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

Showing 1 - 12 of 12 Journals sorted alphabetically
Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 3)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 11)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 2)
Intl. Surgery J.     Open Access   (Followers: 1)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 11  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Effect of tranexamic acid in prevention of postpartum hemorrhage in
           elective caesarean delivery: a randomized controlled study

    • Authors: Abd El-Naser Abd El-Gaber, Hazem H. Ahmed, Mustafa M. Khodry, Ahmed M. Abbas
      Pages: 1 - 5
      Abstract: Background: Postpartum hemorrhage is the ugly ghost that most obstetricians believe because many cases unpredicted and may be associated with rapid patient deterioration that may lead mortality or developing serious long-term morbidities. The objective of this study is to assess the efficacy of slowly intravenous administration of tranexamic acid in prevention and decline the severity of postpartum hemorrhage immediately prior to elective caesarean section.Methods: A double blinded, randomized, case control trial carried out at Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt from May 2017 to April 2018. This study was conducted on 500 full term pregnant women underwent elective caesarean section. The patients were divided randomly into: Group A (study group) included 250 patients received tranexamic acid 1gm slowly iv over 2 minutes at least 10 minutes before operation started and Group B (control group) included 250 patients that received placebo (normal saline NaCl 0.9%).Results: Incidence of PPH in group A and group B were (4.4% and 6.8) respectively, 1.2% in group A and 2.8% in group B had severe degree of PPH. Amount of blood loss immediately after placental delivery up to first 6 hours postoperative was statistically significant increase in placebo group than tranexamic acid group with p value <0.001.Conclusions: Tranexamic acid administration few minutes prior to elective cesarean section was effective in reducing the incidence and severity of PPH and decreased the use of additional uterotonic drugs and additional surgical interventions.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185401
      Issue No: Vol. 8, No. 1 (2018)
       
  • Maternal risk factors and perinatal outcomes in fetal growth restriction
           using obstetric Doppler in South Kerala, India

    • Authors: Heera Shenoy T., Sonia X. James, Sheela Shenoy T.
      Pages: 6 - 13
      Abstract: Background: Fetal Growth Restriction (FGR) is the single largest contributing factor to perinatal morbidity in non-anomalous foetuses. Synonymous with Intrauterine Growth Restriction (IUGR), it is defined as an estimated fetal weight less than the10th percentile. Obstetric Doppler has helped in early detection and timely intervention in babies with FGR with significant improvements in perinatal outcomes.  Hence, authors evaluated the maternal risk factors and diagnosis-delivery intervals and perinatal outcomes in FGR using Doppler.Methods: This research conducted in a tertiary care hospital in South Kerala included 82 pregnant women who gave birth to neonates with birth weight less than the 10th percentile over a period of1 year (Jan 1, 2017-Dec 31, 2017). Socio-demographic, maternal risk, Diagnosis- delivery interval in FGR and neonatal morbidities were studied.Results: Mean GA at diagnosis in weeks was 34.29 and 35.19 respectively for abnormal and normal Doppler respectively (p value-0.032). The mean birthweight in Doppler abnormal FGR was 272.34 g lesser than in Doppler normal group (p value-0.001). Growth restricted low birth weight neonates had Doppler   pattern abnormalities (p value-0.0009). FGR <3rd percentile and AFI <5 had abnormal Doppler (OR:6.7). Abnormal biophysical profile (OR:14) and Non-Reactive NST (OR:3.5) correlated with abnormal Doppler. Growth restricted with normal Doppler had shorter NICU stays than with abnormalities (p value-0.003). Term FGR went home early than early preterm. (p value-0.001).Conclusions: Abnormal Doppler velocimetry is significantly associated with earlier FGR detection, shorter decision- delivery interval, reduction in the mean birthweight and longer NICU stay. Hence, Umbilical artery Doppler and Cerebroplacental index is an integral part of in-utero fetal surveillance to identify impending fetal hypoxia, appropriate management, optimising the timing of delivery and improve perinatal health in FGR.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185062
      Issue No: Vol. 8, No. 1 (2018)
       
  • Elective caesarean section and neonatal outcome: an observational study
           from a tertiary hospital in Mysore, Karnataka, India

    • Authors: Mamatha Shivanagappa, Vinutha K. Veerabhadrappa, Deepthi Thandaveshwar, Madhumitha Mahesh
      Pages: 14 - 18
      Abstract: Background: Globally 18.6 percent of all births occur by Caesarean Section (CS) and the trend is increasing. In India CS rates have risen from 2.9% in 1992 to 17.2% in 2015. The optimal timing of CS is still being investigated. Data with regard to elective CS and neonatal outcome from India is sparse and this study aimed to obtain the same in the setting of a South Indian Hospital. The objective was to evaluate neonatal outcome and NICU admissions in elective CSMethods: This was a retrospective study conducted at a tertiary care referral hospital and data collected was of deliveries conducted from Jan 2017 to July 2018. All term singleton pregnancies (>37 gestational weeks) scheduled for elective CS were included in the study.Results: A total of 3174 Caesarean Sections were performed during the study period of which 1087 were elective CS and 2087 were done on an emergent basis. Of these elective CS, 425 (39%) were performed at early term (37+0 until 38+6) and 662 (61%) were performed at full term (>39 weeks). Analysis of adverse neonatal outcomes revealed that a significantly higher rate of NICU admission, low birth weight, respiratory complications in newborns delivered at early term than in those delivered at full term.Conclusions: In the present study newborns delivered at 37- 38 weeks of gestation had a higher rate of NICU admission, low birth weight and respiratory complications compared to newborns delivered after 39 weeks of gestation. Neonatal outcome was found to be better in those elective CS done after 39 weeks in comparison to those delivered at early term (< 39 weeks).
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185127
      Issue No: Vol. 8, No. 1 (2018)
       
  • Ferricarboxy maltose to treat iron deficiency anemia in pregnancy: is it a
           feasible option'

    • Authors: Reema Kumar Bhatt, P. S. Rao, Sanjay Sharma, Chetan Yadav
      Pages: 19 - 23
      Abstract: Background: Iron deficiency is a common cause of anaemia in pregnancy which influences the health of mother and developing fetus. Intravenous (IV) iron preparations are considered, when oral iron therapy is ineffective or intolerant. Ferric carboxymaltose is an IV preparation that can be given with ease of administration and better tolerated. The aim of this study was to assess the efficacy and safety of IV ferric carboxymaltose in pregnant mother with all grades of anemia in the second and third trimester.Methods: This is a prospective observational study where 44 pregnant women with iron deficiency anemia [IDA] received ferric carboxymaltose up to 15mg/kg in second and third trimester. The parameters that were taken into account, to assess the effectiveness of the treatment was repeat haemoglobin [Hb] measurements and the subjective sense of wellbeing in the patient. The safety of the drug was analysed by continuous fetal heart rate [FHR] monitoring during the infusion and observation of any adverse reactions.Results: Ferric carboxymaltose intravenous infusion significantly increased Hb levels above baseline values in all women. The Increase in Hb levels were observed at 3- and 6-weeks post infusion therapy. FHR monitoring did not show any drug related unfavourable effect on the fetus. Of the 44 women interviewed, 33 (75%) women reported sense of well-being, 7 (15.9%) women could not feel any difference after the infusion and 4 (9.1%) patients could not comment. No serious adverse effects were noticed but minor side effects occurred in 3 (6.8%) patients.Conclusions: This prospective study showed safety and efficacy of ferric carboxymaltose in pregnancy with IDA which is consistent with available observational data.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185063
      Issue No: Vol. 8, No. 1 (2018)
       
  • Integrating age old cultural reproductive health practices with modern
           medicine to bring down morbidity and mortality among Birhor tribes of
           Jharkhand, India

    • Authors: Tejinder Pal Kaur
      Pages: 24 - 30
      Abstract: Background: Among the primitive tribe of Jharkhand, Birhor’s are the smallest group, and have been tagged as 'critically endangered' with population ~5000 (Census 2011). Traditional health care practices, traditional medicines, rituals and supernatural methods of treatment are integral part of tribal community. The main objective of the study was to integrate the cultural health practices focusing on reproductive health with modern medicine so that it impacts maternal and infant mortality.Methods: A three- and half-year study was done in one of the outreach clinical area of Tata Steel Rural development society in Chotabanki village, East Singhbhum, Jharkand, India, among the Birhor tribes.  The study was based on primary quantitative data -Data collection was by interviewing the respondents using questionnaires. Numerous interactive sessions with community members were conducted to learn about their cultural practices related to maternal and infant health.Results: There was a definite change in behaviour in some of traditional health practices, related to maternal and child health. Acceptance of modern health services impacted the health indicators, resulting in increase in population growth by 7.6% with zero still birth, maternal and infant mortality.Conclusions: As medical professionals, extra effort should be taken to understand their cultures regarding health. By establishing a balance between their age-old cultural practices and modern medicine, we may get healthier and résistance free community & success in controlling morbidity and mortality.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185100
      Issue No: Vol. 8, No. 1 (2018)
       
  • Perinatal mortality of placenta previa: a 1-year retrospective study

    • Authors: Shibram Chattopadhyay, Siddhartha Majumder, Kajal Kumar Patra, A. H. Mostafa Kamal
      Pages: 31 - 34
      Abstract: Background: Antepartum haemorrhage is one of the important causes of perinatal mortality and morbidity in India. The increased risk of perinatal morbidity and mortality in placenta praevia is due to preterm birth, low birth weight, birth asphyxia and neonatal sepsis. This is a retrospective study done over a period of 5years to determine the incidence, demographic features, risk factors, obstetric management, maternal mortality and morbidity, and perinatal outcome in women presenting with placenta praevia.Methods: This was a retrospective study done at Nil Ratan Sircar Medical College and Hospital over a period of five years starting from January 2016 to December 2017. Antenatal women with more than 28 weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta praevia on routine ultrasound examination were included in this study and hospitalised.  Among them cases of placenta praevia were 21.Results: There were21 cases of placenta praevia registered amounting to 0.23% incidence. The various antenatal complications seen associated with placenta praevia were severe anaemia (14.28%), coexisting PIH (4.76%), IUD (4.76%), IUGR/Oligohydraminos (4.76%). All the patients in the study had undergone caesarean deliveries. Perinatal morbidity studied as percentage of new-borns requiring resuscitation followed by NICU admission was 33.3%. Among the delivered patients of placenta praevia incidence of perinatal mortality was 23.8%. Prematurity (42.85%) contributed to most cases of perinatal mortality, followed by RDS (14.28%) and asphyxia (14.28%).Conclusions: In this study placenta praevia is seen more commonly in 28-34 weeks of gestation and patients mainly presented with a bout of bleeding eventually had preterm deliveries. Although vaginal deliveries are appropriate in selected cases of placenta paevia liberal use of caesarean section in well-equipped hospitals with availability of blood transfusion services have helped to lower complications.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185090
      Issue No: Vol. 8, No. 1 (2018)
       
  • Clinical study of factors affecting outcome of tubal recanalization using
           microsurgical techniques: a retrospective study

    • Authors: Rashmi A. G., Shikha Singh
      Pages: 35 - 38
      Abstract: Background: In India, many couples complete their families by the age of 25 to 30 years and opt for tubal sterilization as a method of family planning in spite of availability of other spacing methods. Due to unforeseen circumstances, 10 % of them regret their decision and about 1% want to restore their fertility due to various reasons like loss of only child, loss of male child, desire to have more children, loss of children in natural calamities, remarriage and other socioeconomic factors. The objective of the present study was to analyze various factors which are involved in pregnancy rate in tubal recanalization.Methods: 31 women undergoing microsurgical tubal recanalization by mini laparotomy in RRMCH, Bengaluru during a study period of 2 year from 2014 -2016 were followed up for a period of 2 years by telephonic conversation.Results: An overall 67.7 % pregnancy rate was achieved with microsurgery technique.Conclusions: The important factors determining the success of operation were age of the patient, method of previous ligation and the remaining length of tube after recanalization. The microsurgical technique should be available at specialized centres to improve the success of family planning services and also this could be the hope for hopeless.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185181
      Issue No: Vol. 8, No. 1 (2018)
       
  • A study on management of maternal anemia with infusion of intravenous iron
           sucrose and its outcome in management of anemia

    • Authors: Uma Maheswari R., R. Veerakumaran
      Pages: 39 - 43
      Abstract: Background: In India, women become pregnant with low baseline hemoglobin level resulting in high incidence of moderate to severe anemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anemia are to be treated with parenteral iron therapy. The aim of the study is to the infusion of intravenous iron sucrose and its outcome in the management of anemia.Methods: Totally 100 pregnant females were included in the study. The study period was from January 2018-July 2018 at vanavil medical center in Chennai. 50 Patients of Group A was given oral iron tablets containing100mg of elemental iron. 50 patients of Group B was given a total of 1000 mg of intravenous iron sucrose divided into five doses of 200 mg each at weekly intervals. Estimation of hemoglobin was started 4 weeks after commencement of iron therapy and then repeated every 4 weeks till 36 weeks of gestation, pre-delivery and postpartum.Results: Target hemoglobin levels were achieved in 4 weeks’ time in 19 (76%) patients in the iron sucrose group as compared to 08 (32%) of patients in the oral iron group. There was a significant improvement in the various hematological parameters in iv sucrose group as compared to patients in the oral iron group. There were no significant allergic reactions in iv sucrose group.Conclusions: Our results showed that intravenous iron sucrose therapy was effective to treat moderate anemia in pregnant women. Intramuscular preparations are known to be associated with local side-effects. Iron sucrose complex iv therapy was with negligible side effects. It caused a rapid rise in hemoglobin level and the replacement of stores was faster. Long term comparative studies are required to assess if they can be used at a peripheral level.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185128
      Issue No: Vol. 8, No. 1 (2018)
       
  • Platelet count and MPV in women with PIH in their third trimester

    • Authors: Suhail Iqbal, Aditi Sharma
      Pages: 44 - 49
      Abstract: Background: One of the most common and potential life-threatening complications of pregnancy is pregnancy induced hypertension. Though platelet count during pregnancy is within the normal non-pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity and severity of PIH.Methods: This prospective study was conducted in the Department of obstetrics and gynecology in Jhalawar medical college from January 2018 to April 2018.Total 120 pregnant women during third trimester (32-40 weeks) aged 18 to 35 years were selected. Among them 63 were preeclamptic patients and 63 were healthy normotensive control. Subjects and healthy pregnant women (control) visiting the Obstetrics and Gynecology department of Jhalawar Medical College were registered in the study and followed during their pregnancy. Both, subjects and control participants were subject to platelet count manually and MPV was determined by an automated analyser (sysmex XN-1000™) performed using standard methods on.Results: The mean platelet count of the subject group (131.4937±62.05999 lakh/mm3) was significantly lower than that of the control group (324.9683±230.78764 lakh/mm3). This shows that there is thrombocytopenia found in patients with P.I.H in their third trimester. On the other hand, the p value of “mean platelet volume” in patients with preeclampsia was (p<0.0001) which shows that there is no significant difference in MPV of cases (7.1438±2.62 femtolitre) and control (7.8976±3.08 femtolitre) (p>0.142), regular monitoring of platelet counts in women with Pregnancy Induced Hypertension must be subject of the management protocols.Conclusions: In present study we observed that the number of thrombocytopenic subjects was higher in cases of preeclampsia as compared to the control group. These extrapolations indicate that there might be some important mechanism which interferes with platelets life span thus reducing the number of functional platelets in circulation. The platelet count has an association at prediction of increasing grade of PIH. There is an inverse relationship between the severity of PIH and platelet count. The depleted platelet counts are concluded to be consistently associated with clinical groups of severe preeclampsia and the risk of consumptive coagulopathy.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185179
      Issue No: Vol. 8, No. 1 (2018)
       
  • A retrospective study on ectopic pregnancy at tertiary care hospital: a
           two-year study

    • Authors: Sonal Agrawal, Vimal K. Agarwal
      Pages: 50 - 53
      Abstract: Background: Over the last few decades, the incidence of ectopic pregnancy has increased almost to extent of an epidemic disease. The rate of ectopic pregnancy has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine incidence, clinical presentation, risk factor, treatment, morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of 2 year in department of obstetrics and gynaecology, JMCH, Jhalawar from Jan 2015 to Dec 2017. A total of 64 patients with ectopic pregnancy were analyzed.Results: Total 64 cases of ectopic pregnancy were admitted in this duration and total no. deliveries in these 2 year was 18176. So, incidence of ectopic pregnancy at our institute is 0.35%. Most common presenting complain was pain abdomen (in 93.75%) cases. Classical triad of pain, amenorrhea and bleeding was present in 48.3% cases.Conclusions: Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185101
      Issue No: Vol. 8, No. 1 (2018)
       
  • Perinatal outcomes in pregnant women with heart disease: Hospital General
           León experience

    • Authors: Edgar Ruiz Treviño, Gabriela Tecayehuatl Delgado, Junior Joel Araiza Navarro
      Pages: 54 - 58
      Abstract: Background: Pregnancies in patients with heart disease are often complicated. The prevalence in our country is at 0.1 to 4%. An increase in the morbidity and mortality of pregnant patients with heart disease was observed, so it is recommended to evaluate the maternal risk with the WHO Classification. The objective of the study was to determine adverse outcomes; cardiac, obstetric and fetal/neonatal.Methods: We retrospectively studied all pregnancies of women with heart disease that were presented on an outpatient basis in the period of 4 years at the General Hospital of León and maternal, obstetric and fetal/ neonatal outcomes were reviewed.Results: In our study population, no maternal or fetal mortality was observed. Of 16 pregnancies of patients with heart disease were complicated by adverse cardiac events (2 of 16), obstetric (9 of 16), fetal/ neonatal (6 of 16). Hospitalization was required during the pregnancy of 11 patients. WHO class IV was the only group in which there were adverse cardiac events. 12 pregnancies were interrupted abdominally. Low fetal growth curve was observed in 6 of the 16 patients.Conclusions: Pregnancies in patients with heart disease have a high risk of cardiac, obstetric and fetal / neonatal complications. Therefore, preconceptionally counseling and specialized multidisciplinary management should be offered to reduce perinatal morbidity and mortality.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185288
      Issue No: Vol. 8, No. 1 (2018)
       
  • Cervical cancer screening and prevention: how aware is the Indian
           woman'

    • Authors: Trapti M. Saxena, Aditi J. Upadhye, Jayshree J. Upadhye
      Pages: 59 - 62
      Abstract: Background: Carcinoma of the cervix is the second most common cancer in women worldwide. It is the commonest cancer among Indian women. Awareness regarding cervical cancer and its prevention is quite low amongst Indian women. The Pap test is a simple and cost-effective technique for early diagnosis of cervical cancer.Methods: It was a cross sectional study conducted in the months of September and October 2018. We included 200 women between 30 and 60 years of age.Results: In present study, out of 200 respondents, 160 (80%) respondents got married after 21 years of age while 40 (20%) respondents got married below 21 years of age. 148 (74%) respondents had 2 children, 30 (15%) respondents had one child while 22 (11%) respondents had 3 children. 166 (83%) had heard about cervical cancer, 24 (12%) knew that cervical cancer can be cured if detected in early stage while only 10 (5%) knew that it can be prevented. 54 (27%) respondents knew that pap smear test should be done as screening test to detect cervical cancer in early stage while 22 (11%) respondents knew about HPV vaccine as preventive measure.Conclusions: In present study, though women have heard about cervical cancer, proper knowledge was very less. Also, awareness about HPV vaccine and Pap smear was less. There is need for proper information and facilities for pap smear and HPV vaccination.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185102
      Issue No: Vol. 8, No. 1 (2018)
       
  • Insulin resistance in obese and lean women with polycystic ovarian
           syndrome

    • Authors: Jayashree S., Shylaja P., Virupakshi Ajjammanavar
      Pages: 63 - 68
      Abstract: Background: According to NIH criteria for PCOS, the estimated prevalence of this disorder has been reported to range from 4% to 10% of women in their reproductive years, which designates PCOS as the most common endocrinopathy of women. Insulin resistance is common in PCOS and obesity contributes an additional component to insulin resistance in obese PCOS.Methods: The study was a prospective study. One-hundred and twenty PCOS women were divided into two groups: Group O - obese (n = 60) and Group L - lean (body mass index [BMI] cutoff <23 kg/m2). Oral glucose tolerance test, serum fasting insulin and HOMA- IR were compared between these groups.Results: Impaired glucose tolerance was seen in 33.3 % of lean PCOS and 36.7% of obese PCOS women. 5% of lean PCOS and 10% of obese PCOS women had hyperinsulinemia. 38.3% of lean PCOS and 51.7% of obese PCOS women had insulin resistance. But the differences were not statistically significant. However, HOMA-IR and fasting insulin values showed a significant positive correlation with BMI.Conclusions: Both obese and lean women with PCOS are vulnerable to the problems of insulin resistance irrespective of BMI and insulin resistance shows a positive correlation with BMI.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185150
      Issue No: Vol. 8, No. 1 (2018)
       
  • Compare the efficiency of colposcopic VIA, VILI, LIQUIPREP TM and
           conventional Pap smear; as screening procedure for carcinoma cervix

    • Authors: Nithya Subbaiyan, Sabari Kasinathan
      Pages: 69 - 73
      Abstract: Background: Cancer of the cervix is a leading cause of morbidity and mortality among women worldwide. Therefore, to curb the disease, there is a need to develop a screening test that has good sensitivity and specificity. The aim is to compare the efficiency of Colposcopic Via, Vili, Liquiprep TM and conventional pap smear; as screening procedure for carcinoma cervix.Methods: This study was conducted in 100 women in the reproductive age. The pap smear and VIA are done in these cases. In positive cases, cervical biopsy and histopathological studies are done, the sensitivity and specificity of each test are determined and compared.Results: In this study, more cases belonged to 30 - 45 years age group. Among 100 women, 15% cases had high-grade lesion. Among high-grade lesions group, one case that is 6.7% had CIN 1, 73.3% had CIN2/3 and 3cases i.e., 20% had cervicitis. Among 100 women, 1% had ASCUS result, 10% belongs to HSIL group, 39% belongs to LSIL group and 2% had an unsatisfactory result.Conclusions: The lack of an effective and implementable screening programme lead to reporting of advanced cases of Ca Cervix. If detected at CIN or early Ca cervix stage, effective treatment can be provided with encouraging results. Therefore, effective and implementable Ca Cervix screening need to be provided in our country.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185289
      Issue No: Vol. 8, No. 1 (2018)
       
  • Outcome of total laparoscopic hysterectomy in relation to the size of the
           uterus

    • Authors: Virupakshi Ajjammanavar, Vinodini P., Jayashree S.
      Pages: 74 - 78
      Abstract: Background: Laparoscopic hysterectomy is a safe and feasible technique to manage benign uterine pathology as it offers minimal postoperative discomfort; with shorter hospital stay, rapid convalescence and early return to the activities of daily living. However, to date very few studies have been reported on safety and feasibility of total laparoscopic hysterectomy (TLH) in large sized uteri. The present study was planned to evaluate the intra-operative and post-operative parameters in relation to size of the uterus during TLH.Methods: This study was a comparative study. Fifty women with uterine size less than 12 weeks (Group 1) and fifty women with uterine size more than or equal to 12 weeks (Group 2) for whom TLH was planned for benign indications were included in the study. Intra-operative and post-operative parameters like blood loss, duration of surgery, post-operative pain and complications were compared between the two groups. Comparison was done using independent sample t test. A probability (‘p’ value) of less than or equal to 0.05 at 95% confidence interval was considered as statistically significant.Results: The mean age of the patients in both the groups was matched (44.82 years vs. 43.96 years). The mean operative time (48.80±14.12 minutes vs. 77.3±35.11 minutes; p <0.001) and blood loss (40.10±18.25ml vs. 70.6±65.46 ml; p=0.002) were significantly high in Group 2 compared to Group 1. The mean pain scores were similar in both the groups at 6 hours, 24 hours and at the time of discharge. No significant complications were noted in both the groups.Conclusions: TLH is safe, feasible and acceptable for large size uterus (>12 weeks). However, it is associated with longer operative time, and greater amount of blood loss.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185290
      Issue No: Vol. 8, No. 1 (2018)
       
  • Clinical epidemiological study of uterine prolapse

    • Authors: Parvathavarthini K., Vanusha A.
      Pages: 79 - 85
      Abstract: Background: Pelvic organ prolapse is one of the common gynaecological problem in India among the parous and aged women. Though the pelvic organ prolapse is not life threatening if left untreated it can lead to many social issues and also it reduces the quality of life of a woman. Thus, this study aims at generating epidemiological data on uterine prolapse in a clinical setting and identifying its risk factors so that appropriate measures can be taken to prevent the same.Methods: It was a descriptive case control study. Using a study proforma the required information was collected from the patients admitted with uterine prolapse (case) and from amongst the patient’s attendees of Gynaecology ward (control). Obtained data were compared and analyzed using appropriate statistical methods.Results: Uterine prolapse contributes to about 5.9% of the total gynecological patients admitted during the study period. The mean age of presentation with uterine prolapse was 50.1years the mean number of deliveries was higher in case compared to the control with the mean of 4 deliveries. Out of 130 patients, only 13.9% of them had institutional delivery while the others had home delivery.Conclusions: Uterine prolapse is strongly associated with age, parity and place of delivery. As the risk factors for uterine prolapse are easily preventable public health awareness programme must be conducted on its risk factors there by reducing the incidence of prolapse and decreasing the morbidity caused by it.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185287
      Issue No: Vol. 8, No. 1 (2018)
       
  • Inter-hospital obstetric referrals: public versus private sector to a
           tertiary care teaching hospital in South Kerala, India

    • Authors: Heera Shenoy T., Sheela Shenoy
      Pages: 86 - 93
      Abstract: Background: Inter-hospital Emergency obstetric transfers should be carried out effectively and efficiently to avoid maternal and fetal morbidity and mortality.
      Authors would like  to analyse the determinants ,patterns and reasons for referrals to tertiary hospital  for women with obstetric high-risk, complications and obstetric emergencies  from both public and private sectors and look into course in hospital and their feto-matermal morbidities.Methods: Descriptive study done at a tertiary care teaching hospital where 124 obstetrical referrals from nearby private and public health sectors were recruited.Results: Infertility treated obstetric referrals were at significant risk of referral (p value-0.002). Public sector referrals had past history of early pregnancy loss which was significant (p value-0.002). Public sector had statistically significant in -labour referrals (p value-0.04). All the obstetric referrals from public health sector reached within half an hour while one third of private sector referrals travelled more than an hour for emergency obstetric care (p value 0.001). Bronchial Asthma caused significant morbidity among public sector referrals (p value-0.001). Public sector referrals <31 weeks were nil while 55 % obstetric referrals were referred <31 weeks from various private hospitals seeked neonatal care with significant p value (0.016). NICU admissions were statistically significant in private sector referrals (p-value 0.001). Mean hospital stay in private sector referrals was 10.17 days and it was 7.62 days in government referrals.Conclusions: Specific guidelines for whom to refer, how to refer, when to refer and where to refer would be helpful in making timely referral. More stringent documentation in the referral slips and more co-ordination between the referral unit and the higher centers are required to build a strong health system.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185091
      Issue No: Vol. 8, No. 1 (2018)
       
  • Prevalence of blighted ovum in first trimester of pregnancy: a hospital
           based study

    • Authors: Abo Bakr A. Mitwally, Diaa Eldeen M. Abd El Aal, Nermeen Taher, Ahmed M. Abbas
      Pages: 94 - 98
      Abstract: Background: The aim of this study is to know the prevalence of blighted ovum among pregnant women in 1st trimester attending our hospital during their antenatal visits and to know the fate of blighted ovum either if there is spontaneous expulsion of the sac or need of medical induction or surgical evacuation.Methods: This observational study was conducted at Obstetrics and Genecology Department, Women Health Hospital and Sahel Selim Hospital, Egypt from November 2015 to February 2018. All patients recruited in this study attended the antenatal care clinics for antenatal follow-up during their first-trimester of pregnancies.Results: All cases of the study were less than 14 weeks. The mean gestational age was 8.93±1.01 (7.0-11.0) weeks. In patients less than 20 years old, (73%) there is a significant increase in surgical treatment (dilatation & curettage) after failure of medical treatment, patients more than 40 years old (50.7%) there is a significant increase in medical treatment after success taking misoprostol so there is no need to a surgical treatment by (dilatation & curettage) in the majority of cases.Conclusions: The prevalence of blighted ovum was 15.6%. Also, the prevalence of blighted ovum was statistically significant increased with increase maternal age and also, we noticed that there was a statistically significant association between early pregnancy failure and a history of previous early pregnancy loss.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185402
      Issue No: Vol. 8, No. 1 (2018)
       
  • Semen parameters and the incidence and effects of bacteriospermia in male
           partners of infertile couples attending a fertility clinic in the Kumasi
           Metropolis, Ghana

    • Authors: Edward Agyepong, Kweku Bedu-Addo
      Pages: 99 - 107
      Abstract: Background: Inability to conceive after at least 12 months of unprotected regular intercourse has been recognized as a very serious problem for couples especially those who are at the reproductive age and legally married. Bacterial infection of male genitourinary tract is considered as one of the promoting factors for male infertility. These pathogenic bacteria in the ejaculates can induce a defect in semen parameters, such as sperm count, morphology and motility which are predictors of male fertility potential. The study was conducted to assess the semen quality and the incidence of bacteriospermia in male partners of infertile couples attending fertility clinic at Trust Care Specialist Hospital, Kumasi.Methods: Semen samples of 300 male partners of infertile couples were collected and evaluated by WHO guidelines. The samples were also cultured using standard bacterial culture techniques.Results: Oligozoospermia was the highest semen abnormality identified. This was followed by Teratozoospermia. Other semen abnormalities identified were azoospermia, asthenozoospermia, oligoteratozoospermia, asthenoteratozoospermia, oligoasthenozoospermia, and oligoasthenoteratozoospermia. 67 (22.3%) out of the 300 samples showed significant bacterial growth. Eight different bacteria species were isolated. E. coli, was isolated from 27 of the samples, S. aureus from 13 of the samples, U. urealyticum from 10 of the samples, Chlamydia trachomatis from 9 of the samples, Pseudomonas spp from 5 of the samples Proteus spp, Klesbsiella spp and M. morganii were each isolated from one sample.Conclusions: Although bacteria were isolated in 22.3% of the semen samples, their presence imparted negatively on the semen quality. This suggests that bacterial infection should be one of the investigations to be carried out in the treatment of infertility. Even when count, motility, and morphology look normal other parameters such as infection and sperm DNA should be investigated during the treatment of infertility.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185403
      Issue No: Vol. 8, No. 1 (2018)
       
  • Maternal and perinatal outcome in women with eclampsia: a retrospective
           study at the University of Benin Teaching Hospital

    • Authors: Collins E. M. Okoror
      Pages: 108 - 114
      Abstract: Background: Eclampsia is a serious obstetric complication with attendant high maternal and perinatal morbidity and mortality especially in the developing countries. This study aims to assess the maternal and perinatal outcomes of eclampsia and suggest ways to improve them.Methods: This was a 5-year retrospective study (2009-2013) of cases of eclampsia managed at the University of Benin Teaching Hospital, Benin City, Nigeria. The number of cases managed was obtained from records at the emergency room, labour ward, theatre, lying-in wards and special care baby unit and case notes of patients satisfying the inclusion criteria retrieved from the medical records library.Results: The prevalence of eclampsia was 1.99% of total deliveries. It was highest in teenagers (29%), nulliparous (3.1%) and the unbooked (8.5%). Antepartum eclampsia accounted for 69.6% of the cases and a majority (74.6%) was delivered by emergency caesarean section. Eclampsia resulted in 27.78% of total maternal mortality, case fatality rate of 15.96% and eclampsia-related maternal mortality ratio of 318/100,000 deliveries. Perinatal mortality rate was 131/1000 eclamptic deliveries.Conclusions: The maternal outcome worsened with increasing blood pressure, number of convulsion episodes prior to presentation, the time interval between 1st convulsions to delivery, level of proteinuria on dip stick and reduced urine output. Vaginal delivery was associated with more early neonatal deaths and birth asphyxia. More awareness and enabling factors should be created for more women to access antenatal facilities. The government should be committed to providing emergency obstetric care facilities in our hospitals for effective management of eclampsia.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185404
      Issue No: Vol. 8, No. 1 (2018)
       
  • The prevalence and determinants of female serodiscordance among HIV
           positive pregnant women attending PMTCT clinic in Owerri, Imo state,
           Nigeria

    • Authors: Innocent O. Eze, Chijioke Okeudo, Bamidele U. Ezem, Clara U. Ukoh, Emily A. Nzeribe, Uchenna Nwagha, Tobechi Njoku, Onyeka Uzoma, Onyebuchi A. Duke
      Pages: 115 - 120
      Abstract: Background: Human Immunodeficiency Virus sero-discordance is high among heterosexual couples in Africa. However, only few studies have explored the factors that are associated with the prevalence in sub-Saharan Africa. The aim of this study was to determine the prevalence of female sero-discordance among HIV positive pregnant women in Owerri and to assess its possible associated factors.Methods: A cross sectional study of pregnant women (and their partners) who tested positive to HIV I and II at the Prevention of Mother to Child Transmission (PMTCT) clinic from December 2015 to May 2016 in Federal Medical Center Owerri, Imo state, Nigeria.Results: A total of 106 HIV positive pregnant women (and their partners) were studied. The prevalence of female serodiscordance was 63.2% (67/106). Pre-marital serodiscordance contributed about 52.2% (35/67) female serodiscordance among couples in the study. Sero-discordance rate for the lower, middle, and upper classes were 50% (28/56), 76.1% (35/46) and 100% (4/4) respectively and was statistically significant (p<0.01). Condom use was significantly associated with female serodiscondance (P<0.01). CD4+ count of the female partner at booking was also found statistically significantly associated with female serodiscordance (P<0.01).Conclusions: There is high prevalence of female serodiscordance among HIV positive pregnant women in Owerri. Pre-marital serodiscordance contributed significantly to high level of female serodiscordance among couples. Higher social class, condom use and high female- partner CD4+ count are significantly associated with female sero-discordance.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185405
      Issue No: Vol. 8, No. 1 (2018)
       
  • Maternal mortality related to postpartum hemorrhage: a case-control study
           at the Befelatanana maternity of Madagascar

    • Authors: Rakotozanany Besaina, Randriamahavonjy Romuald, Rabearizaka Laingo, Ratsiatosika Tanjona, Randriambelomanana J. A.
      Pages: 121 - 126
      Abstract: Background: Postpartum hemorrhage (PPH) remains the main cause of maternal death throughout the world. present goal was to determine the associated factors to maternal death in postpartum hemorrhage.Methods: This was a retrospective case-control study; carried out within Befelatanana maternity, in Antananarivo, from January 1st, 2013 to December 31st, 2015, on parturients who presented PPH. The cases were represented by the parturients who died despite well-managed care, and the control, by the living parturients.Results:
      Authors recorded 181 cases of PPH from 20,888 deliveries, with a prevalence of 0.86%; 47 of them died and 134 were alive; the mortality rate by PPH is 25.96%. Factors associated with death were low education (p=0.00 OR:3.2), non-working (p=0.01, OR:2.4), multiparity ( p:2.2 OR:0.01), absence of prenatal care (p:0.01 OR:2.2), cesarean section (p:0.00 OR:5.5); Intrauterine Fetal Death (p= 0.02, OR:2.2); uterine atony (p=0.03, OR 2.1); the state of shock (p=0.00 OR:57.8), sanitary evacuation (p=0.01 OR: 2.4), the need for blood transfusion (p=0.00 OR: 3, 7), use of catecholamines (p=0.00, OR:17.5); delayed management (p=0.01, OR:2.2), hemostasis hysterectomy (p=0.00 OR: 8.67).Conclusions: The decrease of maternal mortality related to PPH requires better monitoring of pregnancy, delivery and postpartum. Speed care management, improvement of technical platform and establishment of a powerful health system are also needed. Thus, the global reduction of poverty is indispensable.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185406
      Issue No: Vol. 8, No. 1 (2018)
       
  • Veress needle versus direct trocar entry for laparoscopy: a retrospective
           study

    • Authors: Sushma Sinha, Surya Malik
      Pages: 127 - 130
      Abstract: Background: The aim of this paper is to compare the outcomes of veress needle entry versus direct trocar for laparoscopy in terms of the duration of the procedure, ease of performance and the complications encountered during each technique.Methods: The present study was conducted on a retrospective basis from April ‘2008 to September 2017, in the dept of Obstetrics and Gynecology, in a 100 bedded hospital, ABGH hospital. All the cases who underwent laparoscopic ligation procedure during this time were taken into account. From 2008 to 2012 traditional technique of veress needle entry was used for access(group -1) but it had been switched over to direct trocar since 2013(group -2) These two groups were compared in terms of the demographic profile, duration of procedure, previous h/o surgical interventions ,ease of performance and various complications encountered during the procedure.Results: The total number of patients who underwent ligation during this period were 1912, which were divided into two groups ,till 2012(veress needle entry group,group-1) 754 patients(39.44%),and after 2012 (direct trocar,group -2) 1158 patients(60.56%).Duration of procedure was 4.5±1.2 min in group 1 which was significantly higher than group 2,2.2±0.8 min(p-value <0.001).Amount of gas required was greater in group 1, 4.9±1.3 lts as compared to group 2,2.4±0.5lts.Conclusions: Direct trocar entry is a reliable alternative to traditional technique for pneumoperitoneum establishment and should be regarded as a part of the surgical armamentarium of a trained laparoscopic surgeon.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185407
      Issue No: Vol. 8, No. 1 (2018)
       
  • The spindle of oocytes observed by polarized light microscope can predict
           embryo quality

    • Authors: Tung T. Nguyen, Hang T. Doan, Lam H. Quan
      Pages: 131 - 134
      Abstract: Background: The aim is to evaluate spindle position of metaphase II oocyte and the development of embryos originated from oocytes with spindle and without spindle.Methods: Cross-sectional analysis Research: 250 MII oocytes were analyzed with polarized microscope in Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University.Results: Spindles were detected in 170 (77.98%) of 218 metaphase II oocytes, 115 spindles (67.65%) of MII oocytes is beneath or adjacent to the first polar body, 55 oocytes had the spindle located between 300 and 1800 away from the first polar body. Fertilization rate and the rate of good quality embryos in oocytes with a visible spindle (77.98% and 61.02%) were higher than those in oocytes without a visible spindle (22.02% and 36.84%), the difference was statistically significant with p <0.001 and p <0.05.Conclusions: The spindle position of metaphase II oocytes is not always beneath or adjacent to the first polar body. Fertilization rate and the rate of good quality embryos in oocytes with a visible spindle were higher than those in oocytes without a visible spindle.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185408
      Issue No: Vol. 8, No. 1 (2018)
       
  • Knowledge and practice of emergency contraception among female students of
           public university of Ouagadougou, Burkina Faso, West Africa

    • Authors: Yobi A lexis Sawadogo, Issa Ouedraogo, Sibraogo Kiemtore, Fatou Ouedraogo, Boubakar Toure, Adama Ouattara, Dantola Paul Kain, Charlemagne R. Marie Ouedraogo
      Pages: 135 - 139
      Abstract: Background: Female students are exposed to unsafe sex, sources of unwanted pregnancy and abortions. It is recognized that emergency contraception can effectively prevent pregnancy. The purpose of this study was to evaluate the knowledge and practices of Ouagadougou public university students in relation to emergency contraception in order to propose solutions to reduce the proportion of unwanted pregnancies among female students.Methods: This was a cross-sectional study conducted between May 1st and October 31st, 2016 in the public universities of Ouagadougou. A questionnaire was administered to a sample of 732 students randomly selected.Results: The average age of female students was 22.7 years old. The age group 19 to 24 was the most represented (68.03%). Of the students surveyed, 87% knew or had heard of emergency contraception. The students only used the emergency contraceptive pill. The emergency contraceptive use rate was 44.42%. Approximately, 83% of users were aware of the delay in using emergency contraception. The reasons for using emergency contraception were condom breakage (25.10%) and unprotected sex (74.9%). Female students purchased the contraceptive directly in pharmacies (93.61%).Conclusions: Emergency contraception gives women a last chance to avoid an unwanted pregnancy after unprotected sex.  Awareness and free availability of emergency contraception (EC) could improve the reproductive health of female students.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185409
      Issue No: Vol. 8, No. 1 (2018)
       
  • Analysis of Caesarean section rate in a government teaching institute
           based on Robson’s ten group classification

    • Authors: Kavita Sambharam, Mansi Lalit Verma, Pradip W. Sambarey
      Pages: 140 - 143
      Abstract: Background: Caesarean section rate is a qualitative health care indicator in India. With increasing rates of caesarean sections and no defined method to audit present institutes it is the need of the hour to use tools like Robson’s classification to understand present system. The aim of this study was to determine the rate and analyse Caesarean sections in a tertiary care institute using Robson’s ten group classification system.Methods: This is a retrospective analytical study in which all Caesarean section done over a period of 3 years (July 2014-June 2017) were included which were performed in single unit (out of 6) of Department of Obstetrics and Gynecology of Sassoon General Hospital. Women were classified in 10 groups according to Robson’s classification, using maternal characteristics and obstetrical history. For each group, authors calculated its relative size and its contribution to the overall caesarean rate.Results: Total deliveries were 4750 out of which 985 were Caesarean section, incidence was calculated as 20.7%. The main contributors to the overall Caesarean rate were primiparous women in spontaneous labour (group 1- {18.3%}) and women with previous caesarean section (group 5- {34.9%}).Conclusions: The Robson’s classification is an easy tool to use and identify the current changing dynamics in any hospital setup. Its implementation as an obstetric audit can help lower the Caesarean rates and improve the standards based on WHO criteria.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185410
      Issue No: Vol. 8, No. 1 (2018)
       
  • Comparison between intramuscular oxytocin versus oxytocin with sublingual
           misoprostol in blood loss reduction among risk of postpartum hemorrhage
           vaginal deliveries

    • Authors: M. Vanitha, S. Sujathasenthil, Heber Anandan
      Pages: 144 - 147
      Abstract: Background: This study compares the efficacy of intramuscular oxytocin and oxytocin with sublingual misoprostol administration among the primary postpartum hemorrhage (PPH) mothers of vaginal deliveries. The aim is to compare the effectiveness of intramuscular oxytocin versus oxytocin with sublingual misoprostol in blood loss reduction among women at risk of PPH undergoing vaginal deliveries.Methods: Each group, 50 mothers were selected from the risk of PPH vaginal mothers in the labour ward of the study area.Results: The two groups’ mothers were not statistically significantly differed (P>0.05) in respect of their demographic and clinical variables such as age, gravida, risk factors, the onset of labour and type of delivery. The mean blood loss of group I was 315.4±111.4 ml and group II mean blood loss was 241.4±191.2 ml. The difference between the two groups’ blood losses was statistically significant (P<0.05).Conclusions: Oxytocin with sublingual misoprostol significantly reduced the blood loss during 3rd stage labour than only oxytocin administration.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185411
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of maternal and neonatal outcome in teenage pregnancy

    • Authors: Sharvari Mundhe, Varsha Patil, Divya Saha
      Pages: 148 - 150
      Abstract: Background: Teenage is a period of transition from childhood to adulthood. According to WHO, the period of teenage extends from 11-19 years. The objective of the present study was to find out the incidence and to evaluate the effect of pregnancy in teenage girls (13-19 years) and its maternal and neonatal outcome.Methods: Prospective observational cohort study, the duration from 1st January 2016 to 31st July 2017.Results: 216 teenage patients were studied; however medical termination and abortions were excluded as the study includes both maternal & neonatal outcome. 3944 pregnant patients were admitted for delivery and abortion related care. Out of this, pregnant adolescents were 216. Proportion of adolescent pregnancy was 5.47%. 170(78.7%) were booked, 32 (14.81%) were unmarried, while 50 (23.1%) were literate. Primigravida were 189 (87.5%) & multigravida was 27 (12.5%).39 (18.05%) were Anemic, Preterm labour occurred in 14 (6.5%) & PROM occurred in 41 (18.9%) patients. Preeclampsia and Eclampsia occurred in 27 (12.5%) and 14 (6.5%) respectively. There were 176(81.48%) normal vaginal deliveries.36 (16.66%) had Lower Segment Caesarean Section; commonest indication being Cephalopelvic disproportion (25%) & 4(1.85%) were instrumental deliveries 53 (24.3%) babies required admission at Neonatal Intensive care unit. Low Birth weight babies were 15 (28.3%).Conclusions: - Early ANC registration and good antenatal care with effective intrapartum & postpartum monitoring along with contraceptive advice on discharge help reduce maternal and neonatal morbidity & mortality associated with teenage pregnancy. However, it is evident that teenage pregnancy rates could be reduced by effective measures like sex education in schools, community-based programs, widespread awareness about contraception.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185412
      Issue No: Vol. 8, No. 1 (2018)
       
  • Evaluation of maternal and fetal outcomes in pregnancy with heart disease

    • Authors: Jayshree Mulik, Rahul Patil
      Pages: 151 - 154
      Abstract: Background: Heart diseases complicate >1% of all pregnancies and is the leading indirect cause of maternal deaths. Present study attempted determining the maternal and fetal outcome in pregnant women with heart disease using various relevant parameters.Methods: A total of 44 consecutive cases of heart disease with pregnancy that were admitted at the study centre from December 2013 to August 2015 were included and analyzed for outcome with respect to age, parity, associated comorbidities, nature of cardiac lesions, type of valvular involvement, NYHA functional class, type of anaesthesia used, mode of delivery, maternal outcome, fetal outcome, birth weight of babies and maternal and fetal mortality, if any.Results: Rheumatic heart disease 26 (59.1%) was the commonest lesion observed to be affecting pregnant patients, followed by congenital heart disease (10, 22.7%). Mitral valve (30, 68.2%) was found most commonly affected, followed by aortic valve (10, 22.7%). Regurgitant lesions (26, 59.09%) were commoner than stenotic ones (14, 31.81%). Four (9.1%) patients went into left ventricular failure and had to be admitted to ICU. Of these, one patient (2.3%) died.Conclusions: Maternal heart disease is one of the important causes of maternal mortality. The obstetrician needs to have strong suspicion of the entity right from the start, so as to improve upon the maternal as well as fetal outcomes.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185413
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study on knowledge and experience about emergency contraception at a
           tertiary care centre family planning clinic

    • Authors: Lakshmidevi M., Sheela H. S., Shreedhar Venkatesh
      Pages: 155 - 158
      Abstract: Background: Unintended pregnancies and unsafe abortions are the major reproductive health challenges faced by women of developing countries. According to WHO 42 million induced abortions occur annually and out of which 20 million are performed in unsafe condition and by unskilled providers.Methods: It is a questionnaire-based study planned to be conducted in the family planning clinic of Department Of Obstetrics and Gynaecology, at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Statistical analysis is done by percentage analysis, paired T test or Wilckoxer signed rank test and Mcnemer test.Results: This is a questionnaire-based study conducted on 300 urban educated women seeking termination of pregnancy. Among 300 women studied majority were in the age group of 21-30 years i.e. 174 women (58%). Among 300 women studied about 126 women who had some knowledge about EC and Medias (like TV, radio and magazine) constitutes the major source of knowledge i.e. 60 women (47.6%) then Doctors and nurse i.e. 36 women (28.5%) and other sources like friends, relative and Teachers i.e. 30 women (23.8%). Knowledge about the side effects of EC was very limited in present study, i.e. 30 women (23.8%) were unaware of side effects, 60 women (47.6%) were aware of minor side effects like nausea, vomiting and pain abdomen, and only 36 women (28.5%) were aware of hormonal side effects like menstrual irregularity.Conclusions: From present study it is shown that even among urban educated women knowledge about emergency contraception is very limited. For the proper use of emergency contraception, women should have basic knowledge about fertility and contraception. According to present study only 23.8% of urban educated women have knowledge about safe and unsafe period only (42.8%) had knowledge about timing of use of Emergency contraception.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185414
      Issue No: Vol. 8, No. 1 (2018)
       
  • Hysteroscopy: an effective tool in post-menopausal bleeding

    • Authors: K. K. Junnare, G. J. Desai, G. S. Shekhawat
      Pages: 159 - 164
      Abstract: Background: Postmenopausal bleeding is a condition where endometrial carcinoma is to be ruled out. Traditionally, D and C is the preferred method for diagnosis in such condition. Other diagnostic modalities like trans vaginal ultrasonography (TVS) and hysteroscopy are being used for diagnosis in the cases of PMB. The objective of this study is to evaluate the efficacy and accuracy of TVS and hysteroscopy in women with postmenopausal bleeding (PMB).Methods: One hundred postmenopausal women with vaginal bleeding underwent TVS and hysteroscopy. Endometrial tissue was obtained by curettage and sent for histopathology examination. The results of TVS and Hysteroscopy were compared against HP report.Results: Hysteroscopy was successful in 98 patients. Endometrial histopathology revealed proliferative, secretory and atrophic endometrium in 26, 7 and 23 patients respectively. Polyp was diagnosed in 13 patients. Endometrial hyperplasia was detected in 11 patients and endometrial malignancy in 14 patients. All patients with endometrial hyperplasia and malignancy had ET (endometrial thickness) more than 4 mm, except one patient with endometrial malignancy who had 4 mm ET. The sensitivity and specificity of TVS for suspecting endometrial pathology at ET 4mm were 93% and 69.6%, respectively. Hysteroscopy had sensitivity of 95.2%, specificity of 92.8%, with diagnostic accuracy of 93.8%.Conclusions: Hysteroscopy was found to be the more sensitive and specific than Transvaginal sonography for diagnosing endometrial pathologies. Hysteroscopy is safe and effective for detecting endometrial pathologies in patients with PMB.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185415
      Issue No: Vol. 8, No. 1 (2018)
       
  • Role of sildenafil citrate therapy in pregnant women with foetal growth
           restriction and oligohydrominos from Northern India

    • Authors: Priyanka Joshi, Madhubala Chouhan, Nidhi Choudhary, Abhishek Singh
      Pages: 165 - 168
      Abstract: Background: No specific treatment is available for severe early-onset IUGR. To best of my knowledge, very few studies have assessed the potential benefit of Sildenafil therapy targeted to improve perinatal outcomes in pregnancies complicated by severe early-onset IUGR in Indian pregnant women.Methods: The present hospital based prospective study was carried out on one hundred ANC pregnant women with early and late fetal growth restriction and oligohydrominos at Pannadhai Mahila Chikatsalya, Rabindra Nath Tagore (RNT) Medical College, Udaipur, during Jan to Dec 2017. Sildenafil citrate 25 mg three times in a day was  administered until delivery. Study subjects were subjected to fetal Doppler and ultrasound twice a week after the Sildenafil administration.Results: After sildenafil therapy, out of total 45 cases of IUGR alone, 39 cases (86.66 %) had improvement. Out of 35 cases of oligohydramnios alone, 28 cases (80 %) had improvement.  Out of 20 cases having both IUGR and Oligohydramnios 16 had improvement (80 %) and only 4 cases did not show any improvement. Among gestation age 27-30 weeks group at the time of admission, there were total 10 cases out of which 5 (50 %) had early premature delivery (32-34 weeks), 3 (30 %) had late premature delivery (34-37 weeks) and 2 cases (2 %) had term delivery i.e. between 37-39 weeks after giving sildenafil treatment.Conclusions: The findings of the present study indicate that sildenafil citrate may offer a potential therapeutic strategy to improve outcomes in pregnant women facing foetal growth restriction and oligohydrominos.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185416
      Issue No: Vol. 8, No. 1 (2018)
       
  • A novel approach to meet the unmet need for family planning

    • Authors: Subrata Samanta, Sujoy Dutta, Sudipta Samanta, Agrima Mullick
      Pages: 169 - 173
      Abstract: Background: Post-partum intra-uterine contraceptive device is one of the important methods of spacing to meet up the unmet need of family planning. The low complication rate, ease and certainty of insertion and one-time adoption advantages made it an option of family planning by Government of India. In the background of recent trends in family planning, the study aims to establish the efficacy and draw-backs of PP-IUCD among the clients in a tertiary care hospital of West Bengal.Methods: Prospective observational study on 1680 women during January 2016 to December 2016, where the PP-IUCD was given to the patients after vaginal delivery or Cesarean section and were followed up to 3 months.Results: During the study 1.37% patients did not turnup in either follow-up. The most common complication encountered was missing thread (4.64% at 6th week follow-up and 6.67% at 3rd month follow-up). Expulsion rate was much lower (2.02% at 6th week and 2.5% at 3rd month). Heavy bleeding per-vagina was in 1.55% at 6th week and 2.08% at 3rd month. Pain abdomen was .83% at 6th week and 1.67% at 3rd month. Incidence of perforation and failure was both nil at either follow-up. Dysmenorrhea was complained 2.44% at 6th week and 3.33% at 3rd month. Overall satisfaction rate at 6th week (86.05%) was higher than non-satisfaction (13.95%). This was also true for 3rd month where satisfaction rate (77.85%) was higher than non-satisfaction rate (22.15%).Conclusions: PP-IUCD appears to be a safe, efficacious, acceptable and accessible method of contraception.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185417
      Issue No: Vol. 8, No. 1 (2018)
       
  • Oral nifedipine versus nitroglycerine patch for tocolysis in preterm
           labour

    • Authors: Nidhi Sharma, Shikha Rani, Anju Huria, Deepak Chawla
      Pages: 174 - 178
      Abstract: Background: Preterm delivery is a major cause of neonatal mortality and morbidity. Various modalities have been used to prediction of patient at risk of preterm labor. But due to multi-factorial etiology these predictors are not always useful. Tocolysis has a major role in arresting preterm labor. The purpose of this study was to compare the safety and efficacy of oral nifedipine with transdermal nitroglycerine in the inhibition of preterm labour.Methods: This single blinded randomized control trial was conducted in the labour room of department of Obstetrics and Gynecology from January 2011 to June 2012. One hundred women with singleton pregnancy between 28 weeks to 34 weeks preterm labour and no contraindication for tocolysis were enrolled in the study. After taking the informed consent subjects were randomized into two groups. Randomization was done by random number table. Fifty-one subjects in nifedipine group received oral nifedipine (Tab Depin 10mg). Forty-nine subjects receiving transdermal nitroglycerine patch (Nitroderm Patch 10) were included in NTG group. The variables analysed were delay in delivery for 48 hours, 7 days or more than 7 days, period of gestation at delivery and side effect profile of drugs.Results: The percentage of women delivering after 48hours of administration of nifedipine group (52.9%) and nitroglycerine group (53.1%). Failure of tocolysis, defined as delivery within 48 hours, with nitroglycerine group (32.7 %) was comparable to nifedipine (33.3 %). Headache was significantly higher in nitroglycerine group as compared to nifedipine group (p≤0.001). Maternal tachycardia was more common in nifedipine group compared to NTG group (p=0.001).Conclusions: Oral nifedipine and transdermal nitroglycerine have similar efficacy as tocolytic agent in patients with preterm labour. 
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185418
      Issue No: Vol. 8, No. 1 (2018)
       
  • Serum CRP level in day of ovum pickup and embryo transfer as a predictor
           for success in patients undergoing IVF/ ICSI

    • Authors: Mofeed F. Mohamed, Abd El-Moneim M. Zakria, Walid M. El-Sayed
      Pages: 179 - 183
      Abstract: Background: This study was performed to determine the level of serum C-reactive protein (CRP) in day of ovum pickup and embryo transfer as a predictor for success in patients undergoing In-Vitro Fertilization (IVF) and Intracytoplasmic Sperm injection (ICSI).Methods: This study was a cross sectional study (prospective) that was conducted in assisted reproduction unit in Al-Azhar University Hospital on 50 infertile patients who were candidate for IVF/ICSI, using standard long protocol, blood was drawn two times during cycle, in the day of ovum pick up and the day of embryo transfer.Results: In (70.6 %) the serum of CRP level was higher in day of embryo transfer than day of ovum pick up. The ratio of CRP level in the day of embryo transfer to the day of ovum pick up was heigher (1.54) in patients who became pregnant after ICSI, patients with less than this ratio have not been pregnant.Conclusions: Controlled ovarian hyper stimulation and puncture of ovaries can potentiate systemic stimulation so increasing serum CRP level in day of embryo transfer rather than day of ovum pick up can predict success in patients undergoing IVF/ICSI. 
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185419
      Issue No: Vol. 8, No. 1 (2018)
       
  • Maternal mortality in tertiary care hospital: a 2-year review

    • Authors: Juhi Ankit Patel, Kanaklata D. Nakum, Aditi Vithal, Mayank R. Lunagariya
      Pages: 184 - 187
      Abstract: Background: Epidemiological data pertaining to maternal mortality is valuable in each set up to design interventional programs to favourably reduce the ratio. This study was done to evaluate the maternal mortality rate in our hospital, to assess the epidemiological aspects and causes of maternal mortality, and to suggest recommendations for improvement.Methods: This was a 2-year retrospective study. Epidemiological data was collected from the Last 2 years of Facility Based Maternal Death Review Form. Maternal mortality ratio, epidemiological factors and causes affecting maternal mortality were assessed.Results: A total of 72 maternal deaths occurred. Most maternal deaths occurred in the age group of 20–24 years (40.27%), multiparous women (70.83%), women from rural areas (65.27%), illiterate women, unbooked patients (83.33%), and patients of low socioeconomic status. Direct causes accounted for 62.4% of maternal deaths where as 37.4% of maternal deaths were due to indirect causes.Conclusions: There is a wide scope for improvement as a large proportion of the observed deaths could be preventable.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185420
      Issue No: Vol. 8, No. 1 (2018)
       
  • Correlation between amniotic fluid lamellar body concentrations at
           different gestational ages and respiratory distress syndrome

    • Authors: Amruta C. C., Hema A. Patil
      Pages: 188 - 191
      Abstract: Background: Respiratory distress syndrome (RDS) also known as hyaline membrane disease is the most common cause of respiratory failure in neonates. The risk of RDS rises in prematurity due to decreased production of surfactant. Lamellar bodies (LB) are storage form of surfactant and are actively secreted into the alveolar space and hence into the amniotic fluid. The objective of the present study was to find out correlation between amniotic fluid lamellar body concentrations (LBC) at different gestational ages and respiratory distress syndromeMethods: The study was a prospective observational study conducted over a period of 1 year at department of OBG, SDM college of medical sciences, Dharwad. All women undergoing caesarean section were included in the study. 5 ml of amniotic fluid was collected at the time of Caesarean section and sent to laboratory, Lamellar body concentrations (LBC) was counted in auto analyzer by platelet impedance counting. Incidence of RDS at different gestational age with an LBC cut off 40,500 was calculated.Results: Among 300 patients studied, Respiratory distress was seen in 116 (41.3%) of patients. LBC cut off of 40,500 was chosen. Out of 140 preterm babies, 121 (86.8%) had lamellar body count less than 40,500 and 19 (13.5%) had more than 40,500. There is significant correlation between decreasing lamellar body count in preterms and increasing incidence of RDS.Conclusions: LBC count increases with increasing gestational ages and is inversely proportional to the incidence of RDS in preterm newborns.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185421
      Issue No: Vol. 8, No. 1 (2018)
       
  • Does type of intervention affects the endoscopic procedure outcome in
           female infertile patients' an experience at a single tertiary care
           centre

    • Authors: Namita Agrawal, S. Fayyaz
      Pages: 192 - 199
      Abstract: Background: To compare the types of hysterolaparoscopic interventions in female infertile patients and evaluate the outcome in terms of achieving pregnancy at follow up of 12 months.Methods: We prospectively evaluated 157 female-infertile-patients (age range 19-35 years; mean age 27.75 years). During their workup, all underwent hysterolaparoscopy. The detected anatomical abnormalities on hysterolaparoscopy were also tackled at same time if possible. After hysterolaparoscopy, Patients were advised for regular sexual activity. Follow-up of all recruited patients was done for 12 months or till achievement of fetal cardiac activity.Results: Of the 157 female-infertile-patients, 93 (59.2%) were of primary infertility and remaining 64 (41.74%) were secondary infertility patients. Hysterolaparoscopy revealed abnormalities in 125/157 patients. Of the 125 patients with abnormal hysterolaparoscopic findings, 121 underwent active therapeutic interventions. Out of 121 underwent active intervention and 43 patients conceived during next 12 months. Of 121 patients, 81 (66.9%) experienced single type intervention and remaining 40 (33.1%) experienced multiple type of the intervention. Among 81 patients with single type intervention, 28 conceived while 33 patients with multiple type of intervention 15 conceived. There was no statistically significant difference in pregnancy outcome in both groups. When we analyzed independently in primary and secondary infertility patients, similarly there was no significant difference in the pregnancy outcome.Conclusions: We concluded the conception rate was not significantly difference in infertile female patients, who underwent either single or multiple type hysterolaparoscopic intervention. So hysterolaparoscopy interventions should be performed in infertile female patients irrespective of type and extent of pelvic pathologies.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185422
      Issue No: Vol. 8, No. 1 (2018)
       
  • Evaluation of the uterine cavity by office hysteroscopy in patients with
           infertility and recurrent pregnancy loss: a cross sectional study

    • Authors: Abo Bakr A. Mitwally, Esraa Y. Badran, Tamer Arby, Ahmed M. Abbas, Ahmed Nasr, Momen A. Kamel
      Pages: 200 - 203
      Abstract: Background: The aim of the present study is to determine role of hysteroscopy in women presented with primary or secondary infertility and in women presented with recurrent pregnancy loss.Methods: This cross-sectional study was conducted at Obstetrics and Genecology Department, Women Health Hospital Assiut University, Egypt from October 2016 to February 2018. Reproductive aged women who are suspected as having intrauterine pathology, such as submucosal myoma, endometrial polyps or other endometrial pathological findings based on the transvaginal ultrasound were enrolled. All patients were scheduled for office hysteroscopy as an outpatient. An informed consent was obtained prior to participation in the study.Results: Hysteroscopy was performed in 139 infertile women and 41 cases of repeated pregnancy loss. With regard to infertile patients; 67.6% of the patients had normal findings, 10.1% of the patients had intrauterine adhesion, 8.6% of the patients had intrauterine polyp. 5.8% of the patients had septate uterus and 3.6% of the patients had depressed fundus. With regard to patients with recurrent pregnancy loss; 51.2% of the patients had normal findings, 21.9% of the patients had partial septum, 9.8% of patients had intrauterine adhesions, 7.3% of patients had intrauterine polyp and 4.9% of the patients had submucous myoma.Conclusions: It was concluded that hysteroscopy should be considered as routine investigation in evaluation of women with primary and secondary infertility.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185423
      Issue No: Vol. 8, No. 1 (2018)
       
  • Gestational diabetes mellitus and obstetric outcomes in a Ghanaian
           community

    • Authors: Ahmed Tijani Bawah, Robert Amadu Ngala, Mohammed Mustapha Seini, Francis Abeku Ussher, Huseini Alidu, Joshua Dokurugu Kwame Wumbee, Francis Agyeman Yeboah
      Pages: 204 - 208
      Abstract: Background: This study was aimed at evaluating effect of Gestational diabetes mellitus (GDM) and maternal characteristics on pregnancy outcomes. GDM has several risk factors including; advanced maternal age, ethnic background, obesity and family history of diabetes mellitus. These pregnancy complications are associated with fetal morbidity and mortality and may lead to macrosomia and shoulder dystocia. Others are stillbirth, miscarriages, preterm and small for gestational age babies.Methods: This was a retrospective case-control study which compared maternal characteristics and pregnancy outcome among pregnant women with and without GDM. Diagnosis of GDM was done in accordance with the American Diabetes Association (ADA) criteria. Weight and height were determined and Body mass index (BMI) calculated. Pregnancy outcome was determined at the end of pregnancy and information on maternal characteristics obtained using questionnaire and patient folders.Results: Those who developed GDM were significantly older (OR=1.772; 95% CI=1.432-2.192; P<0.0001) and had higher BMI (OR=1.637; 95% CI=1.004-1.289; P=0.044) than those who did not. A significant number of those who developed GDM also had stillbirths (OR= 5.188; 95% CI=1.093-24.613; p=0.038) and cesarean deliveries (OR=14.362; 95% CI=3.661-56.335; p= 0.001).Conclusions: Women who develop GDM are more likely to deliver stillborn or macrosmic babies and may require surgical intervention in order to have normal deliveries.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185424
      Issue No: Vol. 8, No. 1 (2018)
       
  • Midwives’ skills in the application of non-pneumatic anti-shock garment
           for the management of postpartum haemorrhage in Ondo State, Nigeria

    • Authors: Christiana Olanrewaju Sowunmi, Olufunke Mercy Iwaola, Gbemisola Bolanle Ogbeye
      Pages: 209 - 214
      Abstract: Background: Non-pneumatic Anti-shock garment (NASG) has been identified as a device for effective management of postpartum haemorrhage especially in developing countries where maternal mortality is high. Hence, it is important that midwives are skilled and knowledgeable about its use. This study therefore assessed the midwives’ skills in the application of Non-Pneumatic Anti-Shock Garment (NASG) in the management of postpartum hemorrhage.Methods: This study adopted quasi-experimental research design. The study was done in two secondary health facilities in the state. Sixty-eight midwives participated in the study. Simple random sampling technique was used to select 37 and 31 midwives into experimental and control groups respectively. Written consent was obtained from all the participants. The study involved three stages; Pre-test, an intervention and a post test. Questionnaire and observation rating scale that elicited demographic characteristics, knowledge and skills on the application and removal of NASG was used to collect data pre and post intervention. Data was analyzed using descriptive and inferential statistics.Results: Mean knowledge score of midwives in the control group in the use of NASG in the management of PPH was found to be 10.32±4.17 compared with 12.24±5.05 in experimental group pre-intervention. There was a significant increase in knowledge and skills of NASG application, nonetheless the post intervention from experimental group had the highest increase from 6.32±4.97 to 17.14±0.95.Conclusions: Educational intervention enhanced skills of midwives in the use of NASG. Therefore, continuous education units in hospitals should include periodic training of midwives on the use of NASG.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185425
      Issue No: Vol. 8, No. 1 (2018)
       
  • Perinatal outcome in uncomplicated pregnancies with oligohydramnios

    • Authors: Snehal Gaware, V. B. Bangal
      Pages: 215 - 218
      Abstract: Background: Oligohydramnios refers to amniotic fluid volume that is less than expected for gestational age. We aimed to assess the perinatal outcomes in pregnancies with oligohydramnios.Methods: The prospective study was conducted in the Department of Obstetrics and Gynecology, Pravara Medical College, Loni in which 200 consecutive singleton pregnancies delivered vaginally, with intact membranes were included. Amniotic fluid index was determined using the Phelan’s technique at the time of admission and women were diagnosed with oligohydramnios if AFI was five or less, which formed the first group and the rest of mother formed the second group. Perinatal outcomes were noted in the proforma as well.Results: Of the 200 mothers included in the study, 38 had AFI ≤ 5. Baseline characteristics was similar in both the groups. Most common antenatal risk factors studies were pregnancy induced hypertension (29% vs 12%; p value <0.05), intrauterine growth restriction (34% vs 10%; p value <0.001) and severe anemia (21% vs 9%; p value <0.05). Proportion of pregnancies needing induction of labor and birth weight less than 2.5 kgs were significantly higher among mothers with oligohydramnios.Conclusions:
      Authors observed that induction of labor and low birth weight were significantly associated with oligohydramnios. Prospective randomized trials are needed to establish whether early induction of labor in the presence of a oligohydramnios improves perinatal outcome.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185426
      Issue No: Vol. 8, No. 1 (2018)
       
  • Association of maternal plasma or serum zinc concentration with the birth
           weight of the child

    • Authors: Girija C. Bellad, Laxmi K. S.
      Pages: 219 - 222
      Abstract: Background: Zinc is a divalent cation first isolated in 1509 and since then its importance has been increasingly recognised in human health and nutrition. Present study has been undertaken to confirm the association between maternal plasma or serum zinc concentration and birth weight.Methods: Present study was cross-sectional study conducted in tertiary care hospital. Newborns with a birth weight of < 2.5kg and their mothers labelled as study group while newborns with a birth weight of > 2.5kg and their mothers were considered as control group. The analysis for the serum concentration of zinc was done using the Atomic Absorption Spectrophotometric method (AAS), this method analytically the most reliable for routine assessment of serum zinc levels. The results deduced from the analysis were accordingly grouped to the study group / control group. We had a sub-group analysis based on the gestational age, as Preterm and Term.Results: Maternal serum levels of zinc 67.04 μg /dl±16.66, in the study group, was less as compared to the maternal serum levels of zinc in the control group with a mean level of 75.39 μg/dl±17.89. The results show a significant association between zinc levels and birth weight. Mean Maternal serum levels of zinc 67.04 μg /dl±16.66, in the study group, was less as compared to the maternal serum levels of zinc in the control group with a mean level of 75.39 μg/dl±17.89. The results show a significant association between zinc levels and birth weight.Conclusions: Present study showed a positive correlation of maternal zinc levels with birth weight and prematurity. Hence, we recommend routine zinc supplementation could be included with other nutritional supplements during pregnancy.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185427
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of epidemiology, clinicopathological correlation, prognostic factors
           and management in squamous cell carcinoma of vulva

    • Authors: Chetana D. Parekh, Ruchi S. Arora, Shilpa M. Patel, Pabashi Poddar, Ava D. Desai, Meeta M. Mankad
      Pages: 223 - 228
      Abstract: Background: Carcinoma of the vulva is rare cancer, pruritus is the most common and long-lasting reported symptom. It is found to be associated with HPV and HIV infection. Currently, a more individualized and less radical treatment is suggested. In this study we evaluated epidemiology, clinicopathological prognostic factors, HPV distribution and risk factors for metastases to lymph nodes. We also reviewed multidisciplinary clinical management carried out at our institute.Methods: It is a prospective study of 25 biopsy proven cases of Squamous Cell Carcinoma of Vulva, treated at our center from September 2014 to September 2016. We collected the data regarding the clinical presentation, histological details, treatment given, survival and complications. HPV 16 and 18 testing were done using PCR method. Median follow up of the patients are for 24 months.Results: The mean age of patients was 54.6 years. Commonest presentation was perineal itching (36%). HPV 16/18 were positive in 25% of the patients. Radical vulvectomy with bilateral groin dissection was done in 14/25 (56%) patients. Among these 14 patients, 35.7 % (5/14) has lymph node metastases, disease free survival was 63.6% and overall survival was 81.1% for median follow up of 24 months. About one third of the patient presented with locally advanced disease.  Six (24%) patients received only chemo radiation as a treatment.Conclusions: HPV and HIV infection increase the risk of vulvar cancer. Individualization of treatment is necessary. The use of preoperative chemoradiation in locally advanced disease might have promising results in future.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185428
      Issue No: Vol. 8, No. 1 (2018)
       
  • Comparative study of user friendliness of paperless partogram compared to
           WHO partogram in preventing prolonged labour

    • Authors: Faswila M., Smitha B. Rao
      Pages: 229 - 233
      Abstract: Background: Partogram is being used since 1954 when Friedman described it for monitoring progress of labour. The Paperless Partogram proposed by Dr. Debdas is a low-skill method for detection of abnormal labour. The objective of the present study was to know efficacy and user friendliness of paperless partogram in comparison with WHO partogram in monitoring and management of labourMethods: It’s a comparative study. Total of 100 patients were included in the study where half of the patients were monitored by paperless partogram and the other half by WHO modified partogram. The plotting of the WHO partographs started as soon the cervical dilatation was 4 cm along with regular painful uterine contractions. In the paperless partogram calculation will be two times, an ALERT ETD (estimated time of delivery) and an ACTION ETD. The outcome of labour will be recorded at the end of each partographs.Results: Paperless partogram was better than WHO partogram in terms of documentation, ease of use, learning, time factor, cost effectiveness and monitoring of labour, identification of abnormal labour.Conclusions: In present study paperless partogram was found to be preferred for monitoring of labour.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185429
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of role of tablet misoprostol and extra amniotic normal saline in
           second trimester abortion

    • Authors: Zinkal P. Kothadiya, Bhavesh B. Airao, Bipin R. Shah
      Pages: 234 - 237
      Abstract: Background: Second-trimester pregnancy termination comprises 10 to 15 percent of the approximately 42 million abortions performed annually worldwide.  Second-trimester procedures can be performed either with medication or by mechanical methods (Foleys catheter) or surgically by dilation and evacuation (D and E) or hysterotomy. The objective of the present study was to evaluate and compare the efficacy and safety of Tablet Misoprostol and extra amniotic infusion of normal saline with balloon catheter in second trimester abortion, to find out the maternal outcome, to compare the induction- to delivery interval between tablet misoprostol and extra amniotic infusion of normal saline with balloon catheter and to compare the cost of induction between tablet misoprostol and extra amniotic infusion of normal saline   with balloon catheter.Methods: This randomized controlled study was carried out in the Obstetrics and Gynecology. Department of C.U. Shah Medical College, Surendranagar, from 23th August 2017 to 20th August 2018.Results: Amongst the 100 participants, 50 induction is done with tab. Misoprostol and 50 induction done with EASIBC. Success rate is higher in tab. Misoprost which is 90.20% and in EASIBC is 75.51%. There were longer induction abortion interval in EASIBC: Need for curettage among Misoprostol is 5 and EASIBC is 9. Major complication like PPH occurred in two cases in induction with tab. Misoprostol, which is managed by further intervention and no death occurred. No major complication occurred in induction with EASIBC.Conclusions: Excluding the side effects and complications, which are manageable induction with tab. Misoprostol is better than EASIBC in terms of induction abortion interval, effectiveness, acceptability.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185430
      Issue No: Vol. 8, No. 1 (2018)
       
  • Association of placental position with the development of hypertension in
           pregnancy

    • Authors: Prathima A., Reddi Rani P.
      Pages: 238 - 242
      Abstract: Background: Hypertensive disorders remain the most common medical complication during pregnancy and contribute greatly to maternal and perinatal morbidity and mortality. Several tests have been proposed to identify the women at risk of developing hypertension. Among the various predictors, the placental location by USG at 18-24 weeks is cost effective, non- invasive and has a good positive predictive value. The present study was undertaken to predict the association of placental location with the development of hypertension in pregnancy.Methods: This was a longitudinal cohort study conducted on 380 uncomplicated primigravid women who attended the obstetric OPD of MGMC&RI over a period of 18 months (March 2017-august 2018). A detailed history was taken, and examination done and B.P. was measured. The placental location was determined by ultrasound at 18-24 weeks and the patients were divided into two groups : group A were women with lateral placenta and group B were women with other placental locations. All women were followed up for signs and symptoms of hypertensive disorders of pregnancy and mode of delivery and neonatal outcome were noted.Results: Out of 380 women, 56(14.7%) had lateral placenta and 324(85.3%) had other placental locations. Out of the 57 women who developed hypertensive disorders in pregnancy, 16(28.6%) had lateral placenta and 41(12.7%) had other placental locations. The risk of developing hypertension in pregnancy with lateral placenta was 3.5(odds ratio) with a 95% confidence interval (1.4-8.6). The sensitivity, specificity, positive predictive value and negative predictive value when placental laterality is used as a predictive test was 28.1%, 87.6%, 28.6% and 87.4% respectively.Conclusions: The placental laterality as determined by ultrasound at 18-24 weeks is a simple, non-invasive, cost-effective predictive test to predict women at high risk of developing hypertensive disorders of pregnancy and this test has a high specificity and negative predictive value.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185431
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of route of hysterectomy

    • Authors: Dolly Gupta, Kavita Chandnani
      Pages: 243 - 246
      Abstract: Background: The objective is to study complication rate, advantages and outcome of different route of hysterectomy.Methods: A prospective study of 175 women over a period of 1 year i.e. from 01/01/2011 to 31/12/2011 SSG hospital, Vadodara. Depending on the patient profile, experience of surgeon optimum route of hysterectomy was decided.Results mean operating time in AH group was 68.4±14.4min, which was 80±10.3min, 115.8±40.6min and 148.8±25.5min in NDVH, LAVH and TLH group respectively. TLH was performed by consultants. Febrile morbidity was significantly high in AH (23%). Bladder and ureteral injuries were seen in 4% and 3% cases of NDVH and AH group. Wound complications were seen in AH (10%), whereas vault complications were higher in TLH. The hospital stay was shortest in TLH. Women with TLH had early ambulation, early resumption to normal diet, early return to routine work and better sexual function.Conclusions: Women with excessively enlarged uteri, significant pelvic pathology, or cancer are obvious candidates for AH. On the other hand, VH is frequently chosen for the small uterus in a multiparous woman with a large pelvis and no prior pelvic inflammatory disease or surgery. Although TLH, LAVH have significantly lower complication rate than AH, but overall cost is higher owing to the high operating room charges. The final selection of hysterectomy route should be based on surgeon’s experience and indication for surgery.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185432
      Issue No: Vol. 8, No. 1 (2018)
       
  • Effect of maternal education on antenatal care utilization, maternal and
           perinatal outcome in a tertiary care hospital

    • Authors: Isha Chopra, Sunil K. Juneja, Sarit Sharma
      Pages: 247 - 250
      Abstract: Background: Antenatal Care (ANC) utilization facility is available but poorly utilized because of many factors which play indirect role in inadequate utilization of antenatal care facility: low social status of women in the society, less opportunity for basic education, less ability to make decisions. Therefore, the present study is an attempt to study the effect of maternal education on antenatal care utilization, maternal and perinatal outcome in a tertiary care hospital.Methods: A prospective study was carried out on 525 cases delivered during period of one year at Dayanand Medical College and Hospital, Ludhiana, Punjab, India; a tertiary care hospital catering both urban and rural population. All cases were categorized into two groups: booked and unbooked. The age, parity and education of each patient in booked and unbooked cases was noted. Further, its impact on antenatal care utilization, maternal and perinatal outcome was studied.Results: On studying education pattern, among illiterate subjects 50% were booked and 50% were unbooked; For graduate and above were 80.6% and 19.4%respectively. Among mothers who were illiterate 90.9% had low birth weight babies and 13.6% had stillborn. Among those graduates and above 38.7% had low birth weight babies,1.5 % stillborn and 1.2% neonatal deaths.Conclusions: The educational status of the women came out as a significantly important variable and predictor of perinatal outcome. Hence, whole hearted efforts should be directed in educating women population and also improving health care facilities in rural areas to provide early referral to higher centers.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185433
      Issue No: Vol. 8, No. 1 (2018)
       
  • Anaemia in term pregnancy: influence on maternal and perinatal outcome and
           role of demographic factors

    • Authors: Urvashi Miglani, Priya Bhangadia, V. K. Kadam, Poonam Laul
      Pages: 251 - 257
      Abstract: Background: The aim is to study maternal and perinatal outcome and various demographic factors in term pregnancy complicated with anaemia at DDU Hospital.Methods: Hospital based prospective observational analytical study. 200 pregnant women reporting to antenatal clinic or admitted to the Hospital in labour/not in labour after 36+6weeks of pregnancy were taken as study subjects. Study duration was one year between  July 2017 to June 2018.Results: The prevalence of mild, moderate and severe anaemia was 25%, 56% and 19% respectively. Education status, socioeconomic status, ANC visit, interpregnancy interval were significantly associated with anemia(p<0.05). Significant association was observed between occurrence of PPH and severity of anaemia(OR 12.77; CI 2.32 to 70.12). The incidence of LBW increased with severity of anaemia. (OR-6.25;CI 2.6 to 15). There was a statistically significant difference found in prevalence of IUGR babies. The risk of Apgar score <8 increased with severity of anaemia. Perinatal mortality was observed in 8% subjects with anaemia as compared to 3% in subjects without anaemia.Conclusions: Maternal anaemia is a major public health problem. Simple steps taken to correct anaemia in female contemplating pregnancy and pregnant women can definitely have far reaching influences on maternal and perinatal morbidity.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185434
      Issue No: Vol. 8, No. 1 (2018)
       
  • Neonatal and maternal outcome in term primigravida with isolated
           oligohydramnios

    • Authors: Shelly Agarwal, Samta Gupta
      Pages: 258 - 261
      Abstract: Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes.  After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome. 
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185435
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of cardiac disease and its outcome in pregnancy

    • Authors: Tejal L. Patel, Kritika S. Pandey, Arvind Ambaliya
      Pages: 262 - 266
      Abstract: Background: Pregnancy comes as a temporary complication in the disease process of a patient with a cardiac lesion. It is the 4th common cause of maternal mortality and one of the most important non-obstetrical causes of maternal death. Previously most women with diagnosed heart disease were advised to avoid pregnancy and labor and termination was advised. But in modern obstetrical practice, pregnancy in a patient with a heart disease is no longer an unacceptable hazard. The objective of this study is to find out incidence of cardiac diseases in pregnancy, to evaluate their management and to find out maternal and fetal outcome in pregnancy with cardiac disease.Methods: This study is a prospective cohort study in which an analysis of maternal and fetal outcome in 30 cases of cardiac diseases in pregnancy was carried out in the department of Obstetrics and Gynaecology in our institute at Civil hospital Ahmadabad from 01/01/2017 to 31/12/2017.The study included all known case of RHD, CHD, or newly diagnosed case or surgically corrected case with prosthetic heart valves during current pregnancy.Results: Majority of women having pregnancy with cardiac disease were in the age group of 20-30 years. Majority of them were primigravida and suffered from rheumatic heart diseases with grade 1 NYHA severity. Majority of women got delivered by normal vaginal delivery with healthy fetal outcome. Most of the babies born to cardiac mother had their baby weight ranging between 2.0-2.5kg.Conclusions: The results of present study indicate that heart disease forms a considerable proportion of medical illness complicating pregnancy. Cardiac disease presents problems both to the obstetrician and as well as to the physician, cardiologist and to the neonatologist. But the majority of pregnancies complicated by heart disease are uneventful with a favorably good outcome for both the mother and the fetus.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185436
      Issue No: Vol. 8, No. 1 (2018)
       
  • Combined hysteroscopy and laparoscopy in evaluation of female infertility

    • Authors: Nikita Gandotra, Syed Masuma Rizvi, Preeti Sharma
      Pages: 267 - 272
      Abstract: Background: Infertility has always been one of the most elusive symptom complexes that perplex the best gynecologists and affects about 10-15% of reproductive age couples.Methods: This descriptive study was conducted in the Postgraduate Department of Obstetrics and Gynaecology at Government Medical College, Jammu  for a period of 18 months in which 100 infertile females attending  OPD for infertility workup were subjected to detailed relevant history taking followed by physical examination. Diagnostic hysteroscopy and laparoscopy along with laparoscopic chromopertubation was carried out after written informed consent including minimal therapeutic interventions if required.Results: Out of 100 patients included in the study, 67 (67%) presented with primary infertility and 33 (33%) presented with secondary infertility. Combined laparoscopy and hysteroscopy was normal in 13% (13) of cases. Out of 100 patients, abnormal laparoscopic findings were noted in 73% of patients: Endometriosis ( 13%),Polycystic ovaries (12%), Unilateral tubal block (11%), Pelvic inflammatory disease (9%).Abnormal hysteroscopic findings were noted in 47% of patients: Submucous myoma (8%),unilateral ostial block (8%),Endometrial polyp (7%), Hyperplasic endometrium (7%), Cervical stenois (6%).Most common cause of infertility in present study on Combined hysteroscopy and laparoscopy was Endometriosis (13%) followed by Polycystic ovaries (12%),Uterine myoma (12%) out of which 5% myomas were diagnosed on laparoscopy and 8% on hysteroscopy and 1%  had myoma diagnosed on both hysteroscopy and laparoscopy. In the primary infertility group most, common finding was Polycystic ovaries (16.4%)  followed by Endometriosis (14.9%) and uterine myoma (14.9%) while in patients suffering from secondary infertility, most patients had Bilateral tubal block (18.2%), Pelvic inflammatory disease (12.1%), Unilateral tubal block (12.1%), intrauterine adhesions (12.1%).Conclusions: Combined Hysteroscopy and Laparoscopy is a quintessential tool that provides cost-effective, comprehensive and single set-up diagnostic aid in infertile patients.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185437
      Issue No: Vol. 8, No. 1 (2018)
       
  • A clinical study of impact of anaemia in pregnancy on maternal and
           neonatal outcome

    • Authors: Lokeshwari K., Anju Arpana, Manoj Kumar Mudigubba
      Pages: 273 - 278
      Abstract: Background: The aim is to study effect of anaemia in obstetrics patients during antepartum, intrapartum and postpartum and to find the incidence of maternal and neonatal morbidity and mortality in those patients.Methods: A prospective clinical study was conducted on patients receiving obstetric care at Basaveshwara Medical College and Hospital from July 2016 to July 2018.Pregnant women with Hb less than 8g were included in the study to determine the outcome of pregnancy in severe anaemia and determine the causes of anaemia. Acute cases of obstetrical haemorrhages as in antepartum and postpartum haemorrhages and all medical and surgical high-risk factors except anaemia, were excluded from the study.Results: A total of 200 pregnant anaemic patients with haemoglobin less than 8g/dl were included in the study. The patients were divided into two groups based on haemoglobin concentration at first presentation. Patients with haemoglobin level less than 5g/dl were included in group A (N=44, 22%), and rest of the patients were included in group B (N=156, 78%). Most commonly observed complications in the study were preeclampsia and eclampsia (46 cases), preterm labour (46 cases) and IUGR (30 cases). In both group of patients, the commonest cause of anaemia in pregnancy was iron deficiency. The greater the severity of anaemia in pregnancy, greater was the risk of preeclampsia, preterm delivery, low birth weight and stillbirth.Conclusions: This study reveals that severe anaemia which is commonly observed in the pregnancy in our country, gives rise to maternal and perinatal morbidities and mortalities.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185438
      Issue No: Vol. 8, No. 1 (2018)
       
  • Primary lower segment caesarean section in multipara: materno-fetal
           outcomes

    • Authors: Grishma P. Agrawal
      Pages: 279 - 284
      Abstract: Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging' Who would break the shell to pull the chick out'” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185439
      Issue No: Vol. 8, No. 1 (2018)
       
  • The study of maternal and perinatal outcome in preeclampsia in tertiary
           care hospital

    • Authors: Neelima B.
      Pages: 285 - 289
      Abstract: Background: Preeclampsia accounts for majority of causes for maternal and perinatal morbidity and mortality.Methods: All patients beyond 20 weeks with pre-eclampsia admitted to Gandhi Hospital during two-year study period were enrolled in the study. The  objective of this study was to analyze the type and rate of maternal and perinatal complications in preeclampsia. Women with preexisting renal disease, chronic hypertension, anemia, heart disease, epilepsy, thrombophilias, hemolytic disease, preexisting liver disease were excluded from the study. Obstetrics management was done as per existing protocol in the department. Magnesium sulphate  was the drug of choice to control convulsions. Blood pressure was controlled by either tablet alpha methyl dopa or nifedipine or both.Results: Preeclampsia cases accounted for 460 (4.9%) of total deliveries. Majority (86.52%) were unbooked cases between 20 -25 years of age (63.48%) and were primigravida (60.44%) belonging to low socioeconomic status (73.91%). Commonest maternal complication in present study was eclampsia (34.56%) Total maternal deaths accounted for 14. Most common cause for maternal mortality was eclampsia with HELLP (9,64.28%).  Total perinatal deaths  accounted for164 and most common cause  for perinatal death was prematurity (47,28.65%).Conclusions: Preeclampsia is major leading cause for poor maternal and fetal outcome. Regular antenatal checkup , early diagnosis  , early interventions , early referral to tertiary centers, optimum timing and mode of delivery and awareness among patients will reduce both maternal and perinatal morbidity and mortality.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185440
      Issue No: Vol. 8, No. 1 (2018)
       
  • Does gum chewing affect the timing of return of intestinal motility after
           elective cesarean section'

    • Authors: Atef M. Darwish, Tarek A. Farghly, Beshoy T. Gad, Ahmed M. Abbas
      Pages: 290 - 294
      Abstract: Background: The aim is to evaluate the effect of gum chewing on the return of intestinal motility after elective CS.Methods: Study period was from September 2017 to March 2018 at the Assiut Women Health University Hospital. The study was registered as a prospective cohort study (Clinicaltrial.gov   NCT03355378). Women planned for elective CS according to selection criteria randomized to two groups: Group 1: included 100 patients who received intraoperative and postoperative non-sugary gum chewing as 15 minutes every 2 hours post-operatively for 6 hours with regular care and Group 2: included 100 patients who received regular care without gum chewing.Results: No statistically significant difference regarding the baseline criteria of both groups. There was a statistically significant lower systolic and diastolic blood pressure in gum chewing group. Hospital stay of gum chewing group was 7.33±0.73 hours versus in non-gum chewing group 20.28 ± 9.92 (p=0.000). Passage of flatus of gum chewing group was 8.54±0.98 hours versus in non-gum chewing group 13.22 ± 3.75 (P= 0.000).Conclusions: Gum chewing during elective CS improves gut motility in a safe way resulting in early passage of flatus, less hospital stay, and minimal pain score less cost on hospitals.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185441
      Issue No: Vol. 8, No. 1 (2018)
       
  • A prospective observational study conducted in tertiary teaching hospital
           of Uttar Pradesh to compare safety and efficacy of PPIUCD and interval
           IUCD (380A)

    • Authors: Nidhi Gupta, Akanksha .
      Pages: 295 - 298
      Abstract: Background: The objective of this study was to compare the efficacy and safety of PPIUCD and interval IUCD.Methods: This was a prospective observational study conducted on women attending the OPD and indoor services of S.N. Medical college, Agra. 800 women willing for PPIUCD insertion were included in the study after informed consent excluding chorioamnionitis, PROM>18 hours, unresolved PPH and puerperal sepsis. Another 200 willing women were inserted interval IUCD according to MEC criteria of WHO. All were followed up for 1 year.Results: It was found that rate of expulsion was more in PPIUCD group compared to interval IUCD group (6%vs 1.5% p value <.05),rate of removal was almost similar in both groups (11.5%inPPIUCD and 14%in interval IUCD group), cause of removal was mainly social in PPIUCD group while bleeding was more in interval IUCD group compared to PPIUCD (85.7%vs26%).Conclusions: Postpartum insertion of IUCD is a safe effective, feasible and reversible method of contraception.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185442
      Issue No: Vol. 8, No. 1 (2018)
       
  • A prospective analysis of polycystic ovarian syndrome in infertile women

    • Authors: Soumya Patil, Saraswathi Ramesh, Harinath Srinivasa Murthy Kharidhi
      Pages: 299 - 302
      Abstract: Background: Polycystic ovarian syndrome (PCOS) is a frequently occurring metabolic and reproductive endocrinopathy. Young women with PCOS mainly present with reproductive problems such as hyperandrogenism, menstrual irregularities, infertility and chronic anovulation. Despite its high prevalence and implications on reproductive health, PCOS is underdiagnosed. The objective was to study the prevalence of PCO in women with infertility, their symptomatology, endocrine profiles and coexisting factors of infertility in women with PCOS.Methods: A prospective study was performed over a period of 6 months. Women presenting with infertility were subjected to detailed history taking, general and gynecological examination. Women with features of PCOS on ultrasound were identified and advised investigations such as serum FSH, LH, prolactin and laparoscopy when indicated.Results: During the study period, 102 patients consulted the infertility clinic, out of which 56 were diagnosed with PCOS. The prevalence of PCOS was found to be 54.9% among infertile women. Menstrual irregularity was found in 33 (59%) women, however, 23 (41%) had regular menstrual cycles. 4 among the 33 patients complained of dysmenorrhea, 5 had heavy menstrual bleeding. On examination, 19 (33.9%) were found hirsute, 8 (14.28%) had thyroid enlargement and 2 (3.57%) had galactorrhea. Investigations revealed mean FSH and LH levels of 8.7±2SD and 13.7±2SD respectively and mean LH/FSH ratio of 1.57±2SD.Conclusions: PCOS is a heterogenous disorder and with its high prevalence in infertile women, proper diagnosis and management is essential as it has many potential metabolic and cardiovascular risks if not managed appropriately.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185443
      Issue No: Vol. 8, No. 1 (2018)
       
  • Study of fetomaternal outcome of teenage pregnancy in a tertiary care
           hospital-MGMGH

    • Authors: Gayathrie Devi, Kayalvizhi ., Poovathi M.
      Pages: 303 - 307
      Abstract: Background: The objective is to study the fetomaternal outcome in teenage pregnancy at MGMGH for the study period of 6 months from April 2018 to September 2018. Teenage pregnancy is a worldwide health problem. WHO defined adolescence as the period from 10-19 years. It is a serious health problem in a developing country like India. Teenage pregnancy is associated with high risk of prematurity, low birthweight, preeclampsia and anaemia. The NHFS IV 2015 -2016 estimates that overall teenage pregnancy in India 7.9%.Methods: It is a retrospective study conducted in a tertiary care hospital at MGMGH, Trichy over a period of 6 months.251 teenage pregnant women delivered at our institution were selected for the study out of 4508 total deliveries during the study period. Parameters including incidence, age, parity, booking status, educational and socioeconomic status, medical disorders, antepartum, intrapartum, postpartum complications, mode of delivery and neonatal outcome were studied.Results: Study showed the incidence of teenage pregnancy at our MGMGH is 5.56%. Among these teenage pregnant women 47.1% had anaemia, 23.1% had gestational hypertension,4.8% of women had eclampsia, 22.3% % had preterm delivery. Lscs rate was 27.1%,70.29 % had Normal vaginal delivery,1.6% had instrumental deliveries, 31.5% had low birth weight babies,28.2 % NICU admissions, 2.9% perinatal deaths.Conclusions: Teenage pregnancy is associated with increased incidence of anaemia, pre-eclampsia, eclampsia, preterm delivery, instrumental delivery, low birth weight and perinatal death. By improving socio economic status, education, nutrition, good antenatal care, public awareness, institutional delivery and postnatal care help in reducing maternal and perinatal morbidity and mortality in adolescent pregnancy.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185444
      Issue No: Vol. 8, No. 1 (2018)
       
  • Comparative study of non-descent vaginal hysterectomy with abdominal
           hysterectomy

    • Authors: Tejal L. Patel, Rinkal R. Patel, Vaibhavi Vaghela
      Pages: 308 - 312
      Abstract: Background: Hysterectomy is one of the most common operation performed in Obstetrics and Gynecology next to caesarean section. Due to its advantages vaginal hysterectomy are more and more performed now. Only drawback is lack of expertise. Present study focuses on comparison between outcomes in abdominal versus vaginal hysterectomy and to determine which route of hysterectomy is superior, safer and effective.Methods: The study is a prospective study conducted in the department of obstetrics and Gynecology. Civil hospital, Ahmedabad between the period of Jan 2016 to 2017. Of 100 patients. Fifty patients who underwent hysterectomy by vaginal route are taken as study group A, and the remaining 50 patients who underwent by the abdominal route are taken as study group B.Results: Majority of women undergoing hysterectomy were in age group of 30-50 years; postmenopausal age group women were less;13 NDVH and 5 in AH. Majority of the women were multipara in both age groups. Menorrhagia was found to be major indication with 42 in NDVH and 40 in AH. There is much significant difference in the postoperative pain in both groups with less in NDVH group. There is not much significant difference in blood loss in both the groups. Postoperative complications were more with AH.Conclusions: Thus, it can be concluded that NDVH is feasible, safe and provide more patient comfort without increasing the duration of surgery and other post-operative complications.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185445
      Issue No: Vol. 8, No. 1 (2018)
       
  • The perplexity of malignant ovarian mass in cystadenofibroma: a lesson
           learnt

    • Authors: Priyanka Kathuria, Garima Yadav, Pratibha Singh
      Pages: 313 - 316
      Abstract: The aim of this study is to report a rare case of ovarian cystadenofibroma with even scarcely observed mucinous type histopathological variant and to discuss the modalities which can contribute to prevent misdiagnosing it as a malignant tumor that may inappropriately lead to aggressive surgical interventions. A 40-year-old female presented with pain in lower abdomen and dysmenorrhea of 3 months duration and a large right adnexal mass which had all the features suggestive of malignancy in pre-operative investigations and even on gross overview and cut section. On the contrary histopathology reports confirmed its benign nature and reported it as mucinous cystadenofibroma. Role of Preoperative MRI and intraoperative frozen section cannot be overemphasized in distinguishing ovarian cystadenofibroma from malignant tumors, which can avoid an unnecessary extensive surgery.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185149
      Issue No: Vol. 8, No. 1 (2018)
       
  • Post partum headache: a case series

    • Authors: Reema Kumar Bhatt, Rohin Kumar, L. B. Singh
      Pages: 317 - 320
      Abstract: Postpartum headache is the complaint of head, neck, or shoulder pain occurring during the first 6 weeks following delivery. Among the women who underwent neuraxial aneasthesia Post Dural puncture headache is one of the most common presentations. However, physicians should be aware that post Dural puncture headache is not the only cause of postpartum headache.
      Authors present a series of four cases that had varied presentation of post partum headache with varied diagnosis, the first case was of subdural haematoma where CT scan revealed an acute on chronic SDH. The second case was diagnosed as meningitis and the CSF for culture sensitivity grew Streptococcus Pneumoniae .In our third case of cortical vein  thrombosis , NCCT followed by MR venogram  revealed left transverse venous sinus thrombosis and our last case in the series was of posterior reversible encephalopathy syndrome where MRI confirmed the findings of typical findings are symmetric edema involving the white matter of the posterior regions of the cerebral hemispheres. The diagnostic dilemma was resolved by neuroimaging because the clinical presentation was not making us reach a satisfactory diagnosis of the cause of headache. Early resort to neuroimaging and multidisciplinary team effort paved way to early diagnosis and appropriate recovery of the patients.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185089
      Issue No: Vol. 8, No. 1 (2018)
       
  • Giant chorioangioma of placenta: a rare placental cause of polyhydramnios

    • Authors: Suneetha Allanki, Neethi Mala Mekala, Sunethri Padma
      Pages: 321 - 324
      Abstract: Chorioangioma belongs to benign nontrophoblastic primary vascular neoplasms of placenta, originating from primitive chorionic mesenchyme and has a cited prevalence of around 0.6% to 1% of all pregnancies. Though majority of them are asymptomatic, clinical course depends mainly on the size of the neoplasm. Giant chorioangiomas (> 4-5 centimetres in diameter) with an approximate prevalence of around one in 9000 to one in 50,000 pregnancies, have been associated with many adverse maternal and fetal complications. We report a case of 21-year-old primigravida lady, who presented to us at 37weeks 4 days period of gestation with backache and with clinically evident increased liquor. On evaluating the cause of her polyhydramnios, ultrasonography revealed a well-defined echogenic vascular mass measuring ~ 8х8 centimetres in the placenta, suggestive of chorioangioma. Though the condition is infrequent, through this case report, we emphasize that even placental factors need to be ruled out in evaluating causes of polyhydramnios. Despite large size of chorioangioma and associated hydramnios, our patient exceptionally didn’t have any fetal complications. With proper antenatal surveillance, optimal feto-maternal outcome can be expected as seen in our case.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185180
      Issue No: Vol. 8, No. 1 (2018)
       
  • Incomplete pentalogy of Cantrell: a case report

    • Authors: Heera T. Shenoy, Prasanna Venugopal, Raghu S., Remash K.
      Pages: 325 - 328
      Abstract: Pentalogy of Cantrell (PC) is a rare congenital anomaly characterized by a defect in the lower sternum, anterior diaphragm, and anterior abdominal wall; ectopia cordis; and congenital heart disease.
      Authors report a case of male foetus terminated at 20 weeks of gestation with an Incomplete (class 3) pentalogy of Cantrell presenting with gastroschisis, ectopia cordis and absence of lower sterna. Prognosis of pentalogy of Cantrell depends on severity of intra and extra cardiac defects, pulmonary hypoplasia, extent of abdominal wall defect, cerebral anomalies and diaphragmatic herniation. Full pentalogy of Cantrell is a severe and rare syndrome, but incomplete forms with combination of two or three defects are reported frequently similar to present case report.  Early diagnosis through obstetric ultrasound would help in improved informed clinical decision making on the part of the obstetrician and family.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185446
      Issue No: Vol. 8, No. 1 (2018)
       
  • Outcomes of prolonged preterm premature rupture of the membrane: a report
           of six cases

    • Authors: Asha Dixit
      Pages: 329 - 331
      Abstract: Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185447
      Issue No: Vol. 8, No. 1 (2018)
       
  • Heterotopic pregnancy: case report of a successful first trimester
           metacyesis management and a viable third trimester outcome

    • Authors: Arvind Kumar Singh, Shazia Khan
      Pages: 332 - 334
      Abstract: Heterotopic pregnancies are rare combined intra and extrauterine pregnancies, the incidence of which has shown an increase over the past decade with the rising trend in assisted reproductive technologies (0.75-1.5%).
      Authors report a case of a 29 year old primigravida, a post IVF conception who presented at 6 weeks POG with a ruptured tubal and a viable intrauterine pregnancy. She underwent an emergency laparoscopic right salpingectomy and continued with her intrauterine pregnancy successfully till term. The article emphasizes the need of scanning the adnexa carefully in early pregnancy to diagnose and manage heterotopic pregnancy as early as possible to prevent catastrophic haemorrhage and maternal morbidity and mortality later.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185448
      Issue No: Vol. 8, No. 1 (2018)
       
  • Bilateral absence of fallopian tube segments: an uncommon condition

    • Authors: Tejashri Shrotri, Meenakshi Ahuja
      Pages: 335 - 337
      Abstract: Congenital abnormalities of fallopian tube are rare among the abnormalities of female urogenital system. Bilateral absence of fallopian tube segments is an extremely uncommon condition. The authors report one such rare case diagnosed during diagnostic laparoscopy during evaluation of infertility. On one side, it was completely absent; while on the other side, it was partially absent simulating a formal tubal ligation. To the best of authors knowledge, this is an extremely unusual condition with very few reports available in literature.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185449
      Issue No: Vol. 8, No. 1 (2018)
       
  • Management of postpartum iron deficiency anemia: review of literature

    • Authors: Mohamed Saber, Mohamed Khalaf, Ahmed M. Abbas, Sayed A. Abdullah
      Pages: 338 - 342
      Abstract: Anemia is a condition in which either the number of circulating red blood cells or their hemoglobin concentration is decreased. As a result, there is decreased transport of oxygen from the lungs to peripheral tissues. The standard approach to treatment of postpartum iron deficiency anemia is oral iron supplementation, with blood transfusion reserved for more server or symptomatic cases. There are a number of hazards of allogenic blood transfusion including transfusion of the wrong blood, infection, anaphylaxis and lung injury, any of which will be devastating for a young mother. These hazards, together with the national shortage of blood products, mean that transfusion should be viewed as a last resort in otherwise young and healthy women. Currently, there are many iron preparations available containing different types of iron salts, including ferrous sulfate, ferrous fumarate, ferrous ascorbate but common adverse drug reactions found with these preparations are mainly gastrointestinal intolerance like nausea, vomiting, constipation, diarrhoea, abdominal pain, while ferrous bis-glycinate (fully reacted chelated amino acid form of iron) rarely make complication. Two types of intravenous (IV) preparations available are IV iron sucrose and IV ferric carboxymaltose. IV iron sucrose is safe, effective and economical. Reported incidence of adverse reactions with IV iron sucrose is less as compared to older iron preparations (Iron dextran, iron sorbitol), but it requires multiple doses and prolonged infusion time. Intramuscular iron sucrose complex is particularly contraindicated because of poor absorption. It was also stated that when iron dextran is given intravenously up to 30% of patients suffer from adverse effects which include arthritis, fever, urticaria and anaphylaxis.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185450
      Issue No: Vol. 8, No. 1 (2018)
       
  • Role of camylofin and its combinations in obstetrics and gynaecological
           practice: a review of Indian evidence

    • Authors: Niranjan Mayadeo
      Pages: 343 - 348
      Abstract: Anti-spasmodic drugs like camylofin are used in obstetrics and gynaecological practice for broadly two conditions - spasmodic abdominal pain and management of prolonged labor. Camylofin has been in use in India for almost six decades. As a spasmolytic, camylofin has demonstrated good efficacy and tolerability, both in the management of abdominal spasmodic pain and in augmentation of labor. Literature evidences has suggested that camylofin has demonstrated a statistically significant superiority, such as higher spasmolytic potency compared to other anti-spasmodics like drotaverine, hyoscine and valethamate. In some studies, camylofin maintained the superior efficacy, despite being given as a single dose compared to repeat doses of comparator drugs. Also, in augmentation of labor, camylofin single dose demonstrated superior efficacy when the comparator arm was given a combination of two anti-spasmodic drugs i.e. hyoscine and valethamate in three doses at hourly intervals. Clinical studies in abdominal colic pain revealed significant superiority of the camylofin-paracetamol combination over dicylomine paracetamol combination, this despite the camylofin combination containing 300mg paracetamol as compared to the dicyclomine combination containing 500mg paracetamol. Similar results, highlighting better outcomes in abdominal colic of different types, was shown in studies comparing camylofin-diclofenac combination compared with hyoscine (in renal colic) and also camylofin-mefenamic acid combination compared with dicyclomine-mefenamic acid combination (in menstrual colic). All the above clinical study results resonate in the findings of a recent survey with gynaecologists across the country, which showed that camylofin is considered as the anti-spasmodic most suitable for female patients compared to drotaverine, dicyclomine and hyoscine. Given the availability of strong clinical trial data in Indian women patients, camylofin along with its combinations holds a strong place in the armamentarium of practicing obstetricians and gynaecologists and can be a preferred choice of therapy in treatment protocols of abdominal spasmodic pain and augmentation of labor.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185291
      Issue No: Vol. 8, No. 1 (2018)
       
  • Uterine sparing approaches in management of placenta accreta: a summarized
           review

    • Authors: Ali Hussein, Ahmed A. Abdelaleem, Ahmed M. Abbas, Maher Salah
      Pages: 349 - 352
      Abstract: Placenta accreta is a potentially life-threatening obstetric condition that required multidisciplinary approach to management. Placenta accreta occurs in complete absence of the decidua basalis. Women with previous cesarean section delivery or placenta previa are known to be at greater risk of placenta accreta. A previous study reported that 24%& 67% increase in the incidence of placenta accreta in women 1 versus 3 or more previous cesarean deliveries respectively. Antenatal diagnosis of placental invasion has the potential to improve maternal and fetal outcomes. In practice, incomplete non-separation of the placenta at delivery leads to massive obstetric hemorrhage resulting in maternal morbidities such as massive blood transfusion, DIC, injury to the bladder and intestines and the need for hysterectomy. Sonographic examination with gray scale and color doppler imaging is the recommended first line modality for diagnosis of morbidly adherent placenta. Techniques developed for conservative management are techniques developed to preserve uterus and future fertility which is crucially linked to societal status and self-esteem.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185451
      Issue No: Vol. 8, No. 1 (2018)
       
  • Obstetric hysterectomy: a receding trend

    • Authors: Fasiha Tasneem, Vijayalakshmi Shanbhag
      Pages: 353 - 358
      Abstract: Over 500,000 women die each year due to complications of pregnancy and childbirth, a number that has remained relatively unchanged since 1990, when the first global estimates of the burden of maternal mortality were developed. Hemorrhage due to uterine atony, adherent placenta and PPH are still the causes of maternal death in developing countries. Although advances have been made in the development of conservative medical and surgical treatment of obstetric haemorrhage like brace sutures, internal iliac artery ligation, selective arterial embolization etc emergency obstetric hysterectomy remains a lifesaving procedure in the management of intractable haemorrhage unresponsive to conservative management.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185452
      Issue No: Vol. 8, No. 1 (2018)
       
  • Camylofin dihydrochloride injection: a drug monograph review

    • Authors: Niranjan Mayadeo
      Pages: 359 - 367
      Abstract: Camylofin dihydrochloride is an anti-spasmodic drug available in India and other Latin American and African countries, for the treatment of abdominal colic and for acceleration of labor. Although, the drug has been in use for over six decades, with multiple citations in academic text books of repute, treatment protocols, and multiple research publications, there is no consolidated published information on the pharmacology and clinical details of camylofin. This drug statement/monograph is an attempt to collate and present scientific information that will come in handy to practicing obstetricians and gynaecologists, as well as other primary care physicians, when treating cases of abdominal colic or managing prolonged labor. Approved clinical indications, clinical pharmacology, dosage, contraindications, precautions, drug interactions, adverse effects, overdose and clinical evidence in different indications are covered herein.
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185453
      Issue No: Vol. 8, No. 1 (2018)
       
  • Clinical significance and treatment of striae gravidarum during pregnancy:
           a review article

    • Authors: Ahmed M. Abbas, Fatma M. Kamel, Safwat A. Salman
      Pages: 368 - 371
      Abstract: Abdominal stretch marks found during pregnancy may be indicative of poor skin elasticity. One who does not have stretch marks may have better skin elasticity and may be less likely to tear perineal and vaginal tissue during vaginal delivery. Striae gravidarum (SG) is a common phenomenon of stretch marks observed during pregnancy that may be an indicator of poor skin elasticity. The type and amount of collagen in connective tissue are considered to determine the individual’s elastic index. The skin surface is made up of a complex network of crossing thin lines. The two-dimensional relationship between primary and secondary lines determines the skin texture and its grade of irregularity. SG is caused by changes in the structural connective tissue due to a hormonal elect on the alignment and reduced elastin and fibrillin in the dermis. Severity scoring of SG was observed using the numerical scoring system of Atwal. This score provides a rank based on observation of four areas in which SG is most commonly observed (abdomen, hips, buttocks, and breast).
      PubDate: 2018-12-26
      DOI: 10.18203/2320-1770.ijrcog20185454
      Issue No: Vol. 8, No. 1 (2018)
       
 
 
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