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International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2320-1770 - ISSN (Online) 2320-1789
Published by Medip Academy Homepage  [12 journals]
  • Vulval symptoms in female recreational cyclists

    • Authors: Lizzie Harrison, Katharine Edey
      Pages: 3446 - 3451
      Abstract: Background: Cycling is linked to altered genital sensation, numbness, pain and sexual dysfunction in males and the professional female cyclist. After noticing an increase in women presenting to gynaecology clinics with cycling related vulval symptoms, we aimed to identify the incidence, significance and management of vulval pathology among female recreational cyclists. Methods: An anonymous online questionnaire was distributed to 5 Devon cycling clubs and promoted on the “South West Women’s Cycling” Facebook group. Participants were asked about vulval symptoms, management and if these symptoms had affected their cycling. Results: 508 women responded to the questionnaire between the ages of 20 and 60+. Overall 221, 43.5% of women said they had been deterred from cycling due to vulval/perineal discomfort. The commonest symptom experienced was pain, 37.4%, followed by chafing, 33.3% and redness, 26.6%. Just over a fifth of women had experienced infections they attribute to cycling: 9.8% urinary tract infections, 7.5% vulvovaginal candida and 3.1% bacterial vaginosis. The most important recommendation for the management of vulval discomfort was to use a women-specific saddle with a central cut out. Other recommendations included the benefits of professional bike fit, use of chamois cream and avoidance of hair removal. The menopausal group (the modal group) also commented on the benefits of topical oestrogen to counter the effects of atrophy. Conclusions: Vulval/perineal symptoms are a significant problem for female recreational cyclists. Further research and randomised control trials into the prevention and management is required so that evidence-based guidelines can be developed.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233616
      Issue No: Vol. 12, No. 12 (2023)
  • Predictors of short birth interval among women of reproductive age
           attending the young child clinic at a tertiary hospital in Western Uganda:
           a cross-section study

    • Authors: John L. R. Elioba, Theoneste Hakizimana, Shallon Atuhaire, Marie P. S. Ishimwe, Ubarnel A. Naranjo, Fernando P. Ramirez
      Pages: 3452 - 3457
      Abstract: Background: Short birth interval continues to increase in sub-Sahara Africa of which Uganda is part. If all birth-to-pregnancy intervals were spaced at least 2 years apart as recommended by the world health organization, most under-five deaths would be avoided. We aim at determining the predictors of short birth interval among women of reproductive age at tertiary hospitals, Uganda. Methods: A cross-sectional study involving 325 women of reproductive age attending the young child clinic at Fortportal Regional Referral Hospital was conducted from July 2022 to October 2022. Interviewer-administered questionnaires were used to obtain data used for analysis. Descriptive statistics followed by binary logistic regression were conducted to achieve the study objectives using Stata version 14.2. Results: Out of 325 participants, 94 (29%) had short birth interval. Maternal age (OR=3.4, 95% CI: 1.15-10.13; p=0.02), no previous pregnancy planning (OR=3.4, 95% CI: 1.23-9.41; p=0.01), duration of breastfeeding less than 12 months (OR=1.9, 95% CI: 0.06-0.58; p=0.003), less or equal to 4 antenatal care visits (OR=8.7, 95% CI: 3.19-23.80; p≤0.001) and not using postpartum contraceptives (OR=5.7, 95% CI: 1.64-19.81; p=0.006) were independently associated with short birth interval. Conclusions: The prevalence of short birth interval is still high in Uganda as compared to global report. The predictor factors of short birth interval include maternal lack of pregnancy planning, low number of antenatal care visits, breastfeeding for less than 12 months and lack of postpartum contraceptive use. Women of reproductive should routinely be educated about child spacing by healthcare workers.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233617
      Issue No: Vol. 12, No. 12 (2023)
  • The quest for better outcomes: a randomized controlled trial comparing
           letrozole versus clomiphene citrate in polycystic ovarian syndrome related

    • Authors: Fahmida Hasnat, Mahmuda A. Ferdousi, M. Mahboob Hasan, Mohammad T. Islam
      Pages: 3458 - 3463
      Abstract: Background: Infertility is a widespread concern, particularly among individuals with polycystic ovarian syndrome (PCOS). Clomiphene citrate (CC) has been a primary treatment for PCOS-related infertility, despite suboptimal pregnancy rates. Letrozole, an aromatase inhibitor, presents an alternative with potential advantages for improving pregnancy outcomes. This study aimed to rigorously compare letrozole and CC in the context of PCOS-related infertility, focusing on Bangladeshi women, adopting incremental dosing protocols, and examining endpoints to contribute valuable insights. Methods: A randomized controlled trial was conducted at a tertiary care center in Bangladesh from July 2021 to June 2023. Participants included women aged 18-35 with anovulatory infertility due to PCOS. They were randomized into two groups: letrozole and CC. Treatments were administered following incremental dosing protocols, and outcomes included endometrial thickness, ovulation rate, mono-follicular development, pregnancy rate, and time to pregnancy. Results: Out of 187 patients assessed for eligibility, 102 were enrolled, with 51 in each group. Demographics were comparable between groups. While endometrial thickness did not significantly differ between the groups, letrozole demonstrated a higher rate of mono-follicular development (72.55% versus 50.98%), a significantly higher pregnancy rate (47.06% versus 23.53%), and a shorter time to pregnancy (9.23 weeks versus 11.7 weeks) compared to CC. Conclusions: This study suggests that letrozole may be a preferred option for ovulation induction in PCOS patients due to its superior pregnancy rates and shorter time to pregnancy compared to CC. However, limitations such as a relatively small sample size and variations in dosages should be considered. Further research is needed to validate these findings and address the evolving needs of patients with PCOS-related infertility.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233618
      Issue No: Vol. 12, No. 12 (2023)
  • Practice of ovarian stimulation among poor responders in a country with
           limited resources: case of the Paul and Chantal Biya human reproduction
           center, Yaoundé, Cameroon

    • Authors: Ngono Akam Marga Vanina, Belinga Etienne, Mpono Pascale, Nyada Serge Robert, Christiane Nsahlaie, Mendoua Michele, Kasia Jean Marie
      Pages: 3464 - 3468
      Abstract: Background: Approximatively 2 to 30% of women who undergo ovarian stimulation have a poor response. The management is not clearly defined, constituting a challenge for clinicians and biologist. Methods: This was a longitudinal descriptive study with prospective data collection that took place at Paul and Chantal Biya Gynecological Endoscopic surgery and Human Reproductive Teaching Center, during a period of 1 year and 6 months, from June 2020 to November 2021. Our objective was to describe the practice of ovarian stimulation of patients judged to be poor responders in CHRACERH. We highlighted the numbers, percentages, averages and their standard deviations. Statistical analyzes were carried out using SPSS v15.0 software. Results: Out of 159 cycles included, we identified 55 patients considered possible poor responders, i.e. a prevalence of 34.6%; the average age was 36.36±6.2 years with extremes ranging from 33 to 44 years, mainly overweight in 81.8% of cases. The average AMH level was 0.9±0.4 ng/ml, the average CFA 6.15±3.7. 87.3% of patients were on their first stimulation attempt, the long-delay agonist protocol and the short agonist protocol were used in 58.2% and 41.8% respectively. The maximum daily dose in patients was 300 IU with an average total dose of gonadotropin used of 3371.8±874 IU. At the end of the ovarian stimulation, the average number of follicles collected and mature oocytes were respectively 5.6±3.6 and 4±2.9 with an average maturity rate of 70.7±31% as well as an average fertilization rate in ICSI of 45.2±32%. The pregnancy rate was 12% among poor responders. Conclusions: Poor responders constitute a large proportion of patients stimulated at CHRACERH; their still low pregnancy rates prompt an improvement in care.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233619
      Issue No: Vol. 12, No. 12 (2023)
  • A study to assess the maternal and perinatal outcome of postdated
           pregnancy at a tertiary care institution of Eastern India

    • Authors: Suvidha Saurabh
      Pages: 3469 - 3473
      Abstract: Background: Post term pregnancy has been defined as a pregnancy that persists beyond 294 days or 42 weeks of gestation. It most likely occurs in less than 5% gestation and has been associated with increased perinatal mortality rate. There is a strong body of evidence that the induction of labour at term and prior to 42 weeks of gestation is associated with reduction in perinatal complications without an associated increase in CS rates. Methods: This observational study was carried out in obstetrics/gynaecology department of ESIC Medical College and Hospital, Bihta. All the primi or multi gravida beyond the expected date of delivery and coming under the inclusion criteria were taken. Taking in consideration about the incidence of cases of post term deliveries last year, we are getting 6 to 7 cases every month. So,70 cases in 1 year of study duration was taken from October 2022 to September 2023. Results: This observation study showed that the incidence of postdated pregnancy was higher in primi gravida. Incidence of fetal distress and NICU admissions increased as the period of gestation increases. Conclusions: Post dated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetric complications like postpartum haemorrhage, perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and policies regarding induction of labour beyond expected date of delivery can reduce untoward complications.
      PubDate: 2023-11-16
      DOI: 10.18203/2320-1770.ijrcog20233546
      Issue No: Vol. 12, No. 12 (2023)
  • Efficacy and safety of ormeloxifene, a selective estrogen receptor
           modulator in management of dysfunctional uterine bleeding in
           perimenopausal patients: a prospective interventional study

    • Authors: Namita Shrivastava, Ritu Rani
      Pages: 3474 - 3478
      Abstract: Background: Dysfunctional uterine bleeding (DUB) is one of the most common menstrual disorder of women in any age group and is a diagnosis of exclusion. Medical management of menorrhagia is a difficult task as there are wide variations in the available drugs and a lot of different regimes are available. Present study evaluates efficacy and safety of ormeloxifene a selective estrogen receptor modulator (SERMs) in treatment of dysfunctional uterine bleeding in perimenopausal women. Methods: The study was conducted on 120 patients in the age group of 40-55 years who were treated with 60 mg ormeloxifene twice a week for first 12 weeks and once weekly for next 12 weeks. The primary outcome measures were menstrual blood loss (assessed by pictorial blood assessment chart score), hemoglobin concentration and endometrial thickness. The secondary outcome measures were aceptability and side effects of ormeloxifene. Results: 86.66% of women showed marked improvement in symptoms. Mean endometrial thickness decreased significantly from 9.825 mm to 6.25 mm after 6 months of treatment (p value <0.001). A significant decrease in median PBAC score (p value <0.001) was observed. Also, the mean haemoglobin level increased significantly from 8.03 g/dl to 9.60 g/dl (p value <0.001). Most common side effect reported was amenorrhoea (16%). 4% patient not relieved underwent hysterectomy. Conclusions: Ormeloxifene could be the drug of choice in patients with DUB. It is safe, cost-effective with manageable side effects. The therapy has facilitated compliance, tolerability and reduction of symptoms resulting in adherence towards the treatment.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233620
      Issue No: Vol. 12, No. 12 (2023)
  • Maternal and perinatal outcome in Rh negative mothers

    • Authors: Mamta Sharma, Kiran Raigar, Jyoti Sisodiya
      Pages: 3479 - 3483
      Abstract: Background: Incidence of Rh negativity in India is 5-10%. Rh negative pregnancy poses a risk only when there is incompatible mating, leading to antigen-antibody reaction, and hemolysis. However, it can be prevented by adequate measures. Methods: This prospective observational study conducted at Government Medical College hospital and J.K. Lon hospital Kota 100 women with Rh negative blood group admitted for delivery were enrolled. Results: Mean age of study participants was 26.87 years with SD of 3.62 years and the prevalence of Rh-negative pregnancy was around 2.9. Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality. Conclusions: Rhesus isoimmunization is a preventable cause of fetal morbidity and mortality. Routine antenatal screening and timely management with intrauterine transfusion are lifesaving method which should be incorporated in daily obstetrics practice.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233621
      Issue No: Vol. 12, No. 12 (2023)
  • A cross-sectional study to assess the knowledge, attitudes, and practices
           of cervical cancer screening/pap smear among health care professionals in
           a tertiary care hospital in North India

    • Authors: Richa Aggarwal, Priyanka Mathe, Preeti Sharma
      Pages: 3484 - 3490
      Abstract: Background: Cervical cancer is one of the most easily preventable and curable cancers among females. It imposes a high burden on developing countries, and with the use of screening methods, higher detection rates can be assured. Aims and objectives were to evaluate the knowledge, attitudes, and practices (KAPs) among health care professionals including doctors, nurses, and laboratory technicians regarding a very simple test for cervical cancer screening (i.e., Pap smear) Methods: This was a descriptive cross-sectional study that was conducted on 200 female health care workers in University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi from August 2018 to July 2022. A pretested, self-administered questionnaire was used on health care professionals working in various departments. This questionnaire collected information on sociodemographic data, knowledge regarding cervical cancer screening, Pap smear, and HPV vaccination, and attitudes of participants toward a Pap smear and HPV vaccination. Results: A total of 200 health care workers participated and knowledge among doctors and paramedical staff was compared but only 24.05% of the doctors and 26.44% of the paramedical staff had ever undergone a Pap smear screening, which was statistically insignificant (p=0.7). Awareness about the cervical cancer prevention vaccine was found more among doctors (n=78, 98.7%) than paramedical staff (n=77, 63.63%), and this was found to be statistically significant (p=0.001) Also, data among participants from a gynecology department (GD) versus other departments was compared, and awareness regarding HPV vaccine was much higher in the other-than-gynecology department (OTGD) group (84.29%) versus the GD group (59.54%), and this was statistically significant (p<0.001). Conclusions: Health care workers play an essential role in the community to spread awareness, but there is a need for a change in attitude about the disease and its screening. We can utilize this knowledge in filling the critical gaps in the community regarding awareness, screening, and prevention of the disease.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233622
      Issue No: Vol. 12, No. 12 (2023)
  • A study to determine the effects of epidural analgesia in labour and to
           assess its maternal and neonatal outcome

    • Authors: Anam B. Syed, Deepali S. Kapote
      Pages: 3491 - 3497
      Abstract: Background: There is widespread acceptance of epidural analgesia among many physicians and patients, but disagreement remains regarding the effect of intrapartum epidural analgesia on the subsequent progress of labour and the mode of delivery. This study was designed to look and assess the effects of labour analgesia on maternal and fetal outcomes. Methods: This is an observational prospective cohort study where 60 parturient visiting the hospital in labour during the study period who fulfilled the eligibility criteria & gave written informed consent for the participation were included as cases. Another 60 parturient visiting the hospital during the same period who also fulfilled the eligibility criteria and consent for the same were included as controls. After test dose of 3 ml of 2% lignocaine with 1:2,00,000 adrenaline, an initial bolus of 10 ml of 0.1% Ropivacaine+1microgram/cc Fentanyl is given. Results: Epidural analgesia gave better pain relief when the VAS scores of the two groups were compared. No effect on increase of Caesarean or instrumental delivery rates was observed. Even though the first stage of labour was prolonged and the second stage shortened, the overall time of active stage of labour remained the same in both groups. No adverse neonatal outcome was seen with respect to epidural analgesia. Conclusions: Epidural analgesia provided excellent pain relief for most of the women delivering at our institute & is associated with high patient satisfaction.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233623
      Issue No: Vol. 12, No. 12 (2023)
  • The study of thyroid dysfunction in patients with abnormal uterine

    • Authors: Dhanusha Nekkanti, Vasantha Kumar S.
      Pages: 3498 - 3502
      Abstract: Background: Abnormal uterine bleeding (AUB) is the most common gynecological condition observed during many women's reproductive period. AUB affects the quality of life, causing distress. Most of the cases are undiagnosed or not properly diagnosed. Multiple reasons are causing AUB, one of them is thyroid dysfunction. Nowadays, thyroid testing is readily available, which helps in diagnosis and better management of AUB. Methods: A prospective observational study was conducted with 124 AUB cases using simple random sampling after approval from the ethics committee. Results: Total thyroid dysfunction was noted in 32.26% of cases, and 70.16% were multiparous. About 34.1% of cases of menorrhagia and 54.2% of cases of oligomenorrhea had thyroid abnormalities. Conclusions: For appropriate management of AUB, testing of thyroid levels is necessary.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233624
      Issue No: Vol. 12, No. 12 (2023)
  • Comparison of conventional pap smear with liquid based cytology, and
           assessment of the effectiveness and feasibility of liquid-based cytology
           over conventional pap smear in rural tertiary care centre

    • Authors: Sheela Sharma, Neetu Singh, Amrita Sinha, Smriti Jain
      Pages: 3503 - 3507
      Abstract: Background: Cervical cancer is the second most common cancer in women in India. So, detection of its premalignant lesions is of utmost importance, which can be easily done by screening methods. Screening programmes for cervical cancer using the conventional pap smear (CPS) technique have been in place since decades. However, CPS technique has many limitations. To overcome these limitations liquid-based cytology (LBC) was introduced in the mid 1990 as a better tool for processing cervical samples. The aim of present study is to compare CPS with LBC and to assess the diagnostic accuracy and cost effectiveness of LBC in rural tertiary care centre. Methods: The study was conducted over a period of 2 years at Rama medical college, Mandhana, Kanpur. All women presenting to gynaecological OPD with symptoms and signs suspicious of cervical malignancy were selected for paired samples of conventional pap and LBC. Colposcopy and biopsy were sought which correlated with cytologic findings. Results: A maximum number of cases were in the reproductive age group, most common age of presentation being 40-49 years (27.3%) followed by 30-39 years (25.3%). A majority of patients were presented with a complaint of discharge per vagina 176 (58.7%), followed by pelvic pain 154 (51.3%). Only 4 patients were found to have unsatisfactory smear in LBC (1.33%) while 22 patients had unsatisfactory smear in conventional PAP (7.33%). LBC showed presence of endocervical cells in almost all patients 290 (97.97%). Candida bodies were not evident in LBC smears while the CPS showed presence candida bodies in 4 cases. Conclusions: Both the screening methods are very effective and sensitive in the detection of premalignant lesions with slight discordance of grade on histology. Thus, we conclude that cervical cytology is very effective in the detection of premalignant lesions with the sensitivity of almost 100%. In developing countries such as India, where finances pose a major problem, conventional method is as good as LBC.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233625
      Issue No: Vol. 12, No. 12 (2023)
  • The impact of birth companion on respectful maternity care and labor
           outcomes among Indian women: a prospective comparative study

    • Authors: Isha Seth, Sunayana, Savita Singhal, Aditya Seth, Aksha Mohan Garg
      Pages: 3508 - 3514
      Abstract: Background: Childbirth is a transformative experience for women, and the presence of a birth companion has been shown to have positive effects on the labor process. This study aimed to investigate the influence of having a birth companion on respectful maternity care (RMC) and labor outcomes. The study was conducted at Pandit Bhagwat Dayal Sharma post graduate institute of medical sciences, Rohtak, India, from February 2020 to March 2021. Methods: The study included two groups: group 1 (n=200) with a birth companion and group 2 (n=200) without a birth companion. Participants were recruited from laboring women at the labor ward, ensuring representation and minimizing bias. Inclusion criteria encompassed women between 37-41 weeks gestational age in active labor, with specific prerequisites for having a birth companion. Data were collected using a pre-set questionnaire to assess RMC, pain scores, behavior of medical personnel, and patient satisfaction. Secondary outcomes included the mode of delivery, duration of labor, complications, and the women's experience with their birth companion. Results: The study revealed significant differences between group 1 and group 2 in various aspects. Group 1 exhibited lower rates of physical and verbal abuse, improved consented and confidential care, and higher overall scores for RMC. Group 1 also reported lower pain scores, more favorable behavior from healthcare providers, and better overall hospital experiences. Additionally, group 1 had fewer instrumental deliveries and cesarean sections, as well as a shorter duration of labor compared to group 2. Conclusions: This study demonstrates that having a birth companion during labor significantly improves RMC, pain management, and labor outcomes. Women accompanied by a birth companion experience reduced rate of abuse, increased satisfaction with healthcare providers, and a more positive overall labor experience. Encouraging the presence of birth companions during childbirth can enhance women's experiences, promote RMC, and contribute to improved labor outcomes.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233626
      Issue No: Vol. 12, No. 12 (2023)
  • Quantification of proteinuria by urine protein creatinine ratio in a
           single void urine in pre-eclamptic women and its correlation with 24 hours
           urinary protein

    • Authors: Rashmi Saxena, Manisha Sharma, Rajeev Ranjan
      Pages: 3515 - 3519
      Abstract: Background: Proteinuria is a major indicator of hypertensive disorders of pregnancy. Though 24 hr urinary protein is considered to be the gold standard for evaluation of proteinuria in preeclampsia but its collection is time consuming, cumbersome and needs admission of the patient. The role of spot UPCR in random sample proposed as an alternative Method: A observational cross-sectional study was conducted from 2020 to 2021 on 78 antenatal women of gestational age >20 weeks meeting the inclusion and exclusion criteria were enrolled into this study. Data was compared by using Pearson correlation coefficient (r). ROC curve was plotted for spot UPCR value for detecting significant proteinuria (>300 mg/24 hr). Result: The quantification of proteinuria by spot UPCR strongly correlated with 24hr urinary protein. The p=0.001. There was a positive correlation of 24hr urine protein (mg/24 hr) with spot UPCR urine sample which was significant statistically (r=0.997, p<0.05) ROC curve analysis of Spot UPCR for proteinuria (>300 mg/24 hr) after the 20 weeks gestation. The spot UPCR showed significant large area under the curve (AUC) on the ROC curve. There is positive correlation between 24 hr urinary protein (>300 mg/24 hr) and spot UPCR in patients of pre-eclampsia Conclusions: From our study we concluded that spot urinary protein creatinine ratio has a significant linear correlation with 24 hr urinary protein in pre-eclampsia.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233627
      Issue No: Vol. 12, No. 12 (2023)
  • The role of carbohydrate antigen 19-9 in the clinical evaluation of mature
           cystic teratomas: an observational study at a tertiary care centre

    • Authors: Sumana Manohar, Shanaz Nazeen S.
      Pages: 3520 - 3524
      Abstract: Background: Carbohydrate antigen (CA) 19-9 is a tumour marker mainly used in the evaluation of gastrointestinal tract malignancies including pancreas, colon and biliary tract. Cases of ovarian tumours such as mucinous neoplasms have been reported to have high levels of CA 19-9. However, its role in the management of cystic teratomas (MCT) which are the most common benign ovarian tumours encountered in gynaecology, is not studied in depth in literature. Methods: In our study, we observed the levels of CA 19-9 in 40 patients presenting with MCT. Its association to the cyst size, contents, laterality and torsion or rupture were documented. Results: The various clinical parameters evaluated in our study such as larger cyst size, presence of torsion and tooth as a content had a positive association with elevated CA 19-9 levels (p<0.05). However, CA 19-9 had no significant relationship with the laterality of the cyst. Thus, CA 19-9 may serve as an important adjunct tool to ultrasonography in the management of dermoid cysts (MCT), particularly in those with larger sizes and at risk of torsion. Conclusions: High levels of CA 19-9 can be observed in benign ovarian tumors like mature cystic teratoma (MCT) and it need not always be associated with malignancy or malignant transformation of benign tumors. Levels more than 100 IU may warrant further imaging studies to rule out gastro-intestinal pathologies. Unnecessary medical investigations or patient anxiety can be avoided in cases of moderate elevation in CA 19-9 levels.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233628
      Issue No: Vol. 12, No. 12 (2023)
  • A study on prevalence and determinants of postpartum depression among
           mothers: a cross-sectional study

    • Authors: Nisarga H., Preethimol, Abubaker Siddiq
      Pages: 3525 - 3529
      Abstract: Background: Postpartum depression (PPD) is a common affective disorder. It remains unrecognized and affects the health of mothers and the interpersonal relationships, mother infant bonding as well as emotional and cognitive behavior of baby. It occurs immediately or 2 to 6 weeks after delivery and may last for a year. This study aims at determining the prevalence of PPD among mothers, its associated factors and to correlate mothers age and parity in PPD. Method: It is a cross sectional study conducted in department of obstetrics and gynecology (OBG) in a tertiary care hospital. we have enrolled one seventy-two (172) postpartum women within six months of their delivery after obtaining informed consent. Edinburgh postnatal depression scale was used for determining the prevalence. Sociodemographic and obstetrics questionnaire were given to identify associated factors and correlation between mothers age and parity. Results: Out of 172 enrolled patients, we collected information about PPD, in our study the prevalence of PPD was 44%. Age, marital status, education of mother, occupation of mother, Occupation of husband, wealth index, social support by family, husband substance abuse, type of family, gender of baby, parity, mode of delivery, present pregnancy, sex preference of mother, infant illness, are the factors associated with PPD. Age and parity have no correlation with PPD. Conclusions: The high prevalence rate of PPD and associated risk factors imply the need for strengthening and improving of postpartum care.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233629
      Issue No: Vol. 12, No. 12 (2023)
  • Study and analysis of cervical pap smears in our hospital

    • Authors: Suvidha Saurabh, Sanjita, Ismat Khanam
      Pages: 3530 - 3533
      Abstract: Background: Cervical cancer is one of the major causes of mortality among women worldwide. It has taken fourth place among malignancies that affect women, the first leading is breast cancer. In developing countries including India, it is the leading cause of morbidity and mortality. It is readily preventable and can be diagnosed at the pre invasive stage with adequate and repetitive cytological screening and Papanicolaou smears. Methods: This observational study was aimed to screen the patients attending gynae OPD of ESIMCH, Bihta. The main purpose was to study the incidence of premalignant and malignant lesions in population in and around ESICMCH, Bihta. A total of 100 patients attending gynaecology OPD of ESIC, Bihta were screened during a period of one year from October 2022 to September 2023. Pap smears are taken from women visiting gynaecological OPD between ages of 25 to 70 with different gynaecological complaints using Ayer’s spatula. Smears were reported according to Bethesda system 2001. Results: A total of 200 pap smears were examined. There were 68 patients with NILM, and 67 patients with inflammatory smear. ASCUS was found in 12 patients, LSIL in 10 patients, HSIL in 7 and squamous cell carcinoma in 1 patient. This study concluded that a simple pap smear test could be offered to vast populations for diagnosing premalignant conditions of the survey this has and will in future continue to aid us with the early diagnosis of survival cancer. Conclusions: PAP smear is useful in diagnosing malignant and premalignant lesions of the cervix. In developing countries such as India this screening method is cheap and can be widely used. It can be used by trainers and para medical staffs.
      PubDate: 2023-11-21
      DOI: 10.18203/2320-1770.ijrcog20233556
      Issue No: Vol. 12, No. 12 (2023)
  • A comparative study of ferric carboxy maltose versus iron sucrose for iron
           deficiency anaemia in pregnancy

    • Authors: Nikitha James, Ramalingappa C. Antartani, Neha Anu James
      Pages: 3534 - 3541
      Abstract: Background: Anaemia is a major contributor to maternal morbidity and mortality worldwide. Ferric carboxy maltose is a novel iron preparation which can treat anaemia faster and more effectively. Thus, this study aimed to evaluate the efficacy and safety of FCM in pregnancy and also to compare the same with Iron sucrose in pregnancy. Methods: This was a Prospective, Hospital based, Comparative study performed on 120 women who attended the department of obstetrics and gynaecology at KIMS, Hubli for a duration of one and a half years (2017-18). The patients received either FCM or Iron sucrose, with 60 participants in each group. Results: Among 120 subjects, 75% of the patients had microcytic, hypochromic anaemia, 1.4% had dimorphic anaemia.38.33% of patients had moderate anaemia (Hb 6-7.9g/dl). After FCM infusion, rise in Hb at 2 weeks was 1.5g/dl and at 4 weeks was 2.9 g/dl. Serum ferritin levels raised by 36.7 and 63.1 mcg/l at 2 and 4 weeks with FCM respectively. On comparison with Iron sucrose, the Hb rise was statistically better with FCM at 4 weeks, whereas the ferritin levels were significantly improved with FCM at both 2 and 4 weeks after treatment. Side effects in mild form occurred in 7.5% of the subjects. Conclusions: FCM is a safe, effective alternative to other parenteral iron therapies, offering faster correction of anaemia and iron replenishment. Its use in pregnancy will significantly reduce the burden of maternal mortality and morbidity.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233630
      Issue No: Vol. 12, No. 12 (2023)
  • Study of tamoxifen associated endometrial changes in women with breast
           cancer: a prospective study

    • Authors: Jyotsna Mirabel Coelho, Nagarathna G., Dinesh Shet
      Pages: 3542 - 3547
      Abstract: Background: Studies have estimated that women with breast cancer on tamoxifen therapy have a greater risk of developing endometrial cancer. We undertook this study to correlate the ultrasonographic findings, hysteroscopy findings and endometrial pathology in breast cancer patients on tamoxifen. Methods: This was a prospective study conducted over a period of two years. Patients of histologically proven breast cancer on tamoxifen treatment for more than a year were taken into the study. Transvaginal ultrasonography and hysteroscopic biopsy (if endometrial thickness on TVS was 8mm or more) was performed. SPSS software was used for statistical analysis of data. Results: 23 patients had an endometrial thickness between 5-10 mm. 23 between 10.1-15 mm, 13 between 15.1-20 mm and only 1 patient had an ET of more than 20 mm with a mean of 12.27 mm. On Hysteroscopy 24 patients (51%) had a bald endometrium, 14 (29.8%) had hyperplastic endometrium and 9 (19.2%) had polypoid endometrium. On endometrial biopsy, 19 patients had atrophic endometrium, 14 had polypoid endometrium, 11 had non secretory and 7 had secretory endometrium, 1 patient had disordered proliferative endometrium, 1 as hyperplasia without atypia and 1 with complex hyperplasia. 2 were reported as adenocarcinoma. Conclusions: Usage of tamoxifen is warranted in view of its benefits outweighing its risks, the need of a screening program for patients who receive tamoxifen for a prolonged period and the need for a hysteroscopic biopsy when the endometrial thickness is more than 8mm especially in the symptomatic patients.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233631
      Issue No: Vol. 12, No. 12 (2023)
  • Prevalence of ecosapentaenoic acid and docosahexaenoic acid deficiency in
           pregnant women: a prospective observational study

    • Authors: Vishwa J. Mishra, Sakshi Nayar, Chandra Mansukhani, Sunita Kumar, Kanwal Gujral
      Pages: 3548 - 3554
      Abstract: Background: Docosahexaenoic acid (DHA), ecosapentaenoic acid (EPA) and alpha lineoloic acid (α-LA) are essential fatty acids of the long chain polyunsaturated fatty acid (LC-PUFA) or omega-3 fatty acid. These fatty acids are not synthesized by our body. Diets rich in LC-PUFA reduces the incidence of - preeclampsia, intrauterine growth restriction, preterm delivery, in utero fetal death and placental abruption. Objectives of the study were: to estimate the prevalence of EPA and DHA deficiency in pregnant women by omega-3 index test (O3I), and also to correlate blood levels of EPA and DHA with various socio demographic parameters. Methods: All enrolled subjects were assessed with a pre-defined performa for their demographic and socio-economic characteristics, personal history, obstetric history, body mass index (BMI), education, diet and blood samples were tested for O3I. Results: Result of the study indicated that 98% of pregnant women had EPA and DHA deficiency as indicated by O3I levels. This was regardless of age, parity, BMI, and socio economic status. Women consuming vegetarian diet had statistically significant lower mean and median levels of O3I as compared to the women having a non-vegetarian diet, p value <0.001, 0.004 respectively. In our entire cohort of 150 women, only 2 non-vegetarian women had sufficient O3I. Conclusions: 98% of pregnant women across various socio economic classes had EPA and DHA deficiency as measured by O3I levels. Vegetarians had statistically significant lower levels of O3I as compared to the non-vegetarians.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233632
      Issue No: Vol. 12, No. 12 (2023)
  • Study on assessment of knowledge, attitude and practice towards prevention
           and screening of cervical cancer among couples

    • Authors: Lukram M. Devi, Pesona G. Lucksom
      Pages: 3555 - 3560
      Abstract: Background: Cervical cancer (CC) is caused by Human Papilloma Virus which is sexually transmitted. With the rise in its incidence, it is necessary to know if couple awareness is important to increase uptake of screening. Thus, this study was undertaken to analyze if knowledge, attitude and practice towards prevention and screening of CC in male partners has influence in female counterparts. Methodology: Questionnaire based cross sectional study from August 2022 to August 2023, done in the department of Obstetrics and Gynecology, Sikkim Manipal Institute of Medical Sciences. 340 couples (680 participants), ≥18years of age, attending the outpatient department who consented for the study were enrolled. Results: Only 48% of the study population (142 couples) had heard about cervical cancer. There was no significant difference in the knowledge between males and females among couples who had heard about CC. However, there was significant difference in the female counterpart’s knowledge when males had or lacked knowledge on CC (p<0.00001). Assessment of preventive practice showed that only 17% women had done screening test and only 33% of couples used barrier contraception. More than 80 % couples had a positive attitude towards screening and vaccination against the disease. Conclusions: Though the population exhibited positive attitude towards CC prevention but the lack of knowledge led to less preventive practices. Male partner’s knowledge also showed influence on awareness about CC among females. Hence, to increase screening uptake, educational programs should include couples rather than females.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233633
      Issue No: Vol. 12, No. 12 (2023)
  • Study of lipid profile in polycystic ovarian syndrome: a case control
           study in tertiary care hospital

    • Authors: Racheal Sweet Marbaniang, Ajitkumar Singh Yanglem , Victoria Kshetrimayum, Sangeeeta Naorem, Rosyka Laithangbam, Florida Ashem
      Pages: 3561 - 3565
      Abstract: Background: Polycystic ovarian syndrome (PCOS) is one of the most common causes of endocrine dysfunction in women of reproductive age. Dyslipidaemia plays an important role in the development of PCOS. Lipid abnormalities which include elevated low-density lipoprotein and triglyceride levels and reduced high-density lipoprotein levels are often found in women with PCOS and thus they are associated with long-term risk of coronary heart disease. The study aims to estimate lipid profile levels in patients with polycystic ovarian syndrome (PCOS) taken as cases and normal healthy subjects taken as controls. Methods: This is a case control study conducted in the Department of Biochemistry in collaboration with Department of Obstetrics and Gynaecology, RIMS, Imphal. Fasting blood samples were collected from cases and controls and lipid parameters were estimated. Forty-five cases of PCOS patients in the age group of 18-44 years diagnosed according to Rotterdam criteria and forty-five age-matched healthy women with regular menstrual cycle taken as controls were recruited. Results: The mean±SD of age in cases was 26.38±4.85 years and control was 28.23±3.99 years. However, the difference was found to be statistically insignificant. The majority of cases were from urban areas which comprised of 62% and only 55.6% were from rural areas. The mean±SD for cholesterol, TG, LDL were 203.40±54.20 mg/dl, 163.26±69.49 mg/dl, 132.82±50.39 mg/dl respectively and was higher in cases compared to controls and the difference was statistically significant. However, the mean±SD of HDL in cases 24.81±2.31mg/dl was lower as compared to controls and the difference was statistically significant with p<0.05. Conclusions: PCOS is found to be associated with atherogenic lipid profile. Thus, it may be suggested that dietary control and improvement of living style to control dyslipidaemia should be taken up early in PCOS to prevent development of cardiovascular disease.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233634
      Issue No: Vol. 12, No. 12 (2023)
  • Study of fetomaternal outcome in HIV positive pregnant female at a
           tertiary health center in South Gujarat

    • Authors: Jigisha Chauhan, Shraddha Agarwal, Riya Kansal, Zarana Patel, Krunal Patel
      Pages: 3566 - 3570
      Abstract: Background: Prenatal identification of HIV infected women is crucial for delivery and optimal care to both mother and fetus. Prevention of parent-to-child transmission has been the major tool to identify HIV-infected pregnant women by voluntary counselling and testing for HIV and provide antiretroviral drug prophylaxis to them during delivery and then to their newborn infants. Aim and objective was to study the fetomaternal outcome of HIV Positive antenatal patients. Methods: This was simple descriptive study which was conducted between January 2017 to June 2019 with 18 months follow-up suggestive of 40 patients were having HIV positive among 9015 deliveries. Thorough examination, investigations and treatment given according to NACO guidelines and fetomaternal outcome were noted in all cases. Results: In present study, prevalence of HIV Positive pregnant women was 0.44%. Out of 40 patients, 5 patients were diagnosed with TB. 55% cases were diagnosed with HIV during ANC examination. 22 (55%) patients were having CD4 count >500 and 1 (2.5%) patient having low CD4 count <200. 32 (80%) patients delivered vaginally and 8 (20%) underwent LSCS. 8 (20%) of babies were admitted to NICU, 3 expired and 37 babies tested negative, 3 losses to follow-up and 34 tested negatives at 18months. Conclusions: Mother-to-child transmission is the predominant way children become infected with human immunodeficiency virus worldwide. Good antenatal care and multidisciplinary approach to HIV-infected women can have good pregnancy outcome and early prophylaxis to the baby leads to decreased incidence of disease in the community.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233635
      Issue No: Vol. 12, No. 12 (2023)
  • A comparative study between total laparoscopic hysterectomy and total
           abdominal hysterectomy for benign uterine conditions

    • Authors: Shakuntla, Oby Nagar
      Pages: 3571 - 3577
      Abstract: Background: The aim of this prospective study is to evaluate and compare the results of two routes of hysterectomy for benign uterine conditions of less than 14 weeks who performed in our tertiary centre. Methods: This was a prospective interventional single centre study on 140 consecutive patients (70 patients in each group) who underwent hysterectomy for benign uterine conditions either by total laparoscopic hysterectomy (TLH) or by total abdominal hysterectomy (TAH) route. Results: There were no statistical differences between two groups regarding age, parity, previous history of abdominal surgery, demographic factors, For TLH group vs. TAH group- operative time was (89.34±12.3 minutes) vs. (46.6±5.92 minutes) (p<0.0001), blood loss (19.61±2.34 ml) vs. (124.8±17.29 ml) (p<0.0001), post operative haemoglobin drop (0.34±0.15 gm/dl) vs. (1.36±0.24 gm/dl) (p<0.0001), pain score (2.56±0.97) vs. (5.31±1.02) (p<0.0001), mean ambulation time (15.16 ± 4.64 hours) vs. (48.76±5.08 hours) (p<0.0001), mean time to catheter removal (12.47±0.94 hours) vs. (48.23±0.64 hours) (p<0.0001), hospital stay (3.74±0.50 days) vs. (7.64±0.98 days) (p<0.0001), resumption to normal daily activities (4.39±0.2 weeks) vs. (11.8±1.77 weeks) (p<0.0001), were significantly lower and earlier in TLH group as compared to TAH group, also compared intra-operative and post-op complication (less in TLH group) and patient satisfaction score(better in TLH group). Conclusions: TLH route is safe and feasible as compare to TAH route and found to have, less amount of blood loss, fewer complications and early ambulation, recovery and discharge.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233636
      Issue No: Vol. 12, No. 12 (2023)
  • COVID-19 infection-associated coagulopathy and its association with
           adverse outcomes in Indian gravidas: a prospective analysis

    • Authors: Soumya P. Singh, Preeti Singh, Rohini Gaonkar
      Pages: 3578 - 3582
      Abstract: Background: Objective of the study was the determination of trends of coagulation parameters and association between pregnant women with COVID-19 infection with adverse outcomes. Methods: Design of the study was a prospective observational study. The study was conducted at the Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi. A total of 142 pregnant women with confirmed COVID-19 infection were recruited and studied prospectively between May 2020 and April 2021. Trends of coagulation parameters were compared in groups divided based on the adverse outcomes. 11 patients had adverse outcomes which included ICU admission or mortality. There were no adverse outcomes in the remaining 131 patients. Results: The comparison of trends of coagulation parameters in both groups was studied. D-dimer and INR values were significantly higher, while fibrinogen level was significantly lower in COVID-19 subjects with adverse maternal outcomes than in those in which adverse maternal outcomes were not present (p<0.05). No significant difference was observed in other coagulation parameters like APTT. Conclusions: Universal screening of coagulation parameters of all pregnant women with COVID-19 can be considered because of the association of adverse maternal outcomes with deranged D dimer and fibrinogen in our study.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233637
      Issue No: Vol. 12, No. 12 (2023)
  • Comparison between sequential transfer vs. day 3 and day 5 frozen embryo
           transfer in IVF patients

    • Authors: Rohan Palshetkar, Mayuri More, Nandita Palshetkar , Hrishikesh Pai, Rishma Pai, Arnav Pai
      Pages: 3583 - 3587
      Abstract: Background: Sequential embryo transfer is when both cleavage-stage embryo is transferred on day 3 and blastocyst is transferred on day 5, sequentially in the same cycle. This has been suggested for increasing embryo implantation rate. Sequential transfer gives benefit of both day 3 as well as day 5 transfer in the same cycle, giving better outcome in patients suffering infertility. This study compares the implantation rates in sequential transfer vs Day 3 and day 5 transfers. Methods: This multi-centric study is a retrospective study conducted over a period of one year at D. Y. Patil Fertility Centre, Navi Mumbai. Total of 432 transfers were conducted in patients, out of which 262 were Day 3 or cleavage stage embryo transfer, 109 were Day 5 or blastocyst embryo transfer and 61 were sequential embryo transfer. Results: Day 3 transfer group had the clinical pregnancy rate of 52.67%, whereas day 5 transfer group had 60.55% of clinical pregnancy positive cases. Sequential embryo transfer had implantation rate of 60.66%, which was slightly higher than day 5 (60.55%) and day 3 (52.67%) implantation rates. Conclusions: Sequential transfer has marginally increased rate of implantation and clinical pregnancy when compared to day 5 and day 3 transfers.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233638
      Issue No: Vol. 12, No. 12 (2023)
  • Social egg freezing: a gateway to fertility insurance

    • Authors: Jashan Chhatwal, Rita Bakshi, Sakshi Bakshi, Nidhi Tripathi
      Pages: 3588 - 3591
      Abstract: Background: There is a decline in fertility due to delayed childbearing and hence, elective egg freezing (oocyte cryopreservation) offers a solution. Two primary techniques are used for human oocyte cryopreservation: slow freezing and vitrification. Vitrification is highlighted as a promising method. The present study was conducted to evaluate the pregnancy outcomes from oocytes that were frozen for social reasons and oocytes were frozen by method of vitrification. Methods: This retrospective study was conducted at RISAA IVF International Fertility Centre, New Delhi, collecting the data available over 6 years (2017-2023). It focused on freezing of oocytes and collected data on frozen, thawed, and fertilized oocytes, analysing thawing, survival, and fertilization rates by patient age group. Data was processed using Microsoft Excel and SPSS, with quantitative data presented as mean and standard deviation, and qualitative data as frequencies and proportions. Results: In this study of 25 patients who froze their oocytes, the average age at cryopreservation was 33.38 years. The mean age at implantation was 36.48 years. On average, patients had 10 retrieved oocytes. Most patients with thawed oocytes were in the 35-37 age group, although the highest survival and fertilization rates (86.9%) occurred in the above-40 age group. Established pregnancies were more common in the 35-37 age group, with 5 out of 10 pregnancies regardless of the day of embryo transfer. Conclusions: Elective egg freezing (oocyte cryopreservation) has emerged as a valuable solution to preserve fertility.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233639
      Issue No: Vol. 12, No. 12 (2023)
  • The role of cerebro placental ratio as a predictor of adverse perinatal
           outcome in uncomplicated term pregnancies

    • Authors: Nidhi Gupta, Mohita Agarwal, Akanksha, Abhivyakti Kapoor
      Pages: 3592 - 3597
      Abstract: Background: Aim of the study was to study role of cerebro placental ratio (CPR) as a predictor of adverse perinatal outcome in uncomplicated term pregnancies. Methods: This prospective observational study took place at the Department of Obstetrics and Gynecology in SNMC Agra. We enrolled 140 uncomplicated antenatal cases with gestational age between 37 to 41 weeks, based on specific inclusion and exclusion criteria. Each participant underwent comprehensive assessments, including history-taking, examinations, and ultrasound color Doppler evaluations. We then analyzed perinatal outcomes in correlation with CPR. Results: Adverse perinatal outcomes i.e., asphyxia and NICU admissions were found to be significantly higher in patients with CPR<1. We also observed APGAR<7 at 1 and 5 minutes, cord blood ABG with pH<7.3, pO2<50, PCO2>45 in patients with CPR<1. Conclusions: CPR serves as a noninvasive means to identify fetal compromise in seemingly healthy pregnancies, aiding in the decision-making process regarding the mode of delivery. Clinical significance-CPR can assist in stratifying at risk pregnancies, subsequently influencing decisions regarding the mode and place of delivery.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233640
      Issue No: Vol. 12, No. 12 (2023)
  • Study of demographic profile and causative factor in female infertility

    • Authors: Shivani Bhadkaria, Sakshi Srivastava, Kalpana Mishra, Vibha
      Pages: 3598 - 3603
      Abstract: Background: Infertility is a global health concern affecting millions of couples worldwide, with a significant impact on physical health and societal disparities. This study investigates female infertility in a specific population in India. Methods: The study, conducted at Nehru Hospital, BRD Medical College, Gorakhpur during September 2019 to August 2020 involved 150 infertile couples seeking conception assistance. Demographic profiles, causative factors, and management approaches were explored. Data were collected through medical histories, physical examinations, and various investigations. Results: Of the infertile women, 57.33% experienced primary infertility, and 42.66% had secondary infertility, with the 26-30 age group being the most affected. A majority resided in rural areas (64.67%), followed Hinduism (87.33%), and 65.33% had at least a matriculation level of education. Most women were housewives (90%). Male partners exhibited addictive habits in 37.33% of cases. The study revealed the complexity of female infertility, with factors such as pelvic inflammatory disease, polycystic ovarian syndrome, myoma of the uterus, uterine anomalies, endometriosis, and tubal pathology playing crucial roles. Conclusions: This study provides valuable insights into the multifaceted nature of female infertility. It highlights the importance of tailored diagnosis and treatment approaches to address specific causes. The findings challenge assumptions about the correlation between demographic factors, such as religion, education, and occupation, and infertility outcomes. Male factors, particularly addictive habits, are also significant contributors to infertility. Further research is needed to gain a broader understanding of infertility factors in diverse populations.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233641
      Issue No: Vol. 12, No. 12 (2023)
  • Fertility outcomes in microdissection testicular sperm extraction for
           non-obstructive azoospermia

    • Authors: Simmi Mahour, Sreelakshmy R. Nair
      Pages: 3604 - 3609
      Abstract: Background: The objective of this study was to evaluate outcome of micro dissection testicular sperm extraction (micro TESE) and intracytoplasmic sperm injection (ICSI) for treatment of non-obstructive azoospermia (NOA). Methods: We retrospectively analysed data of 96 consecutive patients with clinical NOA who were treated with micro TESE by single surgeon, between January 2022 and December 2022, in Lifeline superspeciality hospital Adoor, Kerela. Embryological and clinical outcomes were demonstrated based on ICSI-IVF cycles using fresh or frozen sperms, different etiologies of NOA and various counts of sperms retrieved. Results: 96 men underwent micro TESE and 72.9% (70/96) of them had sperms retrieved. ICSI performed in 64 couples. Of those, 41 reached the stage of embryo transfer (ET). Of the couples who underwent embryo transferred, 18 (43%) resulted in biochemical pregnancies and 7 (17%) clinical pregnancies. There was a significant difference in the testicular volume and serum FSH levels between micro-TESE positive and negative groups (p=0.000). Retrieval rates were higher in group of men with normal testicular volume and FSH<12. Clinical pregnancy rate was around 11% in couples who had sperms retrieved by micro TESE. The sperm retrieval rates were higher in men with age <40 years. Similarly younger the female age more was the pregnancy rate. Out of various etiologies idiopathic NOA and Klinefelter syndrome had better sperm retrieval rate in our study which was statistically significant. Total fertilization rate and blasts rates were 79.7% and 51.6% out of ICSI. Conclusions: Microdissection testicular sperm extraction is an effective treatment for NOA with higher rate of sperm retrieval and pregnancy rate. The increasing success rates over several years indicate the importance of surgical skill and laboratory staff experience.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233642
      Issue No: Vol. 12, No. 12 (2023)
  • A study of prevalence of anaemia in pregnant women among rural population
           in Rajasthan

    • Authors: Nidhi Chaturvedi, Ashwani Verma, Pratiksha, Sakshi Chaudhary
      Pages: 3610 - 3613
      Abstract: Background: Anaemia in pregnancy is a major contributor in morbidity seen in pregnancy and childbirth. Prevalence of anaemia in India is still as high as 52%. Aim of the present study is to study the prevalence of anaemia and its socio demographic variables in rural population of Rajasthan. Methods: This study was done in our tertiary care teaching institute in obstetrics and gynecology department in Rajasthan. 2384 women who came to the ANC clinic were screened for anaemia. 1442 women found anemic were enrolled for study. They were interviewed through a structured questionnaire and data thus obtained was analyzed. Results: Prevalence of anaemia was found to be 60.4% in the study. Out of these 58.8% had mild anaemia, 39.8% had moderate anaemia, 1.04% severe anaemia and 0.2% had very severe anaemia. Maximum women were in the age group 20-24years (48.8%). A large proportion of women were from the lower socioeconomic strata 58.9%. Maximum anemic women had received primary education (63%), while 25% were illiterate and 12% received more than primary education. Prevalence of anaemia was almost similar in both primigravidas 49.1% and multigravidas 50.9%. Regular iron intake was seen in 56% women, 27.7% took iron folic acid (IFA) tablets but irregularly and 16.3% had not taken any supplements. Conclusions: Anaemia is still highly prevalent among pregnant women in rural Rajasthan. So, there is a need for effective implementation of the existing programmes for prevention and treatment of anaemia for healthy future generation.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233643
      Issue No: Vol. 12, No. 12 (2023)
  • Post operative wound gape in obstetric and gynaecological surgeries

    • Authors: Aswathi Vijay, Jayanth Chilkund, Siddhi Kore, Saroj Kumari
      Pages: 3614 - 3618
      Abstract: Background: Despite advances made in asepsis, post operative wound infection is one of the major causes for increased postoperative morbidity and huge economic burden for patient and healthcare. This study was undertaken to identify risk factors for the post operative wound gaping in obstetrical and gynaecological surgeries. Methods: Retrospective observational study was conducted in the department of obstetrics and gynaecology of Pt. Madan Mohan Malviya Shatabdi hospital, Govandi, Mumbai for the year 2022. Results: 1611 cases were analysed that underwent various obstetrical and gynaecological surgeries. Post operative wound gaping incidence was 1.5 %. Most of the cases were seen in less than 34 years of age. 21% of cases reported with wound gaping and discharge within 5-7 days of surgery while 79% of cases reported gape after 7 days of surgery. 54% cases with wound gape were obstetric. The most commonly known associated risk factor was found to be diabetes mellitus (12.5%) followed by anaemia (8.3%), obesity (4.2%) and hypertension (4.2%). 62.49% of post operative surgical wound gape were multiparous. It is seen that in all these cases of wound gape the subcutaneous tissue was sutured separately as a layer with absorbable suture material- Vicryl no 1-0 or Vicryl no 2-0. Conclusions: Factors affecting post operative wound gaping are diabetes mellitus, anaemia, hypertension, obesity, chemoprophylaxis given prior to surgery, surgical method of wound closure and type of surgery. Standard wound closure techniques, correction of the avoidable known risk factors would provide a better outcome.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233644
      Issue No: Vol. 12, No. 12 (2023)
  • Venous thromboembolism after major gynecological cancer surgery: an
           analysis of cause and effect from the experience of a tertiary referral
           oncologic centre

    • Authors: M. D. Ray, Premanand N., Saroj Rajan, Romey Rai
      Pages: 3619 - 3625
      Abstract: Background: Patients undergoing extensive gynecological oncologic surgeries are at greater risk for developing deep vein thrombosis and pulmonary embolism than other oncological procedures. The anatomical confinement of vessels, lymphatics, and other structures in the restrictive pelvic space is contributory. We aimed to establish the etiopathogenesis of venous thromboembolism (VTE) with our practical experience. Methods: We present our experience from a tertiary referral oncologic centre in north India in patients with ovarian cancer undergoing cytoreductive surgery (CRS) with or without HIPEC, with a focus on the incidence and etiopathogenesis of deep venous thromboembolism (DVT), including anatomical barriers, restricted movement during surgical dissection, risk stratification and preventive measures. Results: Of 250 patients who underwent cytoreductive surgery (CRS) for ovarian cancer, 124 additionally underwent hyperthermic intraperitoneal chemotherapy (HIPEC). 20 (8%) patients were diagnosed with DVT within 30 days of surgery, and 3 (1.2%) were detected after 30 days. It is the most common significant postoperative morbidity. Conclusions: DVT is the most common postoperative complication in patients undergoing CRS+HIPEC for carcinoma ovary. Anatomical confinement, closed dependant spaces and more significant surgical trauma to pelvic vessels and lymphatics may be the leading cause. Detailed knowledge of anatomy and careful surgical dissection may prevent the development of DVT.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233645
      Issue No: Vol. 12, No. 12 (2023)
  • Maternal and perinatal outcomes, and associated factors in isolated
           borderline oligohydramnios: a cross-sectional analytical study

    • Authors: Roshini S., Gayathri
      Pages: 3626 - 3632
      Abstract: Background: Borderline oligohydramnios is associated with adverse perinatal outcomes. This study aimed to assess the impact of borderline oligohydramnios on maternal and perinatal outcomes, focusing on mode of delivery, fetal distress, neonatal morbidity, and NICU admissions. Methods: A cross sectional analytical study comprising 80 antenatal mothers (≥34 weeks) with borderline oligohydramnios was conducted at an Indian hospital. Data were collected through a semi-structured questionnaire and case record reviews. Maternal and perinatal outcomes were analyzed, including mode of onset and delivery, Apgar scores, NICU admissions, and neonatal morbidity. Results: The mean (SD) age of the participants was 24.5 (2.1) years. Induced labor was prevalent (41%), with 7% of infants experiencing neonatal morbidity, mainly meconium aspiration and neonatal sepsis. About 60% (n=40) delivered a baby between a weight 2.5 to 3 kg, 63% (n=50) had APGAR score more than 7, 34% (n=27) admitted to neonatal intensive care units, and the main reason for NICU admission was fetal distress (n=44.4%). The reason for neonatal morbidity was meconium aspiration (5%) followed by neonatal sepsis (2.5%). Non-reassuring NST and amniotic fluid nature significantly correlated with NICU admissions, while age and AFI influenced delivery mode. Conclusions: Borderline oligohydramnios led to a high rate of induced labor, yet neonatal morbidity was relatively low. Non-reassuring NST and amniotic fluid nature significantly impacted NICU admissions. Further research on a larger scale is warranted to validate these findings for widespread implementation.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233646
      Issue No: Vol. 12, No. 12 (2023)
  • Impact of subclinical hypothyroidism on infertility and other metabolic
           parameters in women with polycystic ovarian syndrome in South Asia

    • Authors: Israt Azmi Rolin
      Pages: 3633 - 3642
      Abstract: Polycystic ovary syndrome (PCOS), is a very common endocrine and metabolic disorder in premenopausal women that affects 1 in 10 women of childbearing age. According to recent studies, the prevalence of PCOS was found around 53%. Many studies showed that subclinical hypothyroidism (SCH) and PCOS share symptoms which can influence PCOS symptoms like infertility and hormonal changes. This systematic review aimed to evaluate the impact of SCH on infertility and other metabolic parameters in women with polycystic ovarian syndrome in South Asia. For this review work, after a literature search through PubMed, Cochrane, and Google Scholar, 5 relevant papers were identified for this systematic review. The publication time was limited to the most recent 10 years, from 2011 to 2022. This review considered quantitative research on PCOS and SCH and used evidence-based data to support the findings. Among the mentioned 5 studies, 3 were cross-sectional and 2 were case-control. The studies were conducted on 2 groups: the SCH-PCOS intervention group and the PCOS control group. For the quality assessment, Cochrane's software, review manager (RevMan) was used to eliminate duplicate studies and reduce bias. The systematic review was conducted on 1468 female patients and measured anthropometric parameters in both groups. Total cholesterol, body mass index (BMI), TSH, free testosterone levels, insulin resistance and menstrual irregularities were all higher in the SCH-PCOS group compared to the PCOS group, along with a p<0.001 for each of the parameters. Usually, SCH and PCOS share symptoms. In cholesterol, BMI, TSH, free testosterone levels, insulin resistance and menstrual irregularities there are significant correlations between SCH and PCOS. So, there are some potential impacts of SCH on infertility and other metabolic parameters in women with polycystic ovarian syndrome in South Asia.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233647
      Issue No: Vol. 12, No. 12 (2023)
  • Interstitial ectopic pregnancy: a case series

    • Authors: Gitanjali Gnanavel
      Pages: 3643 - 3645
      Abstract: Interstitial ectopic pregnancy is very rare with incidence of 2-5%. Their presentation is not uniform and hence may go unrecognized till complications develop. We present three cases of interstitial ectopic pregnancies presenting in our hospital in a span of 1 year. Only one of them had pain in the abdomen at the time of presentation. All cases presented at around five to six weeks of gestation. Ultrasonography confirmed the diagnosis. One case was managed medically while in other two cases, there was a need of surgical management. There were no complications in all the cases. Thus, early presentation of cornual ectopic pregnancy results in satisfactory outcome. Hence, all pregnant women should undergo regular antenatal checkups with early scans once the urine pregnancy test come positive to confirm whether it is an intra uterine pregnancy or not.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233648
      Issue No: Vol. 12, No. 12 (2023)
  • A rare case of life threatening non-obstetric-non-traumatic vulvar-vaginal
           haematoma secondary to suspected spontaneous rupture of the right pudendal
           artery: surgical management in a reference hospital in Southern Nigeria

    • Authors: Innocent Okafor Eze, Noble Chidiebere Anyanyu, Ugochi Ogbonneya Nzeribe-Abangwu, Victor Cletus Igboezue, Rufai Muhammed, David Ugonna Uzoho
      Pages: 3646 - 3650
      Abstract: Vulvar haematoma due to obstetrics and traumatic causes have been reported. However, non-obstetrics-non-traumatic vulvar-vaginal haematoma is very rare yet could be life threatening. Good management and outcome may be challenged by low index of suspicion, inexperience and lack of standard guideline for care. We report a rare case of life threatening non-obstetric-non-traumatic vulvar-vaginal haematoma secondary to suspected spontaneous rupture of the right pudendal artery in a 35-year-old woman which presented as emergency with diagnostic challenges and was successfully surgically managed. This report draws attention of clinicians to this rare but important clinical scenario which can present with diagnostic challenges. It further highlights different approaches to treatment but emphasizes surgical treatment as key to quick recovery with lesser morbidities.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233649
      Issue No: Vol. 12, No. 12 (2023)
  • Urethro-cutaneous fistula: a rare complication in anti-incontinence
           surgery with trans-obturator tapes sling

    • Authors: Omar Treviño Cavazos, Guadalupe Guerrero Reyes, Adrián Gutiérrez González , Ricardo Hernández Velázquez, Karen M. Loya Maldonado , José I. Leyva Vázquez , Jennifer E. Reyes Alcaraz , Alejandra Robledo Torres , Sara Y. Saca Cuevas, Juan C. Herrera Morales
      Pages: 3651 - 3654
      Abstract: This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233650
      Issue No: Vol. 12, No. 12 (2023)
  • The pain is not from the uterus: a rare complication of ovarian cyst
           during term labour

    • Authors: Fadzlin M. Adzlan
      Pages: 3655 - 3657
      Abstract: A case of primigravida with an ovarian torsion at 39 weeks of gestation is reported here. A Malay lady in her late 20s with a known case of ovarian cyst complained of sudden onset of severe pain during labour. Diagnosis of ovarian torsion was made and she underwent laparotomy cystectomy with emergency lower segment caesarean section in the same setting. Post-operative recovery was unremarkable. Histopathological examination confirmed mucinous cystadenoma.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233651
      Issue No: Vol. 12, No. 12 (2023)
  • Supraventricular tachycardia at 37 weeks with electro cardioversion

    • Authors: Donel S., Munawar Adhar L.
      Pages: 3658 - 3660
      Abstract: The health of both the mother and the fetus is at risk when symptomatic maternal arrhythmias occur during pregnancy. Sustained symptomatic arrhythmias should be managed, much like in the non-pregnant population. The specific arrhythmia that has been identified or is suspected must be treated. Electrical cardioversion (ECV) is used to treat supraventricular arrhythmias when medication therapy and physical therapy, such as sinus carotid massage or Valsalva movements, fail or in life-threatening conditions where the patient is hemodynamically unstable. A 27-year-old primipara came to Bengkalis hospital at 37 weeks of gestation due to complaints of palpitations. palpitations felt since 4 hours before admission to the hospital. The patient had experienced the same complaint and was examined by a cardiologist who said that the patient had a tendency to arrhythmia and was given bisoprolol. An ECG examination was carried out in the emergency room, the impression was supraventricular tachycardia with HR 185 bpm, an abdominal termination of pregnancy was carried out, and the cardiologist performed electro-cardioversion (ECV) in the operating room 3 times, and the mother's HR returned to sinus rhythm. The outcome was a baby girl born with a birth weight of 3200 grams, an Apgar score of 8/9. Mother was treated and went home on the 3rd post-operative day in good condition. Provided that a multidisciplinary approach, continuous fetal heart rate monitoring and the possibility to perform a caesarean section are applied, it can be concluded that cardioversion is a safe and effective treatment for maternal tachycardia in pregnancy.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233652
      Issue No: Vol. 12, No. 12 (2023)
  • Takayasu arteritis in pregnancy: a case report, and clinical lessons

    • Authors: Anil P. Sakhare, Tejas P. Bhandari, Jaydeep R. Solanke, Rahul J. Ghante
      Pages: 3661 - 3663
      Abstract: A case report of known case of Takayasu arteritis (known to the woman in case report) in a primigravida, but unrevealed to the obstetrician till advanced stage of pregnancy is reported. The authors share the lessons learnt by them from this case which would improve diagnosis, evaluation and management of pregnancy hypertension. A brief account on clinical manifestations and diagnosis of Takayasu arteritis is also included.
      PubDate: 2023-11-10
      DOI: 10.18203/2320-1770.ijrcog20233537
      Issue No: Vol. 12, No. 12 (2023)
  • Two case reports of accessory cavitated uterine mass-diagnostic challenges

    • Authors: A. Anitha, Mala Vijayakrishnan, N. Usha, Aruna P., Sridevi B.
      Pages: 3664 - 3669
      Abstract: Accessory and cavitated uterine mass (ACUM) is a rare Mullerian duct anomaly of unknown incidence, affects young women. ACUM symptoms such as dysmenorrhea and chronic pelvic pain (CPP) resistant to common analgesics and hormonal contraceptives. Here we report two ACUM cases in our hospital within one year of period with different clinical manifestations. The idea behind reporting this-cases is to increase awareness of the above entity and for concurrent surgical treatment.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233653
      Issue No: Vol. 12, No. 12 (2023)
  • A rare case of live unruptured ovarian ectopic pregnancy

    • Authors: Parth Khandhedia, Karan Sharma, Ashka Joshi
      Pages: 3670 - 3673
      Abstract: Ectopic pregnancy is the implantation of embryo anywhere outside the uterus. The commonest location is fallopian tubes followed by previous scar, abdomen and ovary. Most of them terminates with rupture in first trimester and usually have an intricate diagnosis through surgery and histopathology. A lady in her early-thirties presented with brownish discharge per-vaginally with LMP 2 months ago and UPT positive 15 days ago. The scan revealed a good chorio-decidual reaction without any gestational sac in the uterus which was found live and unruptured along with the heartbeats in right adnexa. She was managed with emergency laparoscopic removal of the ectopic where the Gestational sac was not visualised in right tubes but astonishingly it was found in the right ovary. There were no complications post-operatively and patient was discharged in a stable condition. The overall increase in the incidence is admitted to IUCD, STI, ART, PID and many others. However, the actual factor remains unclear. The diagnosis is often made during surgery but histopathological confirmation is required. Spiegelberg Criteria defines the ovarian ectopic. Hence, it becomes peremptory to identify the cases early for complication prevention and the related deaths.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233654
      Issue No: Vol. 12, No. 12 (2023)
  • Massive hydrosalpinx with torsion in second trimester of pregnancy: a case

    • Authors: Rupita Kulshrestha
      Pages: 3674 - 3676
      Abstract: Acute abdominal pain in pregnancy can be due to obstetrical (preterm labour), gastrointestinal, urinary causes etc. Pregnancy with large adnexal masses are rare presentations. This is a case report about a woman presenting to emergency with 16 weeks and 5 days of gestation with acute pain abdomen. Diagnosis of coexisting huge adnexal mass was made with ultrasound. No response to conservative therapy forced us to do laparotomy which showed huge hydrosalpinx with 4 twists around its pedicle. This case report emphasizes the need to keep hydrosalpinx with torsion in a differential diagnosis for acute pain abdomen in second or third trimester, especially if pain is not relieved on conservative management.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233655
      Issue No: Vol. 12, No. 12 (2023)
  • A rare case report: unruptured ovarian pregnancy

    • Authors: Shipra Sarkar, Somenath Ghosh, Priyanka Mitra
      Pages: 3677 - 3679
      Abstract: Ovarian pregnancy is a rare form of ectopic pregnancy. Its incidence is 0.5-1% of all ectopic gestations or 1 in 7000 to 40000 live births. The diagnosis is intricate and based on surgical and histopathological observations. In our institute in last 10 years, we have seen a single confirmed case out of 189 ectopic pregnancies. It was a spontaneous pregnancy with no history of contraception failure and diagnosed as tubal ectopic by ultrasound imaging. Laparotomy findings and histopathology confirmed it to be an Ovarian Pregnancy.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233656
      Issue No: Vol. 12, No. 12 (2023)
  • Use of intramyometrial carbetocin in caesarean myomectomy to reduce

    • Authors: Rajasri G. Yaliwal, Shilpa Lakshmi, Aruna M. Biradar, Laxmi S. Sangolli, Gauri Bankapur
      Pages: 3680 - 3682
      Abstract: Traditionally myomectomy is avoided during caesarean delivery because of potential excessive blood loss. As the size increases, blood supply of leiomyomas also increases in pregnancy, and specifically at term due to the effect of human chorionic gonadotropin. Carbetocin is an oxytocin analog. It is long acting and is effective in preventing blood loss. It has been used in myomectomy to prevent blood loss in non-pregnant uterus. We present a case report where it is used intramyometrial route during caesarean section. A 30-year-old multigravida of 38 weeks period of gestation with previous caesarean section, presented in labor. Her recent ultra sound report showed single live intrauterine fetus of 35 weeks 3 days with a single posterior wall fibroid. The woman requested for myomectomy along with caesarean delivery as she had heavy menstrual bleeding caesarean section was done and myomectomy was planned along with the caesarean section. Intramyometrial carbetocin 100 mcg was used to prevent excessive blood loss. The patient had an uneventful post-operative period. Intramyometrial carbetocin is an effective method to reduce blood loss in myomectomy during caesarean delivery.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233657
      Issue No: Vol. 12, No. 12 (2023)
  • Navigating mixed connective tissue disease in pregnancy: a rare case

    • Authors: Dipika Nannaware, Anusha Kamath , Neha Gangane, Anita Yadav
      Pages: 3683 - 3686
      Abstract: Autoimmune connective tissue diseases (CTDs) in pregnancy present a complex interplay between maternal health and fetal outcomes. While historically discouraged due to potential complications, proper preconception counselling and disease control offer the prospect of safe pregnancies. This case report focuses on mixed connective tissue disease (MCTD), a rare condition combining features of SLE, systemic sclerosis, rheumatoid arthritis, and polymyositis, presenting during pregnancy. A 29-year-old woman, gravida 2, para 1, with a history of rheumatoid arthritis, was referred at 31+4 weeks with a deranged coagulation profile, fetal growth restriction (FGR), and oligohydramnios. Extensive laboratory and imaging investigations confirmed MCTD diagnosis. Treatment involved LMWH, aspirin, hydroxychloroquine, and prednisolone. Comprehensive monitoring and multidisciplinary care were maintained throughout. Despite initial improvement, the patient faced complications at 35+3 weeks, leading to an emergency caesarean section at 36 weeks due to preterm FGR, oligohydramnios, and breech presentation. A male infant weighing 2.1 kgs was delivered, requiring neonatal intensive care due to prematurity and respiratory distress. Postoperatively, the mother resumed medication and was discharged with her baby. This case highlights successful MCTD management during pregnancy through meticulous monitoring and a multidisciplinary approach. The risk of complications necessitates informed preconception counselling, emphasizing the importance of disease remission, close surveillance, and prompt intervention in disease relapse. Comprehensive care, including medications and careful planning, contributes to improved maternal and neonatal outcomes in this rare and challenging scenario.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233658
      Issue No: Vol. 12, No. 12 (2023)
  • Laparoscopic uterovaginal anastomosis for cervicovaginal agenesis

    • Authors: Jagrut Joshi, Mahesh Gandhi, Meera Gandhi Joshi
      Pages: 3687 - 3691
      Abstract: Cervico-vaginal agenesis is an extremely uncommon mullerian abnormality. Therefore, we describe a case of a female patient, age 21, known case of cervico-vaginal agenesis presented with cyclic abdominal pain and vomiting. She underwent three surgeries for vaginal correction to drain haemometra. She underwent Laparoscopic uterovaginal anastomosis. After surgery, the patient experienced regular menstrual cycles without dysmenorrhea. On follow-up, hysteroscopy showed a patent anastomosis, vagina was completely healed and she continued to have regular menstrual cycles.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233659
      Issue No: Vol. 12, No. 12 (2023)
  • Caesarean scar pregnancy: diagnostic dilemma

    • Authors: K. S. Raja Rajeswari, Anushri M., Priya Shaunthani
      Pages: 3692 - 3694
      Abstract: Caesarean scar pregnancy is a rare but life-threatening type of ectopic pregnancy if not accurately diagnosed on time. With increasing caesarean section rates, caesarean scar pregnancy is bound to increase. We presented a 34-year-old gravida 2 para 1 live 1, last child birth 8 years, conceived with first cycle of follicular study without ovulation induction. Patient was a known case of fibroid uterus with adenomyosis. Pregnancy confirmed with baseline serum beta HCG and small gestational sac in USG at 6 weeks 4 days. At 7 weeks 3 days in dating scan there was two tiny sac within endometrium' early intrauterine pregnancies' early pregnancy failure' pseudo gestational sacs hence serum beta HCG done. Serum beta HCG levels were suggestive of ectopic pregnancy but and feta medicine centre ultrasound was suggestive of twin gestation. Repeat transvaginal ultrasound with inhouse sinologist confirmed the diagnosis of caesarean scar pregnancy with adenomyotic changes (which probably could have been misinterpreted as multifetal gestation) and fibroid uterus. We report this case to highlight the high suspicion of CSP in previous caesarean scar pregnancy.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233660
      Issue No: Vol. 12, No. 12 (2023)
  • Case report on interstitial pregnancy in a post adenomyomectomy woman

    • Authors: Archita Srivastava, Renu S. Gahlaut
      Pages: 3695 - 3698
      Abstract: Intramural pregnancy is a rare form of ectopic pregnancy with early diagnosis essential for prevention of severe hemorrhage and uterine rupture. We report a rare case of an interstitial ectopic pregnancy at 09 weeks gestation in a woman 3 year post laparoscopic adenomyomectomy. 3D transvaginal ultrasound was utilized as diagnostic aids in this case. Due to the size and location of the gestational sac, and early diagnosis made this case undergo conservative surgical management saving her uterus for future pregnancy.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233661
      Issue No: Vol. 12, No. 12 (2023)
  • Microperforated hymen with pregnancy presenting at term: an accidental

    • Authors: Ratna Bulusu, Swati A. Reddy, Vijaya Lakshmi
      Pages: 3699 - 3701
      Abstract: Anatomic variations of the patent hymen exist, the most common configuration having a central orifice. Difficulty in inserting a tampon or the inability to achieve vaginal intercourse in an adolescent is the typical presenting symptom of incomplete hymenal obstruction. Here, a case is reported wherein the patient presented with normal pregnancy at term with an apparently intact hymen. Later in labour, a microperforate hymen (MH) was noted. An emergency lower segment caesarean section along with hymenectomy was performed.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233662
      Issue No: Vol. 12, No. 12 (2023)
  • Postoperative acute parotitis after cesarean delivery under spinal
           anaesthesia: a rare entity

    • Authors: Kavitha V. Shenoy, Usha N., T. R. Srinivasan
      Pages: 3702 - 3704
      Abstract: Postoperative acute painless parotid gland swelling, which is a rare complication has been reported after caesarian section (CS) under neuraxial anaesthesia. Here, we present a parturient who suffered from acute parotitis, which developed after elective repeat CS under spinal anaesthesia.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233663
      Issue No: Vol. 12, No. 12 (2023)
  • Challenges in conservative management of placenta increta with
           methotrexate in nulliparous woman

    • Authors: A. Anitha, N. Usha
      Pages: 3705 - 3709
      Abstract: Placenta increta is a severe complication of pregnancy normally diagnosed during the second trimester. Early detection could reduce the risk of hemorrhage during abortion or miscarriage; however, guidelines on first‐trimester diagnosis are lacking. We describe a case of placenta increta during the second trimester with retained products of conception and its consequences followed by effective management with methotrexate.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233664
      Issue No: Vol. 12, No. 12 (2023)
  • Role of multi-biomarkers and algorithms for diagnosis of early-stage
           ovarian cancer

    • Authors: Anupama Upadhyaya, Priti Singh
      Pages: 3710 - 3713
      Abstract: Our reviews intend to provide a comprehensive update for the diagnosis of ovarian cancer using biomarkers (CA125) and ultrasonography algorithm RMI and ROMA and how to improve our approaches to identify and diagnose ovarian cancer in early stage and improve the survival rate This meta-analysis done in the Department of Obstetrics and Gynaecology Swaroop Rani hospital Prayagraj, Uttar Pradesh. Source of literature was all the standard online articles available in last 3years and also the departmental records of the last 1year following criteria CA125, HE4, RMI, ROMA for screening or diagnosis. Our result on the basis of ODDS ratio and confidence interval (CI) of tumour marker like CA125, HE4, RMI, ROMA from different study. Overall estimation and pooled estimation determined by forest plot and our pooled estimation is present between the 0.8 OR to 1.0 OR and 95 % of confidence interval of the result. Our study concludes that RMI has comparatively good OR ratio and pooled effect of forest plot is in favour of RMI 0.8 OR to 1.0 OR and had good opportunity to identify early-stage ovarian cancer. Our study concludes that RMI score has comparatively good OR ratio and it can be used to identify early-stage ovarian cancer which can help in on time intervention and improved outcomes in such patients.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233665
      Issue No: Vol. 12, No. 12 (2023)
  • A review of hyperandrogenism state in polycystic ovarian syndrome

    • Authors: Mohamed Shabi M., Nivya P. S., Devika C. S., Malayanur Suhas Reddy, Poornima N., Roopesh K. R., Joel Joseph, Shivanand Kolageri
      Pages: 3714 - 3721
      Abstract: Polycystic ovary syndrome is one of the most prevalent endocrinopathy in premenopausal women. The pathophysiology of PCOS is not clear, however disturbance in the hypothalamic-pituitary-ovarian axis and abnormal steroidogenesis along with genetic and environmental factors act as main contributors to this disorder. The steroidogenic pathway is affected by the overexpression of the CYP11A, CYP17, and CYP19 genes in PCOS, which results in a hyperandrogenic condition. The initial effect of too much androgen in PCOS is impaired folliculogenesis. The most frequent clinical manifestations of hyperandrogenism in women with PCOS include hirsutism, acne, and androgenic alopecia. Women with PCOS may have an excess of androgen during foetal life due to the elevated expression of P450c17a during the whole pregnancy. PCOS is believed to be formed in utero by the influence of androgen excess on gene expression in adolescence and adulthood, which offers more solid evidence that real PCOS can be induced by prenatal androgenization. A prenatal androgen excess-induced epigenetic phenomena is suggested by the current theory of PCOS's developmental genesis. It is currently believed that the many tiny follicles seen in polycystic ovaries and the considerable irregularity in the very early stages of folliculogenesis are associated to the formation of anovulation in PCOS.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233666
      Issue No: Vol. 12, No. 12 (2023)
  • Associating factors in postmenopausal women with pelvic organ prolapse

    • Authors: Laraib Daniyal
      Pages: 3722 - 3722
      Abstract: I have reviewed with deep interest the publication "the evaluation between vitamin D level and pelvic organ prolapse in postmenopausal women." As a medical student, I appreciate all authors on their dedicated work and would like to express my gratitude for their findings. This study investigated the association between vitamin D levels and pelvic organ prolapse in postmenopausal women.
      PubDate: 2023-11-28
      DOI: 10.18203/2320-1770.ijrcog20233667
      Issue No: Vol. 12, No. 12 (2023)
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