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Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 9)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Chronic endometritis in cases with recurrent embryo implantation failure

    • Authors: Samir Mohamed El-Sayed, Tarek Mokhtar Tappozada, Fahd Mohamed Mansour, Eman Sheta Ali
      Pages: 3224 - 3231
      Abstract: Background: Chronic endometritis (CE) is a cause of recurrent implantation failure (RIF) in patients undergoing intracytoplasmic sperm injection (ICSI). CE is diagnosed based on the presence of plasma cell infiltration of the endometrial stroma in endometrial biopsies. Hysteroscopy may be suggestive of CE while the immunohistochemistry with specific cell markers for CD138 cells has been suggested as a more accurate test for the diagnosis of CE.Methods: This study included 110 patients with recurrent ICSI failure (two or more), despite using good-quality embryos. Hysteroscopy and endometrial biopsy were performed as an outpatient procedure. Immunostaining was then performed using a mouse monoclonal CD138 antibody. The prevalence rate of CE was calculated, and the correlation between hysteroscopic findings and immunohistochemical results was assessed. Results: In the included patients in this study there was 32 cases (29%) were diagnosed as CE by hysteroscopy, while 27 cases (24.5%) were positive by CD138 immunohistochemistry (IHC), and 18 cases (16.36%) were positive for CD138 IHC with hysteroscopic features of CE. The presence of more than one abnormal hysteroscopic features was considered positive for CE rather than single abnormal feature, the sensitivity, specificity, positive and negative predictive values of hysteroscopy would be 22.2%, 98.8%, 85.7%, and 79.6%, respectively.Conclusions: The negative diagnostic value of hysteroscopy is high, the combination of the two diagnostic modalities (hysteroscopy and CD138 IHC) will aid in the detection of most cases of CE.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223000
      Issue No: Vol. 11, No. 12 (2022)
       
  • Choriocarcinoma on hysterectomy specimen in Senegal: histological study

    • Authors: Amadou Ndiade, Abdou M. Gaye, Mama Sy, Ibou Thiam, Ndiaga Diop, Mame V. Gueye, Robert Diatta, Ange L. Diatta, Fabrice Senghor, Oumar Faye
      Pages: 3232 - 3235
      Abstract: Background: Trophoblastic diseases are in general exclusive to women in their reproductive years. Gestational choriocarcinoma (GC) is a rare malignant tumor derived from the trophoblast of women in childbearing age. Our objective was to study the epidemiological and clinicopathologic aspects at the laboratories of pathological anatomy and cytology (ACP) of Aristide Le Dantec Hospital and General Idrissa Pouye Hospital.Methods: Our study was conducted in the anatomy and pathology laboratories of the Hôpital Général Idrissa Pouye and the Hôpital Aristide Le Dantec in Dakar. This study was based on records of pathological reports of gestational choriocarcinomas from these different laboratories. This was a retrospective and descriptive bi-centric study, spread over eight (8) years from January 1, 2013, to December 31, 2020. All cases diagnosed on hysterectomy specimens and with a formal conclusion of choriocarcinoma have been included. We recorded the data collected in Excel 2007 software and the analysis was made using Epi Info.Results: We collected 25 cases of choriocarcinomas. The mean age of the patients was 38.1±9.7. Mixed seat tumors (intra-cavitary and intra-mural) were the most frequent with 48% of cases. Patients who were at FIGO stage 1 represented for 88% of cases.Conclusions: Gestational choriocarcinoma (GC) is a proliferation of the trophoblast (cytotrophoblast and syncitiotrophoblast). This study has helped establish histopathological data of choriocarcinoma on hysterectomy specimen in Dakar.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223112
      Issue No: Vol. 11, No. 12 (2022)
       
  • Role of fetal pulmonary artery Doppler in prediction of neonatal
           respiratory distress in neonates of diabetic mothers

    • Authors: Hager Mamdouh G. Taha, Nagwa Mahmoud Al Ghorab, Mohammed Mohsen Al-Namory, Naglaa Ali Hussein
      Pages: 3236 - 3241
      Abstract: Background: Newborn respiratory complication is one of the most prevalent and life-threatening disorders. The clinical indications of early newborn respiratory distress with consistent radiologic features. The Doppler examination of the primary pulmonary artery in the foetus has been proven to be beneficial. The foetal pulmonary artery At/Et ratio is linked to foetal gestational age and amniotic fluid foetal lung maturity (FLM) tests. The aim of the study was to assess the accuracy of foetal main pulmonary artery (MPA) Doppler indices in prediction of the development of neonatal respiratory distress syndrome (RDS) in diabetic mothers.Methods: This was a prospective observational study carried out on 100 cases of diabetic mothers in obstetrics and gynecology department, Tanta University during one year from the approval of the university counsel. The physician evaluated the foetal heart in a methodical manner after a regular ultrasound assessment that included foetal biometry, anomaly scan, measured foetal weight, and amniotic fluid index. Classic chest radiological features include reticulogranular patterns, air bronchogram and ground glass look, as well as the need for surfactant.Results: PI and RI were significantly higher in newborns with RDS than those without RDS (p=0.025 and 0.036 respectively) PSV and At/Et ratio were significantly reduced in neonates with RDS compared with RDS free ones (p=0.004 and <0.001 respectively). RI was significantly higher in neonates with RDS than those without RDS (P = 0.048) PSV and At/Et ratio were significantly reduced in newborns with RDS compared to RDS free ones (p=0.008 and <0.001 respectively). The ROC curve displayed that the cut off value of ≤0.25 for At/Et ratio was associated with a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0% and a NPV of 96.7% for prediction of neonatal RDS with AUC of 0.925 and p≤0.001.Conclusions: development of neonatal RDS in foetus of diabetic mothers with a cut off value of ≤0.25, a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0%, a NPV of 96.7% and AUC of 0.925 The usage of corticosteroids improved the Doppler indices of main pulmonary artery and is accompanied by less morbimortality related to RDS.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223113
      Issue No: Vol. 11, No. 12 (2022)
       
  • Intrauterine instillation of granulocyte colony stimulating factor for
           infertile women with thin endometrium in intrauterine insemination cycle:
           a non-randomized clinical trial

    • Authors: Tandra Ghosh, Jesmine Banu, Shaheen Ara Anwary, Abhijit Roy, Mostafa M. Al Tarique, Nurjahan Begum, Nastaran Lasker
      Pages: 3242 - 3246
      Abstract: Background: Endometrial thickness is one of the major factors for a receptive endometrium and successful implantation. Thin endometrium, generally measuring <7 mm are thought to be less able to support implantation and pregnancy. Several adjuvants have been investigated for their efficacy on thin endometrium in assisted reproductive technology. Granulocyte colony stimulating factor (G-CSF) is a glycoprotein that promotes endometrial stromal cell decidualization via cyclic adenosine monophosphate mediator and induces endometrial proliferation and differentiation. This study was done to evaluate the effect of G-CSF in improving endometrial thickness and pregnancy rate in infertile patients undergoing stimulated IUI (intrauterine instillation) having thin endometrium.Methods: This was a non-randomized clinical trial done among 40 infertile patients with thin endometrium (<7 mm) on the day of ovulation trigger in stimulated IUI patients. Study subjects were non randomly allocated into 2 groups. In group A 20 patients received intrauterine instillation of G-CSF (300 mcg/0.5 ml) via intrauterine catheter on triggering day and in group B another 20 patients received intrauterine instillation of 0.5 ml normal saline in the same procedure. After 48 hours endometrial thickness was measured in both groups. IUI was done on the same day. Pregnancy was detected by serum beta hCG level after 14 days of IUI.Results: In both groups most of the respondents were aged between 30-34 years, 14 (70%) in group A and 11 (55%) in group B. The mean±SD of age 32.4±3.1 in group A, 32.2±3.4 in group B and P value was 0.9. In group A the minimum endometrial thickness on day of ovulation trigger was 4.4 mm and after 48 hours of treatment with G-CSF, it was found 6.3 mm. The maximum endometrial thickness recorded in group A was 6.9 mm and it also increased to 8.7 mm after G-CSF treatment and followed by in group B min thickness 4.8 mm increase to 5.2 mm and max thickness 6.8 mm increased to 8.7 mm. The mean±SD of ET (mm) on the day of ovarian trigger was 5.8±0.8 which increased to 7.4±0.8 in group A and followed by 5.9±0.6 to 7.1±0.9 in group B. ET mean change (mean±SD) for group A was 1.6±0.7 which was greater than the group B 1.3±0.8. Pregnancy rate was 2 (10%) in group A and 1(5%) in group B.Conclusions: Mean increase in endometrial thickness and pregnancy rate was higher in G-CSF group than normal saline group, but the difference was not statistically significant.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223114
      Issue No: Vol. 11, No. 12 (2022)
       
  • Attitude and knowledge of Latvian women towards episiotomy

    • Authors: Anna Jete Gauja, Sabīne Bebere, Dace Rezeberga
      Pages: 3247 - 3253
      Abstract: Background: Although episiotomy is one of the most common surgical procedures, there is still not a lot of research on patients' experience, knowledge and attitudes.Methods: A structured questionnaire was developed and carried out online to evaluate the knowledge and attitudes toward episiotomy among pregnant women and women who had given birth in the previous three years.Results: In this study, 1394 respondents were included. 72.6% of respondents knew what episiotomy was and why the procedure was performed, and 50.9% of those women acknowledged that before labour they did not receive an adequate amount of information. There is a correlation between the knowledge of episiotomies and refusal of the procedure (Spearman’s r=-0.133, p≤0.001). In case of insufficient information, women were more likely to refuse the procedure. 36.2% of women who experienced episiotomy were informed about the procedure and gave their consent to it and 51.9% did not, the rest could not give a concrete answer.Conclusions: Women are not provided with sufficient information about episiotomies during pregnancy. In the majority of cases, patient involvement in the decision-making is not observed. Women must be provided with choices and obtaining their consent should be an integral part of the procedure.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223115
      Issue No: Vol. 11, No. 12 (2022)
       
  • Effects of Ebola epidemic on obstetrical emergencies and outcomes in the
           region of Kindia, Guinea

    • Authors: Sadan Camara, Mamadou D. Balde, Bienvenu S. Camara, Aissatou Diallo, Ramata Diallo, Amadou O. Toure, Anne M. Soumah, Alpha O. Sall, Karifa Kourouma, Alexandre Delamou
      Pages: 3254 - 3259
      Abstract: Background: Maternal mortality is still high in Guinea despite a decline from 724 to 550 maternal deaths per 100,000 live births between 2012 and 2018. The proportion of births attended by skilled personnel is estimated at 45%. The objective of this study was to assess the effect of Ebola virus disease (EVD) epidemic on the frequency of absolute maternal indications, as well as the outcomes of these interventions for mother and child in the region of Kindia.Methods: This was a longitudinal study using 20 months of retrospective data collected in the pre-Ebola (March to December 2012 and March to December 2013) and intra-Ebola (March to December 2014 and March to December 2015) periods. The proportions of maternal health indicators in both study periods were compared using a significance level of 0.05.Results: A total of 1747 women were included in this study. The proportion of women who received a major obstetric procedure in Kindia regional hospital was 85% in each pre and post Ebola periods. Ebola, however, contributed to a significant increase in maternal deaths.Conclusions: The Ebola epidemic has contributed to a significant increase in maternal deaths in health facilities. Measures encouraging health workers to manage obstetric emergencies during critical periods would be necessary.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223116
      Issue No: Vol. 11, No. 12 (2022)
       
  • Comparative study between cases of previous one cesarean section delivered
           at Kafr El-Sheikh hospitals, versus those delivered at Tanta Uniersity
           Hospital

    • Authors: Asmaa A. Mostafa, Ahmed M. El-Khiat, Adel E. El-Gergawey, Mohammed M. Ismail
      Pages: 3260 - 3264
      Abstract: Background: Many factors have contributed to the increasing rates of CSs, including increases in maternal age, BMI, and changes in obstetric practices and technologies. CSs requested by the mother and fear of litigation among caregivers have now become one of the most common indications of CS. Aim of this study was to compare between conditions of previous one caesarean section subjects delivered at Kafr El-Sheikh general hospitals, versus those delivered at Tanta University hospital as regard integrity of the uterine scars, presence of adhesions, time of termination, and fetal outcomes.Methods: This study was an observational study that was carried out on 100 pregnant ladies with history of previous one caesarean section. Participants were divided into two groups: group I included 50 pregnant women selected from Tanta University hospitals, group II included 50 pregnant women selected from Kafr El-Sheikh General hospital.Results: The estimated blood loss was significantly higher in cases selected from Kafr El-Sheikh hospitals compared to that lost from cases selected from Tanta University hospitals. Furthermore, operation time was significantly longer in patients selected from Kafr El-Sheikh hospitals than those selected from Tanta University hospitals. Additionally, omental adhesion was observed in 5 cases (5%); 3 (6%) from those selected from Kafr El-sheikh hospitals and 2 (4%) from those selected from Tanta University hospitals. As regard post-operative blood transfusion, there were increase in the incidence of post-operative blood transfusion in pregnant women selected from Kafr El-Sheikh hospitals (8%) compared to those selected from Tanta University hospitals (4%), but without statistically significant difference (p=0.678).Conclusions: There is high rate of caesarean section in our country. But satisfactory results were present in both Tanta university hospitals and Kafr El-Sheikh general hospital with few complication rates found special in cases priory delivered at Tanta University hospitals including less adhesion finding and thus less intra and post-operative complications.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223117
      Issue No: Vol. 11, No. 12 (2022)
       
  • Correlation of uterine scoring system for reproduction with pregnancy rate
           among infertility patients undergoing intracytoplasmic sperm injection and
           frozen-thawed embryo transfer

    • Authors: Yashila Prithika U., Mahalakshmi Saravanan, Nidhi Sharma
      Pages: 3265 - 3269
      Abstract: Background: Successful implantation requires presence of a good quality embryo and receptive endometrium. Endometrial receptivity is ability of endometrium to successfully attach embryo, nourish and keep it alive. Sonographic findings are weighed according to uterine scoring system for reproduction (USSR) or uterine biophysical profile (UBP) by Applebaum. It has become absolute necessity to evaluate uterus and endometrium prior to embryo transfer, so that optimum results are obtained in favourable uteri.Methods: It is a prospective observational study which includes 100 patients undergoing intracytoplasmic sperm injection (ICSI) treatment followed by frozen embryo transfer. The Applebaum scoring system was done on the day of thawing scan, using ultrasonography (USG) and Doppler studies, assessing endometrial thickness, endometrial motion, endometrial layering, myometrial contractions, uterine artery doppler flow, endometrial blood flow in zone 3 and myometrial blood flow – the scores of each parameter was noted, the final score calculated.Results: Receiver operating characteristic curve (ROC) curve total score in Applebaum scoring system for predicting pregnancy has a cut-off- 13 with sensitivity- 90.10%, specificity- 89.5%, positive predictive value (PPV)-97.34%, and negative predictive value (NPV)- 67.95. The above should be incorporated into routine practice. This was suggested by our study results in addition to endometrial patterns.Conclusions: Applebaum’s USSR scoring system is a simple and non-invasive method for prediction of pregnancy rate in ICSI and frozen embryo transfer cycle. Uterine scoring system will help to perform embryo transfers in only favourable uteri and postpone or cancel those cycles in which poor uterine score is demonstrated. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20222974
      Issue No: Vol. 11, No. 12 (2022)
       
  • Changing trends in technique of hysterectomy in abnormal uterine bleeding:
           a comparison between non descent vaginal hysterectomy versus laparoscopic
           assisted vaginal hysterectomy

    • Authors: Ankita Mani, Anjana Agrawal, Kanchan Sharma, Amit Kumar
      Pages: 3270 - 3274
      Abstract:  Background: Hysterectomy is the commonest gynaecological surgery over the world. However, in India there is a huge lack in data regarding this surgery. The common indications are abnormal uterine bleeding (AUB), prolapse, pelvic inflammatory disease (PID) and pelvic pain. This study focuses on pros and cons of different routes of hysterectomy to decide a better approach of management. Aims and objective of the study were to compare non descent vaginal hysterectomy (NDVH) to laparoscopic assisted vaginal hysterectomy (LAVH) to determine better route of hysterectomy.Methods: A randomized prospective observational study conducted in Hind Institute of Medical Science, Barabanki over a period of 2 years on perimenopausal women undergoing hysterectomy for AUB for benign pathology. 100 patients were selected for the study and randomly divided in 2 groups NDVH and LAVH. Preoperative investigations, intra-operative and postoperative complications were compared.Results: The mean duration of surgery was found to be significantly less in NDVH group 71.24 minutes as compared to LAVH group 103.1 minutes. (p value <0.001). Number of patients requiring Blood transfusion during or after surgery was higher in LAVH group (21) than in NDVH (15) (p value <0.05) suggesting more blood loss in LAVH. Patients undergoing NDVH were having significant less postoperative pain visual analogue score 3.8 as compared to 5.4 in LAVH group (p value <0.001) .5 patients in LAVH group were having postoperative abdomen discomfort as compared to only 1 in NDVH group (p value <0.05).Conclusions: NDVH supersedes LAVH being faster, less expensive, less blood loss and cosmetically scarless surgery. However, LAVH should be kept in mind if there is associated adnexal pathology.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20222984
      Issue No: Vol. 11, No. 12 (2022)
       
  • Emergency contraception: knowledge, attitude and awareness of its usage
           among medical students in a private medical college of Davangere

    • Authors: Malavika Jabin Chandramohan, Prema Prabhudev
      Pages: 3275 - 3282
      Abstract: Background: Emergency contraception (EC) is the contraception used to prevent pregnancy after unintended or unprotected sexual intercourse. EC can be used after contraceptive failure or misuse (as in slippage or breakage of condoms, forgotten pills). It is used before the time of implantation and prevents pregnancy in 75-99% of the cases. EC is available as pills or IUCD.Methods: A cross-sectional study involving final year medical students was conducted at SSIMS and RC, Davangere, Karnataka, India. A 32-point questionnaire encompassing the socio-demographic details, knowledge and attitude towards EC was answered by a total 146 participants. The data were entered in Microsoft excel sheet and the descriptive statistics were analysed using Epi-info softwareResults: Majority of the participants had heard about EC and also knew the trade name under which it is available. The main indication for EC usage was thought to be unprotected sex by 76% participants. Nearly 90% participants knew that EC does not protect against STDs. 85% participants thought that failures can happen despite EC usage. On assessing the attitude, majority disagreed to the notion that EC usage promotes promiscuity and using EC is a sinful act.Conclusions: Knowledge and attitude regarding EC and its usage was fairly good among the medical students in our study. The inclusion of EC in medical curriculum has added to their knowledge. Being the responsible future physicians, their knowledge with regard to EC is deemed important. Similarly, an awareness regarding EC should be spread across the general public to prevent the unwanted pregnancies and its consequences.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20222964
      Issue No: Vol. 11, No. 12 (2022)
       
  • Challenges in the management of endometrial cancer and endometrial
           hyperplasia with atypia in sub-fertile patient: an emerging medical
           issue-our experience in a tertiary care centre

    • Authors: Nivedita Reshme, U. D. Bafna, Prathima .
      Pages: 3283 - 3288
      Abstract: Background: The cases of endometrial hyperplasia with atypia/endometrial carcinoma with age below 40 years are rising and many are nulliparous at diagnosis. The purpose of the study was to study the oncological and obstetric outcome among young women with above mentioned endometrial pathology treated with fertility preserving approach.Methods: The retrospective cohort approach included 17 patients who visited Bhagwan Mahaveer Jain Hospital from January 2016 to January 2022 with a diagnosis of endometrial hyperplasia with atypia/endometrial carcinoma who met national comprehensive cancer network criteria. The records of all the patients included in the study have been reviewed retrospectively.Results: In our study 13/17 (76.47%) patients showed complete response to hormonal treatment. Conception rates are low (23.07%) even after reversal of the malignancy. Thirteen of 17 patients had associated polycystic ovarian syndrome. Three out of 17 (17.64%) had progressive disease, 5/13 (38.46%) cases had disease recurrence after initial remission out of which 3 had rechallenge with progestins with remission again.Conclusions: Levonorgestrol intra uterine system along with oral progestins is an effective combination as device might be useful in optimising the dose of oral progestins without the need for further escalation of dosage. Levonorgestrol intra uterine device or low dose oral progestins alone should be continued in responders not opting for conception as maintenance hormonal therapy. Hysterectomy should be advised if hormonal treatment fails, and also after completion of childbearing. Myometrial invasion may not be absolute contraindication for fertility sparing treatment. Molecular profiling of endometrial biopsy might help in better prognostication and treatment strategy. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20222975
      Issue No: Vol. 11, No. 12 (2022)
       
  • Assessment of gestational diabetes mellitus development in correlation
           with elevated first trimester serum uric acid levels

    • Authors: Anushaktha Reddy M., Shridevi A. S., Gayatri L. Patil
      Pages: 3289 - 3294
      Abstract: Background: More than 10% of pregnancies in the world are affected with gestational diabetes mellitus (GDM), making it a prevalent pregnancy complication. The goal of this research was to examine whether or not higher serum uric acid levels in the first trimester of pregnancy are associated with an increased risk of developing GDM.Methods: The study was conducted on 56 first-trimester pregnant females at risk of GDM attending the outpatient clinic of the S. S. institute of medical sciences, Davanagere. All cases underwent estimation of uric acid levels <15 weeks, 24 to 28 weeks, and oral glucose challenge test (OGCT) at 24 to 28 weeks.Results: In our study, among 56 pregnant women, 17 (30.3%) developed GDM. Of these 12 women (70.6%) with GDM had higher uric acid levels and 5 women (29.4%) with GDM had normal uric acid levels. Uric acid levels were higher in women with a higher BMI.Conclusions: GDM development is significantly correlated with elevated serum uric acid levels in the first trimester. Early interventions by dietary and exercise regimes in these patients can reduce the maternal and neonatal complications.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223118
      Issue No: Vol. 11, No. 12 (2022)
       
  • A clinicopathological study of adnexal masses in the tertiary care
           hospital, Kadapa

    • Authors: Sowjanya Bandi, Lakshmi Suseela Thulamandi, Sowjanya Eka
      Pages: 3295 - 3299
      Abstract: Background: Adnexal mass is a common clinical presentation among women of all age groups and is extremely common among reproductive age groups. It may be gynecological or non-gynecological origin. The exact prevalence of adnexal mass could not be determined, as most of them develop and resolve without any clinical symptoms. Adnexal mass poses a special perplexity to the attending gynecologists, because the differential diagnosis is extensive and most masses are benign. Differential diagnosis of adnexal mass is complex and includes benign and malignant ovarian tumors, functional cysts, para ovarian cysts, tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, fimbrial cyst, tubal malignancies, broad ligament fibroid.Methods: It was a prospective study conducted in the department of gynecology, GGH, Kadapa. It was a tertiary care hospital. Total of hundred cases were included in the study based on selection criteria. Ethical committee approval was taken prior to the study.Results: A total 100 cases of adnexal masses were included in the study. 40% of study subjects had parity 2 and 11% had maximum parity 4. 81% of study subjects had surgical management. 45 patients had CA125 >35 u/ml. Among them 48% have benign lesions and 51% have malignant lesions. 92.72% of patients with CA125 <35 u/ml have benign lesions and 7.27% have malignant lesions.Conclusions: Adnexal mass was found to be more common in middle females (54%) in age group 31-50 years. Serous cystadenoma and simple serous cyst (25%) were common benign lesions and most common malignant lesion was serous cystadenocarcinoma.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223119
      Issue No: Vol. 11, No. 12 (2022)
       
  • Comparison of cervical acid phosphatase papanicolaou stain and standard
           papanicolaou stain as a screening tool for cancer cervix

    • Authors: Nandhini E., Sasikala R., Varadharaja Perumal
      Pages: 3300 - 3304
      Abstract: Background: Carcinoma cervix is the second most common cancer in women (18%). Cervical smear by routine Papanicolaou (Pap) smear screening has significant rates of false-positive and false-negative results. To minimise this, we compare the efficacy of cervical acid phosphatase-papanicolaou (CAP-Pap) smear with conventional Pap smear in detecting premalignant lesions of cervix. The red-colored granules (enzyme coated abnormal cells) that are clearly detected, CAP-Pap positive aids in the quick and early diagnosis of aberrant cells, which speeds up the screening procedureMethods: The present observational study conducted among the patients presenting to gynaecology department for cancer cervix screening. Two cervical smears were collected for Pap and CAP-Pap staining. Cytology report showing abnormality either in Pap smear or CAP-Pap smear were subjected for colposcopy guided cervical biopsy after VIA/VILI and their results were correlated with histopathology reports as gold standard.Results: Total of 321 women were enrolled in the study. On comparison with Cervical biopsy, Pap smear had a sensitivity of 83.3%, specificity of 50%, Positive predictive value of 88.2%, Negative predictive value of 40.0%. CAP-Pap had a sensitivity of 100%, specificity of 50%, PPV of 90%, NPV of 100%. As evidenced by the 100% sensitivity, CAP-Pap meets the screening test criteria.Conclusions: The CAP- Pap test has a bright future as a rapid, inexpensive, and efficient method for initial screening or as an addition to Pap smear in primary health care of India for effective cervical cancer screening.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223120
      Issue No: Vol. 11, No. 12 (2022)
       
  • The diagnostic value of endometrial thickness and volume measurements by
           transvaginal three-dimensional ultrasound in patients with perimenopausal
           bleeding

    • Authors: Naira A. Atia, Mohamed M. El Namoury, Manal A. Farhat, Mahmoud S. Hamouda
      Pages: 3305 - 3310
      Abstract: Background: Endometrial hyperplasia (EH) represents a spectrum of irregular morphological alterations, whereby abnormal proliferation of the endometrial gland results in increased thickness of endometrial tissue with alterations of glandular architecture (shape and size) and in an increase in gland-to-stroma ratio when compared to endometrium from the proliferative phase pf the cycle. The aim of this study was to detect the role of measurement of endometrial thickness and volume by transvaginal three-dimensional ultrasound as predictors of abnormal endometrial pathology in women with peri menopausal abnormal uterine bleeding.Methods: This study was conducted at the department of obstetrics and gynecology of Tanta University Hospital. The cases were selected from admitted patient suffering from perimenopausal uterine bleeding. The study started after protocol approval from 2020 to 2022. The calculated sample size was 50 cases. The studied cases were subjected to 3D-TVS measuring endometrial volume and endometrial thickness, study uterine size, shape, endometrial curettage and histopathological examination.Results: Regarding provisional diagnosis by ultrasound in the examined patients, the most frequent diagnosis was benign endometrial pathology: 46% (n=23) of all cases then endometrial hyperplasia 44% (n=22) then endometrial carcinoma 10% (n=5), there was statistically significant difference between the three endometrial pathologies regarding endometrial thickness (p˂0.001),  and  endometrial  volume  (p˂0.001).There was statistically significant difference between the benign endometrial pathology and endometrial carcinoma regarding endometrial thickness (p˂0.001), and endometrial volume (p˂0.001).There was statistically significant difference between the endometrial hyperplasia and endometrial carcinoma regarding endometrial thickness (p˂0.001), and endometrial volume (p˂0.001).Conclusions: From our study we conclude that histopathological examination of the endometrium is the gold standard for diagnosis or exclusion of endometrial pathology. 3D ultrasound is a reasonably accurate, helpful, and non-invasive tool for assessing the endometrium.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223121
      Issue No: Vol. 11, No. 12 (2022)
       
  • A clinical study evaluating maternal and perinatal outcomes in patients
           with decreased amniotic fluid in term pregnancy

    • Authors: Sukanya Nagsen Thorat, Abhyudai Ravooru, Anita Bansal
      Pages: 3311 - 3317
      Abstract: Background: Oligohydramnios is the most frequent third trimester complication resulting in a greater number of caesarean sections. This study was carried out to determine the role of oligohydramnios (AFI<5) and borderline amniotic fluid index (AFI between 5.1-8) for term pregnancy and their impact on maternal and perinatal outcomes. Objectives of current investigation were to study incidence of oligohydramnios in term pregnancy and to study maternal and perinatal outcome in cases with oligohydramnios.Methods: Present study is done during August 2018 to May 2019 in department of obstetrics and gynaecology, northern central railway hospital, Delhi on 90 women with singleton term pregnancy (37-41weeks) with cephalic presentation, with no leaking PV. According to the AFI measurements (1 week before delivery), 3 groups were formed AFI 0-5 cm (oligohydramnios), 5.1-8cm (borderline AFI), 8.1-24 cm (normal AFI), AFI >24 cm was excluded. Maternal and fetal outcome were assessed.Results: The incidence of oligohydramnios (AFI<5 cm) was 4.4%. Induction of labour was 50% in AFI <5 cm group, 57.1% in borderline AFI and 13.9% in normal AFI group. In AFI <5 cm group, 75% had LSCS, in AFI5-8 cm group, 71.42% had LSCS. Most common indication of LSCS in AFI <5 cm and AFI 5-8 cm was fetal distress. APGAR score <7 at 1, 5 mins was 50% in AFI <5 cm and AF 5-8 cm group as against 8.9% in Normal group. Babies weighing less than 2.5kg were 50% in AFI <5cm group, 42% in borderline group and 15.1% in normal AFI group.Conclusions: AFI determination helps to identify foetuses at risk of poor perinatal outcome. It is a valuable screening test to predict fetal distress in labor that may need caesarean section. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223122
      Issue No: Vol. 11, No. 12 (2022)
       
  • Utility of first trimester ultrasound before 12 weeks of gestation at
           tertiary care centre in western India

    • Authors: Shital T. Mehta, Pushpa A. Yadava, Shashwat K. Jani, Tejas V. Solanki, Aastha H. Patel, Sweta D. Mehta, Ashish J. Shyara, Dhwani R. Rawal, Dhruvi R. Patel
      Pages: 3318 - 3323
      Abstract: Background: The first trimester begins on the first day of the last menstrual period (LMP) and lasts until the end of 12 weeks of gestation. Transvaginal ultrasound is modality of choice for establishing the presence of an intrauterine pregnancy in the first trimester. The focus of our study is routine early pregnancy ultrasound. The purpose of this study was to diagnose various conditions of pregnancy at an early stage by using ultrasound.Methods: We conducted retrospective data analysis of random 250 pregnant patients who had undergone first-trimester ultrasonography USG) (transvaginal/abdominal) in their first antenatal visit at S.V.P. Hospital, Ahmedabad, Gujarat, India from March 2021 to February 2022. The patient was selected by a simple randomized method. Maternal age, parity, gestational age, and special features regarding maternal gestational history were compared with USG findings. Patients were divided into 13 groups on the basis of ultrasonographic diagnosis.Results: We noted 76.8% of patients had single, viable, intrauterine pregnancies, while 23.2% had complicated pregnancies with uterine anomalies, ovarian cysts, leiomyoma, caesarean scar pregnancy or subchorionic hematomas.Conclusions: Ultrasound measurement of fetus in first trimester is most accurate method to confirm gestational age. It is less expensive and easily available modality. First-trimester ultrasound is useful to define embryonic landmarks in developmental stages with reference to gestational age, early diagnosis of miscarriage, ectopic pregnancy, molar pregnancy, multifetal pregnancy, major fetal malformation. And also, to diagnose pregnancy with leiomyoma, caesarean scar pregnancy, uterine anomaly and pre-eclampsia with the help of uterine artery PI.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223123
      Issue No: Vol. 11, No. 12 (2022)
       
  • Prospective study to evaluate management of ectopic pregnancy in a
           tertiary care centre

    • Authors: Bhavna ., Kushla Pathania, Kumud Bala Gupta, Sushruti Kaushal
      Pages: 3324 - 3327
      Abstract: Background: To study the pattern of management of ectopic pregnancy in a referral Centre in North India.Methods: This prospective study was conducted over a period of one year in the department of obstetrics and gynecology, in a tertiary care Centre in North India. Total number of cases who reported to hospital with ectopic pregnancy during the study period were 110. All the cases were analyzed and managed either with conservative, medical or surgical treatment depending on the condition of cases at the time of presentation to the hospital. Frequencies of different variables were compared by chi square test using Graphpad Prism 9, p value less than 0.05 was considered statistically significant.Results: The incidence of ectopic pregnancies reported in present study was 18.62 per 1,000 deliveries. Total of 110 cases with ectopic pregnancy reported to hospital during the study period. Mean age of the cases was 28.72 years. Out of 110 cases, laparotomy was performed in 100 cases and medical management in 10 cases. Medical management failed in one case and necessitated surgery in that case. There was no maternal mortality during the study period.Conclusion: Most of the cases presented late to the hospital due to lack of awareness, topographically tough terrain in Himachal with limited transport facilities which delayed management of ectopic pregnancy and precludes conservative management either in the form of medical management or conservative surgery. Screening of high-risk cases, early diagnosis, early referral and early intervention reduces the maternal mortality and morbidity. So awareness at the primary health care level is the necessity of the hour.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223124
      Issue No: Vol. 11, No. 12 (2022)
       
  • Diosmin versus tranexamic acid in heavy menstrual bleeding: a randomized
           controlled trial

    • Authors: Vinita Gupta, Anirban Das, Sujata Dalai, Pallab Kumar Mistri
      Pages: 3328 - 3331
      Abstract: Background: Heavy menstrual bleeding (HMB) is defined as cyclical bleeding at regular intervals but excessive in amount which affect the physical, social and mental aspects of life of a woman. The prevalence is 10-30% in reproductive age women and 50% in perimenopausal women. HMB is not just a clinical burden but also a huge social and economic burden. The aims and objective of my study is to compare the efficacy of diosmin and tranexamic acid in acute HMB in terms of average duration of menstrual cycle, PBAC/PABC score, endometrial thickness, hemoglobin concentration and finally need for other modes of treatment.Methods: The study was a randomized control trial in which the patients (sample size-72) were divided into two groups- group D (n=36) and group T (n=36). Group D was treated with tab diosmin 500 mg thrice daily from day 1 to day 5 of menstrual cycle. Similarly group T was treated with tab tranexamic acid 500 mg thrice daily from day 1 to day 5 of menstrual cycle. The PBAC score was taken at the end of three months along with endometrial thickness and hemoglobin concentration. The results were compared with values obtained before initiating treatment.Results: In this study after 3 months of treatment; the patients in group D had an initial PBAC score of 423.52 and at the end of treatment it was decreased to 149.89 (p<0.0001). Reduction was 60.5%. Group T patients had an initial PBAC score of 441which was reduced to 177.94 (p<0.0001) after treatment. The reduction in this group was 59.6%.Conclusions: In this study it was found that both tranexamic acid and diosmin were effective in reduction of HMB, in terms of PBAC score, average duration of menstrual cycle and endometrial thickness. But the in reduction in PBAC score was similar in both the groups. The failure rates were also similar in both the groups, but improvements in hemoglobin concentration were only marginal
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223125
      Issue No: Vol. 11, No. 12 (2022)
       
  • Comparison of single dose versus multiple doses of antibiotic prophylaxis
           in elective caesarean section

    • Authors: Vidhi Mishra
      Pages: 3332 - 3339
      Abstract: Background: Infectious complications after caesarean delivery (CD) are a substantial cause of maternal morbidity, increase in hospital stay and treatment cost. The spectrum of these complications’ spreads from fever, wound infection, endometritis, urinary tract infection, and some serious complications like pelvic abscess, septic shock and septic pelvic vein thrombophlebitis. To prevent these prophylactic antibiotics have been used however the use of antibiotics should be judicious. Aim was to compare the efficacy of single dose versus multiple doses of antibiotics in elective caesarean section.Methods: This study was conducted in a tertiary care hospital from December 2017 to May 2020. It was a prospective case control study. Sample size was 600, patients were randomly allocated in two groups A and B by card method. Pregnancy category B drug “cefuroxime” was given.Results: Incidence of SSI was 2.7% (n=8) in single dose group and 3% (n=9) in multi-dose group, this difference was not statistically significant. Incidence of fever for more than 48 hours was 1.3% (n=4) in the single dose group and 0.6% (n=2) in multi-dose group, this difference was not statistically significant. Urine R/M for all patients on 3rd post-operative day, in single dose group 2.3% (n=7) patients and in multi-dose group 2.0 % (n=6) patients had more than 5 pus cells. Patients, who had more than 5 pus cells in urine R/M, were subjected to urine culture and sensitivity. Four (1.40%) patients in single dose group had positive cultures (E. coli was detected in three patients and Klebsiella pneumoniae in one) and three (1.0%) patients, in multi dose group, (all the three patients had E. coli in growth). These results were statistically not significant.Conclusions: Single dose antibiotic prophylaxis was found to be comparable to multi-dose antibiotics in our study. Hence it is advocated that single dose antibiotic can be given in elective caesarean section as it is cost effective and as efficient as multi-dose regimen, ensures complete compliance and minimizes side effects and cut-down nursing work-load.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223126
      Issue No: Vol. 11, No. 12 (2022)
       
  • Correlation of levels of early second trimester beta-human chorionic
           gonadotropin levels with severity of preeclampsia

    • Authors: Shilpa Kumari, Gunjan Chaudhary
      Pages: 3340 - 3345
      Abstract: Background: Hypertensive disorders in pregnancy remains a leading cause of maternal morbidity and mortality all over the world as per World Health Organization (WHO), affecting 5-10% of all pregnant women. Screening women at an early stage and preventing complications are corner stone in the management of pre-eclampsia. Several studies have proven the reliability of beta-human chorionic gonadotropin (β-hCG) as predictor of preeclampsia. In this study we aim to find the correlation of increasing levels of β-hCG with severity of preeclampsia.Methods: In this study serum β-hCG estimation was done in 200 pregnant women between 13 and 20 weeks of gestation, selected randomly over a period of 1 year attending antenatal clinic by quantitative determination of β-hCG by electro-chemiluminescence immunoassay. Multiple of median (MOM) is calculated from charts of norms available. They were followed till delivery for development of pre-eclampsia. The following patients were followed up till delivery. Blood parameters, blood pressure readings, were done at 34 weeks for every patient and maternal complications were noted and results were analysed statistically.Results: The incidence of preeclampsia in this study population was 8% (16 out of 200). This study found a significant correlation between increasing levels of MOM’s of β-hCG with the severity of preeclampsia.Conclusions: In this study, there was significant association between MOM values of β-hCG with the parameters defining severity of preeclampsia. The results of our study show β-hCG to be not only a reliable marker for prediction of preeclampsia, but also its severity.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223127
      Issue No: Vol. 11, No. 12 (2022)
       
  • Understanding, acknowledging and accepting the knowledge regarding the
           complication of post-placental intrauterine contraceptive device insertion
           

    • Authors: Rushabh H. Agrawal, Krima V. Shah, Khusboo N. Patwa, Rakesh Anand
      Pages: 3346 - 3350
      Abstract: Background: Intrauterine devices are an effective and increasingly popular from of reversible contraception and are most effective method of long-term contraception. Post placental intrauterine contraceptive devices insertion is done within 48 hours of birth which is ideal period ass women are strongly motivated to do so at this time. Aim was to understand knowledge, acceptance and complication of post placental intrauterine contractive device insertion.Methods: This was a prospective observational study conducted in obstetrics and gynecology department of a tertiary care centre from 1st September 2021 to 28th February 2022.Results: Total 84 patient were counselled out which 50 were willing for PPIUCD out of which 48 (58%) patients PPIUCD was inserted and 2 patients were deferred.Conclusions: PPIUCD was accepted in 50 (60%) of counselled total patients out which most of the patient were 20-29 years having graduate degrees and were mutipara most common cause of acceptance was that it is long term method of contraception most of the patient were counselled intrapartum and had vaginal method of delivery patient were minimum complications with most common complication of missing threads and expulsion.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223128
      Issue No: Vol. 11, No. 12 (2022)
       
  • Correlation of non-stress test with fetal outcome in term of Apgar score-
           a prospective observation study

    • Authors: Neeraj Choudhary, Savitri Verma, Sudha Gandhi, Yukti Gour, Asha Kumari
      Pages: 3351 - 3354
      Abstract: Background: Non-stress test (NST) is a graphical recording of changes in fetal heart activity and uterine contraction along with fetal movement when uterus is quiescent. The objectives of antepartum fetal surveillance are to prevent fetal death and avoidance of unnecessary intervention. This study using NST as a tool for routine antepartum fetal surveillance was trying to catch up those fetuses who might be at risk in womb and provide prompt intervention in otherwise considered normal pregnancies without any obvious high risk factor thus giving the best outcome in mothers.Methods: The objective of this study was to evaluate the correlation of the non-stress test with fetal outcome in pregnancies from 37-42 weeks of gestation.  This was a prospective observational study at Pannadhaya Rajkiya Mahila Chikitsalya Udaipur (Rajasthan) from February 2022 to July 2022. This study included 100 normal pregnant mothers from 37 weeks to 42 weeks who were subjected to NST.Results: The parameters of poor fetal outcome like Apgar score <7 at 5 minutes had increased incidences in the non reactive group.Conclusions: NST tells about acute fetal hypoxia and decision to delivery time can be made for those patients with fetal distress so that a major improvement in the outcome among parturient can be achieved with abnormal NST results. So This study suggested that the NST was found to be a good predictor of the healthy foetus even in normal pregnancies between 37-42 weeks of gestation and the probability of an adverse outcome such as poor Apgar score increases with a non reactive strip.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223129
      Issue No: Vol. 11, No. 12 (2022)
       
  • Study of hypothyroidism in pregnancy and it’s fetomaternal outcome: a
           prospective study at tertiary care hospital

    • Authors: Monika ., Susheela Khoiwal, Aditi Mourya, Nisha Sharma, Anju Jorwal
      Pages: 3355 - 3358
      Abstract: Background: Pregnancy is a stress test of maternal thyroid function. The prevalence of thyroid dysfunction in pregnant women is high. This study is aimed to evaluate maternal and fetal outcomes in pregnant women with deranged thyroid profile. The relevance of this study is to document the association of hypothyroidism and its adverse effects on mother and fetus.Methods: All pregnant mother included in the study are subjected to written consent and detailed history taking and fasting blood sample collection. Blood sample collected in fasting state, because lipidemic content in blood interferes with serum thyroid stimulating hormone (TSH) level if blood sample collected in the fed state.Results: A total of 1000 cases were studied. Out of 1000 cases, 71(7.1%) cases found to be hypothyroid. Among them, 14 (19.4%) had overt hypothyroidism and 57 (80.5%) demonstrated subclinical hypothyroidism.Conclusions: Prevalence of subclinical hypothyroidism is 5.6% in 3rd trimester of pregnancy. Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223130
      Issue No: Vol. 11, No. 12 (2022)
       
  • Comparative evaluation of different methods to quantify proteinuria in
           preeclampsia

    • Authors: Pavani Kannali, Poornima Akki, Nafeesa Farheen S.
      Pages: 3359 - 3363
      Abstract: Background: Worsening of condition in preeclampsia is indicated by progressive proteinuria, hence its quantification helps in decision making and plan treatment accordingly. The present study was undertaken to compare different methods of estimation of proteinuria to find best method for quantification.Methods: It was a hospital based prospective study conducted on a group of 100 pregnant women diagnosed as preeclampsia after 20 weeks of gestation, they were subjected to different methods of quantification of proteinuria after admission in department of obstetrics and gynaecology, Narayana medical college and hospital, Nellore over a period of one year.Results: Present study showed strong positive strength of association of SSA test was higher compared to the spot urinary PCR and spot urinary dipstick. To assess the predictability of three methods compared against 24-hour urine protein estimation by ROC curve. The AUC of the SSA test and spot urinary PCR was stronger than the urinary dipstick. Study showed a significant better method as SSA>>Urinary PCR>>dipstick with accuracy of 96.04%, 95.0% and 54% respectively.Conclusions: This study concluded that spot urine SSA and urine PCR are reliable investigations compared to dipstick method. So, spot urine SSA and urine PCR can be used for detection of proteinuria in pregnant women with pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation. Thus, this quick method with high accuracy is very useful to prevent feto-maternal morbidity and mortality in India.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223131
      Issue No: Vol. 11, No. 12 (2022)
       
  • Maternal outcome in pregnancy with sickle cell trait haemoglobinopathie

    • Authors: Rutvi R. Thakor, Falguni B. Patel, Minal Chaudhary, Anjani Shrivastava
      Pages: 3364 - 3367
      Abstract: Background: Sickle cell trait, the heterozygous state for sickle cell disorders (SCD), which is associated with various obstetrical and non- obstetrical complication. Our objective was to study the pregnancy outcome in women with sickle cell trait.Methods: A prospective observational study was conducted collecting data from medical records of around 40 consecutive consenting subjects admitted in a tertiary health care center of south Gujarat over a period of May 2020 to April 2021 after Human Research Ethics Committee (HREC) approval.Results: In our study majority of the subjects (52.5%) belonged to age group of 18-25 years, majority (62.5%) of subjects were belonged to tribal population. Majority (92.5%) of subjects in our study diagnosed as sickle cell trait post -conceptional. 67% of subjects had various antenatal maternal morbidity among them anemia (45%); preterm labour (12.5%); hypertensive disorder (7.5%) and respiratory failure (2.5%). 65% of our subjects were delivered vaginaly. 5% of subjects had post- partum complication.Conclusions: Though sickle cell trait is considered as a low risk factor during pregnancy, expansion of SCT screening and educational efforts, the availability of reproductive technologies, and the increasing research on clinical complications of SCT have important implications for reproductive and genetic counselling guidelines.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223132
      Issue No: Vol. 11, No. 12 (2022)
       
  • A study of perinatal mortality with obstetrics point of view with
           etiological factors and preventive approach

    • Authors: Hemangini J. Upadhyay, Pallavi G. Ninama, Margi A. Shah
      Pages: 3368 - 3371
      Abstract: Background: Perinatal mortality rate (PNMR) serves as the most sensitive index, directly reflecting prenatal; intrapartum and newborn care. In order to reduce perinatal mortality, it is necessary to study the various factors influencing perinatal deaths.Methods: It was a retrospective study done over the period of 1 year from January 2021 to December 2021. Total 4389 deliveries were included out of which 228 perinatal deaths occurred. Causes of perinatal deaths were identified and studied.Results: Results showed that perinatal mortality rate was 17.5 per 1000 live births. Incidence of early neonatal death was 17.5% per total admissions. Majority of perinatal deaths occurred due to preterm, low birth weight. Maternal factor associated with perinatal mortality were antepartum haemorrhage, eclampsia, obstructed labour, malpresentation, medical problems in pregnancy.Conclusions: The perinatal mortality could be prevented with strengthening of antenatal care screening, educating pregnant women to recognize the signs of complications of pregnancy, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn resuscitation. With proper coordination of neonatologist and obstetrician, sizeable reduction in perinatal mortality can be achieved.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223133
      Issue No: Vol. 11, No. 12 (2022)
       
  • An observational case control study: study of preterm labour- risk factors
           and its outcome

    • Authors: Krima V. Shah, Rushabh H. Agrawal, Radhika Parmar
      Pages: 3372 - 3375
      Abstract: Background: Preterm birth is considered as the most significant risk in infant morbidity and mortality. The number of preterm births can be reduced significantly if all of the risk factors for predicting preterm births were eliminated to maximum extent. The aim of this study was analysis of risk factors of preterm labour and its outcome through case control study.Methods: It was an observational case control study of 200 pregnant women divided into study group of 100 pregnant women who were admitted with signs and symptoms of preterm labour with gestational age between 28-36 weeks. Control group of 100 pregnant women having gestational age above 36 weeks and with spontaneous onset of active labour. Risk factors and other parameters of both the groups were analyzed along with their neonatal outcome.Results: It was found that premature rupture of membrane, previous abortion, previous preterm delivery, anemia and impaired body mass index (BMI) are significantly higher in cases with preterm labour (p value <0.05). Hyperbilirubinemia, birth asphyxia and respiratory distress syndrome are significantly higher in cases with preterm labour (p value <0.05).Conclusions: Preterm labour is a multifactorial problem. Preterm labour and delivery require early and prolonged hospitalization causing great financial and psychological burden on the society and the number of preterm births can be reduced significantly if all of the risk factors for predicting preterm births were eliminated to maximum extent.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223134
      Issue No: Vol. 11, No. 12 (2022)
       
  • Factors leading to surgical evacuation in first trimester medical
           termination of pregnancy

    • Authors: Rasila Mooppichathil, Jayshree V. Vaman, Simi A.
      Pages: 3376 - 3380
      Abstract: Background: Aim of the study was to determine factors leading to surgical evacuation in first trimester medical termination of pregnancy of women attending SAT hospital, medical college, Thiruvananthapuram.Methods: A case control study was conducted at the department of obstetrics and gynaecology, Government Medical college, Thiruvananthapuram. The sample size was calculated to be 58 in each group. Antenatal women attending family planning OPD for termination of pregnancy in first trimester at SAT hospital over a period of one year were recruited for this study. A structured questionnaire was used to record history, examination findings, and investigations including ultrasound. The clinical outcome was defined as successful medical abortion and failed medical abortion which leads to surgical evacuation due to retained products.Results: Previous caesarean, previous induced abortion, previous pregnancy loss or increasing gestational age showed increasing rate of failed medical abortion. Also, in patients with anaemia with haemoglobin <11 gm/dl or diabetes or hypertension showed independent association with failed medical abortion.Conclusions: If patient planning for medical abortion, can do at earlier gestational age as advancing gestation will leads to increasing rate of failed medical abortion and also after correcting anaemia, with proper medication.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223135
      Issue No: Vol. 11, No. 12 (2022)
       
  • The assessment in the awareness regarding nutrition in pregnancy in
           population attending Dhiraj hospital and effect of taboos, customs and
           food availability on such population

    • Authors: Khushboo N. Patwa, Sulay R. Kathrani, Rushabh H. Agrawal, Rakesh Anand
      Pages: 3381 - 3386
      Abstract: Background: Food taboos have great effect on pregnant women through prohibited essential food and/or drinks. It is transferred from generation to generation and has negative effect on pregnant mothers' health. The objective was to assess magnitude of food taboo and associated factors among pregnant women attending antenatal care at Dhiraj hospital, Waghodiya, Vadodara.Methods: Institutional based cross-sectional study was conducted. 180 pregnant women were selected for the study. Multiple logistic regression analysis was conducted to identify independent predictors of food taboo.Results: Twenty-seven percent of pregnant mother encountered food taboos. Avoided food items by pregnant mothers were linseed, coffee, tea, cabbage, meat, wheat bread, banana, groundnut, salty diet, sugarcane, pumpkin, and coca drinks. Reasons mentioned for avoidance of this food items were plastered on the fetal head, making fatty baby which is difficult for delivery, fear of abortion, and fetal abnormality. Age of the mother AOR=2.97 (1.71-5.16), income AOR=0.28 (0.11-0.72), and previous antenatal care AOR=2.33 (1.89-5.47) were significantly associated with food taboo.Conclusions: Our study revealed that considerable proportion of food taboo exists during pregnancy in the study area. This can be improved by strengthening the nutrition counselling components of antenatal care follow-up.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223136
      Issue No: Vol. 11, No. 12 (2022)
       
  • Trends of maternal mortality in a tertiary care hospital: a five year
           retrospective study

    • Authors: Leimapokpam Roshan Singh, Khumanthem Pratima Devi, Lipsa Priyadarshinee, M. Rameswar Singh, Yengkhom Mandakini Devi, Bandi Krupa
      Pages: 3387 - 3391
      Abstract: Background: Maternal mortality is a measure of quality of health care in community. Maternal mortality ratio is a very sensitive index that reflect the quality of reproductive care provided to the pregnant women. The aims and objectives were to study the institutional maternal mortality, the causes of maternal death and the impact of COVID-19 on MMR.Methods: A retrospective hospital-based study of 38 maternal death was done over a period of 5 years from June 2016 to May 2021 in obstetrics and gynaecology department, RIMS Imphal. Details of all the mortalities were collected from individual case sheets, facility based maternal death review forms and MDR case summary.Results: A total of 38 deaths were analysed. MMR in the study period was 86 per 1 lakh live births. Maximum maternal deaths were reported in the age group of 30-34 years. Majority of maternal death were reported in multipara (57.9%) as compared to primipara (34.2%). Most of them were un-booked (63.2%) and belonged to rural areas (60.5%). The commonest cause was obstetrics haemorrhage (42.1%) followed by hypertensive disorders (23.6%). Acute respiratory distress syndrome associated with SARS-CoV-2 is one of the most important causes of increasing mortality rate (10.5%).Conclusions: Early identification of high-risk pregnancy, regular antenatal check-up and proper training of health personnel along with timely referral to tertiary care centre can help to reduce the mortality. There is an increase in MMR during the current pandemic 2020-2021.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223137
      Issue No: Vol. 11, No. 12 (2022)
       
  • Comparison of oral versus vaginal misoprostol for induction of labour at
           term

    • Authors: Perveena Fareed, Rehana Rashid, Saleem A. Wani
      Pages: 3392 - 3395
      Abstract: Background: Preinduction cervical ripening has a great influence on induction of labor. For induction of labor various methods are used. Mechanical methods are Foleys catheter with or without extra-amniotic saline. Various pharmacological methods are misoprostol, dinoprostone, and oxytocin.Methods: This was a prospective observational study conducted on 100 patients with 50 patients in each group in the department of obstetrics and gynecology, Government Medical College, Srinagar from June 2020 to March 2021 over a period of 9 months. Induction with oral misoprostol or vaginal misoprostol was done in respective groups. Various parameters noted were induction delivery interval, number of doses needed, mode of delivery, and fetomaternal outcome.Results: Average number of doses of misoprostol in oral group was 3.84 and average number of doses in vaginal group was 1.90. Mean induction delivery interval in oral group was 16 hours and 10.94 hours in vaginal group. 32% patients delivered by full-term vaginal delivery (FTVD) in oral group and 18% underwent lower segment caesarean section (LSCS), while as 38% patients in vaginal group had FTVD and only 12% patients underwent LSCS.Conclusions: Our data supported the fact that induction with vaginal misoprostol can be equally effective in either oral or vaginal route. However, induction with vaginal misoprostol leads to shorter induction delivery interval compared to induction with oral misoprostol. Our study also highlighted the fact that induction with vaginal misoprostol requires lesser doses as compared to that with oral misoprostol. However, there are no significant differences in number of caesareans between the two groups. Difference in neonatal APGAR scores and maternal complications were non-significant in both the groups.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223138
      Issue No: Vol. 11, No. 12 (2022)
       
  • Pregnant women with COVID-19: a study in tertiary care centre

    • Authors: Sindu K. Subramaniyan, Malathi Thagaraj
      Pages: 3396 - 3398
      Abstract: COVID-19 had become a pandemic since December 2019. Although the infection rate affecting the pregnant women is less when compared to general population, the data on the effect of coronavirus in pregnancy are limited to a few case studies This was a case series conducted at KIMS Hospital, Bengaluru for a period of 1 year from November 2020 to November 2021. All the pregnant women irrespective of the gestational age admitted at KIMS hospital with COVID-19 reverse transcriptase polymerase chain reaction (RTPCR) positive and gave the consent were included in our study. In our study, out of 480 pregnant women 13 cases were COVID-19 positive. Out of the 13 positive patients, 4 delivered vaginally and 6 of them underwent lower segment caesarean section (LSCS) in view of obstetric indications. 3 cases (23%) were lost to follow up. 9 (90%) of neonates were negative for COVID 19. The results of our study concluded that COVID-19 positivity rate is 2.7% among the admitted patients. There is a risk of adverse pregnancy outcome in severe COVID-19 infections. The limitation of our study was that number of infected pregnant women was less to study the pregnancy outcome. Further studies with larger sample size will be required to study the pregnancy outcome.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223139
      Issue No: Vol. 11, No. 12 (2022)
       
  • Non-puerperal uterine inversion caused by a leiomyoma

    • Authors: Fekkoul Soukaina, Rhazi Inas, Taheri Hafsa, Saadi Hanane, Mimouni Ahmed
      Pages: 3399 - 3401
      Abstract: Uterine inversion is characterized by the invagination of the fundus of the uterus through the vagina. It’s a rare postpartum complication leading to massive bleeding and it’s extremely rare in non-puerperal cases. Non-puerperal uterine inversion is caused by tumors exerting force on the fundus of the uterus, turning the uterus inside out. It is most frequently associated with benign tumors such as submucosal leiomyomas however, malignant tumors can also be associated. We reported the case of 43-year-old women, G1P1, who was admitted at the emergency department for a bleeding vaginal prolapsed mass. A pelvic MRI performed revealing a complete uterine inversion probably due to a submucous myoma or a malignant process. She underwent a total abdominal hysterectomy with bilateral salpingectomy by both natural and abdominal way. Pathological study revealed a degenerating leiomyoma. The patient recovered well from the operation with no complications. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223140
      Issue No: Vol. 11, No. 12 (2022)
       
  • Rare association of Turner syndrome and Mayer-Rokitansky-Kuster Hauser
           syndrome

    • Authors: Amadou Ndiade, Mbaye Thiam, Sérigne A. M. Dia, Mama Sy
      Pages: 3402 - 3404
      Abstract: Turner syndrome and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare association. The incidences of Turner and MRKH syndromes are estimated at 1/2000 and 1/4500 female births respectively. This is a 23-year-old patient, born of a consanguineous marriage, who was referred to us for exploration of primary amenorrhoea. The karyotype, performed three times, from peripheral blood lymphocytes was 45X0. The diagnosis of Turner syndrome associated with MRKH syndrome was retained.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223141
      Issue No: Vol. 11, No. 12 (2022)
       
  • Acute lower limb ischemia following surgical management of postpartum
           hemorrhage: about a case and review of the literature

    • Authors: Rhazi Inas, Kamal El Harcha, Hafsa Tahiri, Hanane Saadi, Ahmed Mimouni
      Pages: 3405 - 3408
      Abstract: This is a 30-year-old patient, without history, primigravida, with a full-term pregnancy, who consulted in the obstetric emergency department for treatment of heavy metrorrhagia. After conditioning, the ultrasound showed a completely covering placenta, hence the indication for an emergency caesarean giving birth to an Apgar boy 5/10th then 9/10th. The patient presented with uterine atony resistant to medical treatment. Uterine padding and triple vascular ligation were performed. With the persistence of uterine atony, ligation of the hypogastric arteries was attempted with accidental lesion of the right external iliac artery requiring its ligation to ensure haemostasis. The patient was transferred to our training for additional care. On admission, the patient was intubated, hemodynamically stable with coldness of the right lower limb and absence of the right femoral pulse. CT angiography of the aorta and both lower limbs revealed partial occlusion of the right external iliac artery with downstream patency. Revascularization by bypass using the great saphenous vein of the contralateral limb was performed. The post-operative follow-up was simple. Postpartum hemorrhage is a serious complication in obstetrics. Hypogastric artery ligation is one of the means for the surgical management of postpartum hemorrhage. It is a standardized and effective technique, but complications are not uncommon.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223142
      Issue No: Vol. 11, No. 12 (2022)
       
  • Successful outcome of pregnancy in a case of Guillain Barre
           syndrome-report of a rare case and review of literature

    • Authors: Sakshi Aggarwal, Poonam Sachdeva, Y. M. Mala, Shakun Tyagi, Shalini Shakarwal
      Pages: 3409 - 3411
      Abstract: Guillain Barre syndrome (GBS) is a rare autoimmune neurological disorder that has been reported to carry a high maternal risk and maternal mortality risk of >10% if occurred during pregnancy. It is characterized by acute onset of symmetrical ascending paralysis with or without respiratory depression and autonomic dysfunction secondary to gastrointestinal or respiratory infection. This is case report of 30 years old multigravida who presented at 19 weeks period of gestation with sudden onset back pain and bilateral lower limb weakness that progressed to involve bilateral upper limbs with respiratory insufficiency.  Based on clinical presentation and relevant investigations like serum electrolyte, arterial blood gas analysis and nerve conduction studies, provisional diagnosis of GBS was made. In collaboration with the physician, she was managed with ventilator support for 12 days, intravenous immunoglobulin and supportive therapy. This was followed by complete and rapid recovery as she was extubated on 12th day and discharged on day 16. Patient was followed by strict maternal and fetal surveillance. She successfully delivered a healthy boy at 38 weeks of period of gestation by caesarean section done in view of meconium-stained liquor grade 3 in early labour and she was discharged on day 3 of LSCS. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223143
      Issue No: Vol. 11, No. 12 (2022)
       
  • A rare case of small cell neuroendocrine carcinoma-lung in pregnancy

    • Authors: N. Sumathi, V. Divya, Rekha Karthikeyan, Shameema Begum, Vishnupriya Sivakumar
      Pages: 3412 - 3414
      Abstract: Neuroendocrine tumours constitute heterogenous group of cancers that arise from cells in our body which have neuroendocrine cells-mostly from gastro intestinal tract and lungs. They are further divided into low grade, high grade and poorly differentiated ones. It is rare in pregnancy and it poses diagnostic challenge even among experts in the speciality. So, multi-disciplinary approach to management of neuroendocrine carcinomas (NECs) is the key for optimal management.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223144
      Issue No: Vol. 11, No. 12 (2022)
       
  • Myxoid degeneration of leiomyoma-a masquerader

    • Authors: Anuradha Panda, Deepti N. Mahoorkar, Nikitha Reddy, B. Mounika Reddy
      Pages: 3415 - 3417
      Abstract: Uterine leiomyomas are one of the most common benign lesions in the uterus. The lesion can vary in size from a few millimetres to centimetres, location, its presentation and degeneration. They are easy to diagnose clinically with the help of available imaging techniques. Myxoid degeneration is an uncommon degeneration and has to be kept as a differential diagnosis as it mimics uterine sarcoma. Histopathology and Immunohistochemical analysis help in confirming the diagnosis. Here is a patient in reproductive age group who presented with rapidly growing abdominal mass in a span of 1 year with a prior surgical history of myomectomy. Pre-operative imaging was inconclusive for benign etiology and possibility of uterine leiomyosarcoma could not be ruled out. She was hence counselled for a laparotomy with a frozen section to prevent extensive surgery. Myxoid degeneration is not a common degeneration of leiomyoma with a reported incidence of 10% while the incidence of uterine leiomyosarcoma is less than 1% in reproductive age group. Even though rare, myxoid degeneration should be considered as a differential diagnosis of rapidly growing uterine mass with inconclusive pre-operative imaging.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223145
      Issue No: Vol. 11, No. 12 (2022)
       
  • Leptospirosis in pregnancy: a case report

    • Authors: Sara Guleria, Kapil Dev, Kushla Pathania
      Pages: 3418 - 3420
      Abstract: Leptospirosis is a leading zoonotic disease worldwide with more than 1 million cases in the general population per year. There is significant mortality due to both delays in diagnosis as well as adequate clinical suspicion. There is also an overlap between the signs, symptoms and biochemical disturbances associated with leptospirosis in pregnancy and the presentation of pregnancy associated conditions, such as pre-eclampsia (PET), acute fatty liver of pregnancy (AFLP) and haemolysis elevated liver enzymes low platelets (HELLP) syndrome. This is a case report of a pregnant woman with leptospirosis who delivered a healthy fetus.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223146
      Issue No: Vol. 11, No. 12 (2022)
       
  • A case of post dural puncture headache following labour epidural
           analgesia, managed by sphenopalatine ganglion block

    • Authors: Aishwarya Dinesh, Nitu Puthenveettil, Sobha S. Nair
      Pages: 3421 - 3423
      Abstract: Postpartum headache is a common complaint faced by most obstetricians, with over 39% of women having headache in the first postpartum week. With the increasing use of labour epidural analgesia, the incidence of postdural puncture headache (PDPH) due to inadvertent dural puncture is 0.5-1%. Most treatment modalities relieve the symptoms of PDPH by minimizing compensatory cerebral vasodilatation, or by sealing the dural puncture site. Treatment options include, conservative, pharmacological, and the gold standard, epidural blood patch (EBP). EBP is invasive and may result in rare however, severe complications. Sphenopalatine ganglion block (SPGB) has been proposed as a non-invasive intervention for PDPH, which has minimal adverse effects, which can be performed bedside. Here we are reporting a case of PDPH, following labour epidural analgesia which was effectively managed by a sphenopalatine block. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223147
      Issue No: Vol. 11, No. 12 (2022)
       
  • Mucinous carcinoma recurrence after fertility preservation surgery

    • Authors: Kalyani Saidhandapani, Vidhya Ravichandran
      Pages: 3424 - 3427
      Abstract: Benign ovarian tumours occurs in 7% of women in reproductive age group. The average age of onset for borderline ovarian tumours is ten years younger than that of ovarian cancers. Considered the very good prognosis following an adequate surgical staging in early epithelial ovarian cancers (EOCs), the FPS for women of childbearing age group has become an argument of debate in last decades. 25% of the EOCs are diagnosed in early stages, 14% of those early stage patients are under age of 40 at the time of diagnosis. Fertility preservation is widely accepted in early stage epithelial ovarian cancers, germ cell, sex cord stromal tumours. Based on data, fertility sparing surgery in EOCs recommended in stage 1A, grade 1 and 2 and favourable histologic types (endometrioid, mucinous, low grade serous and clear cell carcinomas) ovarian cancer. Above stage 1A, grade 3, high grade serous and clear cell tumours decision process about FPS should be individualised, weighing a slightly higher risk of recurrence with fertility goals. Correct surgical staging is mandatory and oncological safety should be primary importance. Survival rates in oncological patients have been steadily increasing now a days due to the effectiveness of novel oncological treatments like surgery, chemo and radiotherapy. However, these treatments impair the reproductive ability of the patients and may cause premature ovarian failure in females and azoospermia in males. A multidisciplinary approach with oncology, reproductive endocrinology may be of utility to help these patients to achieve their fertility goals in future.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223148
      Issue No: Vol. 11, No. 12 (2022)
       
  • Wernicke encephalopathy and extrapontine myelinolysis in pregnancy with
           hyperemesis gravidarum: a double jeopardy

    • Authors: Divya Verma, Sanjeev Kumar, Praveen Thakur, Anurag Shukla, Prateek Gupta
      Pages: 3428 - 3430
      Abstract: We report a case of a pregnant woman who had been suffering from hyperemesis gravidarum presented with alteration of consciousness, nystagmus, generalized weakness and extrapyramidal symptoms at 16th week of gestation. Magnetic resonance imaging of the brain showed typical findings of Wernicke's encephalopathy and extrapontine myelinolysis. The clinical features responded dramatically to high dose thiamine supplementation. Wernicke encephalopathy should be diagnosed as early as possible to prevent long-term neurological sequela or death as well as fetal loss. 
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223149
      Issue No: Vol. 11, No. 12 (2022)
       
  • Post‑caesarean vesicouterine fistula: Youssef’s syndrome a
           case report

    • Authors: Tuhin S. Roy
      Pages: 3431 - 3434
      Abstract: Vesicouterine fistula is an uncommon urogynecological fistula, typically induced following lower uterine segment cesarean section, especially an emergency one. The classical clinical features of Youssef’s syndrome are cyclical hematuria, amenorrhea, and urinary continence. The index case reported was a 30 year‐old multipara who had two previous lower segment cesarean sections, underwent a third-time cesarean section and developed urinary incontinence and hematuria on the second week of the post-operative period. CECT urography confirmed vesicouterine fistula. The fistula was managed conservatively.
      PubDate: 2022-11-25
      DOI: 10.18203/2320-1770.ijrcog20223150
      Issue No: Vol. 11, No. 12 (2022)
       
 
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