4552
      Abstract: Background: Ovulatory dysfunction is a common cause of female infertility, occurring in up to 20 - 30% of infertile women. The most commonly prescribed ovulation drugs are clomiphene citrate (CC), tamoxifen, aromatase inhibitors (such as letrozole) and gonadotropins. Objective of the study was to evaluate the efficacy of clomiphene citrate, letrozole and tamoxifen for ovulation induction in anovulatory infertility.Methods: Randomized open label interventional clinical trial. Patients were randomized to 3 drug groups. After baseline investigations, they were subjected to ovulation induction and then USG monitoring of follicular growth and ovulation. The primary outcome measured was occurrence of conception. Secondary outcome was effect on endometrial thickness and ovulation rate.Results: In the study, letrozole group showed 100% mono-follicular response. Mid cycle endometrial thickness in about 17% of cases in CC group is ≤8 mm. But all the cases in tamoxifen and letrozole group have ET >8 mm. This difference is statistically significant. The ovulation and conception rates are highest in letrozole group but the difference was not statistically significant.Conclusions: Letrozole produces higher mid cycle endometrial thickness, 100% mono follicular development than clomiphene and tamoxifen. This difference is found to be statistically significant. Ovulation rate and conception rate is highest in letrozole group. But there is no statistically significant difference among the three drugs.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194891
      Issue No: Vol. 8, No. 11 (2019)
       
  • A comparative study of efficacy and safety of intramuscular carboprost and
           intravaginal misoprostol for cervical priming prior to first trimester
           surgical abortion

    • Authors: Gayatri Mathuriya, Neha Verma, Shivangi Pandey
      Pages: 4553 - 4557
      Abstract: Background: MTP Act no 34 of 1971 has been defined as Legal termination of pregnancy before the age of viability of fetus that is 20 weeks of gestation. There is a need to find a medical agent which can help in the process of abortion by speeding it up, with minimal side effects. The objective of this study was to compare the efficacy of I.M carboprost and intravaginal Misoprostol and to evaluate the safety profile of I.M carboprost and Intravaginal Misoprostol. To compare the cervical dilatation caused by I.M carboprost and intravaginal Misoprostol and to compare the blood loss and adverse effects of I.M carboprost and Intravaginal Misoprostol.Methods: Prospective randomized experimental study including pregnant women up to 12 weeks of gestation opting for M.T.P. Study conducted on 200 patients selected from patients admitted in MGM Medical College and M.Y. Hospital, Indore and Kalyanmal Hospital, Indore during the period July 2014 to March 2015. They were randomly divided into 2 groups. Group A who received intramuscular injection of 250 mcg of caboprost or Group B,which received 400 mcg of vaginal Misoprostol 4 hours prior to suction evacuation.Results: Intravaginal misoprostol achieves better cervical dilatation compared I.M carboprost which is statistically significant. Misoprostol is associated with higher blood loss as compared to I.M carboprost which is associated with nausea/vomiting & more likelihood of loose stools and abdominal cramps which is proved statistically.Conclusions: Intravaginal misoprostol is associated with higher blood loss as compared to I.M carboprost which is significant but intravaginal misoprostol achieves more cervical dilatation and causes less adverse events than I.M carboprost which is statistically more significant and therefore intravaginal misoprostol is the drug of choice for cervical priming prior to surgical abortion in terms of both efficacy and safety.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194892
      Issue No: Vol. 8, No. 11 (2019)
       
  • Clinical significance of HPV-HC2 in diagnosis and prognosis of cervical
           lesions: a retrospective study

    • Authors: Soule Hassanati, Qin Fang, Yuanyuan Fang, Yan Xing
      Pages: 4558 - 4563
      Abstract: Background: To evaluate the human papillomavirus HC2 different range detection values and their clinical significance in prediction of CIN lesions grades as well as their role in the follow-up outcome after treatment.Methods: Using the hybrid capture 2 to detect and measure the HPV and the viral load quantity, we enrolled a total of 527 HPV positive women. All patients underwent thin prep liquid-based cytology test (TCT) and only 325 underwent colposcopy guided biopsy due to abnormal cytology results. All cytology and biopsy results were collected and analyzed according to the HPV viral load. Among these patients 108 patients were followed during 2years post-operatives and their prognosis results were collected and analyzed.Results: The proportion and severity of cytological abnormalities was positively correlated with the HPV-HC2 viral load (P<0.05). There was a positive correlation between cervical biopsy results and the HPV viral load P <0.05). The more the HPV-HC2 viral load was, the higher CIN2-3 grade percentage was getting. However no statically significant correlation was found between the HPV-HC2 viral load and the follow up outcomes after treatment (P>0.05).Conclusions: High HPV-HC2 viral load is significantly associated with the severity of cervical lesions (CIN), however it does not predict any further prognosis on follow-up after treatment.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194893
      Issue No: Vol. 8, No. 11 (2019)
       
  • Autoamputation of the ovary: a rare consequence of torsion in a mature
           cystic teratoma

    • Authors: Nitin H. Shah, Aditi V. Joshi, Amit Pilankar, Shweta Pilankar
      Pages: 4564 - 4566
      Abstract: Autoamputation of the ovary may be a result of longstanding infarction resulting from torsion of the ovarian pedicle. This entity may be confused with an ectopic or supernumerary ovary.  A proper detailed history taking is important to provide clues for diagnosis. We report a case of a young female patient diagnosed with autoamputation of unilateral ovary on laparoscopy, with histopathology confirmation of ovary with dermoid cyst.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194894
      Issue No: Vol. 8, No. 11 (2019)
       
  • Recurrent hematometra with endometriosis in an adolescent girl: a case
           report

    • Authors: Sarita Agrawal, Rajshree Sahu, Pushpawati Thakur, Vinita Singh, Pawan B. Chandramohan
      Pages: 4567 - 4569
      Abstract: Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194895
      Issue No: Vol. 8, No. 11 (2019)
       
  • A rare case of isolated fallopian tube torsion

    • Authors: Namrita Sandhu, Sanjay Singh
      Pages: 4570 - 4572
      Abstract: Isolated torsion of fallopian tube is a rare occurrence. Diagnostic difficulty gets compounded in adolescents because the most commonly used imaging study in young, usually sexually inactive, population is transabdominal ultrasonography which may show normal ovaries, leading clinicians to abandon a diagnosis of adnexal torsion. Other imaging modalities such as CT scan or MRI are less useful for a rapid diagnosis because of the risk of radiation exposure, cost, or lack of ready availability. Delays in diagnosis may increase the likelihood of necrosis of the fallopian tube which would result in salpingectomy as was the case in our case report. Here authors present one such case, wherein one 12 year old girl who attained menarche at 10 years of age presented with acute paraumblical pain and vomiting without any fever, bowel and bladder disturbances. On examination there was tenderness in right iliac fossa. Her USG report was unremarkable. She initially was put-on broad-spectrum antibiotics but without any amelioration of symptoms. Diagnosed as appendicitis by surgeon, she was taken up for laparoscopic appendicectomy. However, it turned out to be a case of fallopian tube torsion, wherein the tube had become gangrenous for which salpingectomy was done.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194896
      Issue No: Vol. 8, No. 11 (2019)
       
  • A case report on broad ligament fibroid mistaken as pregnancy

    • Authors: Shirish Dulewad, Pooja Chandak
      Pages: 4573 - 4575
      Abstract: Leiomyoma is the commonest benign uterine condition arising from smooth muscles. Extra uterine leiomyoma is rare. The incidence of broad ligament fibroid is less than 1%. Because of its rarity broad ligament fibroid poses specific diagnostic difficulties causing an error in making the final diagnosis and therefore the management. Here we report a case of rare broad ligament fibroid got neglected sadly in this modern era, where the facilities like USG which can easily diagnose this rare entity are readily available. Presented as ANC with no labor pains and accidentally diagnosed as a case of huge broad ligament fibroid. Managed surgically by myomectomy with conservation of uterus and bilateral internal iliac artery ligation for minimizing bleeding.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194897
      Issue No: Vol. 8, No. 11 (2019)
       
  • Atypical proliferative Brenner tumour of the ovary with liver metastases:
           a case report

    • Authors: Saaliha Vali, Mohamed Oumar, Shefali Chavhan, Olga Wise, Ahmed Sayasneh
      Pages: 4576 - 4580
      Abstract: Brenners tumours constitute up to 2% of ovarian neoplasms. Most are benign with a gross fibroma like appearance. Here we present the case of a 45 year old woman who underwent a full staging laparotomy for a suspicious left ovarian mass. A 30 cm left ovarian cyst was found with no enlarged lymph nodes. Histologically this was a proliferative Brenner tumour. Postoperatively, a mild increase in the Ca125 prompted an MRI scan which revealed a 3 cm liver cyst. This was resected and histologically found to be a transitional cell carcinoma. Successful treatment with secondary excision and adjuvant chemotherapy has ensured disease free remission to date.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194898
      Issue No: Vol. 8, No. 11 (2019)
       
  • Successful vaginal delivery of spontaneously conceived twins in each horn
           of a bicornuate uterus with previous caesarean: a case report

    • Authors: Farhat Mazhari, Arpita De, Reva Tripathi
      Pages: 4581 - 4584
      Abstract: Mullerian duct fusion anomalies resulting in uterine malformations have prevalence of 3-4%. Among this, bicornuate uterus has a rare incidence of 0.4%. Uterine malformations pose significant threat in terms of obstetric outcomes. We report an extremely rare case of spontaneous conception of twin pregnancy with the fetus occupying each horn of a bicornuate uterus (bicornis unicollis), in a woman with a history of previous caesarean section. She was booked at our hospital and the pregnancy remained uneventful. At 35 weeks she went into spontaneous labour and delivered vaginally without any maternal-fetal complications. The case is unique and the management is worth discussing as till date no protocols or guidelines have been proposed for the mode of delivery of bicornuate uterus with twins with previous cesarean.  Only 12 cases of twins with bicornuate uterus have been reported till date. This is the first case in literature in which a successful VBAC has been conducted in a woman with bicornuate uterus with twins with previous caesarean.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194899
      Issue No: Vol. 8, No. 11 (2019)
       
  • A rare case of endometriosis to clear cell ovarian carcinoma: a case
           report

    • Authors: Anaswara T., Prasanna Venugopalan, Vidhu V. Nair, Alfy Ann George, I. Praseeda
      Pages: 4585 - 4589
      Abstract: Clear cell carcinoma of ovary is a rare tumour with a very low incidence in pregnancy. It is attributed to develop from an existing background of endometriosis. There are very few case reports of the above combination tumours in pregnancy. It is a very aggressive tumour with a worse prognosis and low survival rate because of its peculiar chemo resistant nature. Early detection and effective treatment are the best approach. The treatment options for advanced stages are still under research.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194900
      Issue No: Vol. 8, No. 11 (2019)
       
  • Successful management of a patient with sudden loss of vision and
           eclampsia complicated by posterior reversible encephalopathy syndrome

    • Authors: Babita Vaswani, Sriram Gopal, Meena Satia
      Pages: 4590 - 4592
      Abstract: Reversible visual disturbances in patients with eclampsia may be due to either retinal detachment or retinal arteriolar vasospasm or thrombosis of the central retinal arteries or PRES (posterior reversible encephalopathy syndrome). Although retinal arteriolar vasospasm is the most common mechanism of visual disturbance, cortical blindness may occur in 1% to 15% of patients with eclampsia. Reporting herewith a case of reversible cortical blindness in the setting of severe preeclampsia complicated with eclampsia.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194901
      Issue No: Vol. 8, No. 11 (2019)
       
  • Chronic uterine inversion associated with uterine leiomyoma misdiagnosed
           as cervical fibroid: a case report

    • Authors: Swati Kochar, Ankur Nama, Santosh Khajotia, Neha Suthar
      Pages: 4593 - 4595
      Abstract: Chronic inversion of uterus is a rare clinical entity which is usually associated with obstetrics complication and rarely with gynaecological disorder like fibroid present at fundus of uterus. We here present a case of 40-year-old female P3L3 with chronic inversion of uterus with fundal fibroid which present with 3year history of abnormal vaginal bleeding. Ultrasonography and MRI revealed cervical fibroid. Due to AUB secondary to cervical fibroid decision of hysterectomy was taken. On laparotomy chronic uterine inversion was present which was corrected by haultain’s procedure. Then hysterectomy was done. Histopathology report suggestive of uterine leiomyoma at fundus of uterus. Chronic uterine inversion associated most commonly with fundal submucous leiomyoma. Other causes are leiomyosarcoma, endometrial carcinoma, cervical carcinoma, rhabdomyosarcoma, mixed mullerian sarcoma. It is an extremely rare gynaecological condition and can be misdiagnosed as cervical fibroid, advanced cervical malignancy or other causes of AUB in females. It could be labelled as gynaecological near miss so a high index of suspicion is necessary for it’s diagnosis.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194902
      Issue No: Vol. 8, No. 11 (2019)
       
  • Endometrial osseous metaplasia in a case of abnormal uterine bleeding

    • Authors: Himleena Gautam, Alaka Goswami, Papari Goswami, Kamal Kumar Kathar
      Pages: 4596 - 4598
      Abstract: Endometrial osseous metaplasia is an uncommon pathology with varied clinical symptoms. Its pathogenesis is not exactly known and has a benign course. Here we present a case of a 42-year-old female with abnormal uterine bleeding who did not respond to medical management. On ultrasonography, suspected endometrial calcification was seen. Patient opted for hysterectomy and the biopsy report showed endometrial osseous metaplasia. Thus, in this case of menometrorrhagia and dysmenorrhoea, the cause was found to be osseous metaplasia.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194903
      Issue No: Vol. 8, No. 11 (2019)
       
  • Misplaced intra uterine devices: a rare case of vaginal entrapment

    • Authors: Anshul Grover, Sumita Mehta, Ankita Mann
      Pages: 4599 - 4601
      Abstract: Intra uterine devices (IUD) are the second most common accepted methods of contraception worldwide after sterilization. It is a long acting reversible contraceptive (LARC) which is now being promoted as a simpler, safer and effective method of contraception for those women who do not want a permanent method of contraception. Missing thread is the most common complaint seen within 6 weeks of insertion and may be the only presentation of misplaced IUD. Most women who spontaneously expel the IUD are unaware of the situation. We are presenting a case of misplaced IUD which was partially expelled and got embedded in the vagina which is a rare site of misplaced IUD.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194904
      Issue No: Vol. 8, No. 11 (2019)
       
  • Caesarean scar pregnancy: a case report with review of management options

    • Authors: Vandana Rani, Shaveta Jain, Vani Malhotra, Meenakshi B. Chauhan, Sarika Gautam, Smiti Nanda, Neetu Sangwan
      Pages: 4602 - 4605
      Abstract: Cesarean scar pregnancy is a rare but life-threatening complication. It is the abnormal implantation of gestational sac into myometrium and fibrous scar of previous cesarean section. Its incidence is on rising trend due to increase in rate of cesarean section all over the world. A thirty years old second gravida presented at eight weeks of gestation with complaints of bleeding per vaginum and pain lower abdomen. She was diagnosed as a case of cesarean scar pregnancy (CSP) on ultrasonography and confirmation of diagnosis was done on magnetic resonance imaging. Medical management of scar pregnancy was done successfully with combination of mifepristone and methotrexate. Cesarean scar pregnancy could be catastrophic, if not managed well in time. Management includes both surgical and medical options. Treatment has to be individualized depending on patient’s hemodynamic profile, size of gestational sac, desire for future fertility, compliance for follow up and availability of interventional radiology.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194905
      Issue No: Vol. 8, No. 11 (2019)
       
  • Conservative management of ovarian torsion in pregnancy

    • Authors: Rama Garg, Sangeeta Rani, Sambli Garg
      Pages: 4606 - 4608
      Abstract: Adnexal torsion or other cyst accidents encountered during pregnancy carries a risk to intrauterine foetus. Delays or misdiagnosis can result in the loss of the affected ovary and subsequent reduced reproductive capacity. In this report, a 23-year-old second gravida with viable 9 weeks pregnancy with acute pain abdomen; presented in OPD and sent to labor room. Emergency laprotomy was done with provisional diagnosis of left adnexal torsion. We did detorsion and cystectomy followed by ovarian reconstruction. Repeat scan shows continuing intrauterine pregnancy. So, timely diagnosis and intervention reduces risk to ovary; along with some risk of the antepartum surgical intervention. Also, in place of oophorectomy; de-torsion is more conservative surgical approach that should be considered in all young women with ovarian torsion.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194906
      Issue No: Vol. 8, No. 11 (2019)
       
  • Sirenomelia, the mermaid baby: a case report

    • Authors: Reetika Joshi, Veino Kuveio Duomai, Bianchi Sangma
      Pages: 4609 - 4611
      Abstract: Sirenomelia sequence or mermaid syndrome is a rare congenital structural anomaly characterized by different degrees of fusion of lower limbs, thoracolumbar spinal anomalies, sacrococcygeal agenesis, genitourinary and anorectal atresia. The incidence of sirenomelia is 0.8-1 cases/ 105 births with male to female ratio being 3:1. A malformations patient with 40 weeks of gestation admitted with complaints of decreased fetal movements for one week. An emergency C-section was done in view of term pregnancy with severe oligohydramnios and intrauterine growth restriction with poor bishop’s score. A 1.9 kg live baby with fused lower limbs was delivered. The new born baby had narrow chest, fused both lower limbs and feet with 11 toes, small rudimentary external genitalia, imperforate anus and single umbilical artery. The baby also had features of potter’s facies including low set large ears, receding chin and prominent infraorbital folds. Sirenomelia is a rare fatal congenital anomaly. Early detection by prenatal ultrasound will help in timely termination of pregnancy.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194907
      Issue No: Vol. 8, No. 11 (2019)
       
  • Case series of pubic bone diastasis causing severe pelvic girdle pain in
           pregnancy

    • Authors: Pooja Gupta, Renuka Malik
      Pages: 4612 - 4616
      Abstract: Pelvic girdle pain (PGP) is a pregnancy discomfort that causes pain and limitation of mobility and functioning in any of the three pelvic joints. The patient usually presents antenatally with persistent suprapubic pain which is exaggerated during moving, walking or climbing stairs. Intrapartum, this could be associated with disruption of sacroiliac joint, hematuria and bladder dysfunction in severe cases. Pelvic X-rays, ultrasound, and magnetic resonance imaging aid in confirmation of diagnosis by measuring the degree of separation of symphysis. Treatment modalities range from conservative management to orthopedic interventions in form of pelvic strapping, open reduction and internal fixation. Postpartum pain often masks clinicians to make the diagnosis of pubic symphysis diastasis. A case series of three cases which were diagnosed and confirmed with ultrasound and managed with orthopedic consultation. till their delivery and in post-partum period till recovery. Although there is still no specific consensus on treatment guideline, management generally of conservative management to surgical in the form of pelvic bracing or strapping. Awareness of this rare condition can help in management of pain and associated disability which improves post-delivery.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194908
      Issue No: Vol. 8, No. 11 (2019)
       
  • Budd Chiari syndrome due to inferior vena cava web complicating pregnancy
           in patient with bad obstetric history: an interesting case

    • Authors: Richa Subhash Udhwani, Michelle Nalini Fonseca, Deepali Swapnil Kapote
      Pages: 4617 - 4621
      Abstract: Presenting an unusual case of 27 years old female who presented at 18 weeks of pregnancy with second trimester bleeding per vaginum. Patient had history of recurrent abortions on examination was found to have hypertension and thrombocytopenia. Usg done revealed severe oligohydramnios. Patient was managed conservatively but aborted spontaneously at 22 weeks of gestation. Post-abortionl on day 2 patient developed abdominal distension and liver function tests were found to be deranged. USG and CT abdomen and pelvis was done, which revealed Budd chiari syndrome due to inferior vena cava (IVC) web. This extremely rare condition is characterized by obstruction of inferior vena cava by membrane or fibrous band. This condition is diagnosed by radiological techniques which in our patient revealed classical findings of caudate lobe hypertrophy, non-visualization of hepatic veins, moderate hepatomegaly and spleenomegaly and multiple collaterals. Esophagogastroduodenoscopy done which revealed large varieces for which endoscopic variceal ligation was done. IVCgram and IVC plasty was done by interventional radiology department 6 weeks after abortion. The aim of this case report is to highlight an extremely rare cause of Budd Chiari syndrome and IVC web in patient with recurrent abortion with spleenomegly leading to thrombocytopenia. It is important to rule out other differential diagnosis in these patients like APLA, ITP.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194909
      Issue No: Vol. 8, No. 11 (2019)
       
  • A rare case of steroid cell tumor of ovary: case report

    • Authors: Sharanya ., Monalisa Peter
      Pages: 4622 - 4625
      Abstract: Steroid cell tumors of the ovary account for less than 0.1% of all ovarian tumors. These tumors may present at any age with presentations related to the hormonal activity and virilizing properties of tumor. A 61-year-old postmenopausal women presented with complaints of postmenopausal bleeding for 15 days. Parity score of P3L3, not tubectomised. Menopaused 16 years back. History of weight loss noted. She is a known case of diabetes mellitus for 6 years not on any treatment and a known case of depressive disorder for 35 years on treatment on trihexphenidyl lurasidone. Had undergone sigmoid colon polyp removal in June 2018. On examination, P/A- mild gaseous distension (+). P/S- cervix flushed with vagina, pulled up cervix. P/V- uterus size and position couldn’t be made out, anterior fornix fullness (+). Ultrasonography showed bulky uterus with fibroid 4x4cm, endometrial thickness- 9 mm' Krukenberg tumor and posterior mediastinal lymph nodes. Patient underwent Total abdominal hysterectomy with bilateral salpingo-oophorectomy with frozen section on 01/07/19. Frozen section: 1. Ovaries: right ovary - fibrothecoma, left ovary- simple cyst. 2. Uterus- endometrial hyperplasia with atypia. 3. Myometrium- leiomyoma and adenomyosis. Postoperative period was uneventful. On microscopic examination, impression: right ovary- steroid cell tumor, uterus-endometrial hyperplasia with cytological atypia. Ovarian steroid cell tumors are grouped under sex chord stromal tumors and are usually benign, unilateral and characterized by a steroid cell proliferation. Steroid cell tumors are associated with androgenic changes with variable frequency, ranging from 12% to over 50% respectively. The primary treatment is surgical extirpation of the primary lesion and there are no reports of effective radiation or chemotherapy. In a young patient with stage IA disease, a unilateral salpingo oophorectomy is adequate.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194910
      Issue No: Vol. 8, No. 11 (2019)
       
  • A rare case report: successful outcome of a patient at near term pregnancy
           with maternal chronic obstructive hydrocephalus due to tubercular
           meningitis

    • Authors: Sowmya Mahesh, Himshweta Srivastava
      Pages: 4626 - 4629
      Abstract: The incidence of tubercular meningitis leading to obstructive hydrocephalus is extremely rare accounting for 1% cases and is even rarer during pregnancy. A 20-year-old 2nd Gravida presented at 32 weeks gestation with complaints of intermittent headache, decreased vision since 3 months and irrelevant talks and agitated behavior since 1 day. On examination patient had stable vital signs but constant irritable behavior. Obstetric examination revealed a pregnancy corresponding to 32 weeks with a live fetus. Patient had a past history of Anti-tubercular therapy taken 2 years back for tubercular meningitis. Neurological examination revealed a GCS of 12/15 and Ophthalmologic examination revealed patient to be having only Perception of Light with optic atrophy on fundoscopy. NCCT head revealed moderate dilatation of bilateral ventricles and 3rd ventricle without any periventricular ooze suggestive of Chronic Obstructive Hydrocephalus. Supportive therapy was instituted with Dexamethasone and Mannitol infusion after Neurosurgical consultation along with antenatal care. Decision for termination of pregnancy was taken at 35 weeks by an elective caesarean section with simultaneous ventriculo-peritoneal shunt insertion by neurosurgical team under general anesthesia. A live male baby of 2.25 kg was delivered. Patient with baby was discharged on 10th post-operative day. Obstructive hydrocephalous developing post tubercular meningitis in pregnancy is a rare event. Caesarean section was done along with shunt surgery in our case. Very few cases have been reported in the medical literature so far.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194911
      Issue No: Vol. 8, No. 11 (2019)
       
  • Gossypiboma: a surgical menace

    • Authors: Nitin H. Shah, Aditi V. Joshi, Vaishali N. Shah
      Pages: 4630 - 4632
      Abstract: Gossypiboma is a rare yet devastating complication. It may be a sequela to any kind of surgical procedure, however intra-abdominal surgeries are commonly implicated as the cause for this entity. In chronic cases, it may even lead to severe morbidity. We report a case of gossypiboma post vaginal hysterectomy, diagnosed and treated successfully by laparoscopy.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194912
      Issue No: Vol. 8, No. 11 (2019)
       
  • A rare case of conjoined twins presenting as dicephalus parapagus: a case
           report

    • Authors: Lakshmi Subburaj, Rajkumar K.
      Pages: 4633 - 4635
      Abstract: Conjoined twinning is a congenital abnormality resulting in various presentations of the fetuses in utero. It is a rare embryological developmental disorder occurring in one in 100,000 births. We present a case of conjoined twinning, which is characterized by the presence of two heads, single vertebral column and single symphysis pubis, with single genitor-urinary tract and single gastro intestinal tract. The present condition, referred to as dicephalus parapagus, is a rare entity among the conjoined twinning and has seldom positive outcomes. The mechanism of occurrence of conjoined twinning has been proposed either through fusion or fission of the embryos. In either case, surgical separation of the conjoined twins is often unsuccessful and results in increased morbidity and mortality. However, it is essential to screen for the presence of such congenital anomalies early during pregnancy, in order to terminate and provide parental counselling.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194913
      Issue No: Vol. 8, No. 11 (2019)
       
  • Mifepristone as pre-induction cervical ripening agent: a review article

    • Authors: Nikita ., Seetesh Ghose, Setu Rathod
      Pages: 4636 - 4640
      Abstract: Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194914
      Issue No: Vol. 8, No. 11 (2019)
       
  • Tocophobia: overwhelming fear of pregnancy and childbirth

    • Authors: Jissa Donel
      Pages: 4641 - 4645
      Abstract: Pregnancy and childbirth are a major life process for women. Childbirth is an outstanding life event for every woman. It is considered as normal to experience concern or anxiety to a certain degree, as it can help women to make ready for childbirth. But, if the fear becomes paralyzing and terrifying, it can turn out to be physically and emotionally disabling and give rise to a specific pathology termed as tocophobia. The aim of the present article is to analyze the tocophobic condition and to give a brief overview of the possible approaches currently available to mitigate the tocophobic condition.  
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194915
      Issue No: Vol. 8, No. 11 (2019)
       
  • Navigating through the maze of caesarean myomectomy: generating evidence

    • Authors: Fouzia Zahid A. Khan, Imose Itua
      Pages: 4646 - 4653
      Abstract: Management of myomas during pregnancy and labor is a contested subject so far. Currently no recommended national or international guidelines are in place resulting in conflicted opinion and management variation across the globe. Many obstetricians still discourage its practice due to fear of uncontrolled haemorrhage which may lead to unwanted hysterectomy in a reproductive age. However, some researchers have challenged the conventional perspective and argue that caesarean myomectomy (CM) is a safe procedure. The aim of this study is to examine all aspects of CM with an evaluative lens and to weigh its risk-benefit ratio.  For this purpose, we conducted a literature review of studies, including those from low-resource countries indexed in scientific databases like PubMed, Google Scholar and Scopus. Most recent articles that reported benefits, complications and different techniques to safely perform caesarean myomectomy with proven benefit for the patient were examined thoroughly so that solid evidence on pros and cons of caesarean myomectomy could be generated. There is a dire need to conduct large sample size studies or randomized controlled trials for the risk-benefit evaluation of CM and to produce evidence-based clinical conclusion.
      PubDate: 2019-10-23
      DOI: 10.18203/2320-1770.ijrcog20194916
      Issue No: Vol. 8, No. 11 (2019)
       
 
 
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