bluuebunny/crossref_metadata_2025 huggingface dataset:
Attention to the spiritual and religious needs of patients by healthcare personnel. A model based on spiritual accompaniment.
Authors: Canteros Marcelo
Published: December 2021

During the past decades, spirituality and religion have regained their importance in health care, not only as a way of respecting the decision-making autonomy of the patient but as an element that influences the clinical evolution and quality of life of the sick patient and allowing to provide comprehensive health care. The latter has resulted in many countries guaranteeing spiritual care during hospitalizations by law. However, on the one hand, attention to spiritual and religious needs is usually reserved only for terminal cancer patients and/or patients with catastrophic diseases. On the other hand, attention to these needs has gradually become considered part of the obligations of the health teams, not without their reluctance and without a clear indication of how this task must be carried out. This work aims to present the importance of spirituality and religion inpatient care and a care model based on spiritual accompaniment. Know all the theories, master all the techniques, but as you touch a human soul be just another human soul. Carl Jung
Reliability of Postmortem ABO Blood Grouping: A Study of 100 Cases
Authors: Kumar Kuldeep , Sharma Luv , Gill Meenu , Tanwar Ruchi , Kumar Vinod
Published: December 2021

Blood grouping has been one of the cornerstones for identification of biological materials in forensic investigations. Antigens of the ABO system can be detected even prior to birth. ABO blood groups can also be detected after death for a long period in many body tissues (teeth, bones, etc.). Blood has its own forensic value in many medico-legal issues. The present study looked at a total number of 100 autopsy cases brought for medico-legal investigations in the mortuary of the Department of Forensic Medicine in collaboration with the Department of Pathology at the Postgraduate Institute of Medical Sciences (PGIMS), Rohtak (Haryana, India). The blood samples were collected from right ventricle without any anticoagulant. ABO blood grouping was performed by direct haemagglutination technique using monoclonal antisera. Reverse blood grouping was also attempted. Our results showed that ABO blood group antigens can be detected from blood fluid after death, even in decomposed bodies with an estimated post-mortem interval (EPMI) of <85 hours. Our results also show that as post-mortem interval increases beyond a certain limit there is a decrease in antigens on RBCs in the post-mortem blood.
The Future of Personal Health Records and Patient Portals
Authors: Nazi Kim
Published: December 2021

Over the last two decades, the early development of standalone Personal Health Records (PHRs), and later tethered patient portals, have had a transformative effect on engaging patients by providing them with tools to manage their health and unprecedented access to their heath data. However, despite anticipated benefits and continued high consumer demand for online access to personal health information, adoption and sustained use has been less than expected. Moreover, powerful forces are transforming healthcare, necessitating change and adaptation. This aim of this paper is to examine several significant trends that are influencing the intersection of health care and technology and provide an assessment of the impact of these trends on the future of PHRs and patient portals. An aging population with an increased prevalence of chronic disease and mental health conditions, coupled with rising consumerism and more diverse care settings, has significant implications for patient-facing tools such as patient portals. Similarly, the proliferation of data generating consumer health technology and technical advances such as artificial intelligence and emerging data standards calls for the next iteration of tools to support care delivery. Moreover, the acceleration of virtual care driven by national policy changes and the COVID 19 pandemic requires better tools to realize the promising potential of the technology in an increasingly complex and interconnected world. Taken together, these factors may provide the perfect storm that will enable a critical shift to envision a more holistic patient-centric information and resource hub that is characterized by improved architecture, optimized design and content, a robust set of well-designed tools and functions, and enhanced integration with clinical care processes and structures. This personal health portal could provide a long desired single comprehensive longitudinal personal health record with best of breed design and features to empower patients as they navigate their health journey.
Circumstances of occurrence of uterine ruptures treated in a national reference maternity department in Benin from 2015 to 2019
Authors: Ogoudjobi Ogourinde M. , Dangbemey Patrice D. , Obossou Achille A. A. , Saleh Abdel S. , Hounnouvi Fiacre P. D. , Tshabu-Aguemon Christiane , Denakpo Justin L.
Published: December 2021

Background: Uterine rupture is an obstetric disaster and a major concern for the obstetrician in an African environment because of the insufficient technical support. Objective of current study was to study the circumstances of occurrence of uterine ruptures.Methods: The study was carried out at the university clinic of obstetrics and gynecology of CNHU-HKM in Cotonou. This was a descriptive and cross-sectional study with retrospective collection from January 1, 2015 to December 31, 2019. We made an exhaustive recruitment of all the patients treated in the department for uterine rupture during the study period. The study variables were socio-demographic and clinical characteristics. Data confidentiality and the anonymity of women were respected.Results: The study involved 85 cases of uterine rupture. Patients were relatively young with a mean age of 30±15.02 years. Women profile was that of populations with unfavorable socio-economic conditions. The circumstances of discovery were multiparity equal to or greater than 4 (43.5%), scarred uterus (32.9%), non-use of partogram (97.6%), osseous dystocia (10.9%) and fetal dystocia with fetal macrosomia (21.2%) and dystocic presentation (15.3%).Conclusions: This study identified epidemiological and clinical characteristics related to the circumstances of known uterine ruptures occurrence. A preventive and anticipatory oriented approach can reduce the frequency of that obstetric tragedy, the adequate management of which is often uncertain in Benin.
The role of maternal echocardiography and uterine artery Doppler at 11-14 weeks in the prediction of pre-eclampsia in nulliparous women
Authors: Sah Dipak K. , Deeba Farzana , Chowdhury Saleha B.
Published: December 2021

Background: Pre-eclampsia (PE) complicates 2% of pregnancies and may have serious effects on mother and child, which makes it an important threat to public health in both developed and developing countries. Once high-risk women are identified, they can be targeted for more intense prenatal surveillance and preventative measures. Predicting PE in the first trimester requires the use of maternal echocardiography and the uterine artery pulsatility index (UAPI). Objective of the study was to see whether maternal echocardiography and uterine artery Doppler at 11-14 weeks can predict subsequent development of PE in nulliparous women.Methods: This prospective observational cohort study was carried out in outdoor patients of obstetrics and gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), with collaboration with department of cardiology, National Institute of Nuclear Medicine and Allied Sciences (NINMAS), BSMMU, Dhaka, during 01 December 2013 to July 2015. A total of 135 healthy nulliparous women at 11-14 weeks of gestation were included in this study. Data was processed and analyzed by statistical package for the social sciences (SPSS) version 24.0.Results: Among 135 patients, two (1.5%) patients developed preeclampsia during 1st follow-up (20-28 weeks) and four (2.9%) patients developed preeclampsia during (29-36 weeks). Mean total peripheral resistance was found to be 1332.0±75.2 dynes/sec/cm5 in preeclampsia and 1157.0±139.2 dynes/sec/cm5 in non preeclamptic pregnancy. The difference between two groups was statistically significant. MAP and total peripheral resistance were statistically significant (p<0.05) between two groups.Conclusions: In first trimester of pregnancy UAPI is the best predictor for detection of PE.
Maternal and foetal outcome in preterm births in a rural tertiary care centre: a retrospective study
Authors: M. Deeksha Rao , S. Vasantha Kumar
Published: December 2021

Background: Preterm birth (PTB) is one of the main causes of perinatal mortality and morbidity. It can also result in long term health consequences for both mother and the newborn. The objective was to assess maternal and fetal morbidity and mortality in PTBs.Methods: A retrospective study was done in the department of obstetrics and gynecology in a tertiary care hospital during January 2020 and June 2020. Ninety-three women with records of preterm births were analyzed for maternal and fetal outcomes. coGuide statistical software was used for data analysis.Results: 48.39% of the women were between 20 to 24 years of age. The majority (50.54%) were primigravida. The main causes for PTB among the study participants were medical disorders (39.78%), PPROM (29.03%), spontaneous labor without any underlying cause (18.28%). 51.61% had a vaginal delivery, 88.17% had a live birth. The majority of 52 (55.91%) neonates had birth weights between 1.51 to 2.5 kg. Fifty-nine neonates (63.44%) needed NICU admission. The reason for NICU admission in majority 25 (26.88%) was respiratory distress.Conclusions: Timely, early diagnosis and treatment of medical disorders among antenatal women can aid in reducing the occurrence of preterm births and their associated morbidity and mortality. Medical disorders and premature preterm rupture of membrane remain the main causes of preterm birth.
Correlation between maternal thyroid stimulating hormone and birth weight of neonate
Authors: Shettian Nishita , Pavuluri Hema Venkata Naga Sai Sudha
Published: December 2021

Background: The aim of this study is to determine the pregnancy outcomes in women with thyroid disorders.Methods: This is a retrospective observational study conducted in the department of obstetrics and gynaecology of AJ institute of medical sciences and research centre from the month of March to September 2021. The first trimester thyroid stimulating hormone (TSH) level and birth weight of new born is collected from hospital records, study participants included all the pregnant mothers who were admitted and delivered in the labour ward of AJ institute of medical sciencesResults: According to our study low birth weight in neonates in euthyroid, hypothyroid, hyperthyroid participants were 21.4%, 61.5%, and 100% respectively.Conclusions: This study indicates that there is an association between maternal thyroid levels and neonatal birth weight. A higher TSH concentration during first trimester of pregnancy is associated with low birth weight. Based on these findings, it is recommended that maternal thyroid levels be monitored closely in the first trimester and initiate timely treatment in case of altered thyroid levels during pregnancy in order to have a healthy pregnancy and healthy baby with no compromise in the fetal weight.
Prospective study of maternal outcomes in primigravida with gestational diabetes mellitus in a tertiary care centre Venjaramood, Thiruvananthapuram
Authors: Kuriakose Lency S. , Nair Bhavani L. , Radha Prameeda P.
Published: December 2021

Background: The prevalence of Gestational diabetes mellitus (GDM) is on the rise. Understanding the various outcomes of it is essential to face this challenge. The aim of the study was to understand the maternal outcomes of GDM in primigravida and to compare the maternal outcomes in primigravida with GDM and without GDM.Methods: This prospective study was conducted in the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, on 180 primigravida mothers,90 with and 90 without gestational diabetes. GDM was diagnosed with IADPSG criteria using 75 g Oral glucose tolerance test (OGTT).Results: A total of 180 primigravida with singleton gestation, 90 with GDM and 90 without GDM were followed from pregnancy to delivery after fulfilling criteria during study period. 65.6% GDM mothers had good compliance with Medical nutrition therapy (MNT) and exercise.  88.8% of GDM mothers required induction of labour, 13.3% had pregnancy induced hypertension, 12.2% had vulvovaginal candidiasis and 10% had postpartum hemorrhage. Thus, women with GDM on MNT or MNT with insulin had a higher risk of adverse maternal outcomes but was comparable to normoglycemic mothers if they had good compliance to MNT or insulin.Conclusions: Women with GDM had a higher but comparable risk of adverse maternal outcomes as compared to normoglycemic pregnant mothers, if they strictly adhere to MNT with or without insulin reflecting the importance of good treatment compliance.
Study of maternal deaths with COVID-19 infection in a tertiary care centre
Authors: Chavan Niranjan , . Shikhanshi , Kapote Deepali , Deshmukh Prasad , Sakhalkar Ashwini
Published: December 2021

Background: COVID-19 has been a major speed braker not only for world economy and development but also for health sector. The susceptible population including elderly, co-morbid adults and pregnant females were likewise affected in both major COVID-19 waves in India. Association between COVID-19 cases and pregnancy has been studied throughout the world.COVID-19 is associated with substantial risk of morbidity and mortality in postpartum patients and their infants world-wide, compared with their not-infected pregnant counter-parts, especially if these individuals were symptomatic or have comorbidities.Methods: This single-centre prospective observational study, included all consecutive maternal mortalities with COVID-19 infection admitted to Lokmanya Tilak municipal medical college and general hospital (Mumbai, India), a tertiary referral hospital, from 1 April 2020, to June 2021.In this study, a total of 390 patients were included who were found COVID-19 positive during the study period and 17 patients who died during their admission in hospital. The relation of risk factors and demographics were studied for all the patients.Results: The COVID-19 related maternal mortality was more in women of age group 20-30 years (89%). Most women presented to our centre with complaints of fever, cough, cold or breathlessness (55.5%). Patients who succumbed to COVID-19 were mostly primiparous patients (52.9%) and died within 5 days of delivery (46%). 64% of patients died following 5 days of diagnosis of COVID-19.The co-morbidity present in most patients with COVID-19 associated maternal mortality was pre-eclampsia (31.5%). Most patients were referred with only 17% patients registered at our centre and the type of delay involved in management was mostly Type 1 and 2 (82.2%)Conclusions: Multi-centre retrospective analysis with larger population size is required in order for this to be statistically significant.
A Retrospective evaluation of hysterolaparoscopy as primary diagnostic tool for female infertility
Authors: Jamal Shehla , Sharma Mridula , Masroor Kainat , Singh Shravi
Published: December 2021

Background: Infertility has been equally challenging and frustrating to the couple as well as physician. The causative etiology can have multitude of factors. Evaluation of underlying factors and formulating uniform diagnostic protocols is still a challenge for most of the infertility experts. This study was aimed to evaluate hysterolaparoscopy as primary diagnostic tool for female infertility.Methods: This is a retrospective study conducted in the department of obstetrics and gynecology, SMS and R, Sharda University, Greater Noida, Uttar Pradesh. The data was collected from January2018 to December 2019. A total of 84 cases were studied. Data were entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done.Results: Around 86.9% of the patients had abnormal findings. 13% of the patients had no abnormal laparoscopic findings, according to our inclusion criteria. One or the other findings were encountered in 96.4% of the cases. Only 3.5% of the patients had no discernible characteristics as per our inclusion protocol.Conclusions: Irrespective of the investigations protocols used, hysterolaparoscopy finds its importance in most of the clinical settings. This investigative approach is professed as superior to hysterosalpingogram and Saline Infusion sonography when used alone. In the present study, we propose diagnostic hysterolaproscopy as first and one step approach, between days 8-11 of the cycle, as an effective diagnostic tool in cases of infertility.
Sublingual misoprostol to reduce blood loss at caesarean delivery
Authors: Agarwal Shonali N. , Thakkar Nidhi D.
Published: December 2021

Background: Caesarean section is the most common obstetrical procedure performed worldwide. Sometimes oxytocin alone is not sufficient to prevent postpartum haemorrhage and additional uterotonics may be required. We attempted an additional uterotonic misoprostol by sublingual route to evaluate the role of it to reduce blood loss at caesarean delivery.Methods: This prospective clinical study was done on patients of S. S. G. Hospital, Baroda; 138 patients who underwent lower segment caesarean section (elective or emergency). The primary outcome was less intra/peri operative blood loss, need for additional uterotonic agents and perioperative haemoglobin (Hb) fall. The secondary outcomes studied were incidence of shivering, pyrexia, nausea, vomiting, operating time, blood transfusion, endomyometritis and hospitalization period. Average blood loss after normal vaginal delivery is 500 ml and after caesarean delivery is around 1000 ml.Results: Mean postoperative Hb was high with misoprostol group and perioperative Hb fall was less. Perioperative Hb fall of 1 g or more was lesser in this group.Conclusions: Sublingual misoprostol reduces intraoperative blood loss, perioperative blood loss and the need for additional uterotonic agents and blood transfusions at caesarean delivery.
Comparative study of efficacy and safety of parenteral iron sucrose versus ferric carboxymaltose in treatment of postpartum iron deficiency anaemia
Authors: Dakhle Ganesh N. , Kalikar Mrunalini V. , Fuke Rujuta P. , Parmarthi Anisha S. , Chokhandre Mrunalini K.
Published: December 2021

Background: Postpartum anaemia often leads to multiple clinical complications in mother as well as infant and iron supplementation with parenteral iron is the preferred treatment modality. The present study was planned to compare the efficacy and tolerability of IV iron sucrose and IV ferric carboxymaltose in treatment of postpartum iron deficiency anaemia.Methods: This randomized, parallel, open label, prospective 4-weeks study was conducted from June 2019 to December 2020 in women with postpartum anaemia admitted to obstetrics and gynaecology inpatient department of a tertiary care hospital. Women with postpartum iron deficiency anaemia (N=60) were randomly divided into two groups; receiving Injection iron sucrose (N=30, maximum dose 500 mg) or Injection ferric carboxymaltose (N=30, maximum dose 500 mg). Change in haemoglobin and serum ferritin levels from baseline to the end of 2 and 4 weeks of treatment were evaluated.Results: The results showed early, sustained and significant increase in the haemoglobin levels in both the groups. However, the difference was not significant between groups (p=0.2). Evaluation of replenishment of iron stores (serum ferritin) showed improvement in both the groups, however in FCM group the rise was found to be significant (p<0.05).Conclusions: FCM in a lower dose of 500mg was found to be safe and effective in significantly improving haemoglobin concentration as well as in replenishing iron stores in patients with postpartum anaemia.
An obstetric outcome in pregnant women with consumption of tobacco
Authors: Kansara Vijay , Pateliya Pinal Ambalal , Karia Jil , Kadakar Kunal
Published: December 2021

Background: Tobacco is known to be an established cause of adverse pregnancy outcome. Scientific studies, encompassing various ethnic groups, cultures and countries, have shown that cigarette smoking during pregnancy significantly affects mother, unborn fetus and the newborn baby.Methods: A hospital based cross sectional study was performed on 933 patients, separated in two groups: tobacco users and tobacco non-users and findings from each group were compared.Results: Incidence of complications like anemia, PIH and abruption increase with maternal usage of tobacco during pregnancy, chances of preterm delivery and ectopic pregnancy was raised, rate of wound complication was more in tobacco user women. There was no significant difference in mode of delivery.Conclusions: In the present study may establish association of tobacco consumption with adverse neonatal and obstetrics outcome and may encourage administration to focus on IEC (information, education, communication) to reduce tobacco consumption during pregnancy. Incidence of complications like anemia, PIH, abruption increase with maternal usage of tobacco during pregnancy. Chances of preterm delivery and ectopic pregnancy, was raised usage with of tobacco.
Statistical analysis of gynecological cancer
Authors: Pahwa Sangeeta , Kaur Arshdeep
Published: December 2021

Background: Gynaecologic cancers constitute huge burden of morbidity and mortality all over the world. Statistics on gynaecologic malignancies is deficient. It is the leading cause of death and disability worldwide. In India breast cancer ranks number one followed by cervical cancer. The aim of our study was to establish pattern and incidence of gynaecological malignancy.Methods: This hospital based study was conducted in Sri Guru Ramdass Institute of medical sciences and research, Amritsar on 282 patients from March 2020 to December 2020. The demographic data of all cancer patients regarding age, clinical presentation, site, staging, histopathology and treatment given was collected and was analysed in tabulated form.Results: In our study, breast cancer was the commonest malignancy encountered in 46.09% followed by cervical cancer which constituted 32.26%.Ovarian cancer was diagnosed in 15.24%, endometrial cancer in 3.19%, vulval cancer in 2.12% and vaginal carcinomas in 1.06%.Conclusions: Gynaecological cancers are one of the leading causes of cancer related deaths in women worldwide, hence it is important to be aware of various types of malignancies. In our study, cases reported in advanced stages because of lack of education and COVID scenario as patients were reluctant to visit hospitals. So we must continue to provide our gynecologic oncology patient the highest quality of medical care at the same time assuring maximum safety for patients.
The association between isolated oligohydramnios at term and pregnancy outcome and perinatal outcome in case of isolated oligohydramnosis: a retrospective analysis
Authors: Kansara Vijay M. , Kadakar Kunal D. , Chikani Akash S. , Pateliya Pinal A.
Published: December 2021

Background: Current study was carried out to assess the impact of isolated oligohydramnios on perinatal outcomes and mode of delivery.Methods: A retrospective observational cohort study was conducted at term pregnancy with sonographic finding of isolated oligohydramnios (AFI <5 cm) were recruited for the study. Uterine anomaly and high risk pregnancies were excluded from the study. The mode of delivery and perinatal outcome were compared with control group of pregnancy with normal amniotic fluid (AFI >5-25 cm).Results: When compared to the normal AFI, women with oligohydramnios had significantly lower birth weight babies and were delivered at a significantly earlier gestational age. However there was no difference in the APGAR scores at birth and NICU admissions between the two groups. Reactive NST had more chances of good APGAR score at 1 and 5 minute and that lower the AFI more the probability of nonreactive NST and abnormal Doppler. The number of inductions and caesareans done for foetal reasons were significantly higher in the exposed group.Conclusions: Obstetric and perinatal outcome remains similar in both isolated oligohydramnios with reactive NST as well as in patients with normal amniotic fluid index. Isolated oligohydramnios is not associated with adverse perinatal outcomes. However, it increases the risk for labour induction and caesarean section.
A new indication for elective induction of labor COVID-19 pandemic effect
Authors: Nandal Isha , Kochar S. P. S. , Kaur Rajvir
Published: December 2021

Background: Induction of labour is performed in certain circumstances which involve greater risks of waiting for the onset of spontaneous labour than the risks due to shortening the duration of pregnancy by induction. The objective of this study was to evaluate the maternal and fetal outcome in patients undergoing elective induction during COVID-19 pandemic.Methods: This prospective observational study was conducted on 60 ANC patients with singleton pregnancy and POG >39 weeks coming to OPD with negative COVID-19 RT-PCR report. To avoid the burden of repeat testing after one week and risk of exposure to COVID-19 virus from community, patients were induced. All the data was recorded and analyzed.Results: Most of the patients were in age group of 20-25 years (50%) and only 6.7% of the patients were older than 30 years. 32 (53.3%) patients were multiparous and 50% of the patients were having Bishop score between 2-5 and only 8.3% had bishop score of more than 5. 47 patients (78.3%) underwent normal vagina delivery whereas 12 patients (20%) underwent LSCS. Failure of Induction was the indication for LSCS in 5 patients (41.7%).Conclusions: Elective induction was found to be better option in COVID-19 negative patients. All pregnant women should be monitored for development of symptoms and signs of COVID-19 particularly if they have had close contact with a confirmed case. Pregnancy and childbirth generally do not increase the risk for acquiring SARS-CoV-2 infection but may worsen the clinical course of COVID-19 compared with nonpregnant individuals of the same age.
A retrospective study of ectopic pregnancy
Authors: Banu A. Shameera , Indu N. R. , Rohini E. , P. B. Hiremath , Hiremath Reshma
Published: December 2021

Background: Ectopic pregnancy is one of the common acute abdominal emergencies posing a serious threat to life. The overall incidence of ectopic pregnancy is on a steady increase over the last two decades. Yet the case fatality rate has come down due to early diagnosis and management. 95% of ectopic pregnancies occur in the fallopian tube, and rest 5% cumulatively in the ovary, cervix, peritoneal cavity and previous caesarean section scar. The present study was done to analyse the associated risk factors, clinical manifestations and management options of ectopic pregnancy.Methods: This retrospective observational cohort study was done in the Department of Obstetrics and Gynaecology, at Sri Venkateshwaraa Medical College, Hospital and Research Centre, Ariyur, Puducherry, between January 2018- November 2021. Data was collected from the case sheets, operative notes and a retrospective analysis of the cohort of patients with ectopic pregnancy was done.Results: This retrospective study was conducted from January 2018 to November 2021 involving a total of 50 cases. We found that majority of tubal gestation occurred in the age group 26-30 years 58.6% and 13.7% in the age group more than 30 years. Majority of patients 65.5% underwent U/L salpingectomy.10.34% underwent salpingo oophorectomy. Fimbrial expression was done for two patients. Two patients underwent fimbriectomy. Cornual stump excision was done in two patients. Hemoperitoneum was detected in 55.17% of cases.Conclusion: Ectopic gestation can become an obstetrical emergency and reproductive capacity hampering morbidity if not diagnosed and treated on time. However having a high vigilance and evaluating every woman in the reproductive age group who presents with the classical clinical triad of amenorrhea, pain abdomen and bleeding per vagina can help in curbing the incidence in future.
A study of effects of hypothyroidism on antenatal patients
Authors: Saha Payal , Palve Tushar , R. Pooja
Published: December 2021

Background: After diabetes mellitus, thyroid disorders are the most common endocrine disorders in pregnancy. The most common thyroid gland dysfunction in pregnancy is hypothyroidism with estimated prevalence of 1.5-4.4% of pregnant women. Effects of hypothyroidism in pregnancy include anemia, pre-eclampsia, prematurity, IUGR, low birth weight, mental retardation in neonate. The objective of this study is to find the association of hypothyroidism and its adverse outcomes on mother and the fetus that is listed above.Methods: A study was conducted over a period of 6 months over 50 antenatal patients with hypothyroidism from Jan 2021 to August 2021 in the department of obstetrics and gynecology, Cama and Albless hospital, Mumbai with inclusion, exclusion criteria. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion and fetal outcomes were the main study variables.Results: In this study, majority of hypothyroidism belonged to the age group of 26-30 years (54%). A high prevalence was found in G2 (26%) and antenatal hypothyroidism with past h/0 abortions were found in 26% patients. Low birth weight is found in 32% cases of hypothyroidism, NICU admissions seen in 32% cases of hypothyroidism, 22% cases were found to have anemia.Conclusions: Hypothyroidism is a common health problem in antenatal patients. We concluded that hypothyroidism is more commonly seen to be associated with low birth weight, anemia, pre-eclampsia, NICU admission in neonate. Early ANC registration and regular ANC checkups help in early recognition and initiating early treatment, thus improving fetomaternal outcome.
A study of feto maternal outcome in primary caesarean section
Authors: Mandaliya Maitry , Patel Arti , Shah Devanshi
Published: December 2021

Background: Primary caesarean section is defined as caesarean section to be performed in women who have not had previous caesarean delivery. The increase in the rates of primary caesarean section is not only due to increased caesarean section in nulligravida but also due to upward rise in caesarean section rates in parous women. Through this study we aimed to examine the frequency and the indications of primary caesarean section in nulliparous and multiparous women.Methods: A prospective study was carried out in the OBGY department of smt. SCL Hospital, NHL municipal medical college from April 2020 to April 2021. All multiparous women with previous normal vaginal delivery who underwent caesarean section this time were included in this study. Patients with previous caesarean section <28 weeks of gestation, patients who did not give consent were excluded from the study.Results: 92% were 20-30 years and are gravida 2 or 3 patients. 85% patients were booked patients. Most common indication of primary caesarean section in parous women was MSL+FD (31%). Difficulty in delivery of the baby was encountered in 45% of cases. Major cause of admission in NICU was MAS.Conclusions: Primary caesarean section has become a major driver of overall caesarean section rate. Decision making on primary caesarean section should be carefully scrutinized, introducing a diagnostic second opinion for all primary caesarean section. Primary caesarean section in both multigravida and primigravida becomes mandatory in many cases to prevent maternal and feta morbidity.
Perinatal and maternal outcome in meconium stained amnioticfluid (thin and thick) at dhiraj general hospital, a rural tertiary health centre
Authors: Shukla Jitendra V. , Patel Arpana D. , Chandrayan Piyush
Published: December 2021

Background: To determine the perinatal outcome of with Meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at Dhiraj Hospital.Methods: A prospective observational study was carried out in obstetrics and gynaecology department of Dhiraj Hospital, Sumandeep Vidyapeeth from March 2021 to August 2021. All patients fulfilling inclusion and exclusion criteria as mentioned above were taken for the study. All the categorial variables were analysed independently with the help of chi square test and fisher’s exact test and all the continuous variables were analysed with independent ‘t test’.Results: Out of 500 patients selected for the present study which had inclusion criteria, 13.6% were meconium stained out of which 50 (73.5%) cases had thin meconium and 18 (26.4%) cases had thick meconium. Fetal CTG abnormalities were more common in MSAF group and were noted in 38.2% of cases which is significantly increased compared to control group with CTG abnormalities in 8.3%. The difference was significant with p value of <0.001. 32(47.0%) patients with meconium-stained amniotic fluid had normal vaginal delivery, while in control group out of 432, 360 (83.3%) delivered normally. Incidence of LSCS and assisted vaginal delivery was more in meconium-stained amniotic fluid.Conclusions: Meconium-stained amniotic fluid is associated with more frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid. Better perinatal outcome in clear amniotic fluid compared to meconium stained liquor.
Study of various treatment modalities of caesarean scar pregnancy
Authors: Meghani Prachi C. , Shah Sapna R. , Vyas Rupa C. , Parikh Purvi M. , Chudasama Tanmay J.
Published: December 2021

Background: Caesarean scar pregnancy (CSP) can be defined as the implantation of the gestational sac within the scar of a previous caesarean surgery. Incidence of CSP is 1 in 1800 pregnancies.Methods: It is a retrospective study based on clinical diagnosis and management of CSP of women who presented to the obstetrics and gynaecology department SVP hospital from January 2008 to August 2021. Total number of cases of CSP were 28. Incidence, gestational age, ultrasound findings, serum β-human chorionic gonadotropin (β-hCG) levels, flow profiles of color Doppler, and different methods of treatment were recorded. Diagnosis was confirmed by ultrasound.Results: In this study, all 28 cases of CSP considered were offered definitive management. In present study 5 cases (17.88%) showed torrential haemorrhage during dilatation and evacuation (D and E) which was treated by various methods like 1 (3.57%) Foley’s tamponade, 1 (3.57%) uterine artery embolization (UAE) and 3 (10.71%) hysterectomy. Hysterotomy was performed in 13 cases (46.42%) and (7.69%) of heterotrophic CSP (HCSP). One case (3.84%) of CSP presented at 26 weeks of gestation with haemorrhagic shock, underwent obstetric hysterectomy.Conclusions: There is a rise in the incidence of CSP because of increase in the global rate of caesarean sections and early transvaginal USG in pregnancy. Transvaginal sonography is the best diagnostic tool. Medical management can be offered when diagnosis is made at gestational age of <7 weeks. Whereas, surgical modalities have shown better results at >7 weeks of gestational age. Surgical management has an advantage of shorter follow up.
Abortion care-seeking and reproductive rights violation in health facilities: evidence from six states of India
Authors: Pradhan Manas Ranjan , Shekhar Chander , Alagarajan Manoj , Sahoo Harihar
Published: December 2021

Background: Unsafe abortion continues to draw the researcher's attention due to its close association with maternal morbidity and mortality. Empirical evidence on the role of health facilities in providing safe abortion care addressing the reproductive rights of Indian women is limited.Methods: Using data from the 2015 ‘unintended pregnancy and abortion in India’ study, the present paper aimed to understand the violation of the reproductive rights of abortion care seekers in health facilities (n=4001) in six states of India. The health facilities were sampled using a stratified random sampling strategy. Univariate and bivariate analysis was carried out using SPSS (V 25) on cleaned and weighted data.Results: A sizeable percentage of public and private health facilities across states found seeking the consent of the husband or family members before abortion provision, compel women to adopt contraception and turn away abortion seekers, commonly citing non-medical reasons. The provision of post-abortion complications services is usually not 24/7, even at the primary health centre level, hindering access to an urgent health care need.Conclusions: There is a need to improve access to facility-based abortion services, especially in underserved rural areas, by ensuring that all public-sector facilities have adequate equipment and supplies, including MMA drugs and trained providers. Sensitization of health care providers about the importance of ethical issues and women’s reproductive rights is urgently required to ensure safe, legal, and accessible abortion care.
Challenges in the diagnosis and treatment of extrauterine leiomyomas: case series
Authors: Tang Yafang , Nadarajah Ravichandran
Published: December 2021

Extrauterine leiomyoma is a rare disease with multiple potential metastasizing sites. Pathogenesis of this condition remains debatable with previous myomectomy a considerable risk factor. Diagnosis and treatment remain a challenge due to diverse presenting symptoms and the initial involvement of various specialties, which often cause distress in these patients. In this article, we present one case of pulmonary leiomyomas on expectant management, one case of wide-disseminated extrauterine leiomyomas including the bones, spines, soft tissues and peritoneum who underwent decompression laminectomy and biopsy of paravertebral mass and one case of retroperitoneal leiomyoma who underwent resection of the lesion.
The Mostafa Maged four-stitch technique to avoid leaving dead space during repairing the episiotomy
Authors: Ali Mostafa Maged , Abd-Elfattah Laila Ezzat
Published: December 2021

Most women who are primigravida are mostly confronted with episiotomy during child-birth to prevent the perineal and vaginal lacerations which could be performed at birth. There are many types of episiotomies which are median, mediolateral and J-shaped episiotomy. In here, we performed the mediolateral suture due to its safety. All episiotomy were taken by the Mostafa Maged four-stitch technique. Prevention of the formation of the dead space during the repair of episiotomy so avoiding hematoma formation in the episiotomy area after child-birth. It is an Interventional study. The Mostafa Maged four-stitch technique uses the absorbable vicryls treads with round needles 75 mm. the results of this new technique are Prevention of the dead space formation, Good and tight hemostasis of the episiotomy is achieved, strong approximation of the two edges of the episiotomy, cosmetically, it is so good. The invention of this new technique (Mostafa Maged technique) has shown its effectiveness in those fifteen patients in preventing the dead space during suturing the episiotomy in primigravida cases.
A rare case of ovarian torsion in a pregnant patient
Authors: Kumari Swati
Published: December 2021

Torsion of the ovary is the total or partial rotation of the adnexa around its vascular axis or pedicle. It is an uncommon cause of acute abdominal pain in females, and it is a gynecologic emergency. The majority of the cases present in the pregnant (22.7%) than in non-pregnant (6.1%) women. Diagnostic delay can result in loss of the ovary. This twisting initially obstructs venous flow, which causes engorgement and edema. The engorgement can progress until arterial flow is also compromised, leading to ischemia and infarction. The increased use of ovarian stimulation and assisted reproductive technology has led to an increase in the risk of adnexal torsion, particularly in pregnant women or women with ovarian hyperstimulation syndrome (OHSS). The differential diagnosis of adnexal torsion is particularly difficult in combination with OHSS or pregnancy, as abdominal pain, nausea and vomiting can be presenting symptoms of hyperstimulation or pregnancy as well. Here, we report a case of ovarian torsion occurring in pregnancy in which diagnostic delay occurred due to confusion with OHSS leading to oophorectomy. Fertility conservation may have been possible in case of earlier diagnosis and prompt treatment.
Chronic ectopic pregnancy complicated by septicemic shock and disseminated intravascular coagulation
Authors: Sharma Mamta , . Rajkumar
Published: December 2021

Disseminated intravascular coagulation is a life threatening complication of ectopic pregnancy. It results from washing out of all important procoagulants. This is basically a state of increased propensity for clot formation triggered by a variety of stimuli related to such diverse disorders as sepsis ,endothelial cell damage (heat stroke and shock), obstetrical complication (abruptio placenta, amniotic fluid embolism, severe preeclampsia and retained intrauterine dead foetus). A case of disseminated intravascular coagulation with septicemic shock following laprotomy for ectopic pregnancy is reported. She was treated by vasopressors, broad spectrum antibiotic and aggressive blood and blood component therapy.
Office hysteroscopy: a review
Authors: Shanbhag Vijayalakshmi , Bagde Nilaj
Published: December 2021

With the invention of new techniques and modalities “see and treat” has become the norm of management now a days. Diagnostic hysteroscopy combined with histological examination of an endometrial biopsy is considered the ‘gold standard’ in the diagnosis of intrauterine abnormalities. The importance of office hysteroscopy lies in the fact that there is no need of any anesthesia and after the procedure the patient can return into his routine activity only with the minimal aid of NSAIDs. Two different types of hysteroscopes are used worldwide: flexible or rigid, which are made in different sizes. Optic miniaturization has been one of the greatest technological advancements in the field of hysteroscopy, both for rod-lens and fiberoptic scopes. The main concerns in office hysteroscopy are the need for necessary expertise, pain management and management of the complications in the office setting and the high cost of the equipment needed for the procedure. But office hysteroscopy has already demonstrated good correlation of findings compared with inpatient hysteroscopy, providing distinct advantages such as reduced anesthesia risks, enhanced time and cost-effectiveness, and faster recovery with less time away from work and home.
Association between anemia and preeclampsia: a case control study in Gorontalo region, Indonesia
Authors: Nanda Ari W. , Semarawisma Alit
Published: December 2021

Background: Preeclampsia is one of the most common health problems in pregnancy that relates to several risk factors leading to an increase in maternal and perinatal mortality. The risk factors for preeclampsia include maternal age ≥35 years old, primigravida, chronic hypertension, obesity, and history of preeclampsia. However, studies investigating anemia as a risk factor for preeclampsia were still limited and showed conflicting results. This study aims to investigate the association between anemia and preeclampsia.Methods: A case-control study was conducted in the department of obstetrics and gynecology Dr. M. M. Dunda public hospital, Indonesia, from December 2020 to May 2021. Secondary data was collected in singleton pregnancy patients aged <35 years, admitted from 2016 to 2020. The number of patients used in this study was 264 consisting of 132 preeclampsia and 132 healthy women. Patient basic characteristics, obstetrics status, urinalysis, and complete blood count were collected and analysed using SPSS 25 for Mac. Kolmogorov-Smirnov test was done to examine data distribution. Chi-square was used to analyse the association between anemia and preeclampsia, p<0.05 is considered to be statistically significant.Results: BMI was found significantly higher in preeclampsia group (p<0.000), and infants born to mothers with preeclampsia had lower birth weight and height compared to the control group with p-value respectively p<0.032 and p<0.001. There was no significant association between anemia and pre-eclampsia (p=0.712; p>0.05).Conclusions: Preeclampsia is significantly associated with higher maternal BMI and lower birth weight/height. However, no association was identified between anemia and preeclampsia.
Post craniotomy and electrocardiographic monitoring
Authors: Lesmana Hendy , Pujianto Ahmat , Purnomo Bayu
Published: December 2021

Background: Post craniotomy management mainly emphasizes monitoring complications that occur. Close supervision and monitoring are needed in post craniotomy patients, especially in the first 48 hours so that the patient is placed in the intensive care unit (ICU). Various studies have identified various complications that arise from mild complications to severe complications, namely the death of patients after craniotomy, so that hemodynamic monitoring tool are needed. Electrocardiography is one of the hemodynamic monitoring tools in the intensive care room which is very useful in monitoring heart rhythm abnormalities in post-craniotomy patients.Methods: This descriptive study was conducted on 30 respondents post craniotomy and were treated in the Intensive Care Unit (ICU) for 1-3 days of treatment. An electrocardiographic monitoring analysis was performed on 30 respondents, then confirmed by examination of blood electrolytes and blood gas analysis.Results: In this study 90% of respondents experienced electrocardiographic rhythm abnormalities, 50% sinus arrhythmia, 33.3% sinus tachycardia, 6.7% sinus bardycardia. The results of electrolyte examination 18 respondents experienced electrolyte balance disorders where 4 respondents experienced hyponatremia, 7 respondents experienced hypernatremia+hyperchloremia, 1 respondent experienced hyponatremia+hypochloremia, 5 respondents experienced hyperchloremia and 1 respondent experienced hypokalemia. There are 7 respondents experiencing acid-base balance disorders.Conclusions: in this study showed that most of the patients after craniotomy had heart rhythm abnormalities. The most common arrhythmia is sinus arrhythmia. The pathological conditions that accompany these rhythm disturbances are mostly caused by electrolyte balance disorders, acid-base balance disorders or a combination of the two disorders.