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

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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
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Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 7)
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Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 14)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
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Intl. J. of Scientific Reports     Open Access   (Followers: 4)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 14  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Caesarean section in a tertiary care centre

    • Authors: Rina V. Patel, Divyanshi J. Shani, Parul T. Shah, Dipali Pandey
      Pages: 3106 - 3111
      Abstract: Background: Caesarean section constitutes a major surgical procedure characterized with morbidity even if it is performed a planned procedure. Postoperative infection in obstetrics continues to affect the practice of every surgeon. Infection can cause an increase in patient’s stay in the hospital, create discomfort, cause disfigurement and lead to morbidities to the patient. Thus, preventive measures need to be constantly evaluated and updated and hence authors have to study and analyse prevalence of postoperative infectious morbidities.Methods: The study was conducted in an Urban Based Medical College Hospital in Ahmedabad. It was a retrospective cross-sectional study of 50 cases of patients who suffered infectious complications post caesarean from 1st March 2019 to 31st March 2020.Results: The prevalence rate of surgical site infection in my study is 5.9% whereas of post-operative puerperal sepsis is 0.6%, of post-operative urinary tract infection is 1.09%, of post-operative breast abnormalities is 0.16%. The most common infectious morbidity amongst all was surgical site infection (surgical site) infection and its prevalence was 5.9%.Conclusions: The development of post-operative infection is an important event that can be prevented by taking proper precautions and following prescribed guidelines. There should be specific use of antibiotics in the post-operative period. In the event of early signs of sepsis antibiotics should be administered properly as per culture sensitivity report. The decrease in infection rate also indirectly reduce the health costs involved in treating them post operatively.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203288
      Issue No: Vol. 9, No. 8 (2020)
       
  • Covid 19, the Kerala experience: an observational, single centre
           retrospective study of outcome in covid positive pregnancies

    • Authors: Sabnam S. Nambiar, Ajith S., Reshmi V. P.
      Pages: 3112 - 3118
      Abstract: Background: Covid 19 has spread across the world at an alarming rate. Approximately 4.05 million people have got infected worldwide resulting in around 279,000 deaths. Over 1 million people have recovered worldwide. Aim of this study was to determine whether course and severity of covid 19 is altered in pregnant women and whether covid 19 seemed to worsen the prognosis in pregnant women.Methods: Around 50 covid positive patients were admitted to this study hospital, a tertiary care referral hospital and medical college, between march and May 2020, 11 were pregnant.
      Authors collected their data retrospectively to understand the course of their disease till the period of recovery.Results: There were 6 patients above 31 weeks of whom one had elective repeat caesarean section, one had full term vaginal delivery, one is under follow up. Three patients had foetal distress necessitating emergency caesarean section. Of the remaining 5 patients with periods of gestation between 9-13 weeks, 1 of 24 weeks, 6 patients above 31 weeks, one had a miscarriage. Rest pregnancies are continuing and under follow up. 6 women had been symptomatic at admission, with mild symptoms of low-grade fever, sore throat and rhinitis. All were treated with hydroxychloroquine (HCQs). Those with respiratory symptoms like cough were also treated with oseltamivir. In view of high prevalence of H1N1 in the region. None of the women developed severe disease. The disease did not appear to worsen prognosis in pregnant women. The rate of recovery in pregnant women was similar to that seen in non-pregnant women and also men under the age of 40 years admitted in this study hospital.Conclusions: Covid 19 did not seem to worsen the prognosis in pregnant individuals when compared to rest of the population. The foetal outcomes also seemed favorable. However larger studies are required before concrete guidelines could be formulated for management of the disease in pregnancy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203289
      Issue No: Vol. 9, No. 8 (2020)
       
  • Knowledge, attitudes and practices of breast feeding among lactating
           mothers in a tertiary care hospital in Dakshina Kannada district: a cross
           sectional survey

    • Authors: Pramodha M. S., Nikita Pitty, Chaitra S.
      Pages: 3119 - 3128
      Abstract: Background: Breastfeeding plays a crucial role in the general health and wellbeing of infants. However, this fact has been made to look inconsequential due to various misconceptions and lack of adequate knowledge among lactating mothers. The aim of this study was to assess the knowledge, attitudes and practices of breastfeeding among postnatal women in Dakshinakannada district of Karnataka, India. The objective was to educate them and encourage breastfeeding.Methods: This study is a cross-sectional survey conducted during a period of 2 months from November to January 2019 among 80 postnatal mothers regarding their KAP of breastfeeding. A questionnaire was designed from FAO guidelines for assessing nutrition-related knowledge, attitudes and practices manual and The Iowa Infant Feeding Attitudes. The data was collected by a single interviewer, collaborated into a 3-point Likert scale and analyzed using descriptive statistics.Results: The study shows that 81.25% of the mothers had good knowledge regarding breastfeeding, but the alarming finding was that 46.6% of them had a neutral attitude towards it.Conclusions: The study showed that there is significant possibility for enhancing breastfeeding practices among lactating mothers by simple provision of supportive prenatal and postnatal counselling. The role played by healthcare workers in this context would be very imperative to accomplish millennium development goals of reducing infant mortality.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203290
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study of maternal serum calcium and serum magnesium levels in
           pre-eclamptic and normotensive pregnancies

    • Authors: Pranshi Gupta
      Pages: 3129 - 3133
      Abstract: Background: Hypertensive disorders are major factors responsible for morbidity and mortality in pregnancy and pre-eclampsia is the leading cause. The etiopathology of pre-eclampsia is not known even after significant research done on it. A strong strategy in its management is to try to reduce the incidence and severity by predicting its occurrence. In this study, the effect of serum calcium and serum magnesium levels is being investigated with occurrence pre-eclampsia.Methods: Total 120 pregnant patients attending Tirath Ram Shah Hospital were included in the study. They were divided into two groups namely normotensive and hypertensive of 60 each. The serum calcium and serum magnesium levels were estimated and the correlation of these levels was studied with the pre-eclampsia related factors. The data was analysed by application of statistical test of significance.Results: Mean serum calcium level in the normotensive group was 10.119±1.27 mg/dl while mean serum calcium level in the hypertensive group was 9.461±1.164. Mean serum magnesium level in the normotensive women in the study was 1.979±0.405 mg/dl. In the hypertensive women, mean serum magnesium level was 1.723±0.414 mg/dl.Conclusions: This study shows that low levels of calcium and magnesium are found in serum of pre-eclampsia patients as compared to normotensive cases of the study population. The severity of pre-eclampsia is inversely proportional to the levels of serum calcium and magnesium.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203291
      Issue No: Vol. 9, No. 8 (2020)
       
  • Pregnancy with pancytopenia: an observational study

    • Authors: Sangamesh Mathapati, Aruna Biradar, Laxmi Sangolli, Gamini B. S., Sridevi H. S.
      Pages: 3134 - 3137
      Abstract: Background: Pancytopenia is the reduction in all three major cellular elements of blood; hence it is the simultaneous presence of anaemia, leukopenia and thrombocytopenia. Pancytopenia is associated with many maternal and foetal complications during pregnancy like maternal sepsis, postpartum haemorrhage, pre-eclampsia and preterm labour, IUGR and intrauterine foetal demise.Methods: The study was conducted at BLDE (Deemed to be) University, Shri B. M. Patil Medical College Hospital and Research Centre. It’s an observational study done from November 2019-April 2020. The participants enrolled in the study were subjected for further clinical and laboratory evaluation and followed for feto-maternal outcome.Results: The incidence of pancytopenia with pregnancy in this study was 3% and all the patients were vegetarian by diet along with vitamin B12 and folic acid deficiency. They were associated with different maternal and foetal complications.Conclusions: Proper dietary counselling and well-balanced dietary plans even with plant originate food can prevent the micronutrients deficiency and avoid the deleterious consequences like pancytopenia.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203045
      Issue No: Vol. 9, No. 8 (2020)
       
  • Gestational trophoblastic diseases: an observational study at a tertiary
           care teaching hospital in Jharkhand, India

    • Authors: Archana Kumari, Nikita Chauhan
      Pages: 3138 - 3143
      Abstract: Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203044
      Issue No: Vol. 9, No. 8 (2020)
       
  • Expectant management of incomplete miscarriage, anembryonic pregnancy and
           early fetal demise: a comparative study

    • Authors: Reshma Sajan K. K., Mumtaz P., Chandrika C. V., Abdul Vahab, Hassan Sheikh Imrana
      Pages: 3144 - 3150
      Abstract: Background: Expectant management as first line management of early pregnancy miscarriages is less accepted due to failure and increased complications reported in few studies. Proper selection of cases improves outcome of expectant management. Aim of this study was to compare success rate and complications in expectant management in three groups of early pregnancy miscarriages- Incomplete miscarriage, anembryonic pregnancy and early fetal demise.Methods: Prospective observational study conducted in tertiary care centre for 3 years, including 107 patients with USG confirmed pregnancy miscarriage <13 weeks. Patients preferring expectant management were managed as outpatient without intervention for 2 weeks after which repeat USG was done to ascertain complete miscarriage. Failed expectant management patients underwent planned surgical uterine evacuation. Emergency admission and evacuation was done, if symptomatic during waiting period. Success rate and complications like emergency evacuation, vaginal bleeding, abdominal pain, limitation of physical activity and patient satisfaction were assessed and compared in subgroups of anembryonic pregnancy, early fetal demise and incomplete miscarriage. Statistical analysis was done by chi-square test.Results: Incomplete miscarriage group had highest success rate of 88.46%. followed by anembryonic pregnancy (72.5%) and EFD (47.83%) p value = 0.007. Complication rate was highest in EFD, followed by anembryonic and the least in incomplete miscarriage all of which was statistically significant except vaginal bleeding.Conclusions: Expectant management should be offered as first line choice for all types of early pregnancy miscarriages. Proper selection of case as to type of miscarriage especially incomplete miscarriage and selected cases of anembryonic pregnancy and EFD ensures higher success rate with lesser complications. Reserving medical and surgical management for unsuitable/failed cases.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203100
      Issue No: Vol. 9, No. 8 (2020)
       
  • Is there a perfect protocol for patients with low ovarian reserve: a
           retrospective study comparing antagonist or agonist protocol in patients
           with low ovarian reserve

    • Authors: Seema Rai, Yasaswi Khandavalli, Rama S. Lodha
      Pages: 3151 - 3156
      Abstract: Background: The high prevalence of infertility has made it a major healthcare problem in the present era. A majority of patients presenting with infertility have poor ovarian reserve (POR). Patients with POR are challenging to treat due to reduced treatment success and high cycle cancellation rate as there is no uniform definition and treatment protocol for these patients. The present retrospective study was performed to compare the pregnancy outcome between a long agonist protocol and flexible antagonist protocol in patients with POR. Patients with AMH ≤1.5 ng/mL and AFC ≤4 was included in the study. Controlled ovarian hyperstimulation is the basis of any in vitro fertilisation (IVF) procedure. There is no universally accepted ideal stimulation protocol for patients with POR, and it remains a challenge.Methods: This was a retrospective study covering the period from May 2019 to March 2020. Ninety-nine patients with low ovarian reserve (AMH ≤1.5 ng/mL and AFC ≤4) were included in the study. The patients underwent GnRH agonist/GnRH antagonist stimulation protocol using recombinant FSH. Demographic characteristics like age, BMI, duration of infertility was comparable. Total days of stimulation, total Gonadotropin dose used and clinical pregnancy rate in both the protocols was analyzed. Difference between the two groups was considered statistically significant at p-value <0.05.Results: Fifty-three patients underwent antagonist stimulation protocol and forty-six long agonist protocol. The clinical pregnancy rate was 37.7% (20/53) and 32.6% (15/46) in antagonist and agonist protocol respectively (p-value=0.5983). Pregnancy rate was higher in the antagonist group but the difference was not statistically significant.Conclusions: Antagonist protocol could marginally increase pregnancy rate in patients with low ovarian reserve. However, patients with poor ovarian reserve require a tailor-made protocol.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203046
      Issue No: Vol. 9, No. 8 (2020)
       
  • Association between maternal serum beta human chorionic gonadotropin
           levels and hypertensive disorders of pregnancy

    • Authors: Archana Kumari, Vahini M.
      Pages: 3157 - 3164
      Abstract: Background: A major challenge in obstetrics is early identification of hypertensive disorders of pregnancy (HDP). This study was performed to determine the association between elevated maternal serum β-hCG levels and HDP, the correlation between serum β-hCG level and severity of preeclampsia and to determine the value of serum β-hCG level as a diagnostic marker for early diagnosis of HDP.Methods: This was a hospital based observational study conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi on 375 pregnant women with period of gestation more than 20 weeks, including 250 pregnant women with HDP as study group and 125 normotensive pregnant women as controls. Serum β-hCG concentration was measured and its level was compared between two groups.Results: The maternal mean serum β-hCG levels (51161.08±30038.21 IU/L) of study group of HDP were higher than the normotensive control group (17603.23±16748.21 IU/L). In non-severe preeclampsia, the mean serum levels were 36417.32±23876.74 IU/L while in severe preeclampsia, 60030.34±28771.31 IU/L. There was statistically significant difference (p<0.001) with higher levels in early onset preeclamptic mothers than late onset preeclampsia. The cut-off point of β-hCG for predicting HDP was 32077 IU/L with sensitivity of 65% and specificity of 86%.Conclusions: Serum β-hCG level is higher in HDP when compared to normotensive women. Higher levels of β-hCG are associated with increasing severity of hypertensive disorders of pregnancy. The utility of serum β-hCG as a diagnostic test is limited because of low sensitivity and difficulty in deciding the cut-off value.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203052
      Issue No: Vol. 9, No. 8 (2020)
       
  • Experience with women having uterine cancer in Eastern India: a hospital
           based study

    • Authors: Priyanka Singh, Chandrima Ray, Ranajit Mandal
      Pages: 3165 - 3170
      Abstract: Background: The changing lifestyle has led to a rise in obesity, diabetes and hypertension in India which the most important risk factors for developing uterine cancer. The treatment of uterine cancer is evolving and requires proper evaluation and often adjuvant treatment for better survival. The disease being associated with symptoms of abnormal uterine bleeding often ends up being inadequately managed by non-oncologists practicing in a generalist setting in India. The current study was aimed to audit and observe any difference in outcome of patients primarily treated in the oncology set-up of the Chittaranjan National Cancer Institute, which is a regional cancer center in India versus those receiving primary treatment in a non-oncological set-up.Methods: Retrospective data was collected from hospital records after setting inclusion and exclusion criteria for the study.Results: There is poor correlation between the endometrial biopsy and histopathology findings of patients operated in non-oncological setting as compared to that in the institute. The overall survival of patients operated in the institute was superior to those treated outside.Conclusions: Patients having risk factors and symptoms akin to that of uterine carcinoma must be treated in an oncological set-up ideally.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203065
      Issue No: Vol. 9, No. 8 (2020)
       
  • Does increasing the number of inseminations per cycle increase the
           probability of conception' a randomized trial comparing single versus
           double intrauterine insemination

    • Authors: Yasaswi Khandavalli, Seema Rai, Rama Singodiya Lodha
      Pages: 3171 - 3178
      Abstract: Background: Intrauterine insemination (IUI) remains an inexpensive, non-invasive, and effective first-line artificial insemination technique. The technique of IUI has evolved through various innovations since the time Cohen published the first report of IUI in 1962, and the success rate increased from 5% to >20%. The success of IUI depends upon several factors; two such prognostic factors are the timing and frequency of insemination.  The objective of this study was to compare the effectiveness of single versus double intrauterine insemination.Methods: This prospective randomized study was carried out in 130 patients with male factor infertility, PCOS and unexplained infertility. Patients were randomly assigned into two groups. In the first group of 65 patients, single IUI was applied at 36 to 40 hours after HCG administration, to the other 65 patients in the second group, double IUIs were applied at 12 to 16 hours and 36 to 40 hours after HCG administration. The primary end-point of the study was to compare the clinical pregnancy rate between the two groups.Results: The overall pregnancy rate was 18.46% (12/65) for single IUI group and 30.76% (20/65) for double IUI group. There was a no statistically significant difference between single and double IUI groups (p=0.16).Conclusions: This study did find a higher pregnancy rate following double IUI; however, the difference was not statistically significant. Further, larger sample size studies are required to determine if double IUI increases the pregnancy rate.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203076
      Issue No: Vol. 9, No. 8 (2020)
       
  • The relation between active smoking and colposcopical and cytological
           findings in the cervix uteri

    • Authors: Muhad A. Ali, Safa K. Salman, Rana M. Issa
      Pages: 3179 - 3182
      Abstract: Background: All types of smoking have been associated with cervical neoplasia, and the long-term of use tobacco products and intensity of smoking could influence cervical carcinogenesis. The aim of this study is to identify the association between smoking and the presence of colposcopical and cytological abnormalities in cervix uteri.Methods: An observational case-control study was applied on 100 patients to investigate this relationship. The patients were divided into two groups, smokers’ group (70) cases and nonsmokers’ group (30) cases. All of the patients have been submitted to colposcopy and Papanicolaou smear. Comparison of colposcopic and cellular findings between both groups was done.Results:
      Authors found that there was a significance difference in the rate of abnormal colposcopical findings between two groups. This rate in smokers’ sample was 45.7% and in the second was 26.7% with p-value=0.04. Additionally, there was no significance difference in the rate of abnormal cytological findings. This rate in smokers’ group was 32.9% whereas in the second was 23.4% with p-value=0.6.Conclusions: This study data suggests that smoking increases abnormalities in papanicolaou smear and colposcopy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203292
      Issue No: Vol. 9, No. 8 (2020)
       
  • A comparative study of obstetrics outcome of placenta previa in scarred
           versus unscarred uterus at tertiary Hospital, Kathmandu, Nepal

    • Authors: Rakshya Upreti, Amit Rauniyar, Sumit Rauniyar, Shaheen N. Ansari, Madan Khadka
      Pages: 3183 - 3187
      Abstract: Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203293
      Issue No: Vol. 9, No. 8 (2020)
       
  • Placental abruption an obstetric emergency: management and outcomes in 180
           cases

    • Authors: Pratibha Devabhaktuni, Aruna Kumari Konkathi
      Pages: 3188 - 3195
      Abstract: Background: During a period of eight months, 180 cases of abruption that occurred from January 2007 to August 2007 at GMH, Nayapool, Hyderabad were analysed. Total number of deliveries during the study period of eight months were 14004. Incidence of abruption cases delivered was - 1.3%. In this series 88% were unbooked in our hospital, were referrals. Objective of this study was to study maternal fetal outcome of placental abruption.Methods: Initial clinical assessment, investigations for maternal fetal wellbeing, expedite delivery, manage complications as per accepted protocol. In this series of cases, ARM was done in 85 cases (47.22%), ARM was done and oxytocin drip was started in 36 (20%), ARM was done and PGE1 tablet 25 mcg. was inserted in the vagina in 39 (21.66%).Results: The bleeding was revealed in 146-81.1% and concealed in 34-18.88%. The number of cases with hypertension complicating pregnancy were 102-57%, hypotension in 16-8.88%, prolonged clotting time 13-7.22%, the number of patients who received blood transfusions were 105 (58.3%), number of patients who received fresh frozen plasma, FFP transfusions were 65-36.11%. Taken for LSCS at admission were - 46. Failure to progress after ARM or other methods of labour augmentation were 20 cases. The total number of caesarean deliveries were 66/180 - (36.66%), number of vaginal deliveries were 114 (63.33%). Perinatal outcome: the total number of intra uterine fetal deaths (IUFD) at admission were 103-57.2%. The number of still births were 7-3.8%. Live born babies were 70- 38.8%. Neonatal deaths were 11-6.1% and total perinatal deaths were 121-67.2%. (IUFD at admission-103, + still births - 7, + neonatal deaths - 11=121 perinatal deaths. There were five maternal deaths in 180 cases of placental abruption, 2.7% mortality.Conclusions: Need to consider measures to reduce the occurrence of this condition.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203294
      Issue No: Vol. 9, No. 8 (2020)
       
  • The study of antibiotic-sensitivity and resistance pattern of bacteria
           causing catheter associated urinary tract infection

    • Authors: Abha Singh, Avinashi Kujur, Muthu Lakshmi M., Abha Daharwal
      Pages: 3196 - 3201
      Abstract: Background: present study is done to study the antibiotic-sensitivity and resistance pattern of bacteria causing catheter associated urinary tract infection. Objectives of this study were to study the bacterial etiology of CAUTI, to study the prevalence of various bacteria causing catheter associated urinary tract infection, the antibiogram (sensitivity and resistance) pattern of isolated bacteria and the percentage of asymptomatic bacteriuria in the study population.Methods: In this prospective observational study, under aseptic precautions, urine sample was taken after 48 hours of catheterization and sent for culture and sensitivity pattern is studied.Results: In this study 500 urine samples were cultured and its antibiotic sensitivity pattern was observed. Out of the 53 culture positive samples most the subjects had asymptomatic bacteriuria. The study gave the incidence of catheter associated urinary tract infection (CAUTI) to be 10.6% and about 9% were polymicrobial. In this study about 7 causative bacteria were isolated. Escherichia coli were the most common organism that was isolated. On studying the antibiotic susceptibility pattern of each isolate, it has been observed that all of them are multidrug resistant and the sensitivity pattern is migrating towards higher antibiotics.Conclusions: Empirical use of antibiotics must be avoided and antibiotics must be used only after sensitivity testing. This will help in selection of the appropriate antibiotic for therapeutic use and prevent indiscriminate and irrational use of antibiotics. This will also improve the cost efficiency and decrease the duration of hospital stay.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203295
      Issue No: Vol. 9, No. 8 (2020)
       
  • Cholestasis of pregnancy: effects on maternal and fetal outcome

    • Authors: Nazia Hassan, Rabia Khurshid, Mudasir Muzamil, Shameema Parveen
      Pages: 3202 - 3207
      Abstract: Background: Intrahepatic cholestasis of pregnancy (ICP) typically occurs in late pregnancy affecting 1.5-2% pregnancies. Limited data is available regarding its fetal and maternal implications. This study aims to assess the impact of ICP on maternal and fetal outcome.Methods: A total 200 patients with pruritus in later half of pregnancy were studied over a period of 18 months out of which 135 were diagnosed as ICP. Clinical and biochemical parameters like serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, and gamma glutamyl transferase was recorded. Maternal and fetal outcome was noted in the form of LSCS rate, preterm births, fetal distress and neonatal ICU admissions.Results: In this study, most common symptom was pruritus. Most of cases had onset of symptoms between 32-36 weeks. High LSCS rates were seen among cases. Intrapartum complications viz. meconium staining of amniotic fluid (57.8%), preterm delivery (11.9%), fetal distress (42.2%) were significantly higher in study population and there was high incidence of NICU admissions (49. 6% neonates) among cases mostly due to meconium aspiration and prematurity.Conclusions: ICP increases maternal morbidity and is associated with adverse perinatal outcome viz. increased risk of fetal distress, preterm births and sudden IUD at term as evidenced in this study. A timely intervention at 37-38 weeks will reduce the adverse outcomes.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203296
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study to compare the efficacy, acceptability and side effect of combined
           contraceptive vaginal ring with the combined oral contraceptive pills in a
           tertiary health centre located in central India

    • Authors: Manjari G. Jain, Mita Mazumdar, Neeraj K. Jain
      Pages: 3208 - 3214
      Abstract: Background: A study to compare the efficacy, acceptability and side effect of combined contraceptive vaginal ring with the combined oral contraceptive pills in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective randomized comparative trial enrolled hundred women aged between 20 to 40 years seeking for contraception with no contraindication to hormonal contraception. After proper counseling and informed consent, women divided into two groups, study group (50) includes women using contraceptive vaginal ring and control group (50) include women using combined oral contraceptives. The contraceptive efficacy, acceptability, tolerability and adverse events were recorded at each follow-up visit at RKDF Medical College and Research Centre, Bhopal.Results: Vaginal ring and combined oral contraceptives were found to have comparable contraceptive efficacy. In study group no pregnancy reported during study period while one pregnancy reported in control group, which was statistically insignificant. Satisfaction, continuation and recommendation to others were more with vaginal ring which were not significant statistically. Cycle control is superior with vaginal ring. Incidence of adverse effects was same in both groups.Conclusions: Combined contraceptive vaginal ring is an effective and reliable contraception with excellent cycle control, well-tolerated and highly acceptable to most women.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203297
      Issue No: Vol. 9, No. 8 (2020)
       
  • Hysteroscopic evaluation of postmenopausal bleeding patients and its
           correlation with histopathological examination

    • Authors: Sudhir Mansingh, Atmajit Singh Dhillon, Sandeep Sood, Sirisha Anne, Prema Godi
      Pages: 3215 - 3222
      Abstract: Background: Menopause is defined according to WHO as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is defined as uterine bleeding occurring after at least 1 year of amenorrhoea. Considering the high accuracy of hysteroscopy in evaluation of postmenopausal bleeding, the present study was carried out with an aim to evaluate hysteroscopic findings in women with postmenopausal bleeding in order to assess the causes of PMB and to determine their prevalence in our population.Methods: This was a prospective observation study, comprising of total number of 50 postmenopausal women attending gynae OPD at department of obstetrics and gynecology, Command Hospital (CH), Lucknow, Uttar Pradesh. The data obtained for the purpose of study was fed into computer using Microsoft excel 2013 software.Results: A total of 50 women with complaints of postmenopausal bleeding were enrolled in the study. Maximum number of women had achieved menopause between age 46 and 50 years. Hysteroscopy had an accuracy of 94% for detection of polyps. Hysteroscopy had an accuracy of 90% for detection of atrophy. For fibroid, hysteroscopy had an absolute sensitivity, specificity, positive predictive, negative predictive and accuracy value (100%).Conclusions: The findings of present study suggested that hysteroscopy has a useful role in evaluation of postmenopausal bleeding especially in the diagnosis of polyps and fibroids. Given fewer number of cases, the usefulness of hysteroscopy in evaluation of endometrial cancer and hyperplasia could not be established adequately. Further studies on larger number of sample size will help in providing more useful and confirmatory information.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203298
      Issue No: Vol. 9, No. 8 (2020)
       
  • Postdated pregnancy: its maternal and fetal outcome

    • Authors: Neetu Singh, Devyani Misra, Shubhi Srivastava
      Pages: 3223 - 3227
      Abstract: Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203299
      Issue No: Vol. 9, No. 8 (2020)
       
  • Study of ovarian cancer at a tertiary care centre

    • Authors: Jayashree Mulik, Swapnil Khadse
      Pages: 3228 - 3232
      Abstract: Background: Despite major advances in case management, ovarian cancer continues to have the highest case fatality rate of all gynaecologic malignancies. There is paucity of meaningful screening and diagnostic protocols. Present study was planned with the objective of assessment of the prevalence of ovarian cancer and the associated risk factors at a tertiary care centre.Methods: The present prevalence study was conducted at a tertiary care government hospital and entailed analysis of data of 73 patients of ovarian cancer. All the participants were subjected to comprehensive history taking, followed by general, systemic, per-speculum and per-vaginal examination. Serum tumour markers of the patients were assessed. Imaging studies including ultrasound, CT or MRI abdomen/pelvis were done as per need. Final diagnosis was confirmed on histopathology and the cases were classified according to histological classification of World Health Organization.Results: Majority (41, 56.2%) were aged more than 45 years and above, most of them with one to two previous issues (64.3%). The disease was observed to be more common in postmenopausal women (65, 89%). Three fourth participants had negative family history of ovarian or breast cancer. Out of 73 patients, 31 had value of CA 125 between 150-400 U/mL and 42 had values >400 U/mL. Epithelial ovarian cancer (serous- 33, 45.2%, mucinous- 18, 24.7%) was observed to be the commonest histological type.Conclusions: To diagnose ovarian tumours early using multipronged approach with focussed risk factor identification and screening with CA-125 is very important and is strongly recommended.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203300
      Issue No: Vol. 9, No. 8 (2020)
       
  • Vaginal progesterone after tocolytic therapy in threatened preterm labour

    • Authors: Aparajita Ashok Mishra, Shilpa N. Chaudhari
      Pages: 3233 - 3238
      Abstract: Background: Currently preterm labour is one of the most challenging problem faced by both obstetricians and perinatologists, this episode in the course of woman’s pregnancy takes a heavy tool for perinatal mortality which accounts for approximately 50-75%. The incidence of preterm labour is estimated to be 5-10% of all pregnancies.Methods: It was a prospective randomize control trail over a period of 3 year at department of obstetrics and gynecology, tertiary care hospital Pune, Maharashtra, India. Total 100 subjects were randomized into two groups with group one receiving vaginal micronized progesterone and group two control group receiving only tocolytics and steroids. Subsequently authors compared the safety and efficacy of vaginal micronized progesterone versus placebo as a maintenance therapy in preventing preterm labour.Results: This analysis showed that women who randomized to progesterone prophylaxis had a significantly increase in duration of pregnancy. The mean of birthweight in Group A and Group B was 2963±36 gm and 2567±49 gm and respectively which confirmed the positive effects of progesterone on increasing infants’ weights at birth.Conclusions:
      Authors concluded that progesterone therapy had acceptable efficacy in the prevention of preterm labor in terms of prolongation of delivery and by increasing gestational age at delivery.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203301
      Issue No: Vol. 9, No. 8 (2020)
       
  • Non-descent vaginal hysterectomy in previous cesarean section: a
           retrospective study

    • Authors: K. J. Jacob, Divya M. B.
      Pages: 3239 - 3242
      Abstract: Background: Non-descent vaginal hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. As there is an increase in caesarean section, hysterectomy in women with previous caesarean section is also increasing. The objective of this study is to assess the feasibility and safety of non-descent vaginal hysterectomy in patients with previous caesarean section.Methods: This is a retrospective study conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur from January 2017 to December 2018. Non-descent vaginal hysterectomy in 24women with previous caesarean section was studied. Details regarding age, parity, number of caesarean sections, indication of surgery, intraoperative and postoperative complications were evaluated.Results: All 24 women underwent non-descent vaginal hysterectomy successfully. 10 women (41.7%) were between 46-49 years. Commonest indication of hysterectomy was fibroid uterus (41.7%) and most common complaint was heavy menstrual bleeding (79%). There was bladder injury in one woman with history of previous 2 caesarean section. 3 women developed UTI in postoperative period.Conclusions: Vaginal hysterectomy is associated with lower complications and more rapid recovery. A successful NDVH in previous caesarean section depends on the expertise and experience of the surgeon. NDVH in previous caesarean is safe in expert hands.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203302
      Issue No: Vol. 9, No. 8 (2020)
       
  • Clinical profile of maternal deaths due to postpartum haemorrhage

    • Authors: Vidyadhar B. Bangal, Parikshit Jondhale, Satyajit Gavhane, Krupa Mange
      Pages: 3243 - 3248
      Abstract: Background: Postpartum haemorrhage is one of the dreadful complications that occur during delivery. It is often un-anticipated and occurs suddenly and un-expectedly. It is responsible for 20 percent of maternal deaths in developing countries. These deaths are largely preventable. The objective of the study was to find out the clinical profile, associated co-morbid conditions and contributory factors and treatment modalities used in the management.Methods: Retrospective observational study of maternal deaths due to postpartum haemorrhage (PPH) was carried out at tertiary care hospital. The data of maternal deaths for seven years from year 2013 to 2019 was reviewed, compiled and analyzed to draw conclusions.Results: There were 18 maternal deaths (19%) due to PPH out of total 86 maternal deaths. The average age of the woman who died due to PPH was 24 years. Ninety five percent of the cases of PPH were due to atonic uterus. Seventy percent of the cases had reported in advanced stage of shock with average blood loss of more than two to three litres. Poor general condition due to delay in reaching to tertiary care hospital was predominant feature. Sixty percent women underwent obstetric hysterectomy. Massive blood transfusion was given in fifty percent cases. Severe pregnancy induced hypertension, severe anaemia and severe concealed accidental haemorrhage were common associated factors in sixty percent of maternal deaths.Conclusions: Postpartum haemorrhage is still a common cause of maternal death. Early detection, prompt aggressive management, adequate blood replacement, use of uterine balloon tamponade and non-pneumatic anti-shock garment, timely transfer to higher centre and timely decision for surgical interventions can prevent maternal deaths.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203303
      Issue No: Vol. 9, No. 8 (2020)
       
  • Rupture uterus: a one year review to find out the causative factors

    • Authors: Beena Gupta Gupta, Prabhat Kumar Bhagat, Rezaul Karim
      Pages: 3249 - 3252
      Abstract: Background: Rupture uterus is a life-threatening obstetric emergency associated with high perinatal mortality. This study aims to find out the common factors associated with this catastrophic condition so as to help in decreasing the incidence of this condition in this study set-up. The objective of this study was to determine incidence, socio-demographic factors, etiology, types of presentation, patterns of management and maternal and fetal outcome in cases of rupture uterus presenting in this study hospital in one year.Methods: In this retrospective study 40 cases of ruptured uterus admitted in the hospital between January to December 2016 were analyzed. Detailed history of relevant socio-demographic factors, prior obstetric and surgical history, clinical findings, nature of management done, fetal and maternal outcome were thoroughly analyzed from the record.Results: A total 40 cases of ruptured uterus during this one-year period out of total 1220 deliveries constituted an incidence of 3%. The commonest age group is 25-30 years (47%). Majority of patients of rupture uterus were those with previous scarred uterus trying for vaginal delivery in hands of dais, untrained birth attendants and midwives. Repair was possible in the majority of cases. There were no maternal deaths but fetal mortality was 92.5%.Conclusions: Proper antenatal care, transportation facilities, good counseling of patients with history of previous uterine surgery for institutional delivery can help in reducing the incidence of rupture uterus in developing countries like India. Prompt surgical intervention can help in reducing the maternal morbidity and mortality associated with rupture uterus.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203304
      Issue No: Vol. 9, No. 8 (2020)
       
  • Maternal and fetal outcome in placenta previa: our experience

    • Authors: G. D. Maiti, M. Adhikary, P. R. Lele, Shilpa Gupta, M. Saha, Swagata Maiti
      Pages: 3253 - 3259
      Abstract: Background: Placenta previa contributes substantial maternal and neonatal morbidity including management challenges for obstetrician. This study was to evaluate the potential risks factors and feto-maternal, outcome in placenta previa. This study was done with the intent of developing insight into risk factors, clinical presentation, various interventions and management for overall improvement in maternal and fetal outcome in placenta previa.Methods: A prospective observational study, where 30 cases of placenta previa confirmed after 28 weeks POG, treated in a public sector tertiary care hospital from June 2016 to June 2018 were included.
      Authors analyzed the data to evaluate the potential risks factors and maternal and fetal outcome in placenta previa.Results: In this study, major contributing risk factors for placenta previa were associated with multiparity (76.7%), maternal age >30 in 50%, previous LSCS in 46.7%, repeated uterine procedure like suction evacuation/curretage. There was a high rate of maternal morbidity mainly due to haemorrhage. Perioperative uterine artery embolization (UAE) in 3 (10%), intra-operative procedures namely devascularization, internal iliac ligation in 66.6% cases, peripartum hysterectomy in 2 (6.66%) were done to control haemorrhage. Blood and blood products transfusion required in 26.7% of cases. Fetal morbidity included prematurity in 9 (33.3%), NICU admission in 11 (36.6%) majority of which included 8 (26.7%) babies of birth weight <2000 grams.Conclusions: Placenta previa contributes to significant maternal and neonatal morbidity. Multiparity, post LSCS pregnancy constitute major factor for placenta previa. Management requires high-risk obstetrical care with frequent antenatal visits. Serial ultrasonography in reported cases of low-lying placenta to mandatory exclude overdiagnosis or migration. All cases of placenta previa need to be managed in a higher centre facility of blood component therapy and neonatal intensive care unit. Prematurity and low birth weight remain a significant cause for neonatal morbidity.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203305
      Issue No: Vol. 9, No. 8 (2020)
       
  • Prevalence and outcome of gestational diabetes mellitus in women from
           rural population attending antenatal clinic at a teaching hospital, Tamil
           Nadu, India

    • Authors: Vidhya Muthuramalingam, Amar Nagesh Kumar
      Pages: 3260 - 3264
      Abstract: Background: Prevalence of gestational diabetes mellitus shows wide variation across our country. From the recent studies, it is observed that incidence of gestational diabetes mellitus in antenatal women is increasing globally and India is not an exception from this. Gestational diabetes mellitus should be considered as a serious risk factor for both mother and baby as it affects two generations by having chance of developing diabetes and its related complications in future.Methods: A total of 585 pregnant women with 24 to 28 weeks of gestational age were recruited for the study. The study population was divided into four groups based on the age range; Group I include antenatal women with age <20 years, Group II includes antenatal women of age range 21-24 years, Group III includes antenatal women of age range 25-29 years, and Group IV includes antenatal women of age range ≥30 years.Results: In the present study GDM was diagnosed in 94 women among 585 antenatal women screened for GDM (16.06%). Majority of the studied population are in the age range of 20-29 years (441/585, 75.38%). The mean age of participants was 27.54±3.58 years (range 18-34 years). The prevalence of GDM was higher in the group of women aged ≥30 years (Group IV) followed by ≤20 years (Group I) (23.21% and 15.62% respectively) compared to the groups II and III (14.78% and 13.74% respectively). This observation was found to be statistically significant (p<0.001). Among 585 patients, delivery outcome was 100% successful, all delivered live babies, among them 64 patients delivered babies with macrosomia (11%).Conclusions: The study showed GDM prevalence of 16.06% from the neighboring rural villages attending our teaching hospital.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203306
      Issue No: Vol. 9, No. 8 (2020)
       
  • A comparative study of perinatal outcome in primary caesarean in
           multiparous women to that in nulliparous women

    • Authors: Surabhi Kokate, Abhishek Kokate
      Pages: 3265 - 3269
      Abstract: Background: To compare indication, incidence, complication, fetal and maternal morbidity and mortality in primary caesarean section in multiparous women and nulliparous women. Objective of this study was to compare perinatal outcome of caesarean section in multiparous women to that in nulliparous women.Methods: It is a prospective observational study conducted in a tertiary care centre during April 2017 to April 2018. All patients who delivered vaginally and abdominally were noted during study period. All patients undergoing primary caesarean section were noted. Their indication, incidence and complication throughout stay were noted. Statistics were calculated separately for multiparous women and primiparous women. Statistical analysis was done using chi square test.Results: Total 150 primary caesarean section in primiparous women and 100 primary caesarean section in multiparous women were done.  Fetal distress and meconium stained amniotic fluid forms the most common indication in study. Birth weight of babies was more in multiparous women. Need of blood and blood products was more in multiparous women compared to nulliparous women. Complications like postpartum fever and wound gape was more in multiparous women.Conclusions: In the study population significant difference was seen between the indication and complication between multiparous and nulliparous women.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203307
      Issue No: Vol. 9, No. 8 (2020)
       
  • Evaluation of serum lactate dehydrogenase in hypertensive disorders of
           pregnancy and its comparison with normal pregnancy

    • Authors: Anil Kumar, Kushla Pathania, Meenakshi Kandoria
      Pages: 3270 - 3274
      Abstract: Background: Hypertensive disorders of pregnancy and their complications rank as one of the major causes of maternal morbidity and mortality. The objective of the study was to compare the level of serum LDH in normotensive and hypertensive pregnant women and to correlate the levels with maternal and foetal outcome.Methods: Study was conducted in department of obstetrics and gynecology Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla w.e.f. 15th July, 2014 to 14th July, 2015. Pregnant women enrolled in the study were divided into following groups: - Group 1- Age and parity matched 202 normotensive pregnant women. Group 2- 202 women with hypertensive disorders of pregnancy as per the inclusion and exclusion criteria. Subjects were also divided according to the serum LDH levels into following groups: LDH <600 IU/L, LDH-600-800 IU/L and LDH >800IU/L. The maternal and foetal outcome was correlated with the serum level of LDH. One-way analysis of variance (ANOVA) and the chi-square test were used to compare the results. Differences were considered significant when p<0.05.Results: Severely preeclamptic and eclamptic patients were significantly younger, with low gravidity and parity. The symptoms and complications of preeclampsia and eclampsia along with perinatal mortality were increased significantly in patients with LDH >800 IU/L as compared with those who had lower levels.Conclusions: Lactate dehydrogenase is a useful biochemical marker that reflects the severity of and the occurrence of complications of preeclampsia and eclampsia. Identification of high-risk patients with elevated levels of lactic dehydrogenase, their close monitoring, and prompt, correct management may prevent these complications, with a subsequent decrease in maternal foetal morbidity and mortality.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203308
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study of hypertensive disorders of pregnancy and the fetal outcome in a
           tertiary care hospital: a prospective study

    • Authors: Sangamesh S. Mathapati, Aruna M. Biradar, Laxmi S. Sangolli, Nidhi A. Mangalwadi, Gamini B. S., Sridevi H. S.
      Pages: 3275 - 3278
      Abstract: Background: Pregnancy induced hypertension is one of the major causes of feto maternal morbidity and mortality in pregnancy. The exact cause of PIH is unknown certain factors are known to increase the risk of PIH such as risk factor includes that young women with first pregnancy.Methods: The objective of this study was to assess the socio-demographic and clinico-pathological profile of the patients with hypertensive disorders of pregnancy and its associated fetal outcomes. A prospective study was conducted in department of obstetrics and gynecology Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura Karnataka from 15th July to 15th December 2018. All women admitted to labour ward with diagnosis of hypertensive disorders of pregnancy were included in the study after ruling out the exclusion criteria and thorough history, examination and laboratory evaluation were done and followed till delivery.Results: A total of 123 pregnant women with hypertensive disorder of pregnancy were enrolled in the study. Most of the participants were in the age group of 20 to 30 years. The PIH was seen mostly in primigravida, lower socioeconomic status and with lower educational levels. Emergency LSCS is the most common mode of delivery.Conclusions: The hypertensive disorder in pregnancy affects the majorly younger age group. It is most commonly seen in low socio-economic and uneducated population. Hence, there should be provided with proper antenatal care, early detection of hypertensive disorders for better feto-maternal outcome.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203066
      Issue No: Vol. 9, No. 8 (2020)
       
  • Screening for perceived stress among pregnant women availing antenatal
           care at a tertiary care teaching institution in Kerala, India

    • Authors: Heera Shenoy T., Remash K., Sheela Shenoy T.
      Pages: 3279 - 3287
      Abstract: Background: Stress during pregnancy can have serious adverse outcomes on the mother, the foetus and the new-born. It can lead to low-birth-weight, preterm births and neuro-psychological effects such as anxiety and depression during pregnancy and puerperium. This cross-sectional research aims to assess the severity of stress among postnatal women in Kerala. This study analysed socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of postpartum stress using perceived stress scale (PSS) among postnatal women in a tertiary hospital in Kerala state, India.Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Terminal illness, still birth delivery and comorbid psychiatric illness was excluded. Screening and diagnosis of postpartum stress was done based on perceived stress scale (PSS) and graded as mild 0-13, moderate 14-26, severe 27-40.Results: Study findings indicated a statistically significant association between postpartum stress and risk factors such as unplanned/unwanted pregnancy. The mean age of women was 27±4.8 years. Support from spouse and in-laws was a negative predictor of developing both postnatal stress and depression. Family income, education of couple and husbands’ occupations were non-determinant factors (p>0.05) in this study. Psychiatric illness in the family and past history of psychiatric illness also contributed to postnatal stress. The most important variable which influenced perceived stress during pregnancy was lengthier NICU stay. Even breastfeeding problems and associated neonatal issues worsened the stress scales significantly in the immediate postnatal period.Conclusions: This research concluded that stress detection and timely counselling along with mental and physical support will mitigate stress and postpartum depression.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203309
      Issue No: Vol. 9, No. 8 (2020)
       
  • Thyroid disorders in the first trimester of pregnancy: a cross-sectional
           study

    • Authors: Rashmi Shankarappa, Spoorthy Parvathreddy
      Pages: 3288 - 3290
      Abstract: Background: Thyroid disorders in pregnancy are common and are associated with adverse maternal, fetal and neonatal effects. When the prevalence of thyroid disorders is high, then screening for thyroid disorders in early pregnancy can help improve the obstetrical outcome.Methods: Five hundred and fifty women in their first trimester of pregnancy were studied. They were investigated for estimation of free triiodo thyronine (FT3), free thyroxine (FT4) and thyroid stimulation hormone (TSH). The upper normal limit for TSH considered was 4.0 mIU/L.Results: Prevalence of thyroid disorders in the study was 12.6%. Hypothyroidism (12%) was more common than hyperthyroidism (0.6%). Subclinical hypothyroidism was present in 10%.Conclusions: Screening of thyroid disorders is to be considered for all pregnant women. As the prevalence of thyroid disorders is high, early recognition and treatment shall reduce maternal and fetal morbidity.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203310
      Issue No: Vol. 9, No. 8 (2020)
       
  • A comparative study of serum magnesium levels in preterm labour and term
           labour

    • Authors: Malathi T., Sowmya Sampurna Maddipati
      Pages: 3291 - 3296
      Abstract: Background: The objective of present study was to measure the serum magnesium levels in preterm labor patients, to measure the serum magnesium levels in term labor patients and to correlate the serum magnesium levels in preterm and term labor patients.Methods: It is a prospective case control study conducted in the department of obstetrics and gynecology, KIMS hospital and research Centre, Bengaluru, Karnataka, India. A venous blood sample is drawn from patients admitted to labor room who fulfill the inclusion and exclusion criteria out of which 50 patients belong to the Group-A (preterm labor) and 50 patients belong to Group-B (term labor). Serum magnesium level is measured in both the groups.Results: Women with preterm labor had a significantly reduced serum magnesium level with a mean serum magnesium level of 1.59 mg/dl with a SD of 0.83 whereas the patients with term labor had a mean serum magnesium level of 2.55 mg/dl with a SD of 0.40. The difference of serum magnesium levels observed between the study population and control population is independent of factors like maternal age, parity, gestational age, and socio-economic factors. In this study, it is found that serum magnesium levels are lower in early and late preterm compared to preterm between 33-34+6 weeks.Conclusions: Serum magnesium level can be used as a predicting tool for preterm labor. Preterm labor can be avoided by simple supplementation of Magnesium which might provide an easy and inexpensive means to decrease the problems related to preterm labor. There is a further scope for research on serum magnesium levels based on gestational age.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203311
      Issue No: Vol. 9, No. 8 (2020)
       
  • Respectful maternity care for positive birthing experience at Pravara
           Rural Hospital

    • Authors: Vidyadhar B. Bangal, Sangita Vikhe, Shobha Borhade, Ujjwala Thorat
      Pages: 3297 - 3301
      Abstract: Background: Many women in developing countries experience disrespect and abuse during labour and delivery. Respectful maternity care (RMC) is considered as one of the basic reproductive health rights of the women. It is one of the essential components of LaQshya programme of Government of India. The aim of the study was to highlight the important components of the RMC, its implementation and its impact on patient turnover in the maternity unit of Pravara Rural Hospital Loni and review the literature on the subject.Methods: A prospective observational study was conducted for a period of one year from January 2019 to December 2019 at tertiary care hospital. The implementation of RMC was observed and important findings were documented. The patient turnover and cliental satisfaction was noted.Results: It was observed that all components of RMC were strictly followed in maternity unit of Pravara Rural Hospital Loni. The staff and doctors were trained and oriented towards importance of RMC. The patient turnover has increased exponentially year by year. The patient feedback system about the quality of care in labour and delivery ward shows overall satisfaction score of 4.3 on the 5-point Likert scale. There was a surveillance system that supervises and closely monitor the quality of care in labour room in general and RMC in particular.Conclusions: RMC is one of the important components of LaQshya certification process. Respectful maternity care is implemented at Pravara Rural hospital in its true spirit. It has resulted in gaining the faith and trust of the community, which is reflected through exponential rise in the number of deliveries taking place in the hospital.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203312
      Issue No: Vol. 9, No. 8 (2020)
       
  • Comparison of pregnancy outcome between clomiphene citrate and sequential
           clomiphene citrate+human menopausal gonadotropin in intrauterine
           insemination

    • Authors: Ankita Singh, Rohan Palshetkar, Namrata Singh, Awyay Rege
      Pages: 3302 - 3307
      Abstract: Background: Intrauterine insemination (IUI) has been widely used as a common treatment for infertile couples. This study compares the sequential clomiphene citrate (CC) treatment with CC and human menopausal gonadotropin (hMG) treatment in women undergoing IUI. Therefore, this study was designed to determine the effects of addition of gonadotropin (CC+hMG) would improve the pregnancy rate in women undergoing IUI. And also compare the sequential CC+hMG treatment with CC treatment in women undergoing IUI.
      Methods: A cross-sectional study design was conducted at D. Y. Patil Fertility Centre, D.Y Patil Hospital, Navi Mumbai from September 2018 to August 2019. Source populations were all patients who live in Mumbai, Maharashtra, India. A total of 67 patients were enrolled in this study. (It consisted of 67 sub fertile couples undergoing ovarian stimulation for IUI cycles).
      Results: There was no significant difference between the two studied groups regarding endometrial thickness (8.3±2.1 versus 9.7±2.8, respectively), number of mature follicles on the day of hCG injection (3.3±1.2 versus 3.5±1.1, respectively) and, but there was significant difference between the CC+hMG group and CC group regarding the total dose of gonadotropins used in ovulation induction (305±23.8 versus 655±192; total IU, respectively) p<0.05.
      Conclusions: Women undergoing IUI, ovarian stimulation CC combined with hMG, significantly improved the pregnancy and live birth rates as compared to that of CC group. In women undergoing ovarian stimulation and IUI, there are no significant differences in pregnancy and live birth rates among the various stimulation protocols.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203313
      Issue No: Vol. 9, No. 8 (2020)
       
  • Evaluating the factors influencing perinatal outcome in breech
           presentation

    • Authors: Dharmendra Raut, Srividya Tadru, Bhupendra Patil, Prachi Koranne
      Pages: 3308 - 3312
      Abstract: Background: The objective of this study was to analyse the current obstetric practice regarding breech presentation, document the incidence, perinatal outcome and the factors influencing perinatal outcome in breech deliveries.Methods: It was a retrospective observational study including 252 cases of breech presentation during January 2018 to December 2019 in a tertiary teaching institute in Vidarbha region of Maharashtra.Results: Total number of breech deliveries 252 (incidence is 2.5%). Caesarean section for breech presentation 95 (37.6%). With vaginal deliveries the Apgar score at 5 min below 7 were among 48 out of 157 breech deliveries whereas with LSCS it was only amongst 7 out of 95 deliveries. The maximum percentage of perinatal mortality is seen with birth weight below 2000 gm. Maximum mortality is seen prior to 32 weeks and in babies who delivered by vaginal route. Respiratory distress with prematurity and severe birth asphyxia are the common causes of perinatal deaths. Total 32 (12.69%) babies were transferred to NICU. 20.38% of the total vaginal breech deliveries and 5.26% of the total LSCS were transferred to NICU. Out of total 32 NICU admissions 22 are for the preterm babies and babies with birth weight below 2000 gm.Conclusions: The perinatal outcome does not depend only on the mode of delivery, it is also affected by the weight of the baby, its maturity, associated congenital anomalies, equipped neonatal intensive care unit and also substantially on the expertise of the obstetrician and the neonatologist.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203314
      Issue No: Vol. 9, No. 8 (2020)
       
  • Emergency obstetric care among referrals in more than 24 weeks gestation
           at a tertiary care teaching institution in Kerala, India

    • Authors: Heera Shenoy T., Sheela Shenoy T., Remash K., Sony Simon
      Pages: 3313 - 3319
      Abstract: Background: One of the biggest barriers confronting efforts to reduce maternal mortality through increased skilled delivery is access to emergency obstetric care. This study aimed to look into the profile of emergency obstetric referrals. Referral-decision interval, reasons and morbidities of referral were analysed and their neonatal outcomes assessed.Methods: This observational study reviewed 90 emergency obstetric referrals over 3 years from June 2013 to February 2016.Results: In-labour referrals constituted the majority of emergency obstetric referrals. Preterm obstetric referrals needed emergency interventions in view of medical/obstetric indications and it was statistically significant. Referral- decision and referral-arrival interval was significant in emergency group (p-value-0.001). Babies born to mothers who were obstetric emergency referrals had extended NICU stay (p-value-0.001). There was a maternal death and four near-misses in this research.Conclusions: Timely decisions taken during interhospital emergency referrals resulted in better perinatal outcomes by prompt maternal interventions.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203315
      Issue No: Vol. 9, No. 8 (2020)
       
  • Diagnostic value of saline infusion sonohysterography for detecting
           endometrial lesion and comparing it with hysteroscopy and histopathology
           in postmenopausal bleeding

    • Authors: Suwaram Saini, Shweta Jain, Sarla Saini, Manish Bhardwaj
      Pages: 3320 - 3325
      Abstract: Background: Different diagnostic tools are available to evaluate endometrial lesion such as hysteroscopy, sonohysterography and transvaginal ultrasound. The present study aimed to determine the diagnostic value of saline infusion sonohystrography (SIS) in diagnosis of intrauterine lesions in women with postmenopausal bleeding (PMB).Methods: This cross-sectional study recruited 100 married women with chief complain of PMB referred to gynecologic clinics at the Zenana hospital, Jaipur from March 2019 to February 2020. All participants were in the post-menopausal period that showed abnormal endometrial thickness (>4 mm) or endometrial focal lesions through transvaginal ultrasound. Participants underwent SIS, hysteroscopy plus endometrial biopsy in order. The gold standard was the histopathology of endometrial specimen reported by pathologist.Results: Mean age of women was 57.14 years. It is evident that sensitivity, specificity, positive predictive value and negative predictive value of SIS for the diagnosis of endometrial atrophy was 79.16%, 100%, 100% and 83.87% respectively which is higher than that of hysteroscopy and equivalent to histopathology. SIS and hysteroscopy are equally efficient in diagnosing endometrial polyp and submucous fibroid. And are better than histopathology. Histopathology is better than SIS and hysteroscopy for the diagnosis of endometrial proliferation.Conclusions: Findings show that, SIS probably is a proper method for detecting endometrial focal lesion including polyps and myomas. Future studies may help to define further advantages of this procedure.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203316
      Issue No: Vol. 9, No. 8 (2020)
       
  • Study of fetomaternal outcome in cases of placenta previa at tertiary care
           hospital

    • Authors: Parul T. Shah, Fiza Z. Saiyed, Kruti J. Deliwala, Priya Dhameliya
      Pages: 3326 - 3329
      Abstract: Background: Placenta previa is defined as placenta implanted partially or completely in the lower uterine segment. It contributes upto 30% of the cases the antepartum hemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The objective of the study was to determine the incidence and risk factors, obstetric management, maternal mortality and morbidity and perinatal outcome in women presenting with placenta previa.Methods: It is the prospective study of 50 cases carried out to study the maternal and perinatal outcome in cases of placenta previa in tertiary care hospital. This study included antenatal patient diagnosed as placenta previa by ultrasound >28 weeks to full term pregnancy. This data was compiled and analyzed for maternal and neonatal outcome.Results: In the present study, the incidence of placenta previa is 0.8% among which 42% of cases having age group of 25-29 years and 72% cases are multigravida. In this study 60% cases have major degree of placenta previa and 66% cases have previous history of caesarean section. Out of total cases 96% cases delivered by caesarean section and 4% had Normal delivery. NICU admission in the study is 28 babies i.e. 56%. There is no maternal mortality seen in the present study.Conclusions: Risk factors that increase the cases of placenta previa are multiparity, previous caesarean section, previous abortion. Placenta previa is major risk factor for adverse maternal and perinatal outcome. Good antenatal care, availability of emergency obstetrics services with senior obstetricians, blood bank facility, ICU care and NICU services can improve maternal and neonatal outcome in high risk cases.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203317
      Issue No: Vol. 9, No. 8 (2020)
       
  • Comparative study between vaginal natural progesterone and oral
           dydrogesterone in prevention of red degeneration of uterine fibroid in
           pregnancy

    • Authors: Nermeen M. Hefila, Tarek A. Karkour, Sara M. Elghareeb, Tamer M. Abdeldaiem
      Pages: 3330 - 3335
      Abstract: Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203318
      Issue No: Vol. 9, No. 8 (2020)
       
  • A retrospective analysis of ectopic pregnancies in tertiary care hospital
           of Western India: two year study

    • Authors: Tanmay J. Chudasama, Sapana R. Shah, Rupa C. Vyas, Purvi M. Parikh
      Pages: 3336 - 3340
      Abstract: Background: Ectopic pregnancy (EP) is the leading cause of maternal morbidity and mortality in the first trimester and major cause of reduced reproductive potential. Early detection of EP by improved ultrasonography modalities has decreased the rate of rupture and consequent maternal morbidity. Aim was to study the predisposing risk factors in modern scenario and choose the appropriate management available.Methods: A retrospective study on clinical diagnosis and management of EP of patients was carried out between January 2018 to February 2020. Investigations included CBC, UPT, serum β-hCG and TVS. Management was decided after thorough evaluation.Results: Out of 7,780 deliveries, 70 were EP (0.9%). Women with age 21-30 year had highest incidence (85.7%). Common symptoms were abdominal pain (94%), amenorrhea (87%), bleeding per vagina (48%). Most common risk factor associated with EP was PID (28.5%). Tubal EP was most common (84.2%) involving ampulla (66%), isthmus (15%), fimbria (12%), interstitial (7%). Scar ectopic was reported in 10% of cases and ovarian, rudimentary horn and abdominal pregnancy in 1.4% each. About 52.8% of ectopic was ruptured and salpingectomy was done in 74.3% and salpingo-oophorectomy in 2.8%. Five cases of scar EP required hysterotomy and 1 case was managed by methotrexate (MTX).Conclusions: EP remains a major challenge to the obstetrician worldwide. A high index of suspicion is required for early diagnosis and timely intervention in the form of medical or surgical treatment will definitely help in reducing the morbidity and mortality.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203319
      Issue No: Vol. 9, No. 8 (2020)
       
  • Colposcopy in postmenopausal women: a challenging procedure

    • Authors: Arshdeep Kaur, Gursewak Singh
      Pages: 3341 - 3344
      Abstract: Background: Introduction-carcinoma of cervix is the commonest cancer in Indian women. It constitutes 14%of the total population above age of 50 years. Atrophic changes in the genital tract causes problems in Pap smear as well as in the colposcopy.Methods: This is prospective observational study conducted in the department of obstetrics and gynecology of SGRDIMSR, Sri Amritsar, which comprised 30 cases of postmenopausal women referred for colposcopy. Inclusion criteria were complaints of post-menopausal bleeding, abnormal vaginal discharge, post coital bleeding, an abnormal PAP smear, an unhealthy-looking cervix. Women with history of any surgery on the cervix in the past three months or with obvious cervical cancer were excluded.Results: Patient with age group of 44-70 years were included, and maximum number of patients had complaint of post-menopausal bleeding (50%). 9 (30%) patients were positive for malignancy on histopathology, while with 9 (30%) false positive patients on colposcopy. Problems encountered while performing colposcopy includes cervix flushed with vagina, atrophy of introitus, bleeding from the cervix and relaxed vaginal walls. Use of various corrective measures were helpful to overcome the problems of colposcopy.Conclusions: It is an essential part of cervical screening programme, but it has some limitations and pitfalls which can lead to error in the diagnosis.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203320
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study to compare the diagnostic accuracy of GeneXpert MTB/RIF/assay and
           its comparison with liquid culture in clinically suspected cases of
           genital tuberculosis attending outpatient department of tertiary center

    • Authors: Anu Pathak, Divya Yadav, Urvashi Verma, Yogita Gautam
      Pages: 3345 - 3349
      Abstract: Background: Tuberculosis is a major health issue globally despite a declining trend in mortality with effective diagnosis and treatment, an estimated 10.4 million persons developing active TB each year with 1.33 million deaths. Objective of this study was to evaluate role of GeneXpert MTB/RIF/assay in diagnosis of female genital tuberculosis in suspected cases of tuberculosis.Methods: It was a cross sectional study done in department of obstetrics and gynecology in S. N. Medical college Agra for a period of 2 year (July 2017 to October 2019). 70 cases were selected from OPD of department of obstetrics and gynecology, S. N. Medical College Agra who met the inclusion and exclusion criteria after taking proper consent. In all selected cases endometrial biopsy sample was taken using endometrial biopsy curette in premenstrual period. All samples of endometrial biopsy were taken under all aseptic precaution from both corneal ends, anterior and posterior wall and lower part of uterus using endometrial biopsy curette and sample was collected in two separate sterile vials having normal saline and was sent for GeneXpert MTB/RIF/assay and liquid culture simultaneously.Results: Out of total 70 clinically suspected cases of female genital tuberculosis in between 20-45 years of age cough with expectoration 94% was the most common respiratory symptom followed by fever 81%, weight loss 56% and anorexia 54%. Prevalence of genital tuberculosis in active pulmonary tuberculosis patients was 30%. Irregular menstruation, vaginal discharge and pelvic pain were present in 69%, 60% and 52% patients respectively.Conclusions: The overall sensitivity of CBNAAT was 22% and specificity was 77%. The overall sensitivity of liquid culture was 28% and specificity was 71%.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203321
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study to compare acceptability, safety and continuation rates of
           combined hormonal pill and centchroman as post abortion contraceptives

    • Authors: Inlo Miuli, Rupali Dewan, Kavita Agarwal
      Pages: 3350 - 3359
      Abstract: Background: Centchroman a non-steroidal selective estrogen receptor modifier (SERM). It is highly effective contraceptive which is devoid of side effects of COCs and there is prompt return of fertility upon discontinuation. Data in terms of its acceptability and continuation rates is limited when compared to combined oral contraceptive (COC). Therefore, the study was planned to study the acceptability, efficacy and continuation rates of centchroman and compare it with the combined oral contraceptives.Methods: The study was a prospective interventional comparative randomized study carried out in the department of obstetrics and gynecology VMMC and SJH, New Delhi, for a period of 18 months from November 2018 to April 2019.Results: A total of 945 women were screened and finally 240 women who met the criteria were recruited in 2 study groups of 120 women each. Majority were in the age group 18-28 years in either groups. Patients were followed up at 2nd week and then at 1st, 3rd, 6th and 12th months after initiation of the OCP with no loss to follow up. The pearl index in this study was 0.83 for ormeloxifene. The study showed statistically significant differences with higher level of satisfaction reported with 77.5% in the ormeloxifene compared to 65% of COCs. The continuation rates for ormeloxifene and COC users were in decreasing trend with increase in duration. No untoward events were reported with either formulation.Conclusions: Both the hormonal, combined hormonal contraceptive [combined oral contraceptive (COC), MALA-N] and the non-hormonal, centchroman (ormeloxifene) oral contraceptive pills are safe, effective, well tolerated and not associated with adverse outcomes when used immediately after abortion. Continuation rates of the pills in both the groups decrease in trend with time.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203322
      Issue No: Vol. 9, No. 8 (2020)
       
  • Prospective study of ovarian function in hysterectomised females

    • Authors: Richa S. Sankhe, Ganesh A. Shinde
      Pages: 3360 - 3366
      Abstract: Background: Hysterectomy is one of the most common operations performed in the world. The aim of this study was to determine prospectively the influence of hysterectomy on ovarian function by measuring gonadotrophin levels and studying ovarian doppler over a two-year period.Methods:
      Authors conducted a prospective cohort study at the department of obstetrics and gynecology in study tertiary care center. The study was carried out over a period of two years. (November 2012-November 2014). Serum FSH, ovarian PI and questionnaire data were obtained at baseline and at 6 and 12 months postoperatively.Results: There was significant difference in the mean FSH and mean PI at follow-up visits of 6 and 12 months. Patient characteristics did not contribute to the changes that were observed during the follow-up.Conclusions:
      Authors conclude that hysterectomy affects ovarian function by affecting blood supply (reducing blood supply). This is reflected by increased FSH levels and increased PI values on ovarian Doppler.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203323
      Issue No: Vol. 9, No. 8 (2020)
       
  • Changing trends in the indication of caesarean delivery in multigravida-
           experience from a referral center in Eastern India: a prospective study

    • Authors: Nikhil Sebastian, Anup Pradhan, Pesona Grace Lucksom
      Pages: 3367 - 3371
      Abstract: Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016.
      Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida.  Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203324
      Issue No: Vol. 9, No. 8 (2020)
       
  • Screening of gestational diabetes mellitus using one-step versus two-step
           method: a comparative study

    • Authors: Deepti Khenwar, Juhi Agarwal, Sushruta Shriastava
      Pages: 3372 - 3376
      Abstract: Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the present pregnancy. It affects 7% of all pregnancies worldwide and in India it ranges from 6 to 9% in rural and 12 to 21% in urban area. The aim of this study was to compare the DIPSI criteria with the two-step method (Carpenter and Couston criteria.) and to study merits and demerits of one step and two step tests for GDM.Methods: A total 400 pregnant women of gestational age between 24-28 weeks attending antenatal clinic at this study tertiary care center were enrolled in this study. 200 pregnant women were enrolled in each of the study group (Group I OGTT and Group II DIPSI).Results: In Group I (OGTT) screening 47 (23.5%) were tested positive. In Group II cases, screening test results were found positive among 44 (22%). Out of 95 high-risk pregnant women 38 (40%) were positive for GDM by OGTT and 34 (35.78%) were positive by DIPSI. Out of 305 non high-risk pregnant women, 9 (2.95%) were positive for GDM by OGTT and 10 (3.27%) were positive by DIPSI.Conclusions: Present study concludes that DIPSI is the test which can predict GDM in population comparable to another test like OGTT. Also, India’s major population reside in rural areas, ANC are mostly conducted by ANM, therefore screening test should be easy to perform and interpret.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203325
      Issue No: Vol. 9, No. 8 (2020)
       
  • Study of hundred cases of infertility in polycystic ovarian syndrome and
           its management outcome

    • Authors: Kruti J. Deliwala, Zalak J. Patel, Parul T. Shah, Dhruvit Dholakiya
      Pages: 3377 - 3380
      Abstract: Background: Polycystic ovarian syndrome (PCOS) is relatively common endocrine disorder in reproductive aged women, which leads to reproductive, metabolic and endocrine abnormality. About 70 to 80% patients with PCOS have complained of infertility due to anovulation. Due to advanced diagnostic facility by endoscopic evaluation in infertility, incidence of PCOS has increased now a days.Methods: This is study of 100 cases of infertility with polycystic ovarian syndrome and its pregnancy outcome. In this study, from May 2019 to April 2020, 100 cases of infertility with PCOS were studied at tertiary care hospital. Hormonal assay, ultrasound and laparoscopy were used as diagnostic technique. Clomiphene citrate, letrozole, metformin, and laparoscopic ovarian drilling were used as treatment modalities.Results: The maximum number of patients in the study group are seen in the age group of 21-25 years. Menstrual irregularities are the most common presenting symptom affecting 70% females. Primary infertility is most commonly associated with PCOS. In PCOS, there is increased LH:FSH ratio. On USG examination, there are enlarged ovaries in 82% cases.Conclusions: PCOS is an emerging disease of new generation with high prevalence in infertile women. After proper diagnosis, management with lifestyle modification, pharmacotherapy with clomiphene citrate, letrozole and metformin are used as per necessities. Operative laparoscopy with ovarian drilling is the main treatment which results in good conception rate.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203326
      Issue No: Vol. 9, No. 8 (2020)
       
  • Complications after post placental insertion of Cu T 380 A in women
           undergoing caesarean delivery

    • Authors: Dineshwar Singh, Sita Thakur
      Pages: 3381 - 3387
      Abstract: Background: India is the second most populated country in the world after China with more than a billion people and has highest number of maternal deaths in the world. The aim of the study was to find out the complications after insertion of post placental Cu T 380 A in women undergoing caesarean delivery.Methods: A prospective observational study was carried out in the department of obstetrics and gynecology, Dr RPGMC Kangra (Rural Medical College) after taking approval of Protocol Review and Institutional Ethics Committee of the Institution. A total of 104 women delivering by caesarean section and wanting post-placental intra-caesarean Cu T 380 A insertion and who were meeting WHO standard medical criteria for PPIUCD insertion and were willing to comply with the study protocol was recruited for the study.Results: There were no major complications and only minor side effects like pain and fever were observed in 6.25 and 6.90 and 9.37 and 11.11% of women who were admitted electively and in emergency, respectively during follow-up visit up to 6 months. String became visible in 72.12% of women at the 6 weeks follow-up visit and their visibilities increased with time and at 6 months follow-up in 90.81% of the cases. Continuation rate was 100% at 6 weeks post-partum follow-up. After that spontaneous expulsion occurred in 4 cases (3.84%) and another 4 women (3.84%) requested removal for various reasons leading to continuation rate of 92.30% at six months post-partum follow-up. There was no case of pregnancy with Cu T in situ with no failure at the end of study at six months post-partum.Conclusions: Post placental insertion of Cu T 380 A in women undergoing caesarean section was safe and effective method of postpartum family planning, the complaints and complications initially increased but decreased at 6 months follow-up.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203327
      Issue No: Vol. 9, No. 8 (2020)
       
  • Evaluation of serum paraoxonase, 1 and its association with serum
           cholinesterase as a cause of congenital anomalies

    • Authors: Abhra Ghosh, Jagriti Bhardwaj, Robin Singh, Divya Baruhee
      Pages: 3388 - 3392
      Abstract: Background: Birth defects are conditions of prenatal origin that are present at birth, potentially impacting an infant's health, development, and/or survival. Several environmental toxins affect the growth of the fetus during the intrauterine period by affecting various cellular components. Pesticides and industrial chemicals are known toxins that can hinder the developmental process. In this study, authors are evaluating the relation of cholinesterase and paraoxonase-1 with visible congenital anomalies.Methods: Sixty babies delivered in the labor room were selected for the study. They were divided into two groups. Thirty newborns with visible congenital anomalies were included in Group I. Only babies with visible congenital anomalies were taken as inclusion criteria for this group. This group was compared with Group II, which were taken as controls and consisted of 30 healthy newborns without any congenital anomalies. Serum cholinesterase and serum paraoxonase-1 were estimated and statistical tests were applied.Results: Serum cholinesterase and serum paraoxonase-1 were significantly low in the babies with visible congenital anomalies. Serum cholinesterase levels showed a statistically significant positive correlation with serum paraoxonase 1 level in both the groups.Conclusions: Decrease in acetylcholinesterase by various environmental toxins and the associated decrease in serum paraoxonase level imposes significant oxidant stress and the resultant risk of developing congenital anomalies.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203328
      Issue No: Vol. 9, No. 8 (2020)
       
  • A prospective clinical trial to evaluate the prevalence of thyroid
           disorder among pregnant women and obstetrical and fetal outcome in a
           tertiary health centre located in central India

    • Authors: Manjari G. Jain, Neeraj K. Jain, Mita Mazumdar
      Pages: 3393 - 3397
      Abstract: Background: A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome was done in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective study was carried out in antenatal women in their first trimester attending antenatal OPD in RKDF Medical College and Research Centre, Bhopal, Madhya Pradesh to know the prevalence of thyroid disorder and its association with pregnancy outcome.Results: In this study prevalence of thyroid disorder was 12.4%, subclinical hypothyroidism 7.2%, overt hypothyroidism 3.4%, subclinical hyperthyroidism 1.4%, overt hyperthyroidism 0.4%. Thyroid disorder is responsible for several obstetrical and fetal complication like pre-eclampsia, preterm delivery, abortion, IUGR and low birth weight.Conclusions: Thyroid disorder associated with poor obstetrical outcome and fetal complication. so timely diagnosis and treatment is required. Universal screening should be preferred over high-risk screening because of high prevalence of the disease in India.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203329
      Issue No: Vol. 9, No. 8 (2020)
       
  • Abnormal semen parameters among males in infertile couples: a cross
           sectional study from a tertiary care centre

    • Authors: Jyoti Garg, Rachana Meena, Shailaja Shukla, Sunita Sharma, Riva Choudhury
      Pages: 3398 - 3401
      Abstract: Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203330
      Issue No: Vol. 9, No. 8 (2020)
       
  • Maternal outcome in thyroid dysfunction in admitted antenatal women in
           tertiary care centre: an observational study

    • Authors: Juhi Agarwal, Deepika Kesaraju, Poorva Badkur
      Pages: 3402 - 3407
      Abstract: Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. Aim of this study was to identify thyroid dysfunction as a maternal health problem. Objective of this study was to study the maternal outcomes in these patients.Methods: The main source of data are the patients admitted in Sultania Zanana Hospital, GMC Bhopal. The study was an observational prospective study conducted from March 2018 to February 2019.Results: The present study was conducted in department of obstetrics and gynecology, Gandhi Medical College and associated Sultania Zanana Hospital Bhopal for the period of 1 year. The study could enroll 400 females fulfilling the inclusion criteria during the study period.Conclusions: In developing countries like India where there is prominent micronutrient deficiency, iodine deficiency further aggravates the condition and carries a great potential to show deleterious impacts on maternal and fetal outcomes, thus serving a major health problem. Considering the substantial increase in short term as well as long term perinatal morbidity, a felt need for creating awareness not only on adverse outcomes but also detection of the disorder in first trimester is required. The desired perinatal outcome can be achieved by early detection and prompt treatment of the disorder. Henceforth, universal screening of all antenatal women in the first trimester rather than targeted case finding should be recommended at all the health care facilities.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203331
      Issue No: Vol. 9, No. 8 (2020)
       
  • An observational study of clinical profile and outcome of syphilis
           infection during pregnancy in the tertiary care center

    • Authors: Pooja Gangwar, Arti Jhinwal, Preksha Gupta, Eshu Dixit, Suchita Bajaj
      Pages: 3408 - 3411
      Abstract: Background: Syphilis is a sexually transmitted disease (STD) caused by the bacterium treponema pallidum, but little is known about its mechanism of action. In pregnancy it leads to adverse outcomes among more than half of the women with active disease, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death.Methods: It is an observational study in the department of obstetrics and gynecology Mahatma Gandhi Memorial Medical College Maharaja Yashwant Rao Hospital, Indore between January 2014 to December 2015 total 20870. In Include written informed consent, All the patients attending STI/RTI clinic with clinical diagnosis of STD. In Exclusion criteria include patients not give informed consent. Case definition: All VDRL + TPHA positive patients.Results: Out of 20870 females on which VDRL was performed 77 (0.036%) were found to be positive. The seroprevalence at study hospital thus came out to be 0.036%. These were further confirmed by TPHA and 73 (94.8%) out of 77 samples were positive. A total agreement was seen between TPHA and VDRL with a titer of 1 in 8 and above. Among total 20870 screened females, 77% (16101) were ANC patients of which 26 cases out of 77 that is 33.76% females were syphilis positive.Conclusions: Low prevalence of syphilis in pregnant women and adult general population is very encouraging. participation of people and public health approach to promote awareness of syphilis among physicians and populations at risk in India are very urgently needed to avoid the adverse consequences which could result from undiagnosed or improper treatment.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203332
      Issue No: Vol. 9, No. 8 (2020)
       
  • A comparative study of two layer versus three-layer repair of mediolateral
           episiotomy

    • Authors: Manasi V. Gaikwad, M. Vijaya Sree, Swapnil V. Bobde
      Pages: 3412 - 3416
      Abstract: Background: Since majority of the women attending study hospital are belonging to lower socioeconomic strata and active involvement of paramedical staff in providing obstetric care, this study was undertaken to find the utility of a two-layer repair of mediolateral episiotomy and compare it with the standard method of closure in relation to its simplicity, cost-effectiveness and superiority if any, over the traditional three-layered repair of episiotomy.Methods: This was a prospective interventional study comparing 100 women who underwent two-layer closure with 100 women who underwent three-layer closure of episiotomy in a tertiary care hospital in Pune, India over a period of 2 years from October 2012 to October 2014. The parameters assessed were operative time, number of suture materials required, immediate post procedure pain and complications at follow-up. Qualitative and quantitative data was analysed using unpaired t-test, chi square test and Fisher exact test.Results: Both the groups were comparable in terms of hospital stay and wound complications such as oedema, dehiscence, hematoma, requirement of resuturing, cosmesis and long-term complications such as dyspareunia. However, two-layer repair required less operative time, lesser number of suture materials and decreased pain during hospital stay as there was statistically significant difference observed between the two groups.Conclusions: In this study experience, it can be concluded that two-layer repair of episiotomy is faster, with less post-operative pain and more cost effective. Hence it provides mother with better services.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203333
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study of gestational diabetes mellitus and fetal outcome in a tertiary
           care center

    • Authors: Aashka M. Mashkaria, Babulal S. Patel, Aastha M. Mashkaria, Akshay C. Shah, Shashwat K. Jani, Adwait B. Patel, Raj M. Mehta
      Pages: 3417 - 3421
      Abstract: Background: Modern desk-bound lifestyle and unhealthy dietary changes have brought a rise in the prevalence of obesity and gestational diabetes mellitus (GDM). It is associated with severe hazards to the mother and the baby. It is mandatory that early diagnosis ensues and timely and congruous management is undertaken.Methods: In this observational study, 1250 women were included. A standardized questionnaire was formed and their details were noted. Tests for glucose levels, complete blood picture, urine examination were performed. An oral glucose tolerance test was performed on all the patients. Neonatal outcomes in terms of birth weight and the presence of complications were noted.Results: A total 201 (16.1%) of all women were having gestational diabetes mellitus (GDM). Most mothers were in the 25-30 age group. The majority of the women had a BMI between 26-30. 21.9% of babies were having weight >3.5 kgs. 11.4% of babies were <2.5 kgs. Out of 201 neonates, 90 babies were having complications. Major complications in neonates were macrosomia and respiratory distress. Therefore, early diagnosis, glycemic control, and timely and congruous management are advantageous to both mother and baby.Conclusions: GDM complicating the pregnancy results in a higher prevalence of complications in the mother and the neonate. Therefore, appropriate control of the sugar level in mothers is necessary and it decreases the morbidity and mortality rates in the babies as well as the mothers. 
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203334
      Issue No: Vol. 9, No. 8 (2020)
       
  • A retrospective study on the prevalence of urinary tract infections in a
           tertiary care hospital in Sangareddy district of South India

    • Authors: Sowjanya Mendem, M. Vinyas, Md Aqib Ali Faraz, M. Vishwanath Swamy, Patil Shubham
      Pages: 3422 - 3427
      Abstract: Background: Urinary tract infections (UTI) affect the portion of the urinary tract including kidneys, ureters, bladder, and urethra, and are among the commonly acquired nosocomial infections. Diagnosis based on the culture and sensitivity profile of the organism is highly beneficial for appropriate antimicrobial therapy of the individual.Methods: A retrospective study of culture isolates obtained from urine samples from different departments of a tertiary care hospital was performed in the period January 2018 to March 2020 in the district of Sangareddy, Telangana, India.Results: A total 204 samples of 1886 exhibited significant growth of organisms i.e., ≥105 colony-forming units of bacteria per millilitre (CFU mL-1). The most common pathogen isolated was Escherichia coli (47.05%), followed by Klebsiella pneumoniae (15.68%), Staphylococcus aureus (10.78%), Pseudomonas aeruginosa (10.78%), Enterobacter spp. (7.84%) and, Candida albicans (7.84%). The presence of Gram-negative organisms was found to be more than Gram-positive organisms among the samples cultured. Resistance was found to be more towards Amoxicillin (57.14%), followed by oxacillin (34%), cefotaxime (23.62%), clarithromycin (12.08%), erythromycin (12.08%), azithromycin (9.34%), linezolid (3.84%) and vancomycin (2.19%).Conclusions: Increasing levels of antimicrobial resistance by uropathogens emphasize the importance of therapy based on the culture and sensitivity of the organisms. Many uropathogens exhibit multi-drugs resistance. Regular surveillance and monitoring are useful in controlling the increasing resistance.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203335
      Issue No: Vol. 9, No. 8 (2020)
       
  • An observational study of abnormal findings in fetus during 11-13+6 weeks
           and targeted imaging for fetal anomalies ultrasonography

    • Authors: Amrita D. Patel, Janki B. Shingadia, Devang Patel
      Pages: 3428 - 3431
      Abstract: Background: Congenital anomalies are responsible for a of 14.2% of perinatal mortality in India. This study focuses on incidence of structural fetal abnormalities detected during 1st and 2nd trimester sonography. Aim of this study was to evaluate the need for targeted fetal scans.Methods: This study is an observational study conducted at Gujarat fetal medicine Centre, Ahmedabad, Gujarat, super specialty antenatal radiology centre where exclusively antenatal USGs and prenatal procedures are performed. All pregnant female coming for 1st and 2nd trimester USG were included. All fetal abnormalities in form of soft markers and structural abnormality were included.Results: Out of 2122 total ANC scans, 183 cases (8.6%) had structural abnormality and 235 cases (11%) had significant soft markers. 1185 cases (55.84%) came in late 2nd trimester for TIFFA scan and 468 (22%) were seen in 1st trimester scan. The incidence of fetal anomaly in this study was higher than general population as it is an exclusively fetal medicine centre and majority of patients were diagnosed with anomaly in late 2nd trimester.Conclusions: There is immense need for early diagnosis and timely intervention before 20 weeks in case of prenatal detection of fetal abnormality.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203336
      Issue No: Vol. 9, No. 8 (2020)
       
  • Colposcopy in evaluation of suspected cervical cancer: a prospective,
           observational study

    • Authors: Ashwini Sudhir Desai, Shruti Panchbudhe
      Pages: 3432 - 3438
      Abstract: Background: Cervical cancer is the fourth most frequent cancer in women according to World Health Organization. In India the incidence is approximately 1 in 53 compared with 1 in 100 women in more developed regions of the world. Cervical cancer is eminently preventable by early detection using various screening tests like Pap smear, colposcopy, HPV testing. In this study we aim to evaluate the use of colposcopy in early detection of cervical cancer and also assess risk factors for the same. Primary objective was to study the correlation between colposcopic findings and histopathological analysis with a secondary objective to assess risk factors for development of cervical neoplasia.Methods: The study was carried over a period of 2 years (October 2016 to October 2018) with a sample size of 60 in the department of obstetrics and gynecology at tertiary care centre. Participants who fit the inclusion criteria were included in the study after taking a written and informed consent. The colposcopy findings were correlated with the histopathological findings of the cervical biopsy that was undertaken.Results: Colposcopy impression had sensitivity of 93.8% in predicting the histopathology, specificity was 77.3%, positive predictive value was 60%, negative predictive value was 9% and the diagnostic accuracy was 81.7%. On analyzing the risk factors, it was found that the odds of malignant histopathology were 0.55 times decreasing with each unit increase in age (at first intercourse) (p value<0.05).Conclusions: Colposcopy gives immediate and accurate results and its value as a diagnostic test is undisputable.  The sensitivity of colposcopy is high and hence in high risk population or remote places where women do not turn for regular screening tests, colposcopy can be used primarily as the screening test.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203337
      Issue No: Vol. 9, No. 8 (2020)
       
  • Validation of Edinburgh post natal depression scale in post-natal woman
           from a tertiary referral center in South India

    • Authors: Rashmi A. G., Shubhashri N. S.
      Pages: 3439 - 3444
      Abstract: Background: Pregnancy and childbirth are two most important life-changing events. Post-partum depression can affect mother and has a wide spectrum of presentation depending upon various social factors. Studies suggest that the incidence of postnatal depression among women of high social strata is 13-19% while the incidence is 11-42% among women with limited social support. The present study aims to study postnatal depression and its causes in a postnatal mother in all the aspects of social, physical, cultural and psychiatric grounds in the Indian scenario with the help of the Edinburgh postnatal depression scale (EPDS).Methods: From 1st July 2019 to 31st December 2019, a total 300 postnatal women between 1 to 6 weeks of the postpartum period participated and during their stay in the hospital responded to EPDS. The study was purposive sampling, and full consent of the study subjects was taken before the start of the study.Results: In this study, we found 20.1% of a woman affected by post-partum in South India. The higher percentage of severe depression was seen in the primary gravida (20%). The risk factors such as availability of postnatal care (with NICU admission), the woman with medical complications, late childbirth or delayed childbirth after marriage, multiparity, delivery via caesarean and nuclear family showed significant relationship (p<0.005) with depression.Conclusions: The present study, with a Post-natal depression of 20.1% along with the enumerated risk factors, suggest that the causes for postpartum depression (PPD) among working Indian woman, reflect a change to an urban-centric lifestyle. Further evaluation of these risk factors needs to be made and a routine screening of Postpartum depression (PPD) can help in improving maternal and child health.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203338
      Issue No: Vol. 9, No. 8 (2020)
       
  • Analysis of caesarean sections at a tertiary care centre according to
           Robson’s criteria

    • Authors: Ipsita Mohapatra, Subha Ranjan Samantaray, Achanta Vivekanand, Anandala Manjula, Buyyani Priyanka
      Pages: 3445 - 3448
      Abstract: Background: There has been a considerable increase in the rate of caesarean sections in the past few decades. Some demographers have argued that this increase is largely affected by the uprising trend of new medically indicated caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. This classification is known as Robson’s classification which has ten groups.Methods: This is a retrospective study which was carried out at Civil Hospital, Karimnagar. The study group included all live births and still births of at least 500 gm birth weight or at least 28 weeks of gestation at Civil Hospital, Karimnagar during the period from October 2019 to December 2019. The data collected was analysed using simple statistical methods like percentage and proportion. The data was grouped according to the Robson’s 10 group classification system. The overall caesarean section rate, size of each group and the relative contribution of each group to the overall CS rate were calculated.Results: The total number of deliveries during the study period was 2493. Out of these, the number of caesarean deliveries was 1345. The caesarean section rate was calculated to be 53.95%. The group 5 (multiparous with at least one previous uterine scar with single cephalic pregnancy ≥37 weeks of gestation) contributed to 38.07% of the total caesarean section rate which is the highest.Conclusions: A regular audit into the number and indications of caesarean sections will definitely help in decreasing the primary and repeat caesarean sections.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203339
      Issue No: Vol. 9, No. 8 (2020)
       
  • Evaluation of urea and creatinine levels in vaginal wash fluid for the
           diagnosis of premature rupture of membranes

    • Authors: Abha Sharma, Richa Sharma, Tannavi Agarwal
      Pages: 3449 - 3457
      Abstract: Background: Evaluation of urea and creatinine levels in vaginal wash fluid for the diagnosis of premature rupture of membranes.Methods: The study was conducted on150 pregnant patients, 50 in each group. Confirmed PROM and unconfirmed PROM. Per speculum examination was done to look for pooling, pH tested using the Pehanon paper and vaginal wash fluid was collected. Vaginal wash fluid urea and creatinine levels were tested by a kit based on spectrophotometry.Results: The mean urea levels were 26.35 mg/dl in the study Group 1 and 3.12 mg/dl in the control group. ROC curve was plotted and the cut off value of vaginal wash fluid urea was found to be 8.55 mg/dl. The vaginal wash fluid urea levels of >8.55 mg/dl detected PROM with a sensitivity, specificity, negative and positive predictive value of 100%. The mean creatinine levels were 0.62 mg/dl in study Group 1 and 0.20 mg/dl in the control group. ROC curve was plotted and the cut off value of vaginal wash fluid creatinine was found to be 0.405 mg/dl. Vaginal wash fluid creatinine levels detected PROM with a sensitivity of 76% and specificity of 100%. The negative predictive value and positive predictive values were 80.4% and 100%.Conclusions: Urea can be used as a definite marker of PROM and creatinine can be used as a supportive marker.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203340
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study of role of doppler in gestational hypertension and perinatal
           outcome

    • Authors: Anjali R. Chavda, Parul T. Shah, Rina V. Patel, Hemali N. Patel
      Pages: 3458 - 3462
      Abstract: Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index <1 and 27 cases had cerebro-placental index >1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203341
      Issue No: Vol. 9, No. 8 (2020)
       
  • A study to determine socio demographic corelates of reproductive tract
           infection amongst women of reproductive age group

    • Authors: Anmol K. Gupta, Anita Thakur, Tripti Chauhan, Nidhi Chauhan
      Pages: 3463 - 3468
      Abstract: Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203342
      Issue No: Vol. 9, No. 8 (2020)
       
  • Advanced cervical leiomyosarcoma with severe comorbidities: a clinical
           conundrum for optimal management

    • Authors: Pankhuri Dubey, Sandhya Gadre
      Pages: 3469 - 3472
      Abstract: Leiomyosarcoma of uterine cervix constitute a very rare but aggressive group of neoplasms of the cervix with poor prognosis. Although recognised as a distinct entity, treatment algorithms and overall management strategies rely on suggestions from uterine counterparts as robust data on management of the cervical leiomyosarcoma, especially when advanced, is scarce. Present case was a 51-year-old perimenopausal woman with acyclic vaginal bleeding and dyspnoea on ordinary physical activity. On examining, a firm hypogastric mass of 14 weeks was found abdominally and a pedunculated, polypoidal hard mass of 5X5 cm with a 2 cm thick peduncle coming out of endocervical canal (confirmed on CT) was noted hanging outside vagina. Histopathology suggested cervical leiomyosarcoma. Triple vessel disease and severe cardiac dysfunction (LVEF=30%) with large left ventricular thrombus rendered the patient at very high risk for mortality during surgery. Systematic comorbidity assessment with due consideration to risk-benefit ratio of all treatment options was undertaken and neoadjuvant chemotherapy was started after multidisciplinary recommendation. Patient tolerated the first cycle of chemotherapy well but died of a sudden cardiac arrest after one week. Advanced age and stage are poor predictors for survival in patients with aggressive cervical leiomyosarcomas, even more so, in those with severe comorbidities. Meticulous clinical evaluation and systematic incorporation of comorbidity indices in decision-making for tailored cancer treatment is imperative in arriving at a justified plan of action for this rare and aggressive entity.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203067
      Issue No: Vol. 9, No. 8 (2020)
       
  • Uterine torsion in pregnancy, expect the unexpected: case report

    • Authors: Huda Nabihah Mokhtar, Sumayyah Mohammed Faridz, Rohana Ismail, Nasuha Yaacob, Roziana Ramli
      Pages: 3473 - 3476
      Abstract: Uterine torsion in pregnancy is a rare condition, but potentially life-threatening. The non-specific clinical features make preoperative diagnosis difficult and most cases are discovered during caesarean deliveries done for other obstetric indications.
      Authors present 2 cases of uterine torsion with different clinical presentation and outcome. Case 1 was a G3P2 at 36 weeks with twin pregnancy presented in active labour with a prolapsed cord. A 180 degrees uterine torsion was discovered only after delivery of the foetuses, resulting in inadvertent posterior uterine wall incision. Case 2 was a G6P5 at 35 weeks who presented with an acute abdomen and went into shock. At laparotomy, a 360 degrees uterine torsion was discovered complicated with placental abruption, causing a fresh stillborn baby. These cases highlight uterine torsion as a rare but important diagnosis in obstetrics, which could be associated with potentially devastating outcome.
       
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203343
      Issue No: Vol. 9, No. 8 (2020)
       
  • First delivery of a COVID-19 positive patient in Cameroon

    • Authors: Junie Y. Ngaha, Florent Y. Fouelifack, Madye A. Ngo Dingom, Marileine K. Kemme, Brigitte Wandji, Felix Essiben, Anicet Ngate, Jeanne H. Fouedjio, Charles E. Sone, Philemon N. Arrey, Serge Temkou, Gilles T. Libend, Jean J. Bissemou, Filbert E. Eko, Joel T. Momo, Larissa O. Essomba, Ahmadou H. Djoulatou, Ache Isseini, Monkaree B. Kutnjem, Colbert E. Bisong, Winnie T. Gouanfo, Rebecca Tonye, Georges E. Mballa, Pierre Ongolo-Zogo, Eugene Sobngwi, Pierre J. Fouda, Robinson E. Mbu
      Pages: 3477 - 3479
      Abstract: Since its appearance in China in December 2019, COVID-19 which is caused by the SARS-CoV-2 virus has become a real global health problem. Pregnant women are not immune to this novel infection, which makes it difficult for proper management of pregnancy and childbirth.
      Authors present here the first case of childbirth in Cameroon of a 19-year-old adolescent tested positive for COVID-19.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203344
      Issue No: Vol. 9, No. 8 (2020)
       
  • Imaging resemblance but diagnostic disparity in cervix cancer: a rare case
           report

    • Authors: Namita Agrawal, Tarun Kumar Jain, Abhishek Charan, Sanjay Sharma, Hemant Malhotra, Nitin Khuteta, Ajay Yadav
      Pages: 3480 - 3482
      Abstract: F-18 FDG PET-CT is an establish modality for staging of cervical cancer. The high uptake value in PET with no evidence of necrosis in CECT is generally understood malignant pathology in known cancer patients. A 47 year-old-female with cervix carcinoma underwent staging FDG PET-CT. It showed FDG avid primary lesion in cervix with FDG avid pelvic, retroperitoneal, mediastinal and supraclavicular lymph nodes. USG guided FNA from the supraclavicular lymph node revealed tuberculosis. Now patient scheduled for ATT and chemotherapy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203345
      Issue No: Vol. 9, No. 8 (2020)
       
  • Ruptured cornual ectopic pregnancy: a case report

    • Authors: Arti Sharma, Dipika Singh, Sarika Verma
      Pages: 3483 - 3485
      Abstract: A cornual gestation is one of the most hazardous and life-threatening type of ectopic pregnancy with a mortality rate of 2-5 times higher than other ectopic pregnancies. Because of the myometrium stretch ability, they usually present late around 7-12 weeks of gestation. Thus, the diagnosis and treatment of such cases become challenging. In the case of ruptured cornual ectopic pregnancy, the patient usually presents with hemodynamic instability. Presenting a case report of a 28-year-old female who presented to the labour room of ESI hospital, Okhla, New Delhi at 12 weeks of pregnancy in a state of shock. A provisional diagnosis of ruptured cornual ectopic was made based on clinical examination and ultrasound report. Resuscitation followed by emergency laparotomy done as a life-saving procedure for the patient. Ruptured cornual ectopic needs urgent intervention and multidisciplinary approach. However, with the advancement and expertise in the field of radiology and early diagnosis can be made which can contribute towards more conservative management of such cases.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203346
      Issue No: Vol. 9, No. 8 (2020)
       
  • Xanthomatous oophoritis, a rare pathology: case report with review of
           literature

    • Authors: Basanta Manjari Hota, Kavitha Bakshi, Naimisha Movva, Swathi Pandirla
      Pages: 3486 - 3489
      Abstract: Xanthomatous oophoritis is a rare chronic inflammation of ovary characterized histologically with infiltration of lipid laden foamy macrophages, lymphocytes, plasma cells leading to tissue destruction. Though exact cause is not known, uterine artery embolization, gloves dusting powder and altered lipid metabolism are hypothesized to cause the pathology. A 28-year-old parous lady with history of multiple laparotomies, known case of hypothyroidism under treatment and history of adequately treated pulmonary tuberculosis was diagnosed to have right ovarian dermoid cyst, while undergoing investigation for secondary infertility. On examination she had pallor, healthy abdominal scar, and small tender fixed mass in right fornix on internal examination. She was subjected to laparotomy and right salpingo oophorectomy with left salpingectomy was performed. Histopathological examination of the resected specimen revealed to be xanthomatous oophoritis of right ovary. As this condition mimics tuberculosis and malignancy, clinical assessment, investigation and intra operative findings with the suspicion of inflammatory aetiology help to limit the extent of surgery. Hence, this case is presented for its rare occurrence as well as its need to be differentiated from other conditions like tuberculosis and malignancy of ovary.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203347
      Issue No: Vol. 9, No. 8 (2020)
       
  • A rare case of symplastic leiomyoma: case report

    • Authors: Sharanya ., Julie Thomas
      Pages: 3490 - 3492
      Abstract: Symplastic leiomyoma is an unusual variant of leiomyoma. Malignant transformation accounts for 0.2% of all cases of leiomyoma. Atypical and bizarre leiomyoma synonymous with symplastic leiomyoma are rare smooth muscle tumors that contain cells with moderate to severe cytological atypia, still cell necrosis is absent and mitotic index is fewer than 10/10 HPF. A 42-year P1L1A3 with no comorbidities came with complaints of lower abdominal pain for one year and heavy menstrual bleeding for eight months, LMP- 15/2/19, regular cycles, changes 4-5 pads/day, clots (+) (+), dysmenorrhoea (+). Parity score of P1L1A3, LCB-24 years, not sterilized. On examination - moderately built and nourished, pallor (+). Per abdomen examination - uterus - 22 weeks size, irregular mass, arising from pelvis - no tenderness, lower border not made out. Per speculum examination - cervix and vagina healthy. Per vagina examination - cervix firm, posterior, left fornix: mass felt, non-tender. The patient underwent Abdominal hysterectomy and B/L salpingo-oophorectomy under CSEA. Intraoperative findings - uterus - 20 weeks size, enlarged, a posterior wall subserosal fibroid with degeneration of 6×8 cm. Microscopic appearance - uterus - myometrium shows changes in adenomyosis. Sections of smaller mass reveal structure of leiomyoma. Nuclei are large, hyperchromatic, and show coarse chromatin clumps. Many giant-sized cells with multiple large nuclei were seen. It showed large chromatin clumps. Stroma showed myxoid change. Diagnosis - symplastic leiomyoma, adenomyosis. Symplastic leiomyoma is an unusual variant of leiomyoma. Malignant transformation accounts for 0.2% of all cases of leiomyoma. The regularity of the tumor margins, low mitotic activity, and absence of nuclear atypia or necrosis should be made for the exclusion of malignancy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203348
      Issue No: Vol. 9, No. 8 (2020)
       
  • Uterine leiomyosarcoma: an unusual presentation

    • Authors: Preethi B., Monu Singh, Sarita Singh, Pallavi Singh
      Pages: 3493 - 3498
      Abstract: Uterine leiomyosarcomas are rare aggressive tumors, with high recurrence rates, even when confined to the uterine corpus at the time of diagnosis. It arises from smooth muscle of uterus and is a rare tumor that accounts for 2-5% of all uterine malignancies. These tumors typically spread hematogenously. Patients present with vague symptoms similar to those of patients with leiomyomas. Most patients are diagnosed with leiomyosarcoma postoperatively. Although prognosis remains dismal, various ongoing studies are investigating the role of advanced imaging, multimodality treatment, prognostic nomograms, and unique biomedical pathways to increase understanding of leiomyosarcoma and improve therapeutic options for patients. 46 years old para2 live2 postmenopausal (since 1.5 year) female presented to outpatient clinic with complaints of bleeding per vaginum, foul smelling discharge, unquantified weight loss and something coming out of vagina since 1.5 months. On abdominal examination, an irregular midline mass arising from pelvis corresponding to 20 weeks gestational size of uterus was present. On vaginal examination, 3 infected vaginal growths were present in vagina maximum 4x4cm. Intra-operatively, uterus was nearly 20 weeks size with irregular surface. A 3×3 cm subseroal fibroid with necrotic surface was present on posterior wall of uterus. Cut section of the operative specimen showed myohyperplasia which was compressing the uterine cavity, some necrotic areas were also present. Vaginal growths - 4×4 cm on left vaginal wall near introitus with necrotic surface, 3×3 cm on right vaginal wall, 1×1 cm on right upper vaginal wall present. Excision of vaginal growth was done and was sent for histopathology. Histopathologic examination of sections of uterus showed all features were suggestive of leiomyosarcoma uterus.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203349
      Issue No: Vol. 9, No. 8 (2020)
       
  • Primary malignant melanoma of vagina: a case report

    • Authors: Smruti Shambharkar, Tarachand Sharma
      Pages: 3499 - 3501
      Abstract: Primary malignant melanoma of the vagina is a rare and aggressive disease with worse prognosis as compared with non-genital melanomas or other vaginal malignant neoplasms. Presented here is a case of 42 years female with 3 months history of amenorrhea and vaginal discharge. On vaginal examination, a firm growth of size approximately 7-8 cm was found attached to the left postero-lateral wall of vagina and extending up to the introitus. On biopsy and histopathological examination, it was diagnosed as a case of high-grade malignant melanoma of amelanotic type. Radiotherapy was started as a part of treatment after consultation with an oncologist, considering non-resectable nature of the mass. The patient received first 5 cycles of radiotherapy but succumbed to the disease during treatment.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203350
      Issue No: Vol. 9, No. 8 (2020)
       
  • Maternal congenital complete heart block in pregnancy: a rare case report

    • Authors: Reena Sood, Harmandeep Kaur, Gaurav Mohan, Madhu Nagpal
      Pages: 3502 - 3504
      Abstract: Complete heart block comprises complete absence of AV conduction - none of the supraventricular impulses are conducted to the ventricles. Perfusing rhythm is maintained by a junctional or ventricular escape rhythm. Typically, the patient will have severe bradycardia with independent atrial and ventricular rates. The incidence is 1 in 15,000 to 20,000 live births.
      Authors present the case report of a primigravida, aged 30 years who presented with amenorrhoea of 35 weeks. She was diagnosed as complete heart block by cardiologist. She had no history of syncopal attacks during childhood or antenatal period. She had a heart rate of 50-52 bpm. ECG showed ventricular escape rhythm with narrow QRS complexes. Echocardiography showed no structural defects. Her elective LSCS was done at 39 weeks after consultation with cardiologist. Patient underwent temporary pacemaker insertion just prior to surgery and she delivered a healthy female baby of weight 3 kg with Apgar 9/10 at 5 mins. She remained asymptomatic during the postoperative period and pacemaker was removed after 30 hours. She was discharged under satisfactory condition on day 6. Patient was counselled for follow up with cardiologist. This case lays emphasis on proper history taking, vitals monitoring, early recognition of undiagnosed cardiac disorders and team work for good maternal and fetal outcome.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203351
      Issue No: Vol. 9, No. 8 (2020)
       
  • Volvulus, gangrene and perforation of transverse colon in an antepartum
           eclamptic pregnant patient post caesarean: a case report

    • Authors: Jharna Behura, Sanjiva Kumar, Poonam Bagga, Maruti Sinha
      Pages: 3505 - 3508
      Abstract: Transverse colon volvulus leading to gangrene and perforation is an extremely uncommon acute surgical complication in pregnancy and puerperium, with a very high rate of mortality and morbidity. Surgical resection is the only treatment.
      Authors present a case of a 20 years. old women, with antepartum eclampsia, who underwent caesarean section for fetal distress. She complained of abdominal pain from second post-operative day. The pain increased in severity and on the third postoperative day, she developed sudden abdominal distention and appeared pale. Ultrasound revealed free intraperitoneal fluid suggestive of hemoperitoneum. An emergency laparotomy was performed. There was about a litre of blood in the peritoneal cavity with clots. The caesarean incision site, uterus adnexa and broad ligaments were all intact. On further exploration, volvulus of the transverse colon was seen along with gangrene and perforation of the middle part of transverse colon. Resection of the gangrenous part was done with closure of the distal loop. Proximal loop was brought out as colostomy. The patient had an uneventful postoperative course thereafter and was discharged on regular diet on 12th postoperative day. Volvulus of transverse colon leading to gangrene is rare in pregnancy and puerperium, but must form part of clinician’s differential diagnosis when encountering a patient with persistent abdominal pain and bowel distention. Early diagnosis and timely surgical intervention could significantly improve the outcome of this catastrophic condition.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203352
      Issue No: Vol. 9, No. 8 (2020)
       
  • Ruptured pyogenic liver abscess in pregnancy: a case report

    • Authors: Smruti Shambharkar, Shuchita Mundle
      Pages: 3509 - 3511
      Abstract: Pyogenic liver abscess during pregnancy is an extremely dangerous condition, both from general as well as obstetric point of view. An interesting case of 24-year primigravida reported at 28 weeks gestation with high grade fever and chills with features of peritonitis is being presented here, which on investigations subsequently was diagnosed to be a case of ruptured pyogenic liver abscess. The case was managed successfully with higher antibiotics and percutaneous drainage of the abscess. The obstetric outcome was successful as well, with spontaneous preterm delivery of 920 gm male child which cried immediately after birth and was managed with appropriate care in premature baby unit.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203353
      Issue No: Vol. 9, No. 8 (2020)
       
  • Ectopic pregnancy in a case of congenital mullerian anomaly: a diagnostic
           dilemma

    • Authors: Sanjay Brahmbhatt, Amrita Makhija, Jayna Brahmbhatt, Yagnesh V. Patel
      Pages: 3512 - 3514
      Abstract: Ectopic or extrauterine pregnancy occurring in a case with mullerian defect is very rare and poses diagnostic challenges. Undescended and non-communicating fallopian tubes are extremely rare mullerian anomalies. Here authors present a case of ectopic pregnancy occurring in an undescended non-communicating fallopian tube in a patient with unicornuate uterus with absent horn, which was managed laparoscopically. A 32-year-old lady, diagnosed case of left unicornuate uterus with absent right horn, was referred to us with the suspicion of ruptured ectopic pregnancy. The abdominopelvic ultrasound showed a soft tissue lesion of size 32×24 mm, towards the right lateral pelvic wall near the iliac vessels, with increased vascularity on colour flow doppler.  The patient underwent laparoscopy which showed left sided unicornuate uterus with normal left tube and ovary. The right uterine horn was absent.  An undescended right ovary and tube were found attached to the peritoneum at the level of pelvic brim along the right lateral pelvic wall.  Right sided tubal ectopic pregnancy with rupture was present along with 300-350 cc of hemoperitoneum. The patient was treated with laparoscopic right sided total salpingectomy. In patients with unicornuate uterus and atypical presentation, ectopic pregnancy should be ruled out in an undescended non-communicating fallopian tube. Salpingectomy of incidentally diagnosed non-communicating fallopian tubes is recommended to prevent future ectopic pregnancy.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203354
      Issue No: Vol. 9, No. 8 (2020)
       
  • Vertical transmission of SARS-CoV-2: a brief literature review

    • Authors: Moukit Mounir, Assia El Ouardi, Abdellah Babahabib, Mehdi El Hassani, Jaouad Kouach
      Pages: 3515 - 3518
      Abstract: As COVID-19 virus is still spreading, more infections in pregnant women are likely to be seen. At this time, very little is known about vertical transmission of SARS-COV-2 from infected pregnant woman to her infant.
      Authors reviewed the risk of vertical transmission of COVID-19 by using data of published articles and official websites up to May 11, 2020. The searches revealed 16 articles (12 case reports/series and 4 retrospective studies) collectively comprising 194 infected pregnant women with COVID-19. 140 cases of neonates delivered from pregnant women with COVID-19 were collected. The SARS-COV-2 nucleic acid test, in day 2, was positive in 4 newborns. Based on limited data, there is no evidence for vertical transmission of COVID-19. Some studies suggestive of maternal-fetal transmission deserve careful evaluation before a definitive finding.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203355
      Issue No: Vol. 9, No. 8 (2020)
       
  • Concept of cervical ectopy/Quruhal Rahim in Unani system of medicine: a
           review

    • Authors: Tooba Fahad, Ismath Shameem
      Pages: 3519 - 3529
      Abstract: Cervical ectopy is one of the commonest gynecological conditions seen in OPD’s, about 80-85% of women suffer from cervical ectopy during their life time. Many a times, it is an accidental finding in an asymptomatic woman coming for routine gynecological examination. Although it is a benign lesion, but may predispose to complications like infertility, cervical intraepithelial neoplasm, risk of various sexually transmitted infections like C. trachomatis, N. gonorrhoea, human papilloma virus, human immunodeficiency virus, cytomegalovirus and shows malignant changes as it progresses. Ectopy occurs when the columnar epithelium lining the endocervix, extends onto the ectocervix. As the disease takes 10-20 years to progress from pre invasive to invasive disease, preventive measures such as screening and treatment modalities should be adopted. Early diagnosis of cervical ectopy is important for its effective management and for prevention of its long-term sequel. The treatment option available in conventional medicine includes surgical procedure either electro or, cryocautery, but have their own complications. Hence, this treatment is limited due to its complications and contraindications and need for safer alternate therapy. In Unani system of medicine, various formulations are available as treatment of quruhal rahim, which have been recommended to be used locally in the form of humool for immediate healing of wound, exhibiting the properties of anti-inflammatory (muhallile warm), desiccant (mujaffif), wound healing (mundamile qurooh), sedative (musakkin), antiseptic (dafa’e ta’ffun) etc. This review article gives a detailed description of cervical ectopy as mentioned in classical Unani text including its etiopathogenesis, clinical presentation and principles of treatment as well as evidence-based Unani medicine.
      PubDate: 2020-07-23
      DOI: 10.18203/2320-1770.ijrcog20203356
      Issue No: Vol. 9, No. 8 (2020)
       
 
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