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

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

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Modified ovarian response prediction index: a novel index for ovarian
           response prediction in GnRH agonist cycles

    • Authors: B. Kalpana, Soumya Ranjan Panda
      Pages: 2575 - 2581
      Abstract: Background: Evaluation of the ovarian reserve is necessary to achieve an appropriate controlled ovarian stimulation (COS). This can be done by correctly predicting the ovarian response. The objective of this study was to derive a simple index by combining the above parameters which will be helpful determining ovarian response.Methods: This retrospective analysis was performed at Guru hospital, Madurai, involving 162 patients between July 2016 and July 2018. Inclusion criteria was all patients attending for their first ICSI (intracytoplasmic sperm injection) cycle between the above period, GnRH agonist protocol as the method of ovarian stimulation, no history of any previous ovarian surgery, presence of both ovaries and no evidence of any obvious endocrine disorders. We calculated MORPI values by multiplying the AMH (ng/ml) level by the number of antral follicles (2-9 mm), and the result was divided by the age (years) of the patient and the day- 3 serum FSH level.Results: At a cut-off value of 35 (AUC-0.952) for collection of ≥ 4 oocytes and 140 (AUC-0.952) for collection of ≥ 15 oocytes, MORPI was found to have optimum sensitivity and specificity under ROC curve analysis.Conclusions: MORPI is a simple, precise and cost effective index to predict a low ovarian response, the collection of >4 MII oocytes and an excessive ovarian response in infertile women. This index also has a good ability to predict the clinical pregnancy rate. This might be used to improve the cost-benefit ratio of ovarian stimulation regimens.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193015
      Issue No: Vol. 8, No. 7 (2019)
       
  • Unmet need in family planning at the Cape Coast Teaching Hospital of Ghana

    • Authors: Diallo Abdoul Azize, Ekanem Evans, Agyare-Gyan Frederick
      Pages: 2582 - 2585
      Abstract: Background: Knowing the prevalence of unintended pregnancy, unmet need in family planning and the associated factors in cape coast, is important for ensuring that all women have access to the most effective methods of family planning in order to reduce the occurrence of unintended pregnancies. This study aims to determine the prevalence of unintended pregnancies, unmet need in family planning and the associated factors among women attending antenatal clinics at the Cape Coast Teaching Hospital, Republic of Ghana.Methods: A prospective cross-sectional study with descriptive and analytical components was carried out from 20th April 2015 to 20th June 2015 to simultaneously measure the prevalence of unmet need for family planning and related factors.  All clients reporting for ANC at the Cape Coast Teaching Hospital during the study period were recruited into the study.Results: A total of 324 clients were recruited. The mean age was 29.98±5.86 years, 85.80% were married, 46.58% had tertiary education and 79.94% had a source of income. Up to 54.94% of the clients had not planned their index pregnancy. Among subjects who had not planned their index pregnancies, 74.71% had not used a family planning method. There is a significant association between age, educational level, the presence of a source of income, marital status and the occurrence of unplanned pregnancy.Conclusions: There were high prevalence of unplanned pregnancy and unmet need for family planning. There is a significant association between age, educational level, the presence of a source of income, marital status and the occurrence of unplanned pregnancy.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193016
      Issue No: Vol. 8, No. 7 (2019)
       
  • Effect of oxytocin infusion versus tranexamic acid on reducing blood loss
           during hysteroscopic myomectomy: a randomized controlled trial

    • Authors: Sabry E. Mohamed, Amr M. El Helaly, Mohamed H. Salama
      Pages: 2586 - 2591
      Abstract: Background: Women undergoing hysteroscopic myomectomy are prone to significant blood loss and hematological disturbances. Oxytocin is a uterotonic drug, used mainly in obstetric practice. Tranexamic acid is a haemostatic drug that has been used to reduce blood loss after trauma and in many surgeries. The aim of our study was to compare the safety and efficacy of oxytocin versus tranexamic acid in reducing perioperative blood loss during hysteroscopic myomectomy.Methods: This study included 60 patients scheduled for hysteroscopic myomectomy allocated into 2 groups: group A: received 10 mg/kg of tranexamic acid slowly intravenous after induction of anesthesia, while group B: received infusion of 10 IU of oxytocin at a rate of 400 mIU/min throughout the procedure. Preoperative and postoperative hemoglobin and hematocrit levels, need for blood transfusion, duration of operation, complications and medications adverse effects were recorded.Results: The 2 groups were comparable in terms of the mean difference between preoperative and postoperative hemoglobin a hematocrit levels, operative time, operative complication and medications’ adverse effects. No patients needed blood component transfusion in either group.Conclusions: It can be concluded that tranexamic acid and oxytocin are equally effective in reducing blood loss and transfusion requirements during hysteroscopic myomectomy with comparable good safety profiles. Both of them can be used according to availability and surgeon preferences.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192607
      Issue No: Vol. 8, No. 7 (2019)
       
  • Role of hysterolaparoscopy in unexplained infertility

    • Authors: Shubha Choudhary, Meena Priyadharshini V., Ameya Sirsat, Sunita R. Tandulwadkar
      Pages: 2592 - 2597
      Abstract: Background: Infertility, as defined by World Health Organization (WHO), is failure to achieve pregnancy during 1 year of regular unprotected intercourse. The objective of this study was to determine the incidence of unsuspected pathology at hysterolaparoscopy in presumed unexplained infertility, the incidence of intervention done for correcting pathology and its outcome and the importance of hysterolaparoscopy in the evaluation and treatment of infertile couples.Methods: This prospective observational study was carried out at IVF and Endoscopy centre, Department of obstetrics and gynecology at the Ruby Hall clinic, Pune from 1st November 2014 to 30th July 2016, after obtaining institutional ethical clearance and who met the inclusion and exclusion criteria. A detailed clinical history and physical examination and bimanual pelvic examination were done, following which all the patients were subjected to baseline blood investigation, 3D pelvis (TVS) and semen analysis. Day care hysterolaparoscopy was performed and systematic analysis were done.Results: The mean duration of infertility was 2 to 4 years. In our study out of 75 women 62 (82.67%) showed normal hysteroscopic findings, remaining 13 women (17.67%) showed abnormal hysteroscopic findings like cornaul blockage, intrauterine adhesions and tuberculosis endometrium. Abnormal laparoscopic findings were reported in 29.33% of which the most common pathology was endomertiosis (21.33%).Conclusions: Diagnostic Hysterolaproscopy is a safe, effective, minimally invasive, cost effective, daycare comprehensive procedure in evaluation of unexplained infertility. Apart from routine diagnostic protocol missed pathologies can be detected and this tool can be used for diagnostic as well as therapeutic intervention.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192639
      Issue No: Vol. 8, No. 7 (2019)
       
  • Etiopathogenesis of vaginal discharge among married women in reproductive
           age group residing in rural area of Bhojipura District, Western Uttar
           Pradesh

    • Authors: Monica Agrawal, Nitu Nigam, Ruchica Goel, J. K. Goel, Mukesh Shukla
      Pages: 2598 - 2603
      Abstract: Background: Vaginitis is one of common medical problem in women that often results in frequent medical consultations. Aim was to study the clinico-epidemiological profile and etiopathogenesis of various causes of vaginal discharge among females in age group 18-45 years residing in rural area of Bhojipura district.Methods: This Hospital based cross sectional study was conducted over a period of one year (March 2011 to February 2012) among 150 females aged 18-45 years presenting with the complaint of vaginal discharge. Information on sociodemographic data was obtained with the aid of questionnaires. Samples were obtained with two dry cotton-wool tipped swabs from vaginal fornices and were sending to department of microbiology.Results: The prevalence rate of vaginal discharge was found to be 24.6% among females in reproductive age group attending the outpatient department from rural background. Out of 150 patients who were enrolled for study 86 (57.30%) were diagnosed with non-infective discharge while 64 (42.60%) patients with infective discharge. Bacterial vaginosis was detected in 25 (39.1%), Candida albicans was detected in 23 (35.9%), T. vaginalis in 4 (6.3%) and mixed infections were found in 12 (18.7%). According to vagina flora morphology 85 (56.6%) had normal morphology, 30 (20%) had shift from normal flora and 35 (23.3%) had definitive bacterial vaginosis. About 20.5% females with Candida based etiology were diabetic.Conclusions: Some common reproductive tract infections can be diagnosed and managed at primary level health facilities. This promotes community awareness through behavior change communication which includes safer sex practices, awareness of HIV and appropriate and timely health care seeking behavior.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192638
      Issue No: Vol. 8, No. 7 (2019)
       
  • Maternal morbidity in emergency lower segment cesarean section

    • Authors: P. Kalpana, T. Praveena
      Pages: 2604 - 2609
      Abstract: Background: With a steep fall in maternal mortality and morbidity and with much more liberalization of indications, the incidence of cesarean section rate has greatly increased over the last thirty years and almost doubled in the current decade. The objective of this study was to study incidence of maternal morbidity in emergency lower segment cesarean section.Methods: Hospital based prospective study was carried out among 200 women undergoing emergency lower segment cesarean section. Data relating to demographic characteristics, clinical characteristics, maternal and fetal indications, incidence of morbidity, and types of morbidities, Intra operative complications, and Post operative complications was noted down. Chi square and odds ratio was used for statistical analysis.Results: The incidence of LSCS was 24.21%. Incidence of emergency LSCS was 96.74%. 71% were having primary LSCS and 20.5% were booked cases. The most common maternal indication for emergency LSCS was pregnancy induced hypertension and eclampsia in 32.5% of the cases. The most common fetal indication for emergency LSCS was fetal distress in 60%. Incidence of morbidity was 35% and it was associated with booking status, parity and social class. Incidence of intraoperative complications was 23.5%. Majority (18.5%) developed febrile morbidity followed by wound sepsis in 12.5%, urinary tract infection in 8%, mastitis in 7.5%, respiratory tract infection in 7%, wound gaping in 4%, paralytic ileus in 3%, endometritis in 2.5%, postpartum hemorrhage in 1.5%, 2 cases of burst abdomen and one case of small bowel obstruction.Conclusions: Emergency LSCS was more common than elective LSCS and it was associated with booking status, parity and social class.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192635
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of cesarean section rate by using modified Robson's ten group
           classification system

    • Authors: Meha K. Patel, Saloni M. Prajapati
      Pages: 2610 - 2616
      Abstract: Background: High caesarean section rate worldwide including India is matter of concern. The Robson’s Ten-group classification system allows critical analysis of caesarean deliveries according to characteristics of pregnancy. The objective was to analyze caesarean section rates in a tertiary care centre according to Modified Robson’s ten groups classification.Methods: This retrospective study was conducted at GMERS Gotri Medical College, Vadodara, Gujarat, India. All patients who delivered between August 2018 and March 2019, were included in the study. Women were classified in 10 groups according to modified Robson’s classification using their maternal characteristics and obstetric history. For each group, authors calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caesarean rate.Results: Total number of delivery in my study institute in 8 months was 1531 out of them 456 was cesarean section, so the overall caesarean section rate was 29.78%. The main contributions to overall caesarean rate was 40.78% by group 5 (previous CS, singleton, cephalic, >37weeks) followed by 14.25% by group 1 (nullipara, singleton, cephalic, >37 weeks, spontaneous labour), 11.40% by group 2 (nullipara, singleton, cephalic,>37 weeks, induced or CS before labour). CS rates among various group ranges from 100% among women with abnormal lie (group 9) to 98.4% in previous CS (group 5), 84% in nulliparous breech (group 6), 58% in multiparous breech (group 7) and least 8.2% in multipara spontaneous labour (group 3).Conclusions: The Robson’s classification is easy to use. It is time to implement obstetric audit to lower the overall CS rates.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192636
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prevalence of vitamin D deficiency in postmenopausal women and its
           association with fasting blood sugar

    • Authors: Mridu Sinha, J. K. Goel, Shanti Sah, Akanshamani .
      Pages: 2617 - 2621
      Abstract: Background: Vitamin D is indispensable for human body as it caters for both skeletal as well as extra-skeletal needs, especially in postmenopausal women. Aim of this study was to know the prevalence of vitamin D deficiency among apparent healthy postmenopausal women and to find its association with fasting blood sugar.Methods: This was a cross-sectional observational study of postmenopausal women attending Gynae OPD of Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, over a period of six months. Apparently healthy postmenopausal women were selected after satisfying inclusion-exclusion criteria and were subjected to fasting blood sugar and serum 25-hydroxy-vitamin D level. They were categorized as vitamin D deficient, insufficient or sufficient according to corresponding levels of <20ng/ml, 20-30ng/ml or >30ng/ml respectively. Upper reference level for fasting blood sugar was taken as 110mg/dl. Statistical analysis was done to see the association between vitamin D deficiency and fasting blood sugar.Results: Mean age of study group was 56.9 years and the average age of attainment of menopause was 50.3 years. Prevalence of vitamin D deficiency (57.4%) including insufficiency (13%) among postmenopausal women was high 70.4%, but there was no association between hypovitaminosis D and fasting blood sugar (p=0.949).Conclusions: Despite high prevalence of vitamin D deficiency among Indian postmenopausal women, there is no correlation between it and fasting blood sugar.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192590
      Issue No: Vol. 8, No. 7 (2019)
       
  • Study of maternal and perinatal outcome among twin pregnancies with one
           twin demise

    • Authors: Sunanda N., Akhila M. V.
      Pages: 2622 - 2626
      Abstract: Background: To study the incidence, management and to determine maternal and perinatal outcome in cases of twin pregnancy with one twin demise in the second half of the pregnancy.Methods: This retrospective study was carried out at Cheluvamba Hospital, a tertiary care hospital attached to Mysore medical college and research institute between September 2009 and 2014. 19 twin pregnancies complicated by single intrauterine fetal demise (IUFD) after 20 weeks of gestation were identified from the hospital records. Data collected included maternal age, parity, antenatal complications, cause of IUFD, gestational age at diagnosis, time interval between diagnosis of IUFD and delivery, mode of delivery, birth details, type of placentation and neonatal complications.Results: The incidence of twin with one twin demise was 2.056%. Mean gestational age at presentation was 33.86 weeks. Most common cause of death was growth discordance in 7 cases followed by placental insufficiency in 4 cases. 57.89% of cases had monochorionic placentation. Neonatal course was most commonly complicated by prematurity. Maternal course was uneventful in majority (63.15%) of cases with two maternal deaths due to intravascular coagulopathy sequelae.Conclusions: Single fetal death occurs more often in monochorionic twins. The main problem for the surviving twin is prematurity. It is very important to identify the chorionicity by ultrasound examination in early pregnancy and implement specific surveillance of monochorial pregnancies.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192637
      Issue No: Vol. 8, No. 7 (2019)
       
  • Gynecological problems of adolescent girls attending to rural tertiary
           care centre

    • Authors: Suman Shivanagouda Patil, Hemalatha Mahanthshetty, Supriya H. M., Mahendra M.
      Pages: 2627 - 2630
      Abstract: Background: Adolescence is a transient and dynamic period between childhood and adulthood, characterised by several changes in the body and the child’s mind. The World Health Organization defines adolescents as young people aged 10-19 years, but changes may begin before and continue after this age group. Adolescents constitute over 21.4% of population in India. Adolescence is a period of enormous physical and psychological change for young girls. Hormonal events play a key role in this transition. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding and dysmenorrhea. The aim of this study was to determine the proportion of various gynecological problems among adolescent girls seeking care at a tertiary care centre, Kolar, Karnataka, India.Methods: A cross sectional study was conducted during March 2016 to March 2018 among all adolescent girls (10-19 years) with gynecological problems attending inpatient and outpatient Department of Obstetrics and Gynecology. A pre-tested semi-structured questionnaire was used to collect information regarding their socio-demographic characteristics, gynecological history, family history, obstetric history, documentation of general physical examination and other investigations. Data entered using Microsoft Excel and analysed using SPSS v20.Results: A total of 720 adolescent girls sought care for gynecological problems in the study period with more than 80% of the cases belonging to the age group between 15 and 19 years. Of the 720, 362 (49.8%) had some type of menstrual disorders. Of these 362 cases about 41 of them were a case of puberty menorrhagia (11.32%) and 89 cases were of dysmenorrhea (22.37%). Among 720 cases, 290 (40.2%) of them were diagnosed of teenage pregnancy; among which 34 of them were unwanted pregnancy. Other presentations include vaginal discharge, urinary tract infection, mass per abdomen, trauma to genital tract and turners syndrome (two cases).Conclusions: The study shows around half of the adolescent girls are having menstrual disorders. One third were teenage pregnancies with most of them been ‘wanted’. This alarming finding calls for strengthening of adolescent programme with targeted health education and behavioural change. Setting up a separate adolescent clinics is necessary for efficient management of menstrual disorders in adolescents.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192606
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prevalence and pregnancy outcomes in patients with antepartum haemorrhage
           in a tertiary hospital in Ibadan, Nigeria

    • Authors: Chinedum A. C. Onebunne, Christopher O. Aimakhu
      Pages: 2631 - 2637
      Abstract: Background: Antepartum haemorrhage (APH) as one of the major obstetric emergencies contributing greatly to maternal and fetal morbidity and mortality is of serious concern in the developing world. A retrospective analysis of the APH cases and evaluation of its impact on fetal and maternal outcomes was conducted.Methods: A retrospective study of cases managed between January 2013 and December 2014 at the University College Hospital Ibadan; all cases at a minimum of 28 weeks of gestation with antepartum bleeding were selected. Data was retrieved from the hospital records.Results: Around 5.8% prevalence rate of APH was documented during the study period with placental abruption and placenta praevia accounting for 46.8% and 39.2% of these cases respectively. Only 28.5% of cases were booked. Three-fifths of the women had anemia, 17.7% suffered hypovolemic shock, 33.9% also had primary PPH while 4 out of every 10 (39.8%) were transfused with blood. Seven out of every ten premature deliveries (prior to 34weeks gestation) were due to placental abruption with p value of <0.001. There were 2 maternal deaths (1%), 61 (31%) still births and 11 (5.6%) early neonatal deaths giving a perinatal mortality rate of 35.6%.Conclusions: Antepartum hemorrhage was associated with poor maternal and neonatal outcome in this study. There is need to improve on infrastructures, such as functional blood banks, appropriate antenatal care and referral system in our health facilities to be able to cope with increasing challenges of this obstetric hemorrhage.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193017
      Issue No: Vol. 8, No. 7 (2019)
       
  • Key predictors of modern contraceptive use among women in marital
           relationship in South-West region of Nigeria

    • Authors: Muyiwa Oladosun, Moses Akanbi, Fagbeminiyi Fasina, Gbemisola Samuel
      Pages: 2638 - 2646
      Abstract: Background: Nigeria’s population is the seventh largest in the world and is projected to be the fourth largest by 2050. The demographic scenario is akin by persistent high fertility and low contraceptive use. This paper examined factors influencing contraceptive use among women in marital relationship in south-west region which has the highest percentage of use compared to other regions.Methods: A sub-sample of 3,784 women in marital relationship in the south-west region aged 15-49 was extracted from the 38,945 nationally representative samples of the 2013 Nigeria Demographic and Health Survey (NDHS). The dependent variable was contraceptive use, and key predictors include fertility behavior, employment, agents of modernity, and background factors. Logistics regression techniques were used in modeling the multivariate relationships.Results: Results showed that contraceptive use varied significantly by state of residence. It increased (odds = 3.6, p-value=0.000) for respondents with higher education compared to the uneducated. Also it increased (odds = 2.84, P-value=0.000) for the richest sub-group compared to the poorest/poorer category. The odds of using contraceptive increased (odds=2.20, P-value=0.000) for respondents who preferred no other child compared to their counterparts who preferred to have additional; and it decreased (odds=0.37, P-value=0.000) for those who had two or fewer children compared to those who had three or more.Conclusions: Policies and programme intervention should consider education, wealth status, and preference for additional child, and number of living children as key to increasing contraceptive uptake in the region. 
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193018
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of intrauterine fetal death in a tertiary care hospital

    • Authors: Divya Saha, Vilas N. Kurude, Sharvari Mundhe
      Pages: 2647 - 2651
      Abstract: Background: Intrauterine fetal death is a major obstetrical complication and a devastating experience for parents as well as obstetricians. If the causes of IUFD can be found, an effective strategy for prevention of IUFD can be formed and maternal complications can thus be prevented. This study aims at identifying the various causes, etiological factors and complications of IUFD.Methods: Prospective observational study was carried out in a tertiary care hospital from 1st January 2016 to 31st July 2017.Results: Total number of deliveries during the study period was 3944 and still birth was 170. Still birth percentage was 4.31.Majority of patient belonged to maternal age group of 21-30 year of age that is 138 out of 170 around  68.5%. Only 8.82% of patients presenting with IUFD were having more than three antenatal visits. Among 61 cases (35.8%) cause was not identified while 109 cases cause was identified. Hypertensive disorder contributed to major cause of IUFD i.e. 34 out of 170 (20%) Maternal complications like hypovolemic shock occurred in 13 out of 170 (7.6%), Acute Renal failure 7 out of 170 (4.11), Sheehan syndrome. Maternal mortality was 3 out of 170 cases.Conclusions: Despite availability of modern interventions like ultrasonography, Non stress test, majority of the causes of IUFD remains unknown. Early diagnosis and delivery is important in cases of IUFD to prevent various complications like septicaemia, acute renal failure, DIC, hypovolemic shock etc.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193019
      Issue No: Vol. 8, No. 7 (2019)
       
  • Women’s perception on rights during pregnancy and childbirth

    • Authors: Ibitoye O. F., Adamolekun M. M., Adamolekun P. A., Amuwa T.
      Pages: 2652 - 2657
      Abstract: Background: The Nigerian health system as a whole has been plagued by problems associated with the quality of service, including but not limited to unfriendly staff attitudes to patients, inadequate skills, decaying infrastructures, and chronic shortages of essential drugs. Approximately two-thirds of all Nigerian women deliver outside of health facilities and without the presence of medically skilled attendants.  The study was carried out to assess the awareness and knowledge of women regarding their rights during pregnancy and childbirth, and to explore the extent to which women’s rights were respected during pregnancy and childbirth.Methods: This descriptive study was conducted among randomly selected 140 women at Mother and Child Hospital, Akure, Ondo state, Nigeria. Data was collected with a pretested questionnaire and was analysed using Statistical Packages for Social Sciences (SPSS) version 21.Results: Findings revealed that majority (76.9%) of the women had a fair knowledge of their rights in pregnancy and childbirth, with the source of knowledge majorly from their friends. Right to information, informed consent and refusal, even distribution of healthcare services, maintenance of attainable level of health regarding proper monitoring were fairly observed by the health care providers. Right of women against verbal and physical abuse, privacy, treatment with dignity and respect were least accorded to women.Conclusions: Respective Maternity Care remains a challenge that demands policy interventions in most public health facilities to enhance positive endorsement and utilisation of maternal and health care services.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193020
      Issue No: Vol. 8, No. 7 (2019)
       
  • The study of knowledge, attitudes and practices of husbands accompanying
           patients at obstetrics clinics of a tertiary care center about
           contraception

    • Authors: Manisha Sharma, Sri Sarana, Atul Seth
      Pages: 2658 - 2661
      Abstract: Background: Contraceptive practices are the main tool we have in controlling the ever increasing population. It also has a huge role in preventing sexually transmitted infections. The present study was undertaken to find the knowledge, attitudes and practices of husbands accompanying patient at obstetrics clinics of a tertiary care center about contraception.Methods: The study population was 100 husbands accompanying patients at obstetrics clinics of a tertiary care center. A simple questionnaire of 26 questions regarding knowledge, attitudes and practices regarding contraception was provided to the consenting husbands. The results were then analyzed.Results: Vast majority have adequate knowledge about male contraception (93%), vasectomy (85%) and sexually transmitted diseases (72%). Most of the husbands do not have adequate knowledge about female contraception (only 59%) and emergency contraception (only 27%). 70% of the husbands do not know about the free contraceptives provided by the Government of India. A staggering 74% do not participate in effective contraception. Also, 77% agreed that they would remain contended with a single child.Conclusions: This cross-sectional study clearly shows that husbands accompanying patients at obstetrics clinic of a tertiary care center have adequate knowledge about male contraception, vasectomy and sexually transmitted diseases. It is worth noting that most of the husbands do not have adequate knowledge about female contraception, emergency contraception and free contraceptives provided by the Government of India. Very few couples participate in effective contraception despite wanting to adopt a small family norm. This is a pointer towards the ineffectiveness of the family planning program of our country.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193021
      Issue No: Vol. 8, No. 7 (2019)
       
  • Fetal Doppler for prediction of adverse perinatal outcome in preeclampsia
           in a low resource setting

    • Authors: Pratima Mishra, Bikash Pattanayak, Ramakanta Sahoo, Mahesh Rath
      Pages: 2662 - 2667
      Abstract: Background: Menopause is defined as the permanent cessation of menstruation resulting from loss of ovarian activity. Menopause normally occurs between the age of 45 to 50 years. The age of menopause varies with geographical, racial and nutritional factors. The objective of this study was to evaluate and to know the incidence of various cause of PMB.Methods: This was a prospective study of the patient with PMB attending the OPD or admitted for evaluation under Obstetrics and Gynecology department. Hi-Tech Medical College and Hospital, BBSR, Odisha from November 2016 to October 2018 who fulfilled the inclusion criteria with history clinical examination and investigation and informed consent from the patient. Data analyses will be done by appropriate statistical methods.Results: Maximum number of cases with PMB were found in age group 55-64 (52%). 57% of cases were malignant and rest 43% were benign origin. carcinoma cervix is most common  malignant lesion in 80% cases and atrophic endometrium is most common benign lesion (42%).Conclusions: In the present study the incidence malignancy causing PMB was 57% and benign cases was 43% Universal Screening of all PMB cases for genital tract malignancy is mandatory.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193022
      Issue No: Vol. 8, No. 7 (2019)
       
  • Myomectomy for uterine preservation and fertility

    • Authors: Yelamanchi Savitha Devi, Yendru Katyayani Swapna, T. Kamalakar Naidu, Ganga Bhavani Vaddiraju
      Pages: 2668 - 2677
      Abstract: Background: Leiomyomas are benign monoclonal smooth muscle tumors that are characterized by cellular mutations, growth factor dysfunction, and abnormalities in the extracellular matrix. The objective of this study was to analyse the patient selection, feasibility, complications and the outcomes of myomectomies done for uterine preservation and fertility.Methods: Out of 606 myomectomies performed over 23 years at a tertiary care endoscopy centre, retrospective analysis of 358 cases of laparoscopic myomectomy (LM) and 96 cases of abdominal myomectomy (AM) was done.Results: Myomectomies were done for symptomatic women who wanted to preserve their uterus either to improve fertility or pregnancy outcome. Sizes of myomas tackled by myomectomy ranged from 1 cm to 20 cms. The largest number removed by laparoscopy was 19. 9 out of 358 cases scheduled for LM were converted to AM. 6 patients had repeat myomectomy of myomas. About 0.44% had STUMP and 0.44% had leiomyosarcoma on HPE. Only 10/199 or 5% of patients who wanted to preserve their uterus had subsequent hysterectomies. 95% were satisfied with good symptom relief. 40.1% in LM and 37% in AM group conceived.Conclusions: Majority of the cases were successfully done by laparoscopy. With increasing experience more cases with bigger and multiple myomas could be tackled by laparoscopy. 10.3% in LM and 45.9% in AM were 10 cms-20 cms. The main method of retrieval was morcellation. There were no major complications. Both the methods were found to be safe, feasible and provided good result. With increasing experience bigger and multiple myomas could be tacked by LM, which has several advantages over AM.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193023
      Issue No: Vol. 8, No. 7 (2019)
       
  • Comparative study to evaluate the efficacy and safety of oral Mifepristone
           versus intracervical Dinoprostone gel for induction of labour and their
           effects on fetomaternal outcome

    • Authors: Anu Pathak, Saroj Singh, Shikha Singh, Rajesh Kumar, Arpita Tyagi
      Pages: 2678 - 2682
      Abstract: Background: Mifepristone and Dinoprostone are used in inducing labour in pregnancy by acting as cervical ripening drugs. A randomized case control study to evaluate the efficacy, safety and fetomaternal outcome of induction of labour with oral Mifepristone and intracervical Dinoprostone gel was done.Methods: About 300 patients were included after taking informed consent. 150 patients were placed in each group A and B. In group A patients received 200 mg oral Mifepristone tablet and in group B 0.5 mg Dinoprostone gel was given intracervically and 2nd dose was repeated after 6 hours later if adequate uterine contractions were not achieved. A detailed analysis was carried out in both groups regarding efficacy and safety of drugs in terms of necessity of augmentation of labour with oxytocin, induction to delivery interval, fetal outcome in terms of NICU admission.Results: 59.33% cases in Mifepristone group and 72% case in Dinoprostone group required augmentation with oxytocin. Mean induction delivery interval in Mifepristone group in primigravida was 17.998±1.128 hrs and mean induction delievery interval in multigravida was 11.648±1.112 hours. 88% cases in mifipristone group and 80% cases in Dinoprostone group delivered vaginally. NICU admission was 1.33% in Mifepristone group and 2.66% in PGE2 gel group.Conclusions: Mifepristone when compared with intracervical Dinoprostone gel, acts as a better cervical ripening agent and requires lesser need for Oxytocin augmentation. Though, mean induction delivery interval was more with Mifepistone, the incidence of successful vaginal delivery was higher as compared to Dinoprostone.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193024
      Issue No: Vol. 8, No. 7 (2019)
       
  • Universal screening for hypothyroidism in pregnancy: is it necessary'

    • Authors: Meena Priyadharshini V., Seetha Panicker
      Pages: 2683 - 2686
      Abstract: Background: Thyroid diseases are one of the commonest endocrine disorders affecting women of reproductive age group, and hence constitute one important disorders complicating pregnancy. The objective of this study was to determine the importance of universal screening for hypothyroidism in pregnancy at the first antenatal visit and to formulate whether this routine screening is mandatory in our country.Methods: This retrospective study was conducted in the year 2018 at PSG IMSR Hospital for all pregnant women who attended the first antenatal visit between Jan 2012 to Dec 2012 after obtaining ethical clearance. Pregnant women who were already taking treatment for hypothyroidism, diabetes mellitus, hypertension and those pregnant women who lost their follow up were excluded from the study.Results: The incidence of subclinical hypothyroidism among antenatal women were 7.06%. In our study the maternal complications like anemia 12 (8%), preeclampsia 26 (17.3%), gestational diabetes 25 (16.7%), fetal growth restriction 8 (5.3%), Oligohydramnios 13 (8.7%), pre mature rupture of membranes 25 (16.7%), placental abruption in 2 (1.33%), APLA syndrome 2 (1.33%), low birth weight 26 (17.3%) were observed.Conclusions: Universal screening for hypothyroidism is recommended for all antenatal women especially in iodine depleted country like India.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20192640
      Issue No: Vol. 8, No. 7 (2019)
       
  • Study of knowledge and attitude towards breastfeeding in antenatal mothers
           at Chamarajanagara Institute of Medical Sciences, Chamarajanagar, India

    • Authors: Pradeep Musale Ramachandra, Nayana Davanagere Hiremath
      Pages: 2687 - 2690
      Abstract: Background: exclusive breast feeding practice is major pillar in preventing infant mortality. This study was undertaken to know the knowledge and attitude of antenatal mothers towards breast feeding.Methods: this is a cross sectional study in our hospital in which 264 antenatal mothers were included after verbal consent. Antenatal mothers were explained about the study, their knowledge and attitude regarding breast feeding is assessed by questionnaire. Study will be analysed by appropriate statistical analysis.Results: In total of 264 antenatal mothers, most of them were between 20-25 years, majority in third trimester. Among them 68.2% knows breast feeding should be initiated within first hour of delivery, 90.2% is for no prelacteal feeds and 95.8% wants to feed colostrum. Only 42.4% wants to continue breastfeeding for two years. About 62.9% of antenatal mothers wants to supplement the child with food after six months.81.8% knows breast feeding is not only helpful to the baby but also it prevents breast cancer in mother later in life. 21.2% wants to feed complimentary feeds as early as 3 months.Conclusions: our study on knowledge  of  breast feeding among antenatal mothers shown most of  them are against prelacteal feeds and wants to feed colostrums, but initiation of breast feeding within first hour of birth and weaning after six months and continuation of breast milk up to two years is lagging. Multiple educational sessions, visual aids, pamphlets, electronic media, counseling during antenatal period and in early post natal period is necessary to inculcate appropriate knowledge on breast feeding.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193025
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of preinduction transvaginal ultrasonographic cervical length and
           its comparison with bishop score in predicting successful labour

    • Authors: Tajinder Kaur, Shaveta Garg, Geetanjali Kaur, Harsharan Kaur
      Pages: 2691 - 2694
      Abstract: Background: Significant number of induced pregnancies land in caesarean delivery. Cervical assessment is integral to successful outcome of induction of labour. Objective of this study was to study preinduction transvaginal ultrasonographic cervical length and to compare it with Bishop Score in predicting successful labour.Methods: This prospective study was conducted at the department of obstetrics and gynaecology, MMIMSR, Mullana, Ambala on 150 patients. A total of 150 women were studied from January 2015 to June 2016 after taking an informed consent. The sociodemographic particulars were recorded, detailed history was taken and examination performed. Transvaginal ultrasound was done to assess cervical length after evacuation of bladder. Bishop score was then determined by separate observer. The occurrence of vaginal delivery was considered as primary outcome. All statistics collected were entered in statistical software SPSS-15. ROC curves were constructed for both Bishop Score and TVS.Results: The mean gestational age was 38 week 6 days, majority 134 (89.3%) being less than 40 weeks of gestation. The ROC curve for Bishop Score demonstrated better predictability compared to cervical length by TVS. Optimized cut off for Bishop score in addition to TVS was determined by ROC curve to predict successful vaginal delivery, it was ≥ 6 for Bishop score (sensitivity 90.7%, specificity 68.6%, positive predictive value 91.5% and negative predictive value 66.7%) and ≤ 3.0 cm for cervical length on TVS (sensitivity 74.6%, specificity 51.6%, positive predictive value 74.5% and negative predictive value 51.6%). The relation of both cervical length and Bishop score with successful vaginal delivery was found to be statistically significant with p value of 0.0001.Conclusions: The present study indicates that Bishop Score is a better predictor for successful vaginal delivery as compared to cervical length by transvaginal ultrasonography.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193026
      Issue No: Vol. 8, No. 7 (2019)
       
  • Vaginal progesterone in risk reduction of preterm birth in women with
           short cervix

    • Authors: Shubhi Srivastava, D. Borgohain
      Pages: 2695 - 2700
      Abstract: Background: Preterm birth is a global health problem affecting the neonate, family and country in general. It is the leading cause of perinatal mortality and morbidity. Short cervical length detected on transvaginal ultrasound is the most practical risk factor for prediction of preterm birth. The aim of this study was to determine the efficacy and safety of vaginal progesterone in reducing the rate of preterm birth in women with a short cervix and to determine its effect on neonatal mortality and morbidity.Methods: The study was carried out in the Department of Obstetrics and Gynaecology at Assam Medical College, Dibrugarh for a period of one year. It included 128 asymptomatic women with a singleton pregnancy and a sonographic short cervix. Women were randomly divided into two groups, one of which was given placebo and the other was given vaginal progesterone and a comparative study was conducted.Results: It was observed that delivery before 37 weeks of gestation was less frequent in the progesterone group than in the placebo group (60.94% vs. 90.63%). Vaginal progesterone was also associated with a significant reduction in adverse neonatal outcomes like the rate of sepsis (6.25% vs. 18.75%), requirement of ventilator (12.5% vs. 26.56%), admission to NICU (10.94% vs. 26.56%) and birth weight ≤1.5kg (7.81% vs. 21.88%).Conclusions: Vaginal progesterone reduces the risk of preterm birth and adverse perinatal outcomes in pregnant women without any deleterious effects on the foetus or mother.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193027
      Issue No: Vol. 8, No. 7 (2019)
       
  • Fetomaternal outcome in patients with diabetes mellitus in pregnancy

    • Authors: Kaveri D. Shingala, Sapana R. Shah, Rupa C. Vyas, Purvi M. Parikh
      Pages: 2701 - 2704
      Abstract: Background: Diabetes mellitus (DM) is defined as increased blood glucose level due to defect in insulin secretion, insulin action or both. Undiagnosed or inadequately treated diabetes mellitus during pregnancy can lead to significant maternal and fetal complications. The study was conducted to review feto-maternal outcome in pregnancy with diabetes and to plan management of pregnancy with diabetes and to study the modalities for treatment of DM in pregnancy.Methods: A prospective case study was conducted from July 2015 to December 2018 at a tertiary care center. Study group used single step 75gm oral glucose tolerance test (OGTT) test recommended by WHO for GDM diagnosis.Results: GDM (85%) was more common than overt diabetes (15%) and in younger age group (53.75%) and Multiparous patients (18.2%). Most of patients required insulin (81.2%) for treatment of DM during pregnancy along with medical nutrition therapy and exercise. Most common association in this patient was hypertension (41%). Rate of caesarean section (60%) was more common. Average birth weight was of >3.5 kg, intrauterine death (4.2%), preterm delivery (14.2%) and admission to NICU were also common.Conclusions: There was significant fetomaternal morbidity in patients with diabetes mellitus. Early diagnosis and treatment reduces the fetomaternal outcome.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193028
      Issue No: Vol. 8, No. 7 (2019)
       
  • Study of Oligohydramnios and its perinatal outcome

    • Authors: Sudha V. Patil, Fatima Zahra Shaikmohammed
      Pages: 2705 - 2708
      Abstract: Background: Importance of amniotic fluid volume as an indicator of fetal status is being appreciated relatively recently. Around 3% to 8% of pregnant women are presenting with low amniotic fluid at any point of pregnancy. The present study was undertaken to study the outcome of pregnancies with Oligohydramnios [(amniotic fluid index) AFI≤5cm] at or beyond 34 weeks.Methods: This study consists of 50 cases of antenatal patients with oligohydramnios (AFI≤5) at or beyond 34 weeks of gestation compared with age and gestation matched 50 normal liquor (AFI≥5 and ≤25). The outcome measures recorded were labor, gestational age at delivery, amniotic fluid index (AFI), mode of delivery, indication for cesarean section or instrumental delivery, APGAR score and birth weight.Results: In the present study, AFI was significantly decreased in cases (3.74±1.2) compared (12.54±2.5) with controls. Variable deceleration was noted in 14 (28%) and late deceleration in 5 (10%) cases. In control group, 2 (4%) had late deceleration. In cases induced labor is in 14 (28%), spontaneous labor 36 (72%). In cases, term normal vaginal delivery was in 15 (30%), PVD in 6 (12%), LSCS in 28 (56%) and instrumental vaginal delivery in 1 (2%). In controls, full term normal vaginal delivery was in 41 (82%), PVD in 5 (10%), LSCS in 4 (8%). APGAR score <7 at 1 minute was in 19 (38%) and at 5 minutes was in 5 (10%) in cases. Birth weight is reduced in cases. IUGR was reported in 9 (18%) in cases.Conclusions: Pregnancies with Oligohydramnios (AFI≤5) is associated with increased rate of non-reactive NST. Routine induction of labor for Oligohydramnios is not recommended. It is preferable to allow patients to go into spontaneous labor with continuous FHR monitoring. Antepartum diagnosis of Oligohydramnios warrants close fetal surveillance.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193029
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prevalence and cause of gestational diabetes mellitus in a tertiary care
           center in Kolar district: a population based study

    • Authors: Poojita Tummala, Munikrishna M., Kiranmayee P.
      Pages: 2709 - 2714
      Abstract: Background: Gestational diabetes mellitus (GDM) is carbohydrate intolerance at the onset of pregnancy which induces pathological short term or long term outcomes for both mother and baby. The aim of the present study was to know the prevalence of GDM in pregnant women who were attending the antenatal care (ANC) center at a tertiary care hospital in Kolar, Karnataka, India.Methods: This prospective study was conducted in Department of Obstetrics and Gynecology, Sri Devaraj Urs Medical College, a constituent of Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India. The duration of the study was two months. In this study, 108 pregnant women above 24 weeks of gestation were screened for GDM by oral glucose tolerance test. Fasting 2 milli liter blood was collected and were given 75 grams of glucose in 200 milli liters of water and asked to drink within 5 minutes. Again 2 milli liters venous blood was collected after 1 hour and 2 hours from all participants. Plasma sample was used for the estimation of glucose by glucose oxidase and peroxidase (GOD-POD) method.Results: Out of 108, 12 women (11.1%) were diagnosed with GDM. The prevalence rate was higher in the age group of 26-30 years (41.6%).  Among 12 diabetic women, five (47.2%) exercised regularly and seven (58.3%) did not doing exercise. Out of 12 GDM subjects, eight of them had family history of diabetes in first degree relatives; among which one was hypertensive and five were suffering from thyroid problems.Conclusions: In the present study, the prevalence of GDM was found to be 11.1%. Prevalence of GDM might be influenced by increasing age, pre pregnancy weight, family history of diabetes, past history of pregnancy complications, status of literacy and exercise.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193030
      Issue No: Vol. 8, No. 7 (2019)
       
  • Endometrial evaluation with methylene blue staining in patients with
           normal hysteroscopy

    • Authors: Alka Goel, Pooja Gupta, Akansha Singh, Khushboo Singh
      Pages: 2715 - 2719
      Abstract: Background: Normally, endometrium comprises of non-absorptive epithelium and does not take up stain. Conventional staining with methylene blue is explained on the basis of existence of apoptotic cells in endometrium.Methods: Of 50 patients of unexplained infertility, AUB, recurrent pregnancy loss were randomly selected and included in the study. Those with abnormal ultrasound and history of tuberculosis were excluded. Conventional hysteroscopy was performed using normal saline as distending medium and in those with grossly normal endometrium were subjected to staining with 5% methylene blue instilled trans cervically. After 5 min, irrespective of the size and pattern, focal dark blue stained areas were considered abnormal and randomly biopsied. Incidence of endometritis in both groups was compared after histopathological examination.Results: Of total 50 patients, histopathological report of only one patient with dark blue staining had evidence of endometritis. Rest had no evidence, of which 73.5% had light blue or unstained areas and 26.5% showed dark blue staining. No statistically significant difference was found between histopathological reports and light or dark blue staining (p=0.28). When percentage stained area was considered more than 50% only to be positive, sensitivity was 100%, specificity 94%, PPV 25% and NPV 100%. False positives were 75% and no false negatives were observed. Although p values improved but still statistically insignificant.Conclusions: Present study failed to establish any significant correlation between staining pattern and detection rate of endometritis. With no Indian studies published on chromohysteroscopy so far, role of methylene blue in detection of subtle endometrial changes in modern gynaecology in Indian subpopulation is yet to be established.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193031
      Issue No: Vol. 8, No. 7 (2019)
       
  • Study of antenatal prevalence of HIV and its trend in a tertiary care
           hospital

    • Authors: Nikhil A. Anand, Seema K. Patel
      Pages: 2720 - 2724
      Abstract: Background: HIV/AIDS has become a global problem since first detection in 1981.Women of childbearing age constitute nearly half of the 30 million adults currently living with HIV/AIDs worldwide. Pregnant women are considered as low risk for HIV so estimating prevalence in such low risk people provides us a good basis for long term strategy for implementation of HIV/AIDS control programme. The objective of this study was to study acceptance of antenatal HIV testing during routine ANC checkups using opt in strategy. To study prevalence of antenatal HIV and its trend.Methods: Observational and analytic study. Antenatal women coming for routine antenatal care in obstetric OPD were counseled and blood sample were taken according to guidelines for HIV testing from period 1/1/2014 to 31/12/2018.Results: Out of total 23907 women attending antenatal clinic 23841 accepted HIV testing, Out of these 72 were found positive, making HIV seroprevalence rate of 0.30. 42 spouses were also found positive.Conclusions: Though seroprevalence of HIV in antenatal women is low, slowly rising trend worths a caution for us.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193032
      Issue No: Vol. 8, No. 7 (2019)
       
  • Role of multi-detector computed tomography in the detection and
           differentiation of adnexal mass lesions

    • Authors: Ezzat Khalda, Hafizur Rahman
      Pages: 2725 - 2731
      Abstract: Background: The objective of this study was to evaluate the role of multi-detector computed tomography (MDCT) in the detection and differentiation of adnexal masses using post-operative histopathology findings as the gold standard.Methods: One hundred and forty five cases that were referred with a primary diagnosis of adnexal masses on clinical or USG examination were evaluated by MDCT in the Department of Radiodiagnosis from January 2013 to December 2013. One hundred twelve cases subsequently underwent surgical exploration and histopathological examination, which was used as a control for the evaluation of MDCT findings, were included in this study.Results: Majority (54.5%) of the patients were in the age group of 31-50 years. MDCT detected   adnexal masses as malignant in 56 cases, while in other 56 cases it read adnexal masses as benign. Final histopathology revealed adnexal masses in 57 (51%) cases as malignant while in 55 (49%) cases as benign. There were three cases which on MDCT appeared as malignant were subsequently found to be benign in histopathology. Similarly there were four cases which on MDCT appeared as benign were subsequently proved to malignant in histopathology. The sensitivity, specificity, Positive predictive value and negative predictive value of MDCT for diagnosing a malignant adnexal mass was 93.0%, 94.5%, 94.6% and 92.8% respectively. MDCT findings more predictive of malignancy were solid or cystic-solid mass, necrosis in a solid lesion, cystic lesion with thick, irregular walls or septa, and/or with papillary projections. The presence of ascites, peritoneal metastases, and lymphadenopathy were also helpful to confirm malignancy.Conclusions: MDCT is an excellent and accurate non-invasive modality in the detection and characterization of adnexal masses from benign and malignant
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193033
      Issue No: Vol. 8, No. 7 (2019)
       
  • Knowledge and awareness of the cause, prevention and control of cervical
           cancer amongst female undergraduates and faculty of health sciences: a
           cross sectional survey

    • Authors: Abhishek Tandon, Snigdha Raja, Mangala M. Pai, B. Unnikrishnan, Tanuj Kanchan
      Pages: 2732 - 2737
      Abstract: Background: Carcinoma cervix is the second most common cancer in women worldwide, and the most common in India. In this study, the current knowledge of female undergraduates and faculty of health sciences regarding the various parameters like risk factors, symptoms, screening tests and vaccinations pertaining to cervical cancer was assessed.Methods: A cross-sectional, self-administered anonymous questionnaire-based survey was carried out, in a medical college in Mangalore, which included 260 staff and students. Non random sampling was done and the study was carried out only after gaining institutional Ethical community approval and written informed consent from the subjects.Results: Majority of the participants 185 (71.4%) were aware that cervical cancer is one of the most wide- spread gynecological cancers in Asia. The awareness of causative agents of cervical cancer was known to 53.9% of the undergraduates and 50% of the faculty members. 73% of the total study groups have heard of HPV and around 68% agreed that it was detectable. 71% of the study sample had heard about the Pap smear test and 42% have undergone the test. The questions pertaining to the preventive measures of cervical cancer had good faculty preponderance with 91.8% giving a positive response. 84.1% of the students and 79.5% of the faculty members knew that abnormal vaginal bleeding was a symptom.Conclusions: In this study an attempt has been made to study the correlates of knowledge of cervical cancer in a cohort which consisted of health care undergraduate and faculty. Majority of our study group was well aware of the various risk factors of cervical cancer and its preventable nature however awareness regarding the association between diets, multiple pregnancies and use of tobacco was poor.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193034
      Issue No: Vol. 8, No. 7 (2019)
       
  • Antibiotic susceptibility pattern of group B streptococcal isolates from
           maternal genital tract

    • Authors: Vijayan Sharmila, Thirunavukkarasu Arun Babu
      Pages: 2738 - 2741
      Abstract: Background: Group B streptococcus (GBS) is one of the important cause of early onset neonatal sepsis in developed countries leading to increased neonatal morbidity and mortality. Penicillin and Ampicillin are the drugs of choice for prevention of GBS infections. Antibiotic resistance amongst GBS isolates is an emerging health problem affecting neonates. Hence, this study was performed to determine the antibiotic susceptibility pattern of Group B Streptococcus (GBS) in a population of pregnant women.Methods: A prospective study was done to screen pregnant women for vaginal and rectal GBS colonization during their regular visits to antenatal clinic. Todd-Hewitt broth, an enrichment medium for GBS was used for isolation. The antibiotic susceptibility pattern of the isolates were studied.  Results: A total of 300 pregnant women were screened for GBS colonization. GBS colonization rate in our study was 2.3%. The antibiotic susceptibility pattern of the isolates revealed that none of the isolates were resistant to penicillin or clindamycin, while resistance was noted to erythromycin (14.3%) and   tetracycline (71.4%).Conclusions: GBS continues to remain sensitive to Penicillin which is the drug of choice for prevention and treatment of GBS.  Consistent surveillance of antibiotic sensitivity pattern of GBS as well as for other organisms implicated in new born sepsis and maternal infections is required to formulate guidelines for prevention and treatment.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193035
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prevalence of asymptomatic bacteriuria among low risk pregnant women
           attending antenatal care clinic in tertiary hospital: a cross sectional
           study

    • Authors: Ahmed M. Abbas, Moustafa Kamel, Mohammed Z. Abdelrahman, Ahmed A. Youssef, Mohammed A. Youssef
      Pages: 2742 - 2747
      Abstract: Background: The current study aims to identify the prevalence of asymptomatic bacteriuria among low-risk pregnant women attending the antenatal care clinic of tertiary University Hospital and to detect the most common causative organisms.Methods: A prospective cross-sectional study conducted at a tertiary University Hospital in the period between 1st November 2017 and 31st June 2018. All eligible women attending the outpatient clinic for antenatal care were approached to participate in the study. The recruited women were assessed through detailed history and clinical examination. Urine samples were taken for culture and sensitivity within two hours, in order to avoid bacterial multiplication. Urine culture and antibiotic sensitivity test were done.Results: The study included 250 women. The mean age of included women was 25.89±5.49 (18-42 years). The urine analysis results showed that 32% of cases had pus cells >5 per high power field and 10.4% of cases have protein (+). Casts were present in 0.8% of cases. RBCs >5 per high power field were present in 4.8% of cases. ASB is defined as urine culture with more than 100,000 colony forming unit; this was present in 30 cases. This indicates that the prevalence of ASB among studied cases was 12%. Enterococcus was the most prevalent organism as it was present in 36.7% among positive cases. Antibiotic sensitivity test was performed to the growing organisms indicated that teicoplanin, imipenem, cefoxitin, cefotaxime + clavulanic acid, Entrapenem, and trimethoprim + sulfamethoxazole are the most effective antibiotics against the most common organisms causing asymptomatic bacteriuria.Conclusions: The prevalence of asymptomatic bacteriuria among low-risk pregnant women is about 12%. Urine culture for asymptomatic bacteriuria should be the standard of care for evaluation of pregnant patient during antenatal care as regard presence or absence of UTI.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193036
      Issue No: Vol. 8, No. 7 (2019)
       
  • Induction of labour and its feto-maternal outcome

    • Authors: Mridu Sinha, Shashi Bala Arya, Shashi Saxena, Nitant Sood
      Pages: 2748 - 2753
      Abstract: Background: Induction of labour is an iatrogenic deliberate attempt to terminate the pregnancy in order to achieve vaginal delivery in cases of valid indication. It should be carefully supervised as it is a challenge to the clinician, mother and the fetus. Aim of this study was to find out common indications for IOL in a tertiary care teaching centre and its feto-maternal outcome.Methods: An institutional based retrospective observational study was conducted to describe the prevalence of labour induction and factors associated with its outcome, during the time-period of one year from January 2018 to December 2018, at SRMS IMS, Bareilly. Logistic regression analysis was employed to assess the relative effect of determinants and statistical tests were used to see the associations.Results: Most of the patients were primigravidas of younger age-group. Idiopathic oligohydramnios and postdatism were the commonest indications for induction of labour and Misoprost was the commonest drug used for it. Though majority had vaginal delivery, as the method was changed to combined method it was significantly associated with increased likelihood of LSCS. Similarly there was increased association with maternal cervico-vaginal tear / lacerations as the method was changed to combined type. However there were no association between post-partum hemorrhage, meconium stained liquor or fetal distress.Conclusions: Common indications for induction of labour were oligohydramnios and postdatism. Misoprost can be safely used for induction of labour without any increased risk for LSCS or any fetal / neonatal risks.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193037
      Issue No: Vol. 8, No. 7 (2019)
       
  • Cellular homeostasis, implantation window and unexplained infertility:
           role of phosphatase and tensin homolog deleted on chromosome 10

    • Authors: Annu Makker, Madhu Mati Goel, Kumari Manu, Renu Makker
      Pages: 2754 - 2760
      Abstract: Background: Balance between endometrial cell proliferation and apoptosis is crucial for successful embryo implantation. PTEN (phosphatase and tensin homolog deleted on chromosome 10), a pro-apoptotic factor, is proposed to be one of the signaling proteins through which estrogen and progesterone act to affect cellular homeostasis. Although reports in literature have suggested role of PTEN in regulating endometrial cell proliferation and apoptosis during window of implantation, its involvement in women with unexplained infertility is not clear. In the present study, we examined expression, cellular distribution and activation status of PTEN, cell proliferation, and apoptosis in midsecretory endometrium from women with unexplained infertility as compared to fertile controls.Methods: Endometrial biopsies from infertile (n=11) and fertile women (n=22) were used for immunohistochemical evaluation of PTEN, phospho-PTEN and Ki67. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay was performed for detection of apoptotic cells.Results: Biopsies from infertile women as compared to fertile controls demonstrated statistically significant: i) decrease in nuclear PTEN (P < 0.001), increase in nuclear phospho-PTEN (P < 0.05), increase in nuclear and cytoplasmic phospho-PTEN/PTEN ratio (P < 0.001 and P < 0.05 respectively) in endometrial stroma, ii) increase in cytoplasmic phospho-PTEN (P < 0.001) and phospho-PTEN/PTEN ratio (P < 0.05) in glandular epithelium (GE), iii) increase in Ki67 labeling in GE (P < 0.01) and stroma (P < 0.05) and, iv) decrease in (P < 0.001) apoptosis.Conclusions: Altered PTEN expression and associated modulation in cellular homeostasis during the implantation window might contribute to mechanism underlying unexplained infertility.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193038
      Issue No: Vol. 8, No. 7 (2019)
       
  • Knowledge, attitude and practices of contraception amongst married women

    • Authors: Jyotsana Lamba, Nikita Gandotra, Nivedita Prashar
      Pages: 2761 - 2765
      Abstract: Background: Aim of current study was to assess the knowledge, attitude and practices of contraceptives amongst married women of reproductive age group.Methods: A cross sectional study was conducted in obstetrics and gynaecology out door patient department (OPD) of SMGS hospital Jammu. 100 married women aged between 15-45 years were included in this study. Along with the sociodemographic characteristics of the women, their knowledge, attitude /86*and practices on contraception were evaluated with the help of predesigned questionnaire.Results: It was observed that out of 100 women, majority of them were Hindu (58%), higher secondary educated (21%), housewives (45%) and belonged to low socio economic status (36%). 88% females had knowledge about contraceptive methods that was mainly obtained from health workers (59%) followed by media (23.8%) and social circle (14,7%). 38% women were practicing contraceptive methods, out of which most of them were using condom (39.4%) followed by Oral Contraceptive Pills (OCPs) (21.05%), intra uterine contraceptive device (15.7%) etc. Though most of the women had knowledge about contraceptive methods majority (62%) had negative attitude towards family planning.Conclusions: In spite of having good knowledge, utilization of contraceptives was less because of religious myths and beliefs, fear of side effects, cultural and political barriers.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193039
      Issue No: Vol. 8, No. 7 (2019)
       
  • A prospective study of the incidence and outcomes of eclampsia in a
           tertiary care hospital and teaching institute in India

    • Authors: Garima Gandhi, Kavita Chandnani
      Pages: 2766 - 2772
      Abstract: Background: Eclampsia is a common cause of maternal and foetal morbidity and mortality in India and the rest of the world accounting for nearly 10% of all maternal deaths. However, there is a relative scarcity of outcome data for patients with eclampsia in India. Our goal was to estimate the incidence of eclampsia, the maternal and foetal outcomes of patients presenting with eclampsia, and predictors of clinical outcomes in these patients. Objective of this study was to estimate the incidence of eclampsia in patients who delivered at a single tertiary care institution over a 2-year period and to study the maternal and perinatal outcomes in those patients.Methods: Prospective cohort study conducted from September 2008 to August 2010 on all patients with eclampsia admitted during the study period at Lok Nayak Hospital, New Delhi, India.Results: The incidence of eclampsia among total deliveries was 0.45%.  About 97% of these patients received parenteral magnesium sulphate as the primary anticonvulsant therapy. Caesarean section was performed in 22.7% and majorities were done for foetal distress. Maternal complications were encountered among 17% of patients. There were 2 maternal deaths (2.3%), 13 stillbirths (14.1%) and 7 early neonatal deaths (7.9%).Conclusions: The incidence of eclampsia among all deliveries over a 2-year period at a tertiary care centre in India was 0.45%. Parenteral magnesium sulphate was effective in the vast majority of these patients in controlling the seizures. Further studies to evaluate whether early registration for antepartum care improves maternal and foetal outcomes in patients with eclampsia are warranted.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193040
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prevalence and risk factors of postpartum depression at a tertiary care
           institute

    • Authors: Vanithamani Sivapragasam, Anitha A. Manjappa, Aruna B. Patil, Monicka Kalaimani
      Pages: 2773 - 2780
      Abstract: Background: Up to 85% of the women experience some type of mood disturbance in the postnatal period. Postpartum depression affects bonding with infant which may lead to malnutrition and other complications in the infant. This article focuses on the prevalence of depression among postnatal women attending a tertiary care institute in Chennai and to identify the risk factors that affect postpartum depression.Methods: This study was a cross sectional study, performed over a period of three months from January 2019 to March 2019. 200 postnatal mothers were recruited for the study, who were in postpartum period from 1 to 6 weeks after delivery. Specially designed proforma was used to record various determinants to assess the risk factors which could contribute to postpartum depression. The Edinburgh Postnatal Depression Scale was used to detect the depressive symptoms in postnatal mother.Results: A total of 200 cases were studied. Prevalence of postpartum depression was found to be 25%. Primi gravida, history of miscarriage and unplanned pregnancy were associated with increased risk of developing depression in the postnatal period. Fear regarding gender of the child and failure of lactation were not contributing risk factors to postpartum depression. Spacious house and partner support were found to be protective factors to combat depression in postnatal women.Conclusions: Prevalence of postpartum depression was 25%. Significant association was found between primi gravida, history of miscarriage, unplanned pregnancy and postpartum depression. Early screening of the women will reduce the adverse outcomes among both mother and the child.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193041
      Issue No: Vol. 8, No. 7 (2019)
       
  • Genital tuberculosis in infertile women: role of hysterolaparoscopy and
           tuberculosis polymerase chain reaction

    • Authors: Nikita Gandotra, Abhinav Sharma, Preeti Sharma
      Pages: 2781 - 2784
      Abstract: Background: Genital tuberculosis is an important cause of female infertility in developing countries like India. It is one of the major causes for severe tubal disease leading to infertility.Methods: A prospective study was conducted in which 100 women presented to hospital with infertility were subjected to hystero-laparoscopy over 1 year. Endometrium sent for tuberculosis polymerase chain reaction (TB-PCR) and HPE and results were formulated.Results: Out of 100 women, 28% were diagnosed with Genital tuberculosis (GTB) using accepted clinical criteria, TB-PCR and endometrial HPE. 25 of these 28 were diagnosed by hysterolaparoscopy (89.24%) alone, 16 by positive endometrial TB-PCR (57.14%) and another 2 by HPE (7.14%).Conclusions: In country like ours where TB is endemic, a multi-pronged approach to diagnosis increases the chances of successfully diagnosing this destructive disease.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193042
      Issue No: Vol. 8, No. 7 (2019)
       
  • Associated comorbidities with obesity in pregnancy and its feto-maternal
           outcome

    • Authors: Rupam Sanjay Jain, Sneha D. Shirodkar
      Pages: 2785 - 2791
      Abstract: Background: Obesity is an evolving risk factor in the modern day - a rising global epidemic reported to cause many problems in the pregnant woman - causing ill effects to both the mother and the fetus. Managing the comorbidities associated with obesity is a challenge in obstetric care.Methods: This prospective observational cohort study was conducted at a tertiary care institute over a period of 2 years. 50 antenatal patients fulfilling the inclusion criteria were studied after taking informed consent. The various maternal, fetal and neonatal outcomes were noted to examine the magnitude and significance of the effect of BMI.Results: Obese women have a higher prevalence of infertility and are considered a high-risk state because pregnancy is associated with a higher risk of pre-eclampsia, gestational diabetes mellitus, preterm labour, increased operative and caesarean deliveries, post-partum haemorrhage, post-partum infectious morbidities and a higher incidence of anesthetic and post-operative complications in these deliveries. Neonatal complications include congenital anomalies, fetal macrosomia leading to birth injuries, preterm births and still births. Technical difficulties are faced by the obstetricians while operating and by the anesthesiologists while induction.Conclusions: Considering the adverse effects of obesity on pregnancy outcomes, pre-pregnancy counseling should be done for all overweight and obese females planning conception signifying the negative impact of obesity on maternal and fetal outcome.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193043
      Issue No: Vol. 8, No. 7 (2019)
       
  • Serum lactate dehydrogenase: a prognostic factor in pre-eclampsia

    • Authors: Meena Mehta, Meetali Parashar, Rajesh Kumar
      Pages: 2792 - 2798
      Abstract: Background: Pre eclampsia is responsible for significant maternal and perinatal morbidity and mortality worldwide .Serum LDH level is a useful biomarker for cellular injury which may reflect the severity of pre eclampsia and its level might be a guideline for management of patients. The aim of study was to find out the role of serum LDH in prediction of adverse outcome of pre eclampsia, severity of disease and occurrence of complications.Methods: This prospective observational study was conducted in the department of Obstetrics and Gynecolog, RIMS, Ranchi, Jharkhand, India. A total of 300 cases were studied.150 cases were non severe preeclamptic and 150 cases were severe pre eclamptic patients. Serum LDH was done in both non severe and severe eclamptic patients .Data entry was done in Microsoft excel 2007. Results were analysed by chi square test.Results: Higher LDH levels had significant correlation with high blood pressure as well as poor maternal and perinatal outcome.Conclusions: High serum LDH level correlate well with the severity of disease and poor outcome in patients of pre eclampsia. Detection of high risk patients with increased levels of LDH mandate close monitoring and management to prevent maternal and fetal morbidity and mortality.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193044
      Issue No: Vol. 8, No. 7 (2019)
       
  • New improvements in increasing trends of caesarean section: to compare the
           effectiveness of two techniques Misgav Ladach with Joel Cohen incision
           versus Munro Kerr with pfannenstiel incision for caesarean section

    • Authors: Kanchan Sharma, Ankita Mani
      Pages: 2799 - 2803
      Abstract: Background: Caesarean section (C-section) is the most common surgery among women worldwide, and the global rate of this surgical procedure has been continuously rising. Hence, it is significantly crucial to develop and apply highly effective and safe caesarean section techniques. In this study, we aimed at assessing the safety and effectiveness of the Joel-Cohen-based Misgav Ladach technique and comparing the results with the transverse Pfannenstiel incision (Munro Kerr) for C-section.Methods: It was a prospective randomised controlled trial conducted on 100 women undergoing caesarean section at Patna Medical College and hospital in 2017. Patients were randomly allocated in 2 groups  and intra operative  and postoperative findings (blood loss, duration of surgery, post op fever, wound complication, APGAR scores etc. were calculated.Results: The duration of surgery was significantly low in Misgav Ladach technique (19.9 minutes vs. 29.54 minutes p value <0.001) Misgav technique was found economically better method as only 1 suture was used in 43 patients (p value<0.001). Post operative recovery (ambulation and bowel transit time) was found much early in Misgav Ladach vs. Munro Kerr (p value <0.001).Post operative use of analgesics was significantly less in Misgav technique (p value <0.0001). However no significant difference was observed in incidence of postoperative fever, blood loss and mean APGAR scoring of neonates.Conclusions: From this study it can be concluded that Misgav ladach method of caesarean section is associated with better short time post operative outcomes, especially resulting in reduction of pain and postoperative hospital stay.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193045
      Issue No: Vol. 8, No. 7 (2019)
       
  • Incidence and risk factors of polycystic ovary syndrome among women in
           reproductive age group attending a tertiary health care hospital in
           Western Maharashtra

    • Authors: Khushboo Suresh Shinde, Sunil Somnath Patil
      Pages: 2804 - 2809
      Abstract: Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting women of reproductive age group. Though its incidence is markedly increasing, the awareness is still low; as a result it remains undiagnosed. Aim of this study was to find the incidence and risk factors of PCOS among women in reproductive age group, so as to encourage young women to seek timely treatment and prevent its long term complications.Methods: A study was conducted over a period of 1 year amongst 100 women attending the Gynecology OPD using a paper based questionnaire. General examination and the required laboratory tests were done to confirm the diagnosis.Results: It was found that the incidence of PCOS among the study population was 21%. Risk factors include lack of physical activity, irregular menstrual cycle, body mass index more than 25, and Waist-hip ratio above 0.86.Conclusions: It is seen that there is a need to educate women at an early stage to prevent the development of this syndrome and its early detection by them. This will facilitate the health professionals to start the treatment at a stage where the complications have not yet set in.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193046
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of rate, indications and maternal morbidity associated with
           cesarean delivery in a tertiary care hospital

    • Authors: Asma Nigar, Ausaf Ahmad, Khashia Khan
      Pages: 2810 - 2815
      Abstract: Background: Cesarean section is one of the most commonly performed surgical procedures in obstetrics worldwide. Over  the last three decades, a tremendous increase in cesarean section rates has been observed globally, which is a cause for concern as procedure is associated with higher morbidity and mortality compared to vaginal delivery. This study was done to analyze the rate and indications for cesarean section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period of 6 months from 1st October 2017 to 31st March 2018 in the department of Obstetrics and Gynecology, Integral Institute of Medical Sciences and Research, Lucknow, India. Data of patients who were admitted for delivery in department of Obstetrics and Gynecology in OPD or emergency were recorded. Statistical analysis of various parameters namely, the cesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 577, out of which 210 patients underwent cesarean sections. The overall cesarean section rate in our study was 36.39%. Previous cesarean section was the leading indication of cesarean section (31.9%) followed by arrest of labor (18.1%), CPD (14.2%), and fetal distress (12.9%). Breech presentation (5.2%), failed induction of labor (4.8%), pregnancy induced hypertension (PIH) (3.8%), oligohydramnios (3.3%), obstructed labor (2.4%), APH (1.4%), multiple pregnancy and BOH accounted for 0.95% of cesarean sections. 9% patients had few complications mainly minor wound infection (2.4%) and postpartum hemorrhage (2%). There was no mortality during this period.Conclusions: Previous cesarean section has been found to be the main indication for cesarean section. So primary cesarean section should be reduced to decrease the overall cesarean rates. A comprehensive, evidence based approach needs to be introduced to monitor indication of all cesarean section.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193047
      Issue No: Vol. 8, No. 7 (2019)
       
  • Clinical study of ectopic pregnancy at tertiary care center in Haryana,
           India

    • Authors: Sushila Chaudhary, Meenakshi B. Chauhan, Anjali Gupta, Monika Dalal
      Pages: 2816 - 2819
      Abstract: Background: Ectopic pregnancy is a life threatening condition in the first trimester of pregnancy. Diagnosis can be done by clinical examination, serum β-HCG and ultrasonography. This retrospective study was done to know the incidence, risk factors, and management of ectopic pregnancy.Methods: It was a retrospective study conducted on 75 patients of ectopic pregnancy admitted at tertiary care hospital in Haryana from February-2017 to January-2019. Data collected from record room and analysis done.Results: Total deliveries were conducted were 5064. The incidence of ectopic pregnancy was 1.48%, majority of the women were in the age group of 21-30 (68%), multi-parous (77.32%). The most common risk factor was abortion 33.33%, f/b tubal ligation was 13.13%, medical management of ectopic pregnancy done in 30.66%, 8% were managed by laproscopically and 58.66% by laparotomy.Conclusions: Safe sexual practices can reduce pelvic infections and ectopic pregnancy incidences. Early diagnosis before tubal rupture can reduce morbidity and mortality in ectopic pregnancy.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193048
      Issue No: Vol. 8, No. 7 (2019)
       
  • Vitamin D status of pregnant women and their infants in South India: VIPIS
           study

    • Authors: Preethi Navaneethan, Thenmozhi Mani, Pradita Shrestha, Annie Regi, Niranjan Thomas, Anna Simon
      Pages: 2820 - 2825
      Abstract: Background: Aim was to estimate the prevalence of vitamin D deficiency in pregnant women and their infants and to analyse the effect of maternal vitamin D deficiency on the infant.Methods: A prospective study was done in the Department of Obstetrics and Neonatology in a tertiary centre in South India with 150 women seen in the antenatal clinic after 36 weeks of pregnancy were recruited. Serum vitamin D levels were obtained. Babies were followed up and sampled once between 10 and 20 weeks of age for vitamin D, calcium, phosphate and alkaline phosphatase. Vitamin D levels less than 20 ng/ml was considered as deficiency. Analysis of the data was done using SPSS 16.0 version.Results: Vitamin D deficiency was seen in 64.8% of the pregnant women. Follow up of 76 babies showed vitamin D deficiency in 72.6% infants. Significantly high levels of alkaline phosphatase were noted in infants who were born to mothers with vitamin D deficiency, which indicates risk of developing bone disease.Conclusions: This study highlights the high prevalence of Vitamin D deficiency in pregnant women and their infants in South India in a region with abundant sunshine. This study also emphasises treating vitamin D deficiency in pregnancy to reduce the risk of developing rickets in infancy.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193049
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study on bacterial vaginosis in pregnancy and its effect on pregnancy
           outcome

    • Authors: Sai Deepthi Chikicherla, V. Sitalakshmi
      Pages: 2826 - 2831
      Abstract: Background: Bacterial vaginosis is an extremely prevalent vaginal condition and one of the causes of vaginitis among both pregnant and non pregnant women and associated with severe sequelae. Fifty percent of the women are asymptomatic. Current studies have found that the prevalence of BV ranges from 15% to 30% among non-pregnant women and 10% to 41% among pregnant women.Methods: This is a prospective study conducted among 150 pregnant women who attended the antenatal outpatient and inpatient clinic in the Department of Obstetrics and Gynaecology at Narayana Medical College and Hospital, Nellore over a period of two years from Oct 2016 to Oct 2018. Obstetric cases fulfilling the inclusion and exclusion criteria were enrolled in the study by convenient sampling technique. They were followed till the outcome of pregnancy. The data was subjected to usual statistical analysis by employing the chi-square tests.Results: Prevalence of the bacterial vaginosis was 20% in the present study. BV was significantly (p<0.05) associated with preterm delivery, PPROM, low birth weight, low APGAR and neonatal jaundice. Neonatal sepsis and congenital abnormalities showed no statistically significant difference (p>0.05) between BV positive and negative women.Conclusions: Considering the vast spectrum of maternal and fetal morbidity associated with this infection, and the availability of rapid inexpensive diagnostic tests it may be prudent to screen BV in pregnancy, so that it may be treated early and hence prevent the adverse pregnancy outcomes.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193050
      Issue No: Vol. 8, No. 7 (2019)
       
  • Vaginal birth after cesarean

    • Authors: Shilpa Gupta, Hina Ganatra
      Pages: 2832 - 2837
      Abstract: Background: A heightened awareness must be present among the clinicians while taking the decision to perform the first cesarean section, as it decides the future obstetric career of the women. Because of the rise in cesarean section rate in recent decades, the question of how to manage the subsequent deliveries becomes important. Vaginal birth after cesarean (VBAC) has long been proposed as an alternative measure to reduce repeat cesarean rate. Our present study aims to assess the predictive factors of successful VBAC and study the risks and benefits involved.Methods: A prospective observational study was conducted to assess the success of VBAC and its outcome in GMERS Medical College and Hospital, Ahmedabad. A total of 100 pregnant women with history of previous one cesarean section who fulfilled the criteria for vaginal delivery were recruited for study and the outcome was analyzed.Results: The success rate of VBAC was 58% while failed TOLAC which ended up in emergency repeat cesarean section was 42%. Vaginal delivery either before or after the history of previous cesarean section, neonatal birth weight between 2.5-3kg, and admission during active phase of  labour were associated with successful VBAC. There were 2 cases of partial scar rupture diagnosed peroperatively. The commonest indication of repeat cesarean section was non progress of labour (45.2%) followed by fetal distress (16.7%). The neonatal morbidity rate was similar in both groups due to limited prolonged unsuccessful trial in our study. There was no maternal and neonatal mortality.Conclusions: To reduce the escalating rate of total cesarean section worldwide, VBAC is an alternative option which should be encouraged in carefully selected patients. However, it should be carried out in a well equipped institute with close fetal monitoring and availability of blood and trained personnel. Thus “once a cesarean section, always a hospital delivery” and not, “once a cesarean section, always a cesarean section”.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193051
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of spectrum and fetomaternal outcome of Jaundice in pregnant
           women: an experience from a tertiary referral centre of North India

    • Authors: Monica Agrawal, Meenakshi Bhanu, Pushpa Lata Sankhwar, Sujata Deo, S. P. Jaiswar
      Pages: 2838 - 2844
      Abstract: Background: Pregnancy in jaundice is an important Medical disorder, commonly seen in developing countries like India. The objective of the study was to evaluate the causes leading to jaundice in pregnancy and to analyse the feto-maternal outcome in patients of jaundice in pregnancy.Methods: This was a prospective observational study of antenatal cases with jaundice admitted in the Department of Obstetrics and Gynecology, King Georges Medical University, Lucknow over a period of one year after getting approval of ethical clearance. Total 122 cases were enrolled after informed consent.Results: Total of 122 cases were enrolled, Incidence of jaundice in pregnancy was 1.2%. Majority of patients were of age group 20-25 years 48.4%. About 69.7% presented at gestational age of 29-40 weeks. Most common cause was pre-eclampsia 33.6%, followed by cholestasis 23.75% and hepatitis 17.2%. Amongst hepatitis, most common was hepatitis B in 26.7%. Out of 122 cases, 59.8% delivered while 50.2% were undelivered 52.4% patients improved and were discharged while 47.6% patients expired. Vaginal deliveries were 56.1%, abdominal deliveries were 43.9%, and main reason for maternal mortality was hepatic encephalopathy in 64.6%. Mortality was higher in patients with total bilirubin > 10mg%. Perinatal mortality was 37%.Conclusions: Pregnancy complicated with jaundice carries very poor maternal and fetal outcome. Poor outcome may be attributed to delay in seeking medical advice, lack of awareness, lack of proper antenatal checkups 100% ANC booking can help in reducing fetomaternal morbidity and mortality.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193052
      Issue No: Vol. 8, No. 7 (2019)
       
  • A study of prevalence of asymptomatic bacteriuria in pregnant women from
           rural areas attending to Obstetric Department in Akash Hospital,
           Karnataka, India

    • Authors: Rohini N. S., Ravishankar S. N., Kala K., Rakshith N. R.
      Pages: 2845 - 2850
      Abstract: Background: Asymptomatic bacteriuria (ASB) in pregnancy is a significant risk factor for developing upper urinary tract infection and pyelonephritis which is associated with significant maternal and fetal risks. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify the organisms and their antibiotic susceptibility patterns and to formulate a single or combined rapid screening method as an acceptable alternative to urine culture.Methods: A total of 375 pregnant women aged between 18 to 45 years were included in this study. Clean catch mid-stream urine samples were collected. Screening tests done were gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test. Identification of pathogens and antibiotic sensitivity tests were performed as per standard urine culture and sensitivity methods.Results: Out of the 375 pregnant women, 31 (8.4%) had significant bacteriuria. High percentage of women with ASB were primigravidas (51.38%) and in 2nd trimester (43.86%). The most common organism isolated was E.coli (56.14%). In screening tests, gram staining of uncentrifuged urine had a sensitivity of 85.71%. Sensitivity of 71.42% was found in Nitrite and leucocyte esterase tests. However, the combination of these two tests, with either test positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively.Conclusions: Early detection and treatment of ASB in pregnancy can prevent complications. ASB can be identified by simple and combined rapid screening methods and urine culture along with antibiogram. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193053
      Issue No: Vol. 8, No. 7 (2019)
       
  • Towards safe motherhood to - are we moving in the right direction':
           experience from an urban health facility in South India

    • Authors: Ramya Thangavelu, Lalitha Natarajan
      Pages: 2851 - 2855
      Abstract: Background: This study was designed to evaluate the institutional Maternal Mortality Ratio (iMMR) in our institution, a tertiary private medical college hospital and to suggest recommendations and possible interventions to reduce it.Methods: This retrospective descriptive study was conducted by reviewing the hospital records over a period of ten years from January 2009-December 2018. The case records were reviewed for maternal demographic characteristics and complications.Results: The total number of deaths during the study period was 21, giving an iMMR of 85.268 per 100000 live births. Most of the maternal deaths (>80%) occurred postpartum. Obstetric causes contributed to 57% of the deaths with hypertension and hemorrhage topping the list. Other causes were sepsis and non obstetric causes including one case of maternal suicide. 52.38% of the women died more than 48 hours after admission to the hospital, while 28.57% succumbed in less than six hours. Secondary complications noted were ICU admission, extended intubation, massive transfusion, operative intervention and multi organ dysfunction.Conclusions: The classical triad of Hypertension, Hemorrhage and Sepsis continues to be the major determinant of maternal mortality and are potentially preventable by promoting universal access to quality health care, strengthening of health services and ensuring accountability.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193054
      Issue No: Vol. 8, No. 7 (2019)
       
  • Helicobacter pylori infection and hyperemesis gravidarum: a prospective
           pilot study in India

    • Authors: Akhila M. V., Padmasri R.
      Pages: 2856 - 2860
      Abstract: Background: About 80% of all pregnant women experience some form of nausea and vomiting during their pregnancy. Hyperemesis gravidarum, the commonest indication for admission to hospital in the first half of pregnancy affects approximately 0.3%-2.0% of pregnancies. Helicobacter pylori infection has been implicated in the cause of nausea and occasional vomiting in early pregnancy. The objectives of this study are to determine the proportion of H. pylori seropositivity among women with hyperemesis gravidarum (HG) and determine its relation with socio-economic status.Methods: This was a prospective study conducted in a tertiary hospital in Bangalore among 60 pregnant women with HG for a period of 12 months. Venous blood samples were obtained and serum IgG for H. pylori was measured using enzyme-linked immunosorbant assay (ELISA). Details regarding socioeconomic status, recurrence of symptoms and severity were noted.Results: The proportion of H. pylori seropositivity among pregnant women with hyperemesis in our study was 70%.There was a significant increase in severity and recurrence of vomiting among seropositive cases. Women belonging to rural areas had 1.17 times the risk of infection compared to women with urban area. We also found women belonging to the lower socioeconomic status had 0.52 times more risk to develop Helicobacter pylori infection.Conclusions: This study suggests that H. pylori is an independent risk factor for vomiting in pregnancy. Effective treatment and eradication of H pylori infection may help reduce severity and recurrence of vomiting among positive cases thus reducing its adverse consequences.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193055
      Issue No: Vol. 8, No. 7 (2019)
       
  • Gynecological problems and reproductive health awareness amongst late
           adolescent girls pursuing professional courses: a questionnaire based
           survey

    • Authors: Rambabu Chennuru, Jarina Begum
      Pages: 2861 - 2866
      Abstract: Background: Dysmenorrhoeais a debilitating menstrual problem and may be related to body mass index (BMI). This study was done to explore the various gynecological problems in girls in their late adolescence that is pursuing professional courses in medicine, dental and nursing.Methods: This was a prospective, questionnaire based study conducted between January and February 2019 in a medical college in Visakhapatnam, India. The survey included female undergraduate students of the Medical, Dental and Nursing colleges to find out their menstrual history and reproductive awareness with the help of a self-structured questionnaire. Participants were categorized based on BMI. Data was reported as number and percentage.Results: Of the 190 participants, 154 participants (age range; 16-19 years) were included in the study. Fifty percent of the total participants reported to have dysmenorrhoea, of which 21% reported severe dysmenorrhoea. A very high % of participants in the obese category (77.8%) reported severe dysmenorrhoea, followed by 27.3% in the underweight category. A U-shaped relationship between percentage of participants with severe dysmenorrhoea and increasing BMI was observed. A fair percentage of obese participants reported for infrequent periods beyond 35-45 days and androgenic features like excess hair, acne and dark pigmentation around neck, suggestive of polycystic ovarian syndrome (PCOS). The participants possessed a high level of awareness and reported in the range of 87.1 to 96.8% related to reproductive health.Conclusions: Despite high level of awareness among the participants we observed a considerably high prevalence of dysmenorrhoea which was even more prevalent, in the obese category.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193056
      Issue No: Vol. 8, No. 7 (2019)
       
  • Uterine scoring system for reproduction scoring correlation with pregnancy
           rate in infertility patients undergoing intracytoplasmic sperm injection
           and embryo transfer

    • Authors: Mamta Vijay Shivtare, Nikita Lad, Pallavi Vishwekar, Pradnya Shetty
      Pages: 2867 - 2870
      Abstract: Background: Infertility is defined as failure to conceive a clinical pregnancy after 12 months or more of regular unprotected intercourse. The birth of Louis Brown opened door to whole new world. Science of reproduction unfolded with better understanding of physiology and pharmacology of gonadotropins. Improved stimulation protocol, and lab facilities are available for IVF and intracytoplasmic sperm injection (ICSI). The objective of this study was to study relation between uterine scoring system for reproduction (USSR) scoring and pregnancy rate in patients undergoing ICSI and embryo transferred.Methods: A prospective observational study was conducted. Study comprised 48 women visiting with infertility for ICSI and embryo transfer. Baseline scan done on day2 of menses. Patients started on estradiol valerate for endometrial preparation. Transvaginal sonography done on 10th day of menstrual cycle for USSR scoring. USSR scoring includes parameters such as endometrial thickness, endometrial layering, myometrial contractions, myometrialechogenecity, uterine artery Doppler flow, endometrial blood flow, myometrial blood flow.Results: Out of total 48 infertility patients for embryo transfer 22 conceived, which gives 45.83% pregnancy rate. No patients had a perfect score of 20. Patients with score of 17-19 had pregnancy rate of 66%. Endometrial thickness of 10-14mm gave optimum result of 52%. Pulsatality index <2.19 was associated with pregnancy rate of 66%.Conclusions: USSR scoring is highly indicative of good pregnancy outcome in patients undergoing ICSI and embryo transfer. Endometrial morphology and thickness was strongly correlated with successful pregnancy outcome.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193057
      Issue No: Vol. 8, No. 7 (2019)
       
  • Studying prevention of parent to child transmission services,
           interventions, coverage and utilization

    • Authors: Seema Patel, Nikhil Anand
      Pages: 2871 - 2877
      Abstract: Background: Human immunodeficiency virus (HIV) infection is increasing at an alarming rate globally. Apart from heterosexual route, mother to-child transmission is the next most important route of HIV transmission accounting for over 90% of infections in children. The present retrospective study is undertaken to evaluate the effectiveness of implementation of PPTCT programmed in GMERS Medical College, Sola, Ahmedabad, Gujarat, India.Methods: At ICTCs, registered ANCs are counseled and tested for HIV. HIV+ve ANCs are linked to services and followed-up for institutional delivery. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery and children testing. HIV+ve ANCs since 2014 to 2016 subsequently delivered till December 2018 and their exposed children followed up till 18 months for confirmation of their seropositivity status in PPTCT were study at GMERS medical college, sola, Ahmedabad, Gujarat, India.Results: 13595 ANCs registered, 100% were counseled pre-test, and 99.5% of them tested, 79.5% were counseled post-test.  CD4 testing was carried out in all HIV+ve ANCs. 55 ANCs were detected HIV+ve inclusive of 37 new registered, 16 re-pregnancy and 2 unregistered cases. 55 pregnancy outcomes reported institutionally total 85.9% delivered at institute out of them 26.5% were caesarian sections and 62.4% delivered vaginally. Out of 48 live births, 47 sdNVP-MB-Pair were given. 48 children were traced till 18 months, 82.5% of live births were alive, and 68.75% of live births were tested. 1 was found HIV+ve with history of adherence to all prescribed PPTCT guidelines.Conclusions: PMTCT services - counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193058
      Issue No: Vol. 8, No. 7 (2019)
       
  • Advanced ovarian pregnancy: an elusive diagnosis

    • Authors: Bhanupriya .
      Pages: 2878 - 2880
      Abstract: Primary ovarian ectopic is a rare variant of ectopic pregnancies. It is commonly confused with tubal pregnancy aborted over ovary, hemorrhagic ovarian cyst, ruptured corpus luteal cyst. The women with ovarian ectopic generally presents early because of early onset hemorrhage in ovary. This is a rare case where woman with ectopic pregnancy presents at 13 weeks. The clinical picture is also highly unusual with just spotting and fainting attacks at the end of first trimester to make a diagnosis of ectopic pregnancy. The laparotomy done showed an unruptured ovarian ectopic pregnancy and with 350 cc hemoperitoneum. Salpingoopherectomy was done and the ectopic mass was removed as hardly any ovarian tissue was left to conserve the ovary. Hence, clinicians should be cautious enough to keep a differential diagnosis of ectopic even at advanced gestation.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193059
      Issue No: Vol. 8, No. 7 (2019)
       
  • Infected delayed puerperal hematoma complicated by retention of urine: a
           case report and literature review

    • Authors: Tanjona A. Ratsiatosika, Randriamahavonjy Romuald, Faisoaly ., Rainibarijaona A. Lantonirina, Rakotonirina Martial, Rakotonirina Ando-Miora, Andrianampanalinarivo H. Rakotovao
      Pages: 2881 - 2884
      Abstract: The puerperal hematoma corresponds to a tissue cleavage, most often paravaginal or vulvar, in which the vascular wounds, linked to the detachment, have no spontaneous tendency to haemostasis. The aggravation of this pathology is progressive. Diagnosis and management must be an obstetric emergency. Author report a case of infected puerperal hematoma complicated by rectal compression and acute retention of urine. This is a 26-year-old patient with a history of chronic hypertension. Labor was induced by misoprostol. The delivery was uneventful at 37 weeks vaginally. Ten days after delivery, she returned to the obstetrical emergency service for acute urine retention. The examination with the vaginal speculum showed a tumefaction of six centimeters on the left lateral side of the vagina. Surgical treatment has been performed. The suite was without particularity. The diagnosis of puerperal hematoma must be early. Even for the delayed form, the complications are identical. Blood loss, compression of proximity organs and infection are the most common complications. The care must be multidisciplinary. Resuscitation of the patient associated with haemostasis of the vessel is the main treatment in cases of large hematoma with hemodynamic instability.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193060
      Issue No: Vol. 8, No. 7 (2019)
       
  • Two cases of Salmonella breast abscess in pregnancy: a diagnostic
           challenge

    • Authors: Aishwarya Parthasarathy, Kundavi Shankar, Suresh Anand
      Pages: 2885 - 2887
      Abstract: Breast abscess in pregnancy due to Salmonella has been very rarely reported in the literature and most of the cases till now are due to unknown risk factors or in otherwise immunocompromised adults. Localized disease can occur due to bacteremia followed by seeding of bacteria at distant sites. We report two cases of breast abscess in pregnancy cause by Salmonella typhi where drainage of abscess and appropriate antibiotics helped in complete resolution.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193061
      Issue No: Vol. 8, No. 7 (2019)
       
  • Cases of management of paediatric tubo-ovarian torsion

    • Authors: Ruchi Bhandari, Manju Khemani, Asif Mustafa
      Pages: 2888 - 2894
      Abstract: Ovarian torsion is the fifth most common cause of gynaecologic surgical emergency. It warrants early diagnosis as timely surgical management will avoid the further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation. This leads to delay in surgical exploration and loss of ovarian function. In these cases, the ovary and often the ipsilateral fallopian tube twist with the vascular pedicle, resulting in vascular compromise. Unrelieved torsion leads to haemorrhagic infarction. We encountered 3 cases of ovarian torsion in paediatric age group during a period of 12 months. All cases presented with acute pain abdomen for 3-7 days period with loss of appetite and unable to pass motion with varied disappearance of pain. On ultrasound all the cases were diagnosed with ovarian cyst with torsion and underwent laparoscopic cystectomy. This case series is written just to show the results of de-torsion and conserving the fallopian tube and ovary after vascular damage. This type of conservative management may give chance to ovary to return to viability. This was seen in all 3 cases dealt by us on repeat scan on follow up. Even on de-torsion if ovary does not regain its colour immediately it should be conserved, and cystectomy should be performed rather than oophorectomy. Conservative surgery, in the form of ovarian de-torsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193062
      Issue No: Vol. 8, No. 7 (2019)
       
  • Footprint lesion: a mirror image of an endometrial polyp

    • Authors: Nitin H. Shah, Aditi V. Joshi, Sunita Mourya
      Pages: 2895 - 2897
      Abstract: Endometrial polyps may present with a variety of symptomatology. They are mostly benign and commonly encountered in the reproductive age group. Hysteroscopy is an emerging tool for diagnostic as well as a therapeutic purposes. We report a case of endometrial polyp diagnosed on hysteroscopy, with a “footprint”, that is contact lesion visible. This is a relatively rare phenomenon, and there is sparse information and literature regarding this entity. Hence the true nature of its effects is yet unknown.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193063
      Issue No: Vol. 8, No. 7 (2019)
       
  • Episiotomy site endometriosis: a rare case report

    • Authors: Fatima Usmani, Rashmi Gupta
      Pages: 2898 - 2900
      Abstract: Endometriosis is defined as the presence of endometrial tissue apart from its usual location. Scar endometriosis is an infrequent type of extra pelvic endometriosis. Viable decidual endometrial cells are likely to be transplanted in the episiotomy wounds during normal delivery and subsequent growth may occur. We present here a case of 22 year old female with perineal endometriosis at the episiotomy site. The clinical, operative and pathological findings are reported.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193064
      Issue No: Vol. 8, No. 7 (2019)
       
  • Congenital cystic adenomatoid malformation, antenatal diagnosis: about one
           case

    • Authors: Dembélé Adama, Ouédraogo Issa, Kiemtoré Sibraogo Sibraogo, Bambara Moussa
      Pages: 2901 - 2905
      Abstract: Antenatal ultrasound screening of fetal malformations requires for management, the immediate nature of which at certain birth, conditions the survival of the newborn. The Objectives Describe a case of pulmonary cystic adenomatoid malformation discover during antenatal ultrasonography. It was a 36 years old primary patient, referred to the maternity of Lafontaine hospital (France) for the presence, on obstetrical ultrasound screening, of suspected lesions on the foetal right lung’s field in a 21 weeks gestation pregnancy. After successive obstetric ultrasound scan, it was discovered that the left lungs were big with some parenchymal cysts of different sizes more than 3 mm in diameter. We made a diagnosis of type I left pulmonary cyst adenoma with excess amniotic fluid, without associated anomalies. The pregnancy progressed to 40 weeks gestation and a caesarean section was done with extraction of a live female new born weighing 2730 gr. The new born had 40 days later a successful surgical lobectomy for a cystic adenomatoid dysplasia. Histological examination revealed type I Stocker congenital pulmonary cystic adenomatoid malformation. During obstetrical ultrasound screening, we paid more attention to the brain, the heart, the face. Through this study we realised that during routine antenatal ultrasound for morphology, we should also pay more attention to the lungs.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193065
      Issue No: Vol. 8, No. 7 (2019)
       
  • Uterus didelphys with a successful term pregnancy

    • Authors: Smriti Anand, Soniya Dhaiya
      Pages: 2906 - 2909
      Abstract: Mullerian duct anomalies are congenital defects of female genital system that arise from abnormal embryological development of mullerianducts. Uterusdidelphys also known as double uterus is one of the least mulleriananomalies. Here we present a case of a woman with uterus didelphys and her successful full pregnancy. Patient came to our hospital with diagnosis of G1P0L0 with 39 weeks with antepartum hemorrhage with active bleeding. On ultrasound she was found to be type iv placenta previa, in view of same we had done her lower segment cesarean section with delivery of a 2.5 kg female baby with intraoperative findings of two uterus and two cervix i.e uterus didelphys in which pregnancy was present in right uterus, placenta covering os. Post operative period was uneventful. Patient who have uterus didelphys due to mullerian defect not associated with difficulty in conception but there is increase incidence of preterm labour, malpresentation and malposition. Howeverwith appropriate antenatal and intrapartum surveillance pregnancy outcome are good.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193066
      Issue No: Vol. 8, No. 7 (2019)
       
  • True broad ligament fibroid mimicking ovarian mass in a postmenopausal
           woman

    • Authors: Lata Singh, Taru Gupta, Snigdha Kumari, Sangeeta Gupta
      Pages: 2910 - 2912
      Abstract: Fibroids are benign smooth muscle tumors. Large fibroids are known to arise from the uterus, but occasionally from the broad ligament.  Here, we report a case of true broad ligament fibroid which is rare and difficult to diagnose in a 57 year old postmenopausal women with a large mass of 24 weeks size gravid uterus. Patient presented with pain lower abdomen and mass in abdomen with no other co-morbidity. This broad ligament fibroid was mimicking as ovarian tumor on ultrasonography and MRI as left ovary was not visualised separately, thus leading to diagnostic dilemma of ovarian malignancy. Mass resection with total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. No local or distant metastasis observed, and Histopathology showed true broad ligament fibroid of left side weighing 3.57 kilograms.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193067
      Issue No: Vol. 8, No. 7 (2019)
       
  • Aggressive angiomyxoma of broad ligament: an uncommon mesenchymal tumor

    • Authors: Sunil Vitthalrao Jagtap, Nitesh Nasre, Nitin S. Kshirsagar, Shubham S. Jagtap
      Pages: 2913 - 2915
      Abstract: Aggressive angiomyxoma is a rare mesenchymal tumor occurring predominantly in the pelviperineal region.
      Authors present a case of a 70 years female presented with history of distention of lower abdomen with recurrent pain since 6 months. On clinical examination there was suspicion of fibroid. On USG it was reported as huge fleshy, soft tissue mass measuring 20x10x9 cm in lower abdominal flanks and pelvis with vascular pedicle attached to right parametrium. Pan-hysterectomy was performed. Right broad ligament showed mass measuring 18.5x10x6 cm. On histopathological examination it was diagnosed as a case of Aggressive angiomyxoma of broad ligament. We are presenting this case for its extreme rarity, clinicohisto-pathological and radiological findings.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193068
      Issue No: Vol. 8, No. 7 (2019)
       
  • Full term broad ligament pregnancy: a case report

    • Authors: Vidhi J. Shah
      Pages: 2916 - 2918
      Abstract: A broad ligament pregnancy is extremely rare form of ectopic pregnancy with high maternal and perinatal mortality. The eventuality of such pregnancies reaching full term is even rarer. Although ultrasonography is helpful in making diagnosis, but it is mostly established during laparotomy. Our patient is an unbooked case, G2P1 reported to us at 39 weeks of pregnancy with abdominal pain. Ultrasonography showed viable foetus with severe intrauterine growth restriction (estimated fetal weight of 1.98 kg), transverse lie, severe oligohydramnios with complete placenta praevia. Patient was taken for caesarean section. Intraoperative diagnosis of left broad ligament pregnancy was made, foetus was removed alive and broad ligament along with placenta, left fallopian tube and ovary was excised. Post-operative period was uneventful.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193069
      Issue No: Vol. 8, No. 7 (2019)
       
  • A rare case of Meckel Gruber syndrome

    • Authors: Rudrika Chandra, Bhanu Pratap Singh, Sanjay Singh
      Pages: 2919 - 2922
      Abstract: Meckel Gruber syndrome (MGS) is a rare lethal autosomal recessive disorder.  It is characterized by triad of features having occipital meningoencephalocele, polycystic kidneys and post-axial polydactyly. We report an antenatal patient detected with occipital meningoencephalocele in foetus on early anomaly scan at 15 weeks of gestation followed by foetal MRI which revealed the typical triad features strongly suggestive of MGS. The patient opted for medical termination of pregnancy and the abortus was autopsied, with the permission of the patient, for detailed evaluation of anomalies which were consistent with MGS. This case highlights the importance of a detailed foetal evaluation antenatally to detect anomalies which are incompatible with life and proper diagnosis as it has bearing on patient’s future obstetric outcome.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193070
      Issue No: Vol. 8, No. 7 (2019)
       
  • Pyometra in the postpartum: a forgotten complication

    • Authors: Rana A. Choudhary, Kedar N. Ganla, Kavita N. Desai, Priyanka H. Vora
      Pages: 2923 - 2925
      Abstract: We report a case of 37 years old women who conceived after in vitro fertilization (IVF). Her antenatal course was uneventful. On delivery there was placenta acreta. She later presented in the postpartum period with pyometra. She was managed with conservative treatment. We believe that the placental bed sutures and the sloughing placenta could have led to sterile pyometra in this patient. This rare but important complication need to be kept in mind specially in high risk women with thin endometrium, h/o IVF, cervical encerclage, and placenta acreta.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193071
      Issue No: Vol. 8, No. 7 (2019)
       
  • Case reports for embryo banking: for women who want their own

    • Authors: Amishi Vijay Vora, Purnima Nadkarni, Pooja Nadkarni Singh, Vaibhav Nadkarni, Aditi Nadkarni
      Pages: 2926 - 2931
      Abstract: Out of the many challenges in management of female factor infertility, poor responders and low response to stimulation in aged and even younger women, seems to be a common problem. It is very difficult to offer one particular management strategy or treatment protocol for optimum outcome in this group of women of poor responders. In a low resource set up, IVF (In vitro Fertilization) specialist doctors usually face a challenge in treating women with poor/ low ovarian reserve as ovum / gamete donation is considered as a taboo in various sections of society even today. Hence women insist on having an offspring of "their own" and vehemently deny ovum / gamete donations. In this article we discuss 2 cases of poor ovarian reserve retrospectively, who underwent multiple cycles of controlled ovarian hyperstimulation for embryo banking and ultimately achieved pregnancy. Both patients achieved pregnancy with the method of embryo banking. Embryo banking should be considered and discussed. Various articles have discussed the advantages and disadvantages of embryo banking or even oocytes accumulation. The advantages of this technique is patients with poor/low ovarian reserve get a chance to be pregnant with their own oocytes and also have a chance for vitrification of residual embryos. Another advantage in such patients is that the embryos can undergo PGS (Preimplantation Genetic Screening) techniques in cases of suspected genetic disorders. The disadvantage in a low resource set up like India is the cost of the treatment. Nevertheless, embryo banking and accumulation of oocytes should be given as an option for treatment of poor/ low ovarian reserve and could be considered as a ray of hope for all future mothers hoping for a child of "their own".
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193072
      Issue No: Vol. 8, No. 7 (2019)
       
  • Vagino-cutaneous fistula: unreported, under-reported or unheralded'

    • Authors: Ashwath Narayan Ramji
      Pages: 2932 - 2936
      Abstract: Fistulas are communicating tracts between two surfaces, linking structures and planes that should, under normal circumstances, not be in dialogue. They may be congenital or acquired and are most commonly associated with the gastrointestinal and ano-rectal territories, where they link two different organ systems internally, or track outwards, creating a communicating channel between the internal viscera and the skin surface. Vaginal fistulas on occasion result from perineal tears due to traumatic delivery, or less commonly, infection or non-healing of the episiotomy wound, and are of the rectovaginal or vesicovaginal variety. Very rarely, the channel from the vagina tracks to an opening in the skin. This is the report of a patient who developed the rare vagino-cutaneous fistula following a normal vaginal delivery with episiotomy, and review of the limited literature available about the peculiar entity, so rare that no previous reports of vagino-cutaneous fistulas developing after vaginal delivery with episiotomy could be found.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193073
      Issue No: Vol. 8, No. 7 (2019)
       
  • Vaginal ligation of descending branch of uterine artery in the management
           of massive secondary post-partum haemorrhage

    • Authors: Rudrika Chandra, Sanjay Singh
      Pages: 2937 - 2939
      Abstract: A 25 year old lady presented on day 22 of an uneventful caesarean delivery, in a state of class IV haemorrhagic shock, secondary to sudden onset of vaginal bleeding without any inciting cause. Immediate resuscitation was initiated and the cause for massive secondary post-partum haemorrhage (PPH) was identified as an actively bleeding vessel at 3 ‘O’ clock position on a visibly healthy cervix with a well contracted uterus. This was the descending branch of left uterine artery, which was ligated after pulling the cervix with a sponge holder towards the introitus and application of Vicryl No 1-0 suture. The bleeding decreased significantly post vascular ligation. Further exploration of vagina and cervix did not reveal any active bleeding or laceration and no retained placental tissue was found inside uterine cavity on ultrasound examination. This is a rare case of Massive Secondary PPH in a post-caesarean patient due to spontaneous giving way of descending branch of uterine artery.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193074
      Issue No: Vol. 8, No. 7 (2019)
       
  • Prolongation of a pregnancy with second trimester severe oligohydramnios
           to term: a case report

    • Authors: Alka C. Bapat, Nitin P Paidhungat
      Pages: 2940 - 2942
      Abstract: The occurrence of oligohydramnios complicating a pregnancy is seen in 0.8 to 5.5 % of pregnancies. Severe Oligohydramnios, though not clearly defined, but clinically with an AFI of less than 5 cm appears to be an important predictor for an abnormal fetal outcome. In general, the prognosis of mid trimester oligohydramnios is still poor. Hence we report a case with a very favourable neonatal outcome following severe oligohydramnios documented in early pregnancy. The aim of this case report is to add our experience to the currently limited literature regarding the best treatment of this unique obstetrical problem.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193075
      Issue No: Vol. 8, No. 7 (2019)
       
  • Pelvic tuberculosis: from millets to masses

    • Authors: Nitin H Shah, Aditi Vivek Joshi, Sunita Mourya
      Pages: 2943 - 2945
      Abstract: An adnexal mass is a common entity in the reproductive age group. Ovarian masses form a majority of this condition. Tuberculosis is a disease commonly encountered in the Tropics and is endemic to India. Abdominopelvic affliction of this disease is common in women especially in the reproductive age groups. It may present with variety of non-specific clinical features and often poses an enormous diagnostic dilemma Author report one such case, presenting with a clinical impression of ovarian malignancy, however, was diagnosed to be a case of extensive pelvic tuberculosis on laparoscopy. Tissue biopsy was consistent with the finding of tuberculosis.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193076
      Issue No: Vol. 8, No. 7 (2019)
       
  • Cryptomenorrhoea due to imperforate hymen: a case report

    • Authors: Romi Bansal, Priyanka ., Sneha .
      Pages: 2946 - 2948
      Abstract: Imperforate hymen is a rare obstructive congenital anomaly of the female genital tract which arises as a result of complete failure of canalisation of the inferior end of the vaginal plate at the junction between the urogenital sinus and the vagina. Its prevalence is 0.05%-0.1%. We are presenting a case of 14 years old girl who came with complaints of lower abdominal pain since 10 days not associated with nausea, vomiting and diarrhoea. She had not attained menarche but her secondary sexual characters were developed with breast, pubic and axillary hair in tanner stage 4. MRI revealed hematocolpos and hematometra with imperforate hymen. Hymenotomy was performed and 300-400 ml of thick tarry colour blood was drained. Her postoperative period was uneventful, and patient was discharged in satisfactory condition. On follow up after 1 month, patient resumed normal menses.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193077
      Issue No: Vol. 8, No. 7 (2019)
       
  • Challenges in emergency peripartum hysterectomy in initial phase of
           obstetrics practice: series of 9 cases

    • Authors: Ranima Deka
      Pages: 2949 - 2953
      Abstract: Emergency peripartum hysterectomy (EPH) is usually done to control bleeding of life threatening peripartum haemorrhage when all of all conservative measures fail. It is a technically demanding surgical procedure that carries high rate morbidity and mortality. From January 2016 to January 2019 data of all EPH done by our in different hospital of the city is collected. Total of 9 patients fulfil the definition of EPH. We tried with all sorts as bimanual uterine compression, administration of oxytocin or prostaglandins, uterine packing, compression sutures such as the B-Lynch brace suture before operation to controlled haemorrhage. On failure of the above mentioned measure we plan EPH. We took help of a surgeon in all of 9 cases. Bleeding is the greatest challenge in our series. Out of 9 patient 8 patient survived, one patient died of bleeding due to DIC. There is one urinary bladder injury and repaired intraoperatively. All patient has minor wound infection and that was managed with oral antibiotics and wound dressings. Postoperative average ICU stay was 3 days. Average PRBC transfusion is 4 units and two patient required FFP transfusion. In one patient we did subtotal hysterectomy and in rest all other patient we did total hysterectomy. With good team work EPH can be done with acceptable morbidity and mortality. 
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193078
      Issue No: Vol. 8, No. 7 (2019)
       
  • Obstructive mullerian anamolies: a case series

    • Authors: Urvashi Miglani, Poonam Laul, V. K. Kadam, Sanjeev Miglani
      Pages: 2954 - 2958
      Abstract: AIM of the study was to review the heterogeneous clinical presentations and management options for some of the obstructive mullerian anomalies through a case series. Background: Müllerian duct anomalies (MDAs) are a miscellaneous group of entities that result from the non-development, defective vertical or lateral fusion, or resorption failure of the müllerian ducts due to genetic mutation. 5 cases of obstructive mullerian anomaly are reviewed. Cases of OHVIRA (obstructed Hemivagina with Renal Agenesis) syndrome, transverse vaginal septum, imperforate hymen and obstructed rudimentary horn of unicornuate uterus are included. Results: We found that cyclical abdominal pain was the most common presenting complaint. There is a high incidence of associated renal anomalies. Psychosocial counselling before treatment is necessary to address the functional and emotional aspects of the patient. Surgical management was done in all patients with good postoperative outcome. Conclusion: Obstructive mullerian anomalies need to be evaluated by a meticulous examination and imaging studies to reach the diagnosis with precision. The treatment has to be tailored to the specific anomaly.
      PubDate: 2019-06-29
      DOI: 10.18203/2320-1770.ijrcog20193079
      Issue No: Vol. 8, No. 7 (2019)
       
 
 
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