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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 9  Open Access journalISSN (Print) 2320-1770 - ISSN (Online) 2320-1789 Published by Medip Academy  [12 journals]
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- Incidence and risk factors associated with caesarean section among
Bangladeshi women: a retrospective cross-sectional study
Authors: Sohelee Nargis, Rabea Khatun, Kakali Saha, Shilpi Saha
Pages: 515 - 519
Abstract: Background: Caesarean section is a lifesaving procedure in the presence of maternal and fetal complications. In recent decades the rate of caesarean section is increasing rapidly due to several associated risk factors. The objective of this study was to assess the prevalence and associated risk factors of C-sections among women at Kumudini Women's medical college. Methods: This retrospective cross-sectional study was conducted at the department of obstetrics and gynaecology in Kumudini Women's Medical College, Tangail, Bangladesh. The study was conducted during the period of July 2019 to January 2020. The total sample size this study was 2105. Results: Majority 696 (33.1%) of participants were aged between 18-24 years and followed by 464(22%) aged 25-30, 569 (27%) aged 31-35 and the rest 376 (17.9%) were aged 36-40 years. A significant association was noticed in respect of previous history of CS, gestation age and fetal weight with the type of delivery (p value, 0.000, 0.033, 0.021). whereas in parity there was no significant relationship with caesarean section (p value, 0.421). A significant association was noticed in respect of pre-eclampsia, eclampsia induction failure, fetal distress, APH, twin, malpresentation, and the type of delivery (p value, 0.02, 0.003, 0.001, 0.001, 0.002, 0.04, 0.03 and 0.1). Whereas in PROM there was no significant relationship with caesarean section (p value=0.1). Conclusions: This study concludes that the incidence of caesarean sections is seemed to be very high in Bangladesh. Although it is a life-saving procedure, it is important to choose carefully when performing a C-section birth.
PubDate: 2023-02-06
DOI: 10.18203/2320-1770.ijrcog20230300
Issue No: Vol. 12, No. 3 (2023)
- Factors affecting to neonatal thyroid hormone deficiency in the era of the
COVID-19 pandemic, Akat Amnuai district, Sakon Nakhon Province
Authors: Jirattikal Suttawanit, Preedie Srisamai
Pages: 520 - 527
Abstract: Background: In the spread of COVID-19 Less exposure to iodine affects the health of the pregnant woman and fetus, causing miscarriages and premature births. low birth weight, anemia and hypothyroidism in newborns. Changes in levels of thyroid-stimulating hormone besides genetics, and many environmental factors can also affect thyroid function. This research aims to study the impact of environmental factors on thyroid-stimulating hormone in newborns. Methods: The sample consisted of 134 postpartum women randomly selected by simple method from 807 postpartum women in 2020-2022. The data were collected between June-July 2022 by interviewing social, environment, and household economy. Lifestyle, Iodine salt intake, drugs, iodine supplements and quality antenatal care correlation with Thyroid-stimulating hormone were determined by multiple logistic regression, adjusted odd ratio (ORadj), and 95%Confidence Interval (95% CI) were presented. Results: The results revealed that 67.7% were pregnant aged 20-34 years, 50.7% took iodized salt before pregnancy, 67.2% consumed during pregnancy, 45.5% received salt during antenatal care, 30.6% took folate(B9) before pregnancy,53.0%took antenatal care qualitatively and took iodine supplementation (57.5% daily intake, 29.9% intake 4-6 days/week, 11.9% intake 2-3 days/week). Most of them consume high iodine foods not variety and not frequent enough. High iodine supplements/diet intake, household income, COVID-19 infection, and antenatal care qualitatively were not significant. The significant correlation factor was not eating iodized salt, low education level and residing in the sub-district administrative organization. The results of the correlation analysis using Backward elimination showed that positively correlated with pregnant women whose husbands drink alcohol were hypothyroidism 0.3 times (95%CI=0.10-0.66), husbands smoking 0.4 times (95% CI=0.20-0.94, and pre-pregnancy malnutrition were 2.6 times (95%CI=1.17-5.74). Conclusions: The findings iodine affects to health of pregnant women and fetuses, Therefore, a more rigorous monitoring system for Iodized salt should be designed to encourage a higher rate of pregnant women to take iodine supplementation daily.
PubDate: 2023-02-14
DOI: 10.18203/2320-1770.ijrcog20230345
Issue No: Vol. 12, No. 3 (2023)
- Prevalence of hyperemesis gravidarum using the 24-hour pregnancy unique
quantification of emesis scale scoring-a descriptive study
Authors: Santosh Kumar Jha, Veena Rani Shrivastava
Pages: 528 - 532
Abstract: Background: Nausea and vomiting occur in 80% of all pregnancies that do not require treatment however; hyperemesis gravidarum (HG), a potentially life-threatening condition affecting 0.3% to 2% of pregnancies, which is characterized by protracted vomiting, retching, severe dehydration, and weight loss (>5% of pre-pregnancy weight) require hospitalization. Methods: This was a hospital based cross-sectional descriptive study done at Kathmandu medical college over duration of 18 months from 1st January 2018 to 30th June 2019. Pregnant women ≤22nd weeks of gestation admitted with nausea and vomiting were taken as study group. Data collection was done with the questionnaire (modified 24 hours pregnancy unique quantification of emesis (PUQE) scoring system) on a structured proforma covering the relevant subjects of the study. Data were analyzed comparing difference in percentages of categorical variables chi-square test. Results: Hundred and forty-nine women were enrolled in this study with nausea vomiting in pregnancy (NVP) among 692 patients of all obstetric admission within 22 weeks of pregnancy. The prevalence of NVP during the study period was 21.67%. Most of the women in the study group belonged to age group of 20-30 years. Only 12% of cases admitted with severe NVP. Mean duration of hospital stay was found to be 2.95±1.86 days. The incidence of the disease was maximum between 7-9 weeks of gestation. Conclusions: There was no significant relation seen in severity of NVP and age, gravidity, education, occupation and BMI of women. Treatment with regular hydration and antiemetic had favourable outcome with early recovery.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230517
Issue No: Vol. 12, No. 3 (2023)
- Clinicopathological analysis of ovarian neoplasm
Authors: Samira Areen, Shahanaz Parvin, M. Nazmunnahar Mina
Pages: 533 - 537
Abstract: Background: Ovarian neoplasm is a type of cancer caused by uncontrolled growth and division of cells within the ovary. It is a common type of gynecological cancer that affects a wide range of ages and can have various clinical, morphological, and histological features. This study aimed to examine the relationship between clinical presentation and histological pattern of ovarian neoplasm. Methods: This cross-sectional study conducted among 45 patients admitted to department of gynecology at Shaheed Suhrawardy medical college and hospital with features of ovarian neoplasm from February 2013 to February 2014. Results: The 82.3% of cases were benign tumors, 15.5% were malignant tumors, and 2.2% were borderline tumors. Benign tumors were more common in the 3rd decade, while malignant tumors were more common in the 4th to 6th decade. Symptoms of benign tumors included abdominal lumps and pain, while malignant tumors presented with abdominal pain, GIT-related symptoms, and ascites in some cases. The most common type of tumor was surface epithelial (84.5%), followed by germ cell (13.3%) and sex cord-stromal (2.2%) tumors. Conclusions: The study highlights the importance of recognizing the different clinical presentations of benign and malignant ovarian neoplasm.
PubDate: 2023-02-09
DOI: 10.18203/2320-1770.ijrcog20230323
Issue No: Vol. 12, No. 3 (2023)
- The effectiveness of intrapartum cardiotocography with fetal outcome-a
hospital-based study
Authors: Anima Sarker, Anjuman Ara, Mosammat Shahina Begum, Juthi Bhowmik, Hafija Akter, Shanta Fahmida Haque, Shah Jasmine Basir
Pages: 538 - 543
Abstract: Background: The determination of the fetal condition during labour is important to minimize fetal mortality, morbidity and neurological sequelae of fetal hypoxia. The study aims to evaluate the effectiveness of intrapartum cardiotocography (CTG) in detecting fetal outcomes. Methods: This cross-sectional observational study was conducted at the department of obstetrics and gynecology in the centre for women and child health (CWCH), Ashulia, Dhaka from November 2020 to August 2022. The study was carried out with a total of 63 pregnant women (n=63) who had delivered their child either by lower uterine caesarian section (LUCS) or normal vaginal delivery (NVD) during the study period. Result: Among the participants, almost half participants (47.6%) were aged between 25-29 years. Intrapartum CTG was reactive in around half (54%) of the participants, while non-reactive in 46% of the participants. During the study period, intrapartum CTG was reactive in 34 patients. Of them, only 19 patients had an NVD, while 15 patients despite normal intrapartum CTG also underwent LUCS due to various reasons such as having meconium-stained liquor or slightly stained liquor, non-progressing labour or prolonged labour, premature rupture of the membrane (PROM), fear of NVD etc. During the study period, all twenty-nine patients having intrapartum non-reactive CTG underwent LUCS. During the study period, intrapartum CTG was non-reactive in 29 cases. However, after delivery, the baby’s APGAR score was ≥7 for the 20 neonates of those 29 non-reactive CTG cases. On the other hand, intrapartum CTG was reactive in 34 of the participants. Among them, 3 neonates were delivered through NVD. However, meconium-stained liquor was found and the baby’s APGAR score was <7, which required NICU admission. In total, thirteen neonates (13, 20.6%) had required admission to the neonatal intensive care unit (NICU). Conclusions: CTG is one of the reliable methods of monitoring the fetus. Non-reactive CTG record with a high probability indicates the likelihood of the presence of perinatal asphyxia. Instant and adequate decisions regarding obstetric intervention and optimal procedures should be taken if fetal distress is suspected.
PubDate: 2023-02-09
DOI: 10.18203/2320-1770.ijrcog20230324
Issue No: Vol. 12, No. 3 (2023)
- Ten years of survival among early-stage breast cancer patients: a
hospital-based study
Authors: Shamsun Nahar, Jamal Uddin, Saidul Haque, Nazir Uddin Mollah, Sarwar Alam, M. A. Bari, Faruk Ahmed, Khursheda Akhtar, Mahmudur Rahman
Pages: 544 - 548
Abstract: Background: The incidence rate of breast cancer is gradually increasing all over the world. In Bangladesh, we have very little research-based information regarding the survival of patients with early-stage breast cancer. The aim of this study was to determine the survival outcome of early-stage (Stages I- IIIA) breast cancer among female patients in respect to their age group, stage of the disease, tumor grade, nodal status, and hormone receptor status Methods: This was a prospective observational study focused on the survival outcome conducted in the department of clinical oncology, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka, Bangladesh during the period from December 2011 to December 2021. One hundred and five (105) female patients with early-stage (Stages I-IIIA) breast cancer were selected following the inclusion and exclusion criteria as the study subjects. Properly informed written consent was taken from all the participants before starting data collection. All data were processed, analyzed, and disseminated by MS office and SPSS programs as per need. Results: The survival rate was found 79% (n=83). We observed stage-wise 10-year overall survival among the participants where 51.60%, 36.10%, and 12.30% survived from tumor stage I, II, and III respectively. We also observed that 29%, 60% and 11% of patients had survived from tumor grade I, II, and III respectively (Out of 83 survival cases). On the other hand, among the 83 10-year survival patients, 53.8% were of negative nodal status whereas 34.20% were of positive nodal status patients. Among the survived 83 patients, 86% were from >40 years’ age group whereas the rest 14% were from <40 years of age group. Conclusions: Early detection and treatment of breast cancer provide a definitive survival benefit. The results of the study showed that comprehensive screening and early detection of breast cancer is required to improve the survival outcome.
PubDate: 2023-02-09
DOI: 10.18203/2320-1770.ijrcog20230325
Issue No: Vol. 12, No. 3 (2023)
- Clinicopathological significance of preoperative thrombocytosis in
patients with epithelial ovarian cancer
Authors: Sabiha Yeasmin, Sabera Khatun, Farhana Khatoon, Nadira Sultana, Reeta Rani Sarker, Nahida Yeasmin, Abu Raihan Siddique
Pages: 549 - 556
Abstract: Background: Reactive thrombocytosis is reported in a variety of solid tumors. A few studies have documented preoperative thrombocytosis in ovarian cancer. Methods: This was a cross-sectional study conducted in the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, during January to December 2019. A total of 94 patients with epithelial ovarian cancer between 18-70 years of age who underwent primary surgical treatment were included in this study. Chi-square tests were done to see the significance of differences between the two groups where p<0.05 considered as the level of significance with 95% CI. Results: The mean age was 45.39±13.23 years in the thrombocytosis and 48.98±15.46 years in without thrombocytosis group with a range of 18 to 70 years (p=0.231). The difference in education and occupation were statistically significant (p<0.05) between the two groups. The mean Hb% was 10.02±1.47 (gm/dl) in thrombocytosis and 11.15±1.52 (gm/dl) without thrombocytosis group. The difference was statistically significant (p<0.001) between two groups. The study showed that 30 (75.0%) patient’s serum CA-125 was >500 in the thrombocytosis group and 9 (16.7%) in the without thrombocytosis group (p=0,001), OR=15.0, 95.0% CI=4.92 to 47.72, p=0.001. Optimal cytoreduction between two groups were observed statistically significant (p=0.004), OR=3.49, 95.0% CI=1.33 to 9.28. The difference of grade of tumor observed statistically significant between the groups (p=0.022). The 11 (27.5%) patients had lymph node metastasis in thrombocytosis group and 6 (11.1%) in without thrombocytosis, OR=3.03, 95.0% CI=0.91 to 10.48, p=0.022. The OR of developing lymph node metastasis was 3.03 times higher in the thrombocytosis group. Conclusions: Thrombocytosis was commonly detected in preoperative evaluation of women diagnosed with epithelial ovarian cancer. Anemia, higher serum CA-125 level >500, sub-optimal cytoreduction, advanced stage disease, higher grade tumor, and lymphnode metastasis were significantly more frequent in patients with thrombocytosis.
PubDate: 2023-02-09
DOI: 10.18203/2320-1770.ijrcog20230327
Issue No: Vol. 12, No. 3 (2023)
- Effects of COVID-19 in maternal and perinatal morbidity and mortality
among obstetrics patients in tertiary care center
Authors: Asma Ul Hosna, Yeasmin Dil Jannat, Munmun Nahar Lipi, Tabassum Tamanna, Syeed Mehbub Ul Kadir, Ashraful Alam Nipu
Pages: 557 - 561
Abstract: Background: By the end of 2019, WHO had identified COVID-19 disease as a public health emergency. Research has focused on the impact of SARS-CoV-2 infection during pregnancy, including symptoms, disease severity, risk of vertical transmission, and perinatal and neonatal prognosis. Methods: This was a cross sectional prospective observational study, conducted at Gynae and Obstetric Department, in Bangabandhu Sheikh Mujib Medical University, between July 2020 to August 2021. 75 pregnant women who tested positive for COVID-19 were included in this study. Results: Most of the patients 29(38.7%) were aged 25-29 years. Majority 96% (72) of the cases were asymptomatic, symptomatic cases with cough were 4% (3). On the basis of our data, 94.7% (71) of the cases were Antenatal, while Postnatal and Abortion were 4% (3) and 1.3% (1) respectively. Complications such as fetal distress 25.3% (19), scar tenderness 17.3% (13), pre-eclampsia 12% (9), post-dated pregnancy 9.3% (7), previous 2LSCS with pain abdomen 2.7% (2), oligohydramnios 2.7% (2), malpresentation (transverse lie) 1.3% (1). All pregnant postpartum women were administered antibiotics and enoxaparin. 60% (45) were given HCQ, 40% (30) were given Antiviral drugs, 40% (30) were given Steroids. Injection methyl-prednisolone and tablet hydroxychloroquine 400 mg 12 hourly loading dose on day 1 followed by 200 mg 12 hourly for next 4 days and improvement in symptoms were noted. 16% (12) were managed conservatively and only 1.3% (1) were ICU admissions. Conclusions: In this study, we found that the majority of patients had moderate or no symptoms and discharged with satisfactory outcome.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230518
Issue No: Vol. 12, No. 3 (2023)
- Maternal and fetal correlates of umbilical cord length in a sample of
deliveries at a tertiary hospital in Southern Nigeria
Authors: Olakunle I. Makinde, Nkencho Osegi
Pages: 562 - 566
Abstract: Background: Long and short umbilical cords are associated with adverse perinatal outcome. This study aimed to determine whether umbilical cord length at birth has a correlation with maternal parity, maternal age, sex of the baby, birth weight, birth length and placenta weight. Methods: A cross-sectional descriptive study conducted at the federal medical centre Yenagoa, Nigeria. Data collected using a pre-designed proforma was analysed using IBM SPSS statistics version 23. Results: Mean age of the parturient was 31.1±4.4 years. Half were multiparous. Mean birth weight, birth length and placenta weight were 3.18±0.57 kg, 49.31±3.18 cm and 0.65±0.18 kg respectively. Mean umbilical cord length was 55.75±7.10 cm. There was a significant relationship and a positive correlation between umbilical cord length, parity (ɼ=0.39; p=0.001) and birth length (ɼ=0.27; p=0.024). Difference between male and female babies’ cord length was not statistically significant (ꭓ2=0.36; p=0.721). There was no significant relationship between maternal age, birth weight, placenta weight and umbilical cord length. Conclusions: Umbilical cord length increased significantly with increasing parity and birth length from this study. Women of increasing parity are therefore at increased theoretical risk of perinatal morbidity and mortality associated with long umbilical cords during labour and delivery. The relationship between cord length and birth length may be dependent on parity. This requires further study. There was no significant relationship between umbilical cord length and maternal age, sex of the baby, birth weight and placenta weight.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230519
Issue No: Vol. 12, No. 3 (2023)
- Fetal ductus venosus Doppler as a predictor of pregnancy outcome
Authors: Medhat S. Hewidy, Ahmed M. Hagras, Mohamed M. Elnamoury, Heba M. Hendy
Pages: 567 - 571
Abstract: Background: The ductus venosus (DV) transports oxygenated blood to the developing heart and brain by avoiding the hepatic circulation. Due to the anatomical location of the DV, measurement of DV blood flow velocity waveforms indirectly disclose the cardiac functions and health of the foetus, which represents the pressure gradient between the umbilical vein and right atrium. The aim of this study was to evaluate the value of ductus venosus pulstality index of veins in early pregnancy in prediction of adverse pregnancy outcomes. Methods: 50 pregnant women with a single viable foetus between 13 and 24 weeks participated in this prospective cross-sectional study from 2021 to 2022 at Tanta University Hospital. Results: PI in normal group ranged from 0.80-1.20 with mean value 0.90±0.130 and in abnormal group ranged from 0.46-0.50 with mean value 0.522±0.069. S/a ration in normal group ranged from 1.74-3.18 with mean value 2.30±0.40 and in abnormal group ranged from 1.50-2.05 with mean value 1.833±0.212. There was statistically significant difference between outcomes of pregnancy with ultrasound findings (p<0.05). Conclusions: Numerous foetal disorders that might result in cardiovascular deterioration and other aberrant outcomes in newborns can be managed clinically and predicted perinatally using the DV Doppler examination.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230520
Issue No: Vol. 12, No. 3 (2023)
- The relationship between psychological stress of female human immune
deficiency virus positive serodiscordance and the birthweight of babies
delivered by them at the Imo state university teaching hospital Orlu
Authors: Victor I. Ogoke, Chijioke Okeudo
Pages: 572 - 576
Abstract: Background: The aim of the study was to determine if the emotional distress (stress, and depression) experienced by HIV positive sero-discordant pregnant women because of their retroviral status had any effect on the birth weight of their baby. Methods: This was a comparative analytical study carried out among HIV positive sero-discordant pregnant women carried out at The Imo State University Teaching Hospital (IMSUTH), Orlu, Imo state, Nigeria, from January 2016 to December 2018. The women were grouped into two groups- A and B. Group A did not experience emotional stress from their husbands because of their serostatus, while group B did. Using the DAS-21 scale (depression, anxiety and stress-21), group B was further sub-classified into mild, moderate and severe emotional distress. After delivery, the birth weights of the babies from the two groups were accordingly recorded. Results: Out of 322 HIV positive sero-discordant pregnant women recruited for the study, 161 (group A) were supported by their husband, while 161 (group B) were abused and had varying degrees of emotional distress. Emotional distress was significantly more in group B, where 100% of them had varying degrees of emotional distress, while 0% in group A. Similarly, birth weight of babies delivered by group B women were significantly less than that of babies delivered by group A mothers. Conclusions: There are psychological stress faced by female HIV sero-discordant pregnant women and this is found to be associated with delivering of low birth weight babies by these women.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230521
Issue No: Vol. 12, No. 3 (2023)
- The results of using self-stigma reduction programs of HIV infected people
in Akat Amnauy Hospital, Sakon Nakhon Province
Authors: Jirattikal Suttawanit, Nava Phanawong
Pages: 577 - 583
Abstract: Background: Thailand has been fighting AIDS for more than 30 years, with some success in lowering the number of new HIV cases and deaths, but the country still has a high HIV infection rate and struggles with unfair discrimination linked to both HIV and gender. Methods: This action research was undertaken to reduce self-stigmatization of HIV-infected people in Akat Amnuay Hospital. The participants included 67 infected HIV cases at Antiretroviral clinic. Data collection was conducted from June 2022 to December 2022. Data collection from group activity, and individual follow-up. Qualitative data were analyzed by classification, inferential analyzing, interpret meaning, conclusions and explain explorer. Descriptive statistics and paired t-tests were analysis. Results: The study found that Self stigma reduction programs of HIV infected people gained an understanding of the stages of self-management, enabling them to resolve issues correctly and have a positive impact on their own health. It also found that participants' self-stigma scores before and after the intervention differed significantly, and that self-stigmatism decreased significantly at.000. Conclusions: The development of one's own power is one of the results of a program to reduce self-stigma. by spending more time dealing with unfavorable attitudes. Recognize your own worth and adopt a positive outlook. It is advantageous for hospital staff who oversee the HIV clinic to put in place a procedure for lowering self-stigma in new patients, patients who have missed appointments, and patients who take the medication erratically and experience complications.
PubDate: 2023-02-09
DOI: 10.18203/2320-1770.ijrcog20230328
Issue No: Vol. 12, No. 3 (2023)
- The Effect of dexamethasone on fetal heart rate variability, by
non-invasive non-stress test tracing in preterm labour
Authors: Arnna Ananya, Manidip Pal, Banasree Bhadra, Suvobrata Sarkar
Pages: 584 - 589
Abstract: Background: To analyse the effects of antenatal dexamethasone on fetal heart rate variability (fHRV), when administered to mothers between 30-37 weeks of gestation, at risk of preterm delivery and corroborate presenting maternal symptoms with mode of delivery and perinatal outcomes. Method: Prospective observational study conducted for 1 Year among pregnant women with gestation between 30 completed weeks to 36 weeks 6 days, with symptoms suggesting risk of preterm delivery. The sample size calculated was 52. Dexamethasone phosphate, 24 mg in 4 divided doses, was administered as intramuscular injections 12 hours apart. NST tracings were taken at three points-before first dose, one hour after first dose and one hour after the fourth dose. Chi-square test and Paired t test was applied, p<0.05 was considered statistically significant. Results: Strong correlation was found between antenatal dexamethasone administration and fHRV (p<0.05) which increased after administration of the first dose of dexamethasone compared to its value prior to administration. There was a further increase after the fourth dose. Conclusions: Dexamethasone is associated with increase in fHRV evident on non-stress test recordings, without significant decrease in baseline fetal heart rate.
PubDate: 2023-02-20
DOI: 10.18203/2320-1770.ijrcog20230353
Issue No: Vol. 12, No. 3 (2023)
- A retrospective study of intrauterine fetal demise in a tertiary care
center
Authors: Shravya Monica K., Rathnamma P.
Pages: 590 - 594
Abstract: Background: Intra uterine foetal death is an emotional distress for mother, her family and for the obstetrician also. Proper planning, seeking antenatal services reduces this. Objectives of current study were to determine incidence rate of intrauterine foetal death and to evaluate the maternal and foetal factors responsible for intrauterine foetal death. Methods: This retrospective observational study was conducted in a tertiary care hospital from November 2022 to April 2022. The data was collected from previous records of 60 IUFD cases with 1576 births. Age, parity, gestational age, aetiology was studied. Results: The most common maternal cause of IUFD was pre-eclampsia and eclampsia (18.33%) followed by anaemia (11.67%). The most common foetal cause was IUGR (6.67%), and the most common placental cause was placental previa (8.33%). Conclusions: In this study, incidence of IUFD was 38.1/1000 live births. To prevent IUFDs, all the antenatal cases have to be booked for better care of antenatal period and management of any complications.
PubDate: 2023-02-04
DOI: 10.18203/2320-1770.ijrcog20230298
Issue No: Vol. 12, No. 3 (2023)
- Robson’s ten group classification: a tool for predicting cesarean
section rates
Authors: Meghna Tiwari, Sanghmitra Singh, Beenu Singh Kushwah
Pages: 595 - 602
Abstract: Background: Increasing cesarean section delivery rates in India and world is a serious maternal health concern. It is important to understand the trends, reasons behind this change and to find ways to achieve optimum cesaerean section (CS) rates. As per the latest data national family health survey 2019-21 (NFHS 5), CS rates at population level in India seems to be 22% while WHO recommends 10-15% threshold. So, we aim to analyze trend of CS and evaluate it according to Robson’s 10 group classification at tertiary care hospital in Rewa, Madhya Pradesh, India. Methods: A cross sectional study was conducted at department of obstetrics and gynecology, Shyam Shah medical college Rewa for 3 years from May 2019 to April 2022 on all deliveries occurring on or after 28 weeks of gestation by cesarean section. Results: Total of 26552 deliveries over 3 years period were analyzed, of these 7484 were CSs (28.18%). Overall C section rate increased from 18.97% in 2019 to 39.95% in 2022. Major contributors to this increase were Robson’s group 5-32.58%, Robson’s group 1-29.45% and Robson’s group 2-12.22%. Conclusions: Robson’s group 1, 2 and 5 were major contributors to overall increased cesarean section rates. Fetal compromise, meconium aspiration risk, obstructed labor and cesarean scar tenderness were underlying indications for most of the cesarean sections done. Efforts should be made to implement standard protocol to reduce primary cesarean section rates.
PubDate: 2023-02-04
DOI: 10.18203/2320-1770.ijrcog20230297
Issue No: Vol. 12, No. 3 (2023)
- Study of fetomaternal outcome in congenital heart disease in pregnancy in
IPGME and R and SSKM Hospital, Kolkata
Authors: Baishakhi Mandal
Pages: 603 - 608
Abstract: Background: Because of improving medical and surgical management, most infants born with congenital heart disease (CHD) will reach reproductive age, and women are now presenting for obstetric and congenital cardiac care, many following reparative cardiac surgery or intervention. The maternal and fetal risk of a pregnancy for this population will depend on the anatomic and physiologic classification of the type of CHD. Aim of the study was to determine any complications during pregnancy and after birth in pregnant mother with CHD and to find out any complications of newborn baby, born to a mother with CHD. Methods: The present study was descriptive observational study. This study was conducted for 1 year in department of obstetrics and gynaecology, IPGME and R and SSKMH, Kolkata, sample size 71. Results: In our study there is no maternal death. Most of patients had vaginal delivery under local anesthesia. Thus, concluding early intervention and proper follow up can reduce the morbidity and mortality in CHD mother, vaginal delivery should be preferred in case of CHD in pregnancy. Also, baby born to CHD mother do not suffer from the same disease. Conclusions: We concluded that early intervention and proper antenatal check-up can improve the outcome of the pregnant women with CHD as well as the baby, combined obstetrics and cardiac follow-up can reduced maternal mortality rate. There is no correlation between mother heart diseases with baby.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230522
Issue No: Vol. 12, No. 3 (2023)
- Postpartum depression: a prospective observational cross-sectional study
Authors: Asha Dalal, Ashwin Shetty, Rakshitha Shetty, Aashish Contractor, Mehezabin Dordi
Pages: 609 - 613
Abstract: Background: To determine the prevalence of postpartum depression in the puerperium and offer referrals to counsellor/mental health practitioner for at risk patients Methods: Sample size was 214 patients and duration of study was 1 year, it included all deliveries at HN reliance foundation hospital. It excluded women with pre-existing mental health problems or neurological disease on medications and those who declined participation. On day 7 and day 42 post-delivery the women were phoned and asked questions from the Edinburg postnatal depression scale which is a validated questionnaire. Interpretation used was; EPDS ≥13 or saying yes to question no 10, with depression and EPDS <13 without depression. Those identified with depression were appropriately referred. Results: Patient identified to be depressed were more likely to have perceived complications during delivery (p=0.02), problems with lactation (p=0.035), hospital stay of more than four days (p=0.002). There was no statistical association with help available and place where the mother stayed post-discharge. Conclusions: Out of 213 study participants, 32 study participants (15.02 percent) had post-partum depression. This was prevalent among those that felt their delivery was complicated, those with lactation difficulties and those with hospital stay of more than 4 days. The prevalence of post-partum depression at our hospital was significantly high to institute routine use of EPDS for new mothers.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230523
Issue No: Vol. 12, No. 3 (2023)
- In vitro anti-estrogenic potential of FertiZen-R™- a nutraceutical
ingredient for estrogen modulation
Authors: Mihir Gadani, Ratna Upadhyay, Supriya Raut, Sneha Badak
Pages: 614 - 618
Abstract: Background: According to CDC, polycystic ovarian syndrome (PCOS) is responsible for infertility in women with 6-12% incidences all over the world. The current treatment options available have several side effects such as amenorrhea and obesity amongst others. Dietary interventions such as non-estrogenic and androgen-suppressing foods along with nutraceutical products is considered for treating PCOS with minimum side effects. One such product of Zenherbs lab called FertiZen-R™ is a combination of three phytochemicals from three plants viz., Foeniculum vulgare, Linum Usitatissimum, Glycyrrhiza glabra, hibiscus extract and is developed as a product to treat and control PCOS. Methods: The FertiZen-R™ was quantified for the presence of phytochemicals such as glycyrrhizic acid, polyphenols, and saponins. It was further tested for estrogenic/anti-estrogenic potential on estrogen-positive breast cancer cell line (MCF-7) using an E-Screen assay. Results: The FertiZen-R™ showed presence of 5% glycyrrhizinic acid, 5% saponins, and 2-3% polyphenols. It exhibited a strong anti-estrogenic potential with 40-50% inhibition from concentrations as low as 0.156 mg/ml like tamoxifen (IC50 at 0.156 mg/ml), while inositol, a natural growth promoter, showed no effect on the cell viability. Conclusions: FertiZen-R™ showed anti-estrogenic potential when tested in-vitro and can be used to treat PCOS in women even with ER-positive breast cancer cells. However, clinical studies to determine the dosage are required to warrant the potential of FertiZen-R™.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230524
Issue No: Vol. 12, No. 3 (2023)
- Profile of obstetric patients in intensive care unit -a retrospective
study
Authors: Nandini Bhavanam, Munikrishna Munisamaiah, Pavithra Jayalingegowda
Pages: 619 - 622
Abstract: Background: Obstetric patients form a particular subgroup of population to intensive care admission. Pregnancy specific problems like pre-eclampsia, postpartum haemorrhage or deterioration of pre-existent conditions can be sudden and life threatening, requiring immediate intensive management and monitoring. The main objective was to determine the pattern and outcome of obstetric admissions to intensive care unit. Methods: It was a retrospective study from June 2020 to June 2022. Obstetric patients admitted to intensive care unit were included in the study. Data were obtained from the patient’s case notes and records from the ICU and were entered into a predesigned proforma. Results: Maximum study subjects were between age group 21-25 years of age. Most of them were primigravida and admitted in the postpartum period. The most common indications for admission to ICU were preeclampsia with severe features followed by obstetric haemorrhage. The mortality rate was 18.8% and shock attributing to the main cause. Conclusions: Maternal and child health have become an important measure of human and social development. Early and prompt diagnosis and treatment of high-risk obstetric patients in intensive care unit can prevent and ameliorate serious maternal morbidity.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230525
Issue No: Vol. 12, No. 3 (2023)
- Assessment on serum CRP and serum ferritin level in COVID-19 patients of
Dehradun Uttarakhand, India
Authors: Samiksha Arya, Tariq Maqsood, Rana Ushmani, Ved Prakash, Sunny Biswas, M. Abass Dar
Pages: 623 - 628
Abstract: Background: Since being declared a global pandemic, COVID-19 has ravaged many countries worldwide and has over-whelmed many healthcare systems. The pandemic has also resulted in the loss of livelihoods due to prolonged shutdowns, which have had a rippling effect on the global economy. Even though substantial progress in clinical research has led to a better understanding of SARS-CoV-2 and the management of COVID-19, limiting the continuing spread of this virus and its variants has become an issue of increasing concern, as SARS-CoV-2 continues to wreak havoc across the world, with many countries enduring a second or third wave of out-breaks of this viral illness attributed mainly due to the emergence of mutant variants of the virus. Our study tried to evaluate the fact regarding CRP and feritin parameters concentration efficacy in the detection and evaluation of inflammatory disorders, tissue injury and infections. Methods: CRP concentration measurements are useful in the detection and evaluation of inflammatory disorders, tissue injury and infections. The VITROS CRP slide method is performed using the VITROS 5600 integrated system. The VITROS CRP slide is a multi-layered, analytical element coated on a polyester support. The immune-rate format for CRP is based on enzymatic heterogeneous, sandwich immunoassay format. In this format a derivative of phosphorylcholine (PC) is covalently bound to polystyrene polymer beads and in the presence of calcium serves as a capture agent, monoclonal anti-CRP antibody conjugated to horseradish peroxidase (HRP) serves as a signal generator. Results: A total of 175 patients were selected for the study for estimate levels of C-reactive protein and serum ferritin in COVID-19 patients. The data obtained was coded and entered into Microsoft Excel Worksheet. Data was analysed and results were tabulated. In our study, serum CRP and serum ferritin values were found to be elevated in patients infected with COVID-19. Conclusions: CRP levels were positively correlated with lung lesions. CRP levels could reflect disease severity and should be used as a key indicator for disease monitoring. Serum ferritin was found to be elevated among the COVID-19 patients who could not survive the treatment as compared to the recovered patients. Therefore, serum concentrations of ferritin could be used as a prognostic marker in the management of COVID-19 patients which is easily available and cost effective too.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230526
Issue No: Vol. 12, No. 3 (2023)
- Serum 25-OH vitamin D and insulin resistance in women with polycystic
ovary syndrome
Authors: Savita Chandra, Arshi Ansari
Pages: 629 - 633
Abstract: Background: This was a prospective case control study conducted in the department of obstetrics and gynecology, Era’s Lucknow Medical College and Hospital from November 2018 to March 2020. Aim was to find whether there was a link between serum 25-OH vitamin D levels, and insulin resistance in women with polycystic ovarian syndrome (PCOS). Methods: 30 newly diagnosed cases of PCOS and 30 women without PCOS were enrolled. Their clinical details as well as BMI and waist hip ratio were noted. The biochemical parameters which were measured included fasting glucose, fasting insulin, serum 25-OH vitamin D. The insulin resistance was calculated. Results: 50% of the PCOS had insulin resistance and also deficient /or insufficient vitamin D levels, versus 16.7% in the control group. This association was statistically highly significant with p value as 0.00016. No statistical significance was found with regard to the mean serum 25-OH vitamin D level. 53.4%, of the PCOS women had hirsutism versus 3.3% in the control group and was statistically significant, p value <0.0001. 20% of PCOS women had acne in contrast to 3.3% in the control group which was statistically significant with p value 0.0443. Conclusions: Hirsutism and acne were important clinical signs of PCOS. There was a negative correlation between insulin resistance and serum 25-OH vitamin D levels. Thus, vitamin D may be an important link in the genesis of PCOS. Larger randomised case control studies need to be done to understand PCOS.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230527
Issue No: Vol. 12, No. 3 (2023)
- A comparative study of labour progress and delivery outcome among
spontaneous induced patients
Authors: M. Jayalakshmi, G. Manisha, P. Lahari, Hyndavi
Pages: 634 - 638
Abstract: Background: Induction of labour is one of the most common procedures during pregnancy. Indications for induction of labour have essentially not changed. The benefit of labour induction must be weighed against the potential maternal or fetal risks associated with the procedure. Objectives were to compare the duration and progress of labour in spontaneous and induced labour, to compare the maternal outcome and fetal outcome, to compare the mode of delivery in spontaneous and induced labour, and to compare the need for oxytocin augmentation. Methods: It was a prospective study conducted in the department of obstetrics and gynaecology, MIMS hospital, Vizianagaram from Jan 2021 to June 2022. Study population consisted of two groups. Results: A total of 300 patients were taken into study. Among them 150 patients were those who went into spontaneous progression and the other 150 included patients who were induced. Women in spontaneous labour had higher chance of full term normal vaginal delivery than women in induced group. Various factors like maternal age, gestational age, parity, were compared between both these groups using a proforma. In our study we found that patient gets into spontaneous labour on an average around 38 weeks. Conclusions: Latent phase and active phase of labour are prolonged in induced patients when compared to that of spontaneous labour. There was an increase in caesarean section rate from 1.3% in induced patients to 23.3% in spontaneous labour patients. Apgar scores of the babies at 5 minutes in the spontaneous group were found to be better than the induced group.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230528
Issue No: Vol. 12, No. 3 (2023)
- Comparative study of ultrasonographic, hysteroscopic and histopathological
findings in patients with abnormal uterine bleeding
Authors: Iram Wani, Syed Najmul Ain, Jabeena Ali Chalkoo
Pages: 639 - 645
Abstract: Background: AUB (Abnormal uterine bleeding) is a considerable health care burden not only for women but their families and has a definite effect on their quality of life. Objective was to compare the ultrasonographic, hysteroscopic and histopathological findings in patients with abnormal uterine bleeding. Methods: This prospective observational study was conducted at the department of obstetrics and gynecology, Indraprastha Apollo Hospital, New Delhi, from July 2018 to June 2019. The women who came to the OPD with the complaint of AUB in the one year period and met the eligibility criteria were taken for the study. TVS was performed in 126 patients presenting with complaints of abnormal uterine bleeding followed by hysteroscopic biopsy or curettage. The specimens were sent for histopathologic examination. Results: Mean age was 43.95±8.48 years. Most common presenting complaint was found to be menorrhagia (n=53; 42%) followed by post-menopausal bleeding (n=30, 24.0%). The mean endometrial thickness was 9.79±4.84 mm. The diagnostic specifications of TVS taking histopathological examination as gold standard were: sensitivity = 64/77= 83.1%, specificity 39%, positive predictive value 68%, negative predictive value 59% and accuracy 66%. Hysteroscopy has a sensitivity of 87%, specificity of 51%, positive predictive value of 74%, negative predictive value of 71.4% and diagnostic accuracy of 73% in diagnosing aetiology of abnormal uterine bleeding. Conclusions: Both TVS and hysteroscopy are good diagnostic modalities for investigation of AUB. However, hysteroscopy has an edge over TVS in diagnosing aetiology of AUB in terms of high sensitivity, specificity and negative predictive value.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230529
Issue No: Vol. 12, No. 3 (2023)
- The maternal and perinatal outcomes in heart disease in pregnancy in a
tertiary care hospital
Authors: Lisley Konar, Divya J. Patil, Vasantha Kumar
Pages: 646 - 649
Abstract: Background: The incidence of cardiac diseases in pregnancy ranges from 1 to 3%. Pregnancy in women with heart disease is associated with considerable mortality and morbidity. Thorough prenatal care and team approach involving obstetricians, cardiologists, anaesthesiologists and neonatologists can improve the maternal and fetal outcome in these women. Rheumatic heart disease is still the leading cause of maternal heart disease during pregnancy in developing countries. Methods: Between February 2022 and August 2022, a retrospective research at the RL Jalappa Hospital in Kolar was carried out. Out of 764 deliveries made at the facility throughout the study period, 30 singleton pregnancies complicated with heart disease admitted department of obstetrics and gynaecology at different periods of gestation. The maternal and perinatal outcome was thus noted. Results: Out of 764 deliveries, 30 women were found to have been complicated with heart disease. Overall incidence was 3.9%. Rheumatic heart disease was the most common heart disease seen among them. The most common congenital heart disease present was atrial septal defect (ASD). The most common cause for LSCS was fetal distress. 93.3% of the babies delivered were shifted to NICU, with the most common cause being, preterm and low birth weight. No maternal mortality seen, though 1 neonatal mortality present due to extreme low birth weight. Conclusions: A multidisciplinary team approach including obstetrician, cardiologist, pediatrician and anesthesiologist is needed in the cases of pregnancy with heart disease to determine the mode of delivery, timing of delivery, change in anticoagulant drugs in pregnancy, type of anesthesia, care of neonate, and follow-up of mother for better maternal and fetal outcomes.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230531
Issue No: Vol. 12, No. 3 (2023)
- Comparison of DIPSI and IADPSG criteria for diagnosis of gestational
diabetes mellitus- a prospective study in a sub-urban multi-speciality
hospital
Authors: Yogini Patil, Kamalpriya Thiyagarajan, Vaishali Chaudhari, Kshama Shah, Ria Vijay
Pages: 650 - 653
Abstract: Background: Gestational diabetes mellitus (GDM) refers to any degree of glucose intolerance with onset or when it is first diagnosed during pregnancy. Gestational diabetes mellitus is found to adversely affect the maternal and perinatal outcomes. The extent of the risks associated with GDM and the prevalence rate of GDM depends on the diagnostic criteria used and ethnicity of the pregnant women. Hence in order to prevent the morbidities that could result due to GDM, it is crucial to diagnose and treat during the early stages. However, confusion pertaining to the detection and diagnosis of GDM still prevails due to applicability of various threshold guidelines for its diagnosis. Methods: The study was a prospective, single-center, randomized, controlled study conducted in the year 2021 at the department of obstetrics and gynaecology of Bhaktivedanta Hospital and Research Institute, Thane, India. The objective of the study was to evaluate the utility of IADPSG and DIPSI guidelines for screening and diagnosis of GDM at a tertiary care center. Results: The sensitivity and specificity of DIPSI and IADPSG were compared and their readings were evaluated. The results proved that DIPSI criteria was more sensitive as compared to IADPSG criteria. Conclusions: DIPSI is a non-fasting, fairly simple, single test method that is appropriate for low resource countries. The sensitivity of IADPSG criteria was shown to be slightly lower when compared with DIPSI criteria in the current study, despite the fact that they are universal criteria for screening and diagnosing GDM around the world. The only limitation was that it was a single center study.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230532
Issue No: Vol. 12, No. 3 (2023)
- Review of emergency obstetric hysterectomies at a tertiary care hospital
Authors: Renjini R., Roshni R., Simi J.
Pages: 654 - 657
Abstract: Background: Emergency obstetric hysterectomy refers to surgical removal of pregnant or recently pregnant uterus with the pregnancy in utero or due to complications of delivery. This surgery is usually done as a last resort in life threatening obstetric hemorrhage. Objective of present study was to determine the incidence, sociodemographic and obstetric factors and indications associated with emergency obstetric hysterectomies. Methods: A retrospective, analytical study was conducted over a period of five years in the department of obstetrics and Gynecology of Government Medical college Thiruvananthapuram. Kerala. All cases of obstetric hysterectomy done during the study period in this hospital were analysed after getting approval from the institutional ethical committee. Results: During the study period there were total number of 78613 deliveries in SATH. Emergency obstetric hysterectomy was done for 86 cases. Obstetric hysterectomy rate in SATH during the study period was 0.109% or 1.09/1000 deliveries. Atonic postpartum hemorrhage (55%) was the most common indication followed by placenta praevia (27%). Majority were referred cases. Conclusions: Emergency obstetric hysterectomy can be a lifesaving procedure when other medical and surgical methods fail to control obstetric hemorrhage. This study highlights the unpredictable need of this procedure, need for identifying the at-risk cases and early referral to higher center.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230533
Issue No: Vol. 12, No. 3 (2023)
- Role of magnesium sulphate as a neuroprotective agent on neonatal outcome
in preterm deliveries
Authors: Neena Gupta, Uruj Jahan, Swadha Seep, C. P. Singh, Savita Shukla
Pages: 658 - 664
Abstract: Background: Globally, prematurity is a leading cause of death in children under the age of five years and in almost all countries with reliable data, preterm birth rates are increasing. This study was conducted to compare the perinatal outcome of preterm deliveries between women receiving MgSO4 and those who were not received MgSO4. Methods: This randomization study was conducted in department of obstetrics and gynaecology, GSVM Medical College, Kanpur, Uttar Pradesh, India, over a period of one year. After informed consent and ethical clearance from institutional ethics committee, Kanpur, total 100 pregnant women were recruited for this study and were divided into two group of 50 women each. Women in group I were subjected for MgSO4 therapy. Fetal conditions were monitored. These patients were followed up for the next 6 months for outcome. Results: Overall maternal age ranged from 21 to 32 years. Majority of cases in both the groups were from rural areas and belonged to lower socio-economic status. Majority of women in both the groups were multigravida (68.75%) and (60%) respectively. In both groups, most common risk factors were severe anemia followed by preeclampsia. APGAR score was better in women who received MgSO4, but the difference was found to be statistically significant only for 5 minutes. Although IVH and periventricular leukomalacia rate was higher in group I as compared to that in group II. Although proportion of alive neonates was higher in group I as compared to that in group II yet there was no significant difference between two groups (p=0.961). Incidence of respiratory distress, followed by perinatal asphyxia were most common in both the groups but was not found to be significant statistically (p>0.05). Conclusions: Proportion of those with Apgar score <7 at 1 minute, 5 minutes and 10 minutes was higher in group II as compared to group I but the difference was significant statistically only at 5 minutes evaluation.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230534
Issue No: Vol. 12, No. 3 (2023)
- Clinical study of primary caesarean section among multigravida in a
tertiary care hospital
Authors: Rajesh Kumar, Rachna Chaudhary, Vandana Dhama, Shakun Singh
Pages: 665 - 670
Abstract: Background: Primary caesarean section in multigravida refers to first time caesarean section in multiparous women who have had previous one or more vaginal delivery. The study focused on the frequency, indication, intra operative and postoperative complications, maternal and fetal outcome of primary caesarean section in multiparous women with previous vaginal deliveries. Methods: It was a prospective study of all the cases of primary caesarean section in multigravida admitted at LLRM Medical College Meerut, Uttar Pradesh over period of 1 year from January 2021 to December 2021. Results: Total number of deliveries during the study period of 1 year was 5670 and total no of caesarean section was 2432 with a caesarean rate of 42.89%. Out of 2432 caesarean section 488 (20.10%) were done in primigravida and 253 (10.40%) in multigravida. In present study most common indication for caesarean section was malpresentation 68 (26.86%) followed by severe oligohydramnios in 47 (18.57%). Most common maternal complication was pyrexia in 24 (9.48%). Most common morbidity were due to preterm 65 (22.13%) neonates followed by RDS in 22 (8.69%) neonates. Conclusions: Though responsible for least number of overall caesarean section, multiparous subjects undergoing primary caesarean section is high risk pregnancy with possibility of adverse obstetric outcome in significant number of subjects and hence multiparous women deserve the same attention during pregnancy and labour as primigravida and women with repeat caesarean section.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230535
Issue No: Vol. 12, No. 3 (2023)
- Improvement in the cases of hypertensive disorder of pregnancy with help
of HDP-gestosis score
Authors: Syeda Tuba Imam
Pages: 671 - 674
Abstract: Background: An assessment tool for the risk of pre-eclampsia is the HDP-gestosis score, which has a range of scores from 1 to 3. A pregnant woman is classified as "at risk for pre-eclampsia" and treated appropriately if her overall score is 3 or higher. In order to predict pre-eclampsia, it is necessary to assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the HDP-gestosis score. Methods: From January 2022 to December 2022, 109 pregnant patients who presented at the obstetrics and gynaecology department were included in this prospective research. The patients' risk of developing pre-eclampsia was evaluated after 20 weeks of pregnancy. We collected information on the patient's age, gravida, obstetric history, menstrual cycle regularity, polycystic ovarian disease history, length of marriage, parity, prior medical and surgical intervention, prior/current pharmaceutical use, and family history. Gestosis score was determined and grouped into three risk categories: mild (score of 1), moderate (score of 2), and high risk (score of 3). For predicting the onset of pre-eclampsia, the HDP-gestosis score's sensitivity, specificity, PPV, NPV, and diagnostic accuracy were assessed. Results: The mean age, gestational age, and BMI of the women were 25.71±5.9 years, 11.9±2.19 weeks, and 24.9±3.6 kg/m2, respectively. The gestosis score was 2 in 47.70% (n=52) of the participants, 1 in 38.53% (n=42), and ≥3 in 13.77% (n=15) of the women. Pre-eclampsia developed in 17.43% (n=19) participants. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of HDP-gestosis score for predicting pre-eclampsia were 86.66%, 96.49%, 86.91%, 97.98% and 96.12%, respectively. Conclusions: Gestosis score is a brand-new early marker for pre-eclampsia development that enables patients to receive quick care, reducing the negative effects.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230536
Issue No: Vol. 12, No. 3 (2023)
- Prospective study of platelet count as a prognostic marker in predicting
feto-maternal outcome in gestational hypertension
Authors: M. Jyothsna Saisree, Shreya Alluri, K. Kameswaramma
Pages: 675 - 680
Abstract: Background: Hypertensive disorders of pregnancy are one of the leading causes of maternal and neonatal morbidity and mortality worldwide. Hypertensive disorders of pregnancy (HDP) affects approximately 5-7% of all pregnancies. The reported incidence of HDP in India ranges from 5% to 15%. These disorders form a deadly triad-in conjunction with hemorrhage and infection, in significantly contributing to maternal morbidity and mortality. Objectives were to determine the correlation between the severity of HDP and low platelet count; to analyze maternal and fetal outcomes in relation to thrombocytopenia; to aid in early diagnosis and management and to prevent complications and thereby improving maternal and fetal outcomes. Methods: A hospital-based prospective study was conducted in women with a provisional diagnosis of gestational hypertension over a period of 18 months. The study group comprised of pregnant women who were more than 20 weeks and were subjected to detailed history: pre-obstetric history, family history, general physical examination, abdominal examination, routine laboratory investigations, and ultrasonography and Doppler. Results: In the study, platelet count at ≤275000 cut-offs had the highest sensitivity of 52.11%, specificity of 82.76%, PPV of 88.1%, and NPV of 41.4% in predicting feto maternal complications. Platelet count at ≤275000 cut-offs had the highest sensitivity of 62.86%, specificity of 69.23%, PPV of 52.4%, and NPV of 77.6% in predicting preeclampsia. Conclusions: From the study, it was concluded that in gestational hypertension the estimation of platelet count is thus a reliable method for early detection and management of hypertensive disorders of pregnancy. Platelet count was significantly decreased in subjects with maternal complications, fetal complications, and with respect to the severity of preeclampsia. Platelet count however had moderate validity in predicting fetomaternal complications.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230537
Issue No: Vol. 12, No. 3 (2023)
- A clinical trial to assess the blood loss in women predisposed to
postpartum hemorrhage with the use of prophylactic intravenous tranexamic
acid
Authors: K. Satyasri, Chandana C.
Pages: 681 - 686
Abstract: Background: Postpartum hemorrhage (PPH), a complication encountered during third stage of labour, contributes to 25% of maternal death worldwide. Despite various measures for prevention and management of PPH, burden of PPH still looms. Methods: Prospective randomized controlled clinical trial (RCT) was conducted in Vydehi Institute of Medical Sciences, among 128 patients predisposed to PPH, over 18 months. After meeting the inclusion and exclusion criteria, participants were randomized to receive tranexamic acid (TXA) intravenously 10 mg/kg along with 10 IU of oxytocin following the delivery. Patients were analysed for, blood loss, need for medical or surgical interventions. Results: Parameters like age, mean gestational age at haemoglobin estimation, and at delivery were similar among groups. The need or parenteral iron, blood transfusions, uterine artery ligation and compression suture were higher in controls group, but not statistically significant. Among the cesarean section (CS) group, most significant pre-disposing factors for PPH were previous CS (p value=0.012) and anaemia (p value =0.01). Incidence of PPH 0.69% (p value =0.031) and use of additional uterotonics were statistically significant (p value <0.05). Among the vaginal delivery (VD) group, most significant pre-disposing factors were anaemia (p value =0.002), thrombocytopenia (p value =0.045), and fetal-macrosomia (p value =0.020). Incidence of PPH 0.25% (p value <0.001) and use of additional uterotonics and hospital stay were statistically significant. Conclusions: We conclude that, anemic patients were at higher risk of PPH irrespective of the mode of delivery. Prophylactic TXA lowers incidence of PPH, blood loss, use of additional uterotonics and hospital stay even in the presence of pre-disposing factors. Quantification of blood loss is better estimated by drop in haemoglobin after 24 hours.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230538
Issue No: Vol. 12, No. 3 (2023)
- Variations in sympathovagal balance, psychogalvanic reflex and isometric
grip force in females with polycystic ovarian syndrome- an exploratory
study
Authors: Ruchi Kothari, Yugal Jogad, Shabbir Gheewala, Pradeep Bokariya, Poonam Shivkumar Verma
Pages: 687 - 694
Abstract: Background: Poly-cystic ovarian syndrome (PCOS) is an endocrine ailment and recently emerging cause of infertility amongst reproductive females. The disease is associated with multifactorial etiologies. Autonomic dysfunction is cause or result of this disorder is yet a paradox. Various autonomic function tests can be done to reveal this dilemma. Heart rate variability is pivotal amongst these and assesses trivial variations between two heart beats and stands as a marker of cardiac risk. Sympathetic skin response checks integrity of sympathetic reflex tract. Isometric grip force relates contracting force and electromyography with a person’s heart rate during exercise. As there is meagre published evidence on autonomic function testing in central Indian women with PCOS, this study was undertaken on the PCOS patients and their data was compared with regularly menstruating healthy controls. Methods: A cross sectional study was performed on 35 healthy controls and 35 PCOS diagnosed patients of age range 18 to 42 years short-term HRV was recorded using ECG and RR interval using power lab system. Thereafter SSR was obtained using bio amplifier by giving standard acoustic stimuli. The patients were then asked to perform isometric grip force exercise using grip force transducer to obtain various related parameters. Results: The mean age group of controls was 22.62±2.15 years and that of among cases was 23.29±4.26 years. Compared to healthy controls PCOS patients had higher waist circumference, lower HF Norm whereas higher VLF norm and LF/HF ratio, delayed SSR latency while hand grip strength was significantly higher in the control group as compared to the PCOS patients. LF/HF ratio, mean HR, waist circumference and SSR latency were positively correlated to each other and negatively correlated to mean hand grip strength. Conclusions: PCOS females have altered adrenergic status as compared to normal women. Various autonomic function tests like HRV, SSR and hand grip strength exercise can be useful in evaluating these patients as the disease exposes them to various co morbid risk factors.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230539
Issue No: Vol. 12, No. 3 (2023)
- Prediction of metabolic syndrome by visceral adiposity index, lipid
accumulation product and model of adiposity index amongst infertile women
with and without polycystic ovary syndrome
Authors: Pikee Saxena, Jyoti Gaur, Archana Mishra, Anju Jain
Pages: 695 - 700
Abstract: Background: This study was conducted to compare visceral adiposity index (VAI), lipid accumulation product (LAP) and model of adiposity index (MAOD) for prediction of metabolic syndrome (MS) amongst infertile women with and without PCOS. Methods: It was a case control, retrospective study performed in gynecology outpatient department of a tertiary care center. Total 143 infertile women with PCOS and 367 infertile women without PCOS were recruited in the study. Waist circumference (WC), BMI, waist hip ratio (WHR), insulin resistance, VAI, LAP, MOAD were assessed in both groups. Results: Significantly higher values of WC, WHR, systolic BP, insulin postprandial and all 3 adiposity indices were found among infertile women with PCOS as compared to women without PCOS. In hormonal profile, testosterone, AMH, FSH, prolactin, estradiol was found to be significantly higher in PCOS group. For predicting MS in PCOS women, VAI had the highest AUC 0.878 with a cut off value of 3.1, highest sensitivity of 88.9%, specificity of 90.7%, positive and negative predictive value of 76.2% and 96% respectively followed by LAP and MOAD. Conclusions: To conclude, all three adiposity indexes VAI, LAP and MOAD were significantly raised in PCOS women. VAI followed by LAP were the best indicators to predict metabolic syndrome in women with PCOS.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230540
Issue No: Vol. 12, No. 3 (2023)
- Fetomaternal outcome of women with thrombocytopenia in labour
Authors: Palak Thakkar, Dhwani Desai, Ragini Verma
Pages: 701 - 705
Abstract: Background: This study was conducted to study fetomaternal outcome in pregnancy with severity of thrombocytopenia. Methods: It was a prospective observational study of fetomaternal outcome of women with thrombocytopenia admitted in labour room of a tertiary health care center of south Gujarat for 1-year period (April 2021-March 2022) after official approval from ethical committee. 100 consecutive consenting women with thrombocytopenia admitted in labour room of New Civil Hospital Surat were enrolled in this study. Results: Mild thrombocytopenia was noted in 68% of the total cases, moderate thrombocytopenia in 27% and severe thrombocytopenia in 5% of cases. 59 subjects belong to age group of 20-25 years, 56 subjects were multipara, 70 subjects were registered antenatally, 68 subjects were delivered beyond 37 weeks of gestation. 48 subjects underwent LSCS and rest were delivered vaginally. 29 subjects had maternal complication. 95 subjects delivered alive baby of which 14 had NICU admission and 5 subjects had preterm still birth baby. Conclusions: Thrombocytopenia is the second most common haematological finding in pregnancy next to anaemia. Majority of cases generally present at gestational age beyond thirty-seven weeks and belong to category of mild thrombocytopenia. Efforts should be made on improving antenatal registration, screening of maternal thrombocytopenia, early diagnosis and treatment.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230541
Issue No: Vol. 12, No. 3 (2023)
- Maternal and perinatal outcome in preterm premature rupture of membranes
Authors: Sudha R., Priyanka Biradar
Pages: 706 - 710
Abstract: Background: Preterm premature rupture of membranes (PPROM) and preterm birth results in one third of perinatal mortality and maternal morbidity such as chorioamnionitis and abruption placenta and preterm caesarean section, Preterm premature rupture of membranes occurs in 3% of pregnancies. PPROM is associated with intrauterine infection. Early detection of intrauterine infection may help in prevent neonatal sepsis. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6 days and predict intrauterine infection by access the level of C reactive protein to prevent chorioamnionitis and neonatal infection. Methods: A descriptive study was conducted on 126 antenatal patients between 24 to 36 weeks+6 days with PPROM admitted to Department of Obstetrics and Gynaecology, Cheluvamba Hospital Mysore medical college, Mysore, Karnataka, India from February 2022 to July 2022. After establishing the diagnosis of PPROM patients were monitored and maternal and perinatal outcomes were studied. Results: 24% patients had late PPROM. 63% of early PPROM latency period >24 hours and were managed conservatively till 34 weeks. 18% had chorioamnionitis in that 12% CRP positive status and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period 24 hours and sepsis was 36% in >24 hours and 10% in <24 hours. Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. C-reactive protein helps to pick up chorioamnionitis early. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230542
Issue No: Vol. 12, No. 3 (2023)
- A comparative study on the effect of intravenous Ringer lactate at 125
ml/hour versus 250 ml/hour on the duration of labour in nulliparous
pregnant women
Authors: Shivika Mittal, Amit Gupta, Chanderdeep Sharma, Prashant Dhatwalia, Rita Mittal
Pages: 711 - 715
Abstract: Background: Several factors may influence the progression of normal labour. It has been postulated that the routine administration of intravenous fluids to keep women adequately hydrated during labour may reduce the period of contraction and relaxation of the uterine muscle, and may ultimately reduce the duration of the labour. However, the routine administration of intravenous fluids to labouring women has not been adequately studied although it is widely practiced, and there is no consensus on the type or volume of fluids that are required, or indeed, whether intravenous fluids are at all necessary. This study was conducted to study the effect of intravenous Ringer lactate at 125 ml/hour versus 250 ml/hour on the duration of labour. Methods: In the study, patients were divided in two groups of nulliparous pregnant women in spontaneous early labour (between 3-5 cm dilatation), at term with singleton pregnancy and cephalic presentation, where one group received intravenous Ringer lactate at 125 ml/hour and the other group received Ringer lactate at 250 ml/hour. The duration of labour, mode of delivery and caesarean rates were measured in both groups along with incidence of prolonged labour and need for oxytocin augmentation. Results: The incidence of prolonged labour and oxytocin augmentation were less in the group receiving intravenous RL at 250 ml/hour but was not statistically significant. Remaining outcomes were comparable in both the groups with no outcome reaching statistical significance. Conclusions: Rate of fluid administration is one of the many variables which affects the labour outcomes. The incidence of prolonged labour and oxytocin augmentation was less in the group which received intravenous RL 250 ml/hour. There was no statistically significant difference in both groups in respect of duration of labour, mode of delivery and caesarean rates.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230543
Issue No: Vol. 12, No. 3 (2023)
- A study of fetomaternal outcome in elderly primigravida
Authors: Ronak R. Bhankhar, Anjali R. Chavda, Hemali N. Patel
Pages: 716 - 720
Abstract: Background: Elderly primigravida is defined as all women going through their first pregnancy over the age of ≥35 years. They are considered to be categorized as high-risk pregnancy. Advanced contraception methods and artificial reproductive technology have played key role in delaying the pregnancy. Methods: A retrospective study of fetomaternal outcome in elderly primigravida was conducted at department of obstetrics and gynecology, GMERS medical college, Junagadh from 1st September 2021 to 1st August 2022. All the patient data was obtained from their case records and indoor files and were followed up till delivery for fetal outcome. Results: There were 54 elderly primigravida patients in our study with an incidence of 1.05% based on the inclusion criteria with 96.3% between the age 35-40 years. Most common reason for delayed child bearing was pursuing higher education and work preferences. Gestational hypertension was most common maternal complication (48%), associated with preeclampsia in 28%. Among fetal complications 46% had low birth weight, 38.5% had IUGR. 54% patients had delivered by LSCS. Conclusions: Although elderly primigravida is considered a high-risk pregnancy with increased maternal and fetal complications, proper antenatal care, early recognition of maternal risk factors with timely intervention pregnancy outcome can be improved.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230544
Issue No: Vol. 12, No. 3 (2023)
- The effect of comorbidities of preeclampsia and eclampsia on maternal and
fetal outcome
Authors: Abinaya M. C., Milon K. Taye, Nabajyoti Saikia, Long Teron, Pulak Kalita
Pages: 721 - 725
Abstract: Background: The aim of this study is to comparatively assess the maternal and fetal outcome in preeclampsia and eclampsia patients with and without comorbidities. The objectives are to assess the comorbidities associated with preeclampsia and eclampsia cases and to find out the effects of the comorbidities of preeclampsia and eclampsia on maternal and fetal outcome. Methods:380 patients who had attended antenatal OPD and emergency labour room of Assam medical college and hospital, Dibrugarh during June 2020 to July 2021 with preeclampsia and eclampsia were selected for present study. Based on relevant history, clinical and laboratory findings, these patients were further evaluated for associated comorbidities. The cases were distributed in the respective comorbidity group. Then the outcome of the mother and the baby were analyzed till the day of discharge in patients without comorbidities and with comorbidities and the same was compared. Results: The eventful maternal (44.1%) and fetal (50.92%) outcome was more in preeclampsia and eclampsia patients with comorbidities than in patients without comorbidities which is statistically significant, (p value=0.029), (p value=0.009) respectively. Conclusions: The effect of preeclampsia and eclampsia itself would adversely affect the pregnancy outcome and the effect is worse when associated with comorbidities. Appropriate prenatal counselling and optimization of the comorbidities is critical for women who are planning pregnancy.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230545
Issue No: Vol. 12, No. 3 (2023)
- A comparative study of twenty-five micrograms oral versus vaginal
misoprostol for labour induction at term
Authors: Yandapalli Sudheera, Shaik Mubeena, Vineela Myneedi
Pages: 726 - 729
Abstract: Background: Many societies from primitive to the modern, have been interested in, the ability to induce labour. The majority of women’s labours begins spontaneously and end in a normal vaginal delivery at or near term. Labour induction is often required due to medical or obstetric complications during pregnancy. This procedure has the potential to provide significant maternal and perinatal advantages. Methods: Cases for this study were collected from the Narayana Medical College and Hospital Nellore between January 2021 and December 2022. Informed consent was obtained from 100 pregnant women with indications for induction of labour in the third trimester, who were divided into two groups of 50 each for the oral and vaginal routes. The study was conducted after taking approval from institute ethics committee. Results: A total of 100 individuals were included in the trial, with each group of 50 receiving either oral or vaginal misoprostol 25mcg, 4th hr upto a maximum of 6 doses. In the vaginal misoprostol and oral misoprostol group, Primigravida required more doses of oxytocin compared to multigravida. Conclusions: Vaginal misoprostol had lesser induction-delivery interval, lesser c-section rates than oral misoprostol. Therefore, misoprostol when administered vaginally has higher efficacy than oral route. The increased efficacy of misoprostol raises the possibility of a local cervical effect, when administered vaginally.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230546
Issue No: Vol. 12, No. 3 (2023)
- A clinical comparative study of preoperative clinical staging and surgical
and histopathological staging in endometrial carcinoma
Authors: Priya Bulchandani, Tushar Palve
Pages: 730 - 736
Abstract: Background: Endometrial cancer is the fourth most common carcinoma in women across the globe. Treatment and prognosis are influenced by surgical international federation of gynecology and obstetrics staging system with evaluation of the depth of myometrium invasion, cervical extension and the presence of lymph node and distant metastasis. This study aims to compare the MRI findings in preoperative staging of endometrial carcinoma with intra-operative findings and revised international federation of gynecology and obstetrics staging based on postoperative histopathology. Methods: The study was prospectively carried out in department of obstetrics and gynecology of a Cama Hospital, Mumbai for a total period of 1.5 years; 30 patients diagnosed with endometrial carcinoma were selected. Results: The patients were predominantly multiparous with most common presenting complaint as postmenopausal bleeding. The clinical- radiological staging was concordant with histopathological staging in 60% (18/30) cases. Upstaging was seen in 10% (3/30 cases), while 30% (9/30) showed down staging in the final histopathology. While comparing the surgical intra-operative staging, it was seen to corroborate with the final histopathology in 63.33% (19/30) cases. Conclusions: The pre-operative radiological assessment especially MRI with high accuracy in determining myometrial invasion is an inseparable tool. The surgeon would have to rely on intra-operative assessment for further plan of action and effectively dealing with carcinoma.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230547
Issue No: Vol. 12, No. 3 (2023)
- A comparative study of efficacy of two different regimens of vaginal
misoprostol in first trimester termination of pregnancy in a tertiary care
hospital
Authors: Ramya S. P., Ushadevi Gopalan
Pages: 737 - 742
Abstract: Background: Misoprostol has been authorised as an effective medication for termination of pregnancy at different gestations, cervical ripening, labour inducing in term pregnancy, and possibly therapy of postpartum haemorrhage in the last two decades. Objectives were to compare the efficacy of two different regimens of vaginal misoprostol in first trimester termination of pregnancy. Methods: This was a randomized controlled trial conducted among 50 women in the reproductive age group with single live intrauterine gestation less than 12 weeks. All patients including both groups received mifepristone 200 mg oral administration as day 1 followed by group A received misoprostol 800 mg stat after 36 hours of mifepristone and group B received misoprostol 400 mg stat after 36 hours of mifepristone followed by 200 mg at 6 hourly 2 doses. Results: The mean age of the study participants was 26.48±3.77 and 24.72±3.33 in group A and B respectively. The 20% and 16% in group A had repeat dose and dilatation and curettage (D and C) done whereas only 8% had D and C done in group B. There was no significant difference between the prevalence side effects between the groups. Group B showed higher dissatisfaction than group A. The 36% and 8% of the study participants in group A and B respectively had incomplete abortion. Conclusions: Multidose regimen is found to be more effective in the first trimester termination of pregnancy than the single dose regimen.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230548
Issue No: Vol. 12, No. 3 (2023)
- Primary squamous cell carcinoma of the breast about one case: presentation
of a rare entity
Authors: Sanae Stimou, Hafsa Taheri, Hanane Saadi, Ahmed Mimouni
Pages: 743 - 746
Abstract: Squamous cell carcinoma of the breast is a rare disease, it is presented as a palpable mass, often of large volume. The clinical aspects are not specific. Squamous cell carcinomas of the breast are not hormone-dependent and are not very lymphophilic. The diagnosis is histological after eliminating the metastatic origin. Overall survival and no recurrence are worse than any other forms of breast cancer. Treatment is similar to the ductal infiltrating carcinomas one and is based on surgery, radiotherapy and chemotherapy. The prognosis is poor. We reported one case of squamous cell carcinoma of the breast collected at the department of gynecology and obstetrics at Mohammed VI university hospital of Oujda through this observation we will focus on the different characteristics of this entity which remains rare.
PubDate: 2023-02-06
DOI: 10.18203/2320-1770.ijrcog20230299
Issue No: Vol. 12, No. 3 (2023)
- A giant aggressive angiomyxoma of the vulva in a dwarf: a rare case report
Authors: Shubhra Mukherjee, Advait Prakash, Hemlata Sodhiya, Sarika Jaiswal
Pages: 747 - 749
Abstract: Aggressive angiomyxoma is a rare soft tissue tumour that carries a high risk of local relapse. The tumour usually arises from the pelvic and perineal regions. We presented a case of a young girl with dwarfism, mental retardation and thyroid agenesis who presented with aggressive angiomyxoma of the vulva. As it is almost exclusively seen in women of reproductive age group, this is the first case reported in a teenage girl, to the best of our knowledge. A mentally retarded girl, aged fifteen years, presented with a large mass hanging from the vulva, with ulceration over the mass. She had short stature, anasarca, mental retardation, primary amenorrhoea, under-developed secondary sexual characters .and thyroid agenesis. Local examination revealed a pedunculated mass of 15 by 4 cm size arising from the mons pubis closely resembling a giant penis. Full hormonal and radiological work-up was done. Her condition was optimized and the mass was removed with wide excision of margins followed by cystoscopy under general anaesthesia. Histopathology and immunohistochemistry were suggestive of aggressive angiomyxoma. She has no recurrence till date. Despite its rarity, angiomyxoma should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region. The principal treatment is surgical excision. Long term follow-up is needed due to its high tendency of local recurrence.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230549
Issue No: Vol. 12, No. 3 (2023)
- Live unilateral tubal pregnancy: a case report
Authors: Rimple Tiwary, Manish Kumar Tiwary
Pages: 750 - 752
Abstract: The pain in the abdomen during pregnancy presenting to the emergency department (ED) is a big diagnostic challenge. A pregnancy that occurs most commonly in the fallopian tube, outside of the uterus is known as ectopic pregnancy. Acute appendicitis and ectopic pregnancy are the two most common causes of pain in the abdomen during pregnancy presenting to the emergency department. At 11 weeks of gestational period, 27-years-old gravida 2 para 1 presented with a 3-day history of right iliac fossa pain which was not associated with vaginal bleeding, fever, diarrhea, and vomiting. The vitals were stable on general examination. There was mild tenderness and guarding at the lower abdomen. An elevated beta-human chorionic gonadotrophin (βhCG) levels, cervical motion tenderness on digital vaginal examination, and transvaginal ultrasonography found a single live gestation with fetal heartbeat of 170 beats/min and a single placenta. The right live tubal ectopic pregnancy was diagnosed in the patient. Open right salpingectomy was performed on the patient. The patient remained stable in the postoperative period and was discharged uneventfully from the hospital.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230550
Issue No: Vol. 12, No. 3 (2023)
- Survival of a fetus after advanced abdominal pregnancy-challenging
obstetric concern: a case report
Authors: Saima Alam, Shahena Akter
Pages: 753 - 756
Abstract: Abdominal pregnancy is a very rare form of ectopic pregnancy with very high morbidity and mortality for both mother and fetus. A 29 years old Bangladeshi woman presented from a rural area to Chittagong medical college hospital for first gynecological evaluation after 36 weeks of amenorrhea and lower abdominal pain. An ultrasound revealed a live fetus with sub amniotic collection and possibility of ruptured uterus. Laparotomy was done and a live fetus weighing 2500 gm was delivered. Placenta was adhered with both GIT and bladder. Placenta kept in situ and injection MTX given postoperatively. After re-laparotomy for postoperative pelvic abscess and hemoperitoneum, placental tissue removed and hemostasis maintained. Both mother and fetus are discharged in good health. A live fetus can be delivered after an advanced abdominal pregnancy. Whether the placenta should be kept in situ or removed, it is controversial. After medical literature review, we propose a management in this regard. Advanced abdominal pregnancy is extremely rare diagnosis and requires a high index of suspicion. The life-threatening complication is bleeding from the detached placental site. Placenta should be kept in situ to avoid intraoperative bleeding. Placenta involution during follow-up can be revealed by ultrasound, color Doppler and β-HCG serum level decrease.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230551
Issue No: Vol. 12, No. 3 (2023)
- Krukenberg's tumor: about 2 cases
Authors: Hind Bouyabla, Hafsa Taheri, Kouchih Abdelilah, Ibtissam Bellajdel, Fatima Zahra Bouabdellaoui, Imane Guerrouj, Hanane Saadi, Ahmed Mimouni
Pages: 757 - 760
Abstract: Krukenberg's tumor is a rare metastatic malignant tumor of the ovary, it represents 1 to 2% of ovarian tumors, the most frequently described primary site is the gastrointestinal tract. It is an aggressive tumor with a poor prognosis. Surgery is the treatment of choice. It consists of removal of the primary gastrointestinal cancer with bilateral adnexectomy, total hysterectomy, locoregional lymphadenectomy and omentectomy when the gastric tumor is discovered secondary to the ovarian lesion. We have collected over a period of 1 year, between April 2021 and May 2022, 2 observations of Krukenberg tumors secondary to digestive neoplasia that were followed in the department of obstetrics and gynecology of the CHU Mohammed VI Oujda. The aim of this article is to make practitioners aware of the difficulties of diagnostic and therapeutic management of this disease in order to improve its poor prognosis. In our observations, the patients certainly complained of digestive signs but it is the gynecological picture made of pelvic pain which was dominant and the main reason for consultation, the two patients were in very bad general state at their admission. The histological study is the only one able to affirm the diagnosis. On the hormonal level, CA-125 is the marker most frequently used by the authors in Krukenberg tumors. This work reconfirms the poor prognosis of Krukenberg's tumor given its insidious evolution.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230552
Issue No: Vol. 12, No. 3 (2023)
- Case report on perioperative management of combined factor V and VIII
deficiency in a patient with prolapse uterus
Authors: Bhavani Sree K. P., Usha Rani G.
Pages: 761 - 762
Abstract: Combined factor V and factor VIII deficiency is a rare autosomal recessive disorder with incidence of one in 10,00,000. We reported a case of seventy-one-year-old patient with third degree uterovaginal prolapse, diagnosed as combined factor V and VIII deficiency and the successful perioperative management during vaginal hysterectomy. With our experience in this, we conclude that for the patient's with factor V and VIII deficiency that the correction should be given for at least 2 weeks post operatively.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230553
Issue No: Vol. 12, No. 3 (2023)
- Mc Cune Albright syndrome: gynecological perspective
Authors: Thangamani M., Priyadharshini P., Dharani E.
Pages: 763 - 766
Abstract: The key features of McCune-Albright syndrome include sexual precocious puberty, polyostotic fibrous dysplasia and café au lait spots. It is associated with hyperfunction of multiple endocrine glands. Other endocrine dysfunctions often associated are growth hormone excess, hyperthyroidism, Cushing’s syndrome, hyperprolactinemia and phosphate wasting. We had a case of McCune-Albright syndrome with precocious puberty and irregular cycles and was managed. It is a rare cause of precocious puberty and should be kept in mind while dealing with such cases.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230530
Issue No: Vol. 12, No. 3 (2023)
- A rare case report on uterine perforation by levonorgestrel releasing
intrauterine device
Authors: Vijaykumar C. R., Asha C.
Pages: 767 - 769
Abstract: A levonorgestrel-containing intrauterine contraceptive devices are widely used in contemporary gynaecology, primarily as an effective method for contraception and for control of menstrual disorders like menorrhagia and dysmenorrhea. A case report of the uterine perforation by the levonorgestrel-releasing intrauterine device (LNG-IUD) in a 33-year-old asymptomatic woman after an 18-month of insertion. On routine cervical smear examination, the LNG-IUD threads were not visualised through the cervical os. After abdominal ultrasound scan the confirmation of perforated LNG-IUD was done and was removed laparoscopically.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230554
Issue No: Vol. 12, No. 3 (2023)
- Case report of massive haemorrhage following medical miscarriage requiring
uterine artery embolization
Authors: Sharma Jyotsna, Murugesan Sneha, Bhabani Pegu, Sasirekha Rengaraj, Ajith Ananthakrishna Pillai, Veena Pampampatti
Pages: 770 - 772
Abstract: Uterine arteriovenous malformations (AVM) are an abnormal, nonfunctional connection between uterine arteries and veins. These occur mostly after damage to uterine tissue following uterine surgical procedures. They may occur following even spontaneous abortion and resolve with expectant management without requiring a medical/surgical intervention. We report an interesting case of a woman who presented after medical abortion with uterine AVM with heavy bleeding requiring radiological intervention. Mrs. K, multiparous woman was referred in hypovlomeic shock from a district hospital. She had a medical abortion with Misoprostol at 9 weeks of gestation 2 months ago. No history of any curettage. She was stabilized and received appropriate transfusions. Sonography revealed a normal size uterus, with retained products of conception adjacent to a focal echogenic mass of size 5.8×4.6 cm in the posterior myometrium, with vascularity into and outward from the lesion suggestive of an AVM. The same was confirmed by CT angiography and an urgent uterine artery embolization (UAE) was undertaken. She withstood the procedure and recovered well. Anticipating spontaneous resolution of the retained products of conception, she was discharged home after clinical improvement and advised permanent method of contraception. Uterine AVM should be suspected in a woman who presents in child bearing age with heavy bleeding per vaginum following childbirth/abortion. Attempts of curettage may prove to be fatal in such scenarios. A high index of suspicion can help in an early diagnosis and seeking appropriate interventional assistance.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230555
Issue No: Vol. 12, No. 3 (2023)
- A rare case of genital myiasis in genital prolapse
Authors: Asha Kumari, Sudha Gandhi, Savitri Verma, Yukti Gaur, Neeraj Chowdhary
Pages: 773 - 775
Abstract: Genital myiasis is an infestation by fly larvae in genital organs, where they feed and develop as parasites. They can cause severe infection, inflammatory reaction and can be linked to psychiatric disturbances. Commonly cutaneous, ophthalmic, auricular and nasopharyngeal myiasis are seen, with genital myiasis being a rare condition. We reported a case of an 82-year-old postmenopausal female who presented with the complaint of intense pain in genital region. After clinical evaluation she was clinically diagnosed as a case of genital myiasis of prolapsed uterus. Myiasis of the genital organ is a rare clinical entity. Good personal hygiene and proper sanitary conditions are very crucial for prevention of myiasis.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230556
Issue No: Vol. 12, No. 3 (2023)
- A 16-year-old with borderline mucinous tumor of the left ovary
Authors: Saloni S. Zunzunwala, Vibha S. More, Pradnya Changede, Arun H. Nayak, Rachana Barkale, Ashwini Shinde
Pages: 776 - 778
Abstract: Incidence of ovarian malignancy in children and adolescents is 1 to 1.5% with non-epithelial tumors being the most common type. Ovarian mucinous tumors commonly seen in third to sixth decade, are rarely seen in adolescents. Timely diagnosis and management are important to save patient’s life and fertility. We are presenting an interesting case of a 16-year-old girl with atypical borderline mucinous ovarian tumor.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230557
Issue No: Vol. 12, No. 3 (2023)
- Non-obstructive cecal perforation in post-partum period: a rare case
report
Authors: Sanjay Mathuriya, Shubhra Mukherjee, Sarika Jaiswal
Pages: 779 - 780
Abstract: A primi-para patient presented in emergency, ten days after normal vaginal delivery, with acute abdominal pain, low grade fever and constipation. Clinical examination revealed poor general condition, signs of dehydration, tachycardia, hypotension, guarding and rigidity all over the abdomen. Investigations were suggestive of perforation and peritonitis. Contrast enhanced CT confirmed the presence of around 800 ml of free fluid. After initial resuscitative measures, patient is taken up for laparotomy in view of acute abdomen. Intra-operatively around 1 l of purulent fluid drained. Exploration of the bowel revealed a large cecal perforation. Repair was carried out with rescue colostomy. Her post-operative period was un-eventful, she showed steady improvement and was discharged in a stable condition with colostomy in situ. The colostomy was closed after 12 weeks.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230558
Issue No: Vol. 12, No. 3 (2023)
- Pregnancy and COVID-19: an update
Authors: Soma Biswas
Pages: 781 - 784
Abstract: COVID-19 was identified in December 2019 in China. Previous research has suggested a potential link between COVID-19 and pre-eclampsia (PE). Therefore, it is crucial to comprehensively evaluate the clinical symptoms and laboratory results of these conditions. This narrative review was conducted in light of the limited understanding of how COVID-19 affects pregnant women and its association with pre-eclampsia. It is important to note that these two conditions may share similar features that can influence the outcome of pregnancy.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230559
Issue No: Vol. 12, No. 3 (2023)
- LaQshya- an uphill climb: a review of implementation of LaQshya programme
at a tertiary centre in Chennai
Authors: M. Mahalakshmi, K. Kanmani, Vidyaa U. Kirubanidhi, S. Swetha
Pages: 785 - 793
Abstract: LaQshya- labour room quality improvement initiative, a National Quality Assurance Programme was launched by the National Health Mission, Government of India in 2017 for improving the quality of services provided at the time of delivery and immediate post-partum period. The programme has been implemented at the Institute of Social Obstetrics, Government Kasturba Gandhi Hospital for women and children from the year 2019. A plethora of changes have been brought about at the legendary institution since then. A retrospective programme review of the changes brought about at the Institute of Social Obstetrics, Government Kasturba Gandhi Hospital for Women and Children in the dimensions described under the LaQshya program i.e.; structural improvement and process improvement and henceforth a comparison of the various outcome as key performance indicators before and after the implementation of the programme. The quality of Institute of Social Obstetrics Government Kasturba Gandhi Hospital started at the bottom with 40%, under the guidance of LaQshya has improved to an astounding 93% making us the proud bearers of the prestigious platinum badge which was evident with the obvious improvement in various outcome indicators. Despite the implementation, LaQshya was an uphill trudge, to break old habits and restrain into new norms and guidelines, the results as mentioned proved to be a beautiful view at the end of the climb. LaQshya is indeed a boon not only to the mothers benefiting from it but also to the service provider as a tool to be a better health care personnel.
PubDate: 2023-02-27
DOI: 10.18203/2320-1770.ijrcog20230560
Issue No: Vol. 12, No. 3 (2023)
