bluuebunny/crossref_metadata_2025 huggingface dataset:
Content-analyses scales of the social motivation test. Results of correlation and factor analyses. Part 2
Authors: Almayev N.A. , Murasheva O.V. , Bessonova Y.V. , Kiselyova N.I.
Published: October 2018

The topic of the relative impact of motivation and intelligence was investigated on the sample of students of Humanities at one of the ordinary universities of Moscow. Motivation was measured twofold with semi-projective Test of Social Motivation (Almayev, Murasheva 2012) and by «Motivation to work Profile» by Ritchie and Martin (psychometrically checked and adopted for the Russian sample). Intelligence was measured with Amthauer test. No significant correlations were found between both intelligence and motivational scales with the educational scores. Exception were the two content analysis scales those detect stress: “Negative emotions”(0,22), and “Negative events”(0,24) and their sum “Fear to live” (0,32). Moderate stress accompanies academic success. The influence of Power, Achievement and Affiliation motives was not detected. Two intellectual scales those dialed with spatial imagination and spatial generalization positively correlated with “impulse control” r=0,22 content analyses scale and negatively with the “Motivational conflict” r=-0,35 for spatial generalization, and -0,28 for spatial relation. Achievement scale correlated negatively with spatial imagination r=-0,26 that rise suspect regarding whether this motive was not partially of the compensative nature in this sample. Validity of nPower was also tested. Need for Power consists of two rather independent constructs: Rivalry and Loyalty with their connection being positive but weak and detectable only on relatively big samples.
Analysis of the thoracic and abdominal mobility in elderly through computer photogrammetry
Authors: Oliveira Nayara Priscila Dantas de , Pereira Silvana Alves , Cruz Maria do Socorro Luna , Andrade Luiz Eduardo Lima de , Dantas Thaissa Hamana de Macedo , Correia Grasiela Nascimento , Dantas Diego de Sousa
Published: October 2018

Background: Computerized photogrammetry has become a promising aspect for respiratory analysis, being a technology of low cost, good reproducibility and accuracy, compatible with the Brazilian public health situation. Objectives: To verify the applicability of the computerized photogrammetry method for analysis of thoracoabdominal mobility in the elderly. Methods: This is a methodological study, performed with 16 elderly women from Santa Cruz, RN, Brazil. Morphofunctional evaluation of body mass, stature, body mass index and thoracoabdominal mobility were performed through the computerized photogrammetry, whose technique was based on the capture of images at the maximum ventilation moments (maximal inspiration and expiration followed by apnea) of the elderly. For the delimitation of the thoracic wall were used 20mm diameter markers positioned at specific anatomical points, and the images were treated through the irregular quadrilaterals system in the AutoCAD 2007 Software. Results: Using computerized photogrammetry was possible to identify areas of compartments and sub-compartments of the thoracic wall with higher values at the inspiratory moment when compared to the expiratory moment, and with a greater contribution of the thoracic compartment in the pulmonary ventilation process of the elderly at the inspiratory moment. In addition, in the studied sample there was a higher prevalence of overweight elderly women (56%). Computerized photogrammetry was sensitive to the nutritional status of these elderly women, presenting areas of the abdominal compartment and sub-compartments with values higher than those presented by the elderly women with low weight. Conclusions: Computerized photogrammetry proved to be an effective and reliable technique for the thoracoabdominal mobility analysis of elderly women.v
Северная Индия как территория миротворчества и культурного диалога
Authors: Иванов Андрей Владимирович , Журавлева Светлана Михайловна
Published: October 2018

В статье анализируется миротворческий потенциал Северной Индии — важнейшего региона Евразии, расположенного на стыке караванных путей, связывающих Индию с Ближним Востоком и Ираном, Средней Азией и Восточным Туркестаном, Тибетом и Китаем. В этом районе сохраняется уникальное культурно-языковое и этническое разнообразие, представляя фактически всю панораму народов Евразии в миниатюре.

Исходная методологическая установка авторов предполагает различение «кровавой истории», т. е. истории войн, межгосударственных конфликтов и борьбы за власть, дипломатических игр и обманов, религиозной и национальной розни, и «истории духа» (или «духовной истории»), т. е. появления и распространения созидательных идей, эпох мира и культурного творчества, когда побеждали мораль и религиозная терпимость, расцветали науки и искусства. История Северной Индии является едва ли не эталонным объектом в плане обнаружения эпох, имен и событий «духовной истории», а главный урок, который может быть из нее извлечен, — это реальный опыт миротворчества и продуктивного культурного диалога, который сохраняет свое значение и поныне. Для обоснования этого тезиса авторы обращаются к эпохе Маурьев, Кушанской империи, империи Гуптов и к периоду правления династии Великих моголов в Индии, где были заложены и во многом воплощены в жизнь важнейшие принципы индийского миротворчества: ненасилия (ахимсы), религиозного согласия, развития науки, искусства и литературы как важнейших средств осуществления продуктивного диалога между различными народами и религиозными традициями. Устанавливаются некоторые значимые параллели между традициями индийского и российского миротворчества, особенно при движении русских в Сибирь.

Делается вывод, что в нынешний год 70-летия установления дипломатических отношений между Россией и Республикой Индия обращение к идейному и практическому миротворческому наследию двух великих стран представляется особенно важным. 
Культурно-коммуникативные формулы в рамках тезаурусного подхода
Authors: Завьялова Наталья Алексеевна
Published: October 2018

Культурно-коммуникативная формула (ККФ) в статье трактуется как языковая универсалия, прецедентный текст, существующий в культурном коде. Она в целом представляет собой общие символы, манифестирующие социокультурную динамику. Обосновывается такое понимание фразеологии, которое опирается на тезаурусный подход, подразумевающий субъектную организацию знания и идею понимания социально значимой информации.

Анализируются ККФ Китая, Японии, Великобритании, США и России. Сопоставление проводится по принципу социумов островной («талассократической») и континентальной («теллурократичной») культур. Показано, что ККФ выполняет целый ряд социально значимых функций: семиотическую функцию знака, транслирующего социально значимый опыт представителями разных поколений; функцию единицы культурного кода, фиксирующей паттерны поведения, общественные нормы, культурные образцы; компонент социализации и инкультурации; компонент репрезентации социальной идентичности; функцию транслятора идеологической «надстройки» в виде лозунгов; функцию детерминации социальных практик путем спецификации социальных групп по территориальному, гендерному, возрастному, профессиональному признаку; функцию рекурсивности социального опыта, реализуемую путем кумуляции и трансляции социально значимых знаний; ряд функций, обусловленных современной коммуникацией: информирующая, просветительская, регулятивная, социально манипулятивная, нормативная, рекреационная; адаптивную функцию стереотипного ориентира.

Учитывая транспарадигмальный характер современной науки, автор подчеркивает, что применение в теории тезаурусно-информационного подхода к анализу коммуникативных формул позволит представить все многообразие данного феномена в упорядоченном структурированном виде. Это существенно облегчит понимание сложных культурных явлений повседневности, отраженных сквозь призму коммуникации.
Accuracy of saline infusion sonography versus hysteroscopy in the evaluation of uterine cavity abnormalities in infertile women at CHRACERH, Yaounde, Cameroon
Authors: Noa Ndoua Claude C. , Belinga Etienne , Ayissi Ngah Gaspard G. , Metogo Junie N. , Mendibi Sandrine , Kasia Jean Marie
Published: October 2018

Background: Uterine cavity abnormalities are seen as a cause of infertility in around 10%-15% and can go up to 50% in women with recurrent implantation failure. Saline infusion sonohysterography (SIS) is a minimally invasive diagnostic modality in the evaluation but hysteroscopy remains the gold standard in the assessment of intra uterine cavity. The aim of this study was to compare the diagnostic accuracy of saline infusion sonography (SIS) considering hysteroscopy (HS) as the gold standard to evaluate uterine cavity pathologies in infertile women at CHRACERH.Methods: Authors carried out a cross-sectional, retrospective study, over 2 years, from the 1st January 2016 to the 31st December 2017, with retrospective data collection in 110 records of infertile patients subjected to an ultrasound assessment of uterine cavity using saline as the contrast medium with a 6.5-MHz transvaginal transducer. When SIS found intra uterine abnormality, HS was done on a later date, using a 5 mm Bettocchi hysteroscope. Sensitivity, specificity, accuracy, positive and negative predictive values of SIS and HS were compared using the SPSS 20 software.Results: The mean age and body mass index were respectively 39.3±7.8 years and 28.7±4.1 kg/m². The main findings both in SIS and Hysteroscopy were respectively polyps (n=61; 55.5% vs 52.7%; n=58), myomas (n=43; 39.1% vs 31.8%; n=35), intrauterine adhesions (n=18; 16.4% vs 21.8%; n=24). The overall sensitivity, specificity and accuracy of SIS were 81.2%, 86.9% and 86.5% respectively.Conclusions: SIS as a diagnostic tool in the evaluation of intrauterine lesions has a good accuracy and can therefore replace HS when this later is not available, especially in our African setting.
Determinants of mother to child transmission of HIV among HIV exposed infants managed in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
Authors: Mairo Hassan , A. Panti A. , A. Tunau K. , S. Nasir , T. Burodo A. , A. Adamu N. , A. Garba J.
Published: October 2018

Background: Mother to child transmission of HIV (MTCT) is globally known to be the major route of spread of HIV to the unborn fetus and neonate. Many factors related to the mother, infant or the type of HIV virus interplay to increase the risk of MTCT of the virus. Antepartum antiretroviral drugs administration reduces the maternal viral load therefore lowering   the risk of transmission. The objective is to determine infection rate and assess determinants of MTCT of HIV exposed infants delivered in UDUTH Sokoto.Methods: It was a 5-year retrospective study. Records of all HIV positive pregnant women and their babies managed in UDUTH were reviewed from the E health system of the hospital. Patient’s details were recorded from booking to delivery for the period under study. The infant’s records were retrieved and information from delivery to 18 months post-delivery obtained. Structured data collection tool was developed to compile the required information. Data was analyzed using SPSS IBMS 22. Descriptive statistics and comparisons between variables were made statistically using Chi square. P value of   ≤ 0.005 was considered as significant.Results: Records of all the patients recruited were all available for evaluation because authors use the E-health system of records keeping in our hospital. MTCT rate was 0.92%. Majority 60 (47.2%) were within age group 26-30yrs. The subjects were predominantly house wives 97(71.4%) and multipara 77 (60.6%). Viral load ranged between 112 to 28228 copies/ml. Twenty-two (17.3%) had CD4 count less than 250 cells/µl while 61 (48%) had counts above 500cells/µl. All were in WHO clinical stage 1-3. All were on triple regimen anti-retroviral drugs. Spontaneous rupture of membranes for over 4 hours occurred in 51(32%). Vaginal delivery was recorded in 89.7%. Breast feeding was practiced by 48%.Conclusions: Breast-feeding still remains a risk factor for MTCT OF HIV Early administration of   maternal antiretroviral drugs significantly reduces the rate of mother to child transmission of HIV.
Determinants of low birth weight in the Lower Manya Krobo Municipality of the Eastern region of Ghana
Authors: Larbi Paul , Dedu Vincent K. , Okyere Gabriel A.
Published: October 2018

Background: Low birth weight refers to new borns weighting less than 2.5 kg at birth. In November 2017, the WHO reported a global prevalence of 15.5% with 96.5% of these cases happening in developing countries. Whilst this is a global canker, the risk factors differ from locality to locality.  This study aims at determining which maternal factors explains low birth weight baby delivery in the Lower Manya Krobo Municipality.Methods: The chi-square test for independence was used to test for independence. The binary logistic model is fitted for the associated factors. The receiver operating characteristic (ROC) is used to classify unbiased estimators.Results: ANC (yes β= -2.769 sig.=0.000); Alcohol (none β=-1.479 sig.=0.000, occasionally β= −2.043 sig.=0.000); Age (<20years β=0.178 sig. =0.676, 20 to 25years β= -1.487 sig.=0.000, 26 to 30 β= -0.941 sig.=0.086); Education level (None β=2.778 sig. =0.000, primary β=3.090 sig.=0.000, JHS β=1.913 sig.=0.002, SHS/Secondary β=1.951 sig.=0.000); Exposure to Heat (Yes β=4.507 sig.=0.000). AUC education=0.67, 95% CI=0.6,0.7 and AUC Exposure to heat=0.73, 95% CI=0.68,0.77 of low birth weight.Conclusions: Social status was not significant factor. Mothers exposed to heat had the highest risk (odds=90 times). Adolescent mothers stand high risk with odds 1.195. Mothers who attended antenatal clinics were at 94% less likelihood. Mild drinkers had lesser risk compared to no and heavy drinkers. Mothers with primary education (odds=21 times) were the riskiest compared to mothers with tertiary education. This differs from researches where no education mothers were riskiest. Only mother’s exposure to heat was found to be fairly good unbiased estimators.
A clinical study of ectopic pregnancy in a tertiary care hospital
Authors: Behera Arati , Ghadei Ranjita , Bal Rudra Narayan
Published: October 2018

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.
A demographic profile of patients seeking MTP for gross congenital malformations in a tertiary referral hospital in North India
Authors: Jain Shaveta , Rani Vandana , Sangwan Roopa , Jain Nitin
Published: October 2018

Background: The objective of the study was to study the sociodemographic, obstetrics profile and folic acid intake in women seeking medical termination of pregnancy for gross congenital malformed fetus (GCMF)and to study pattern of GCMF.Methods: A cross sectional study was conducted among women who underwent medical termination of pregnancy for congenital malformation in fetus in tertiary referral hospital of north India. The details regarding their sociodemographic profile, previous obstetrics history, pattern of GCMF, history of folic acid intake and method of termination were taken.Results: 61% of women seeking medical termination of pregnancy for GCMF were of age group 20-25 years.  75 women were from rural area which is 83.3 % in present study. Only 13.3 % of women in present study were illiterate. Most of the women 66.6 % belongs to middle class of society in present study.  40 % women seeking medical termination of pregnancy for congenital anomaly were primigravida. 96.6 % of patient’s congenital anomaly was detected in second trimester. 74.4 % of patient had central nervous system (CNS) congenital anomaly, most common was anencephaly in 34 patients followed by meningocele/myelomeningoceles in 9 fetuses.   Only 27 % women had history of folic acid intake and 55 patients were given mifepristone 200 mg with 400 mcg misoprostol while 32 patients who had previous history of cesarean section were given lower doses.Conclusions: Anencephaly was the most common congenital anomaly detected. The high reporting of anencephaly suggests the need for a fortification of folic acid in food. Dismal rate of cardiac malformation suggests there is need of inclusion of cardiac echo in level II anomaly scan. Prolonged induction to abortion time in present study shows need of further studies for simultaneous or 24-hour regimen of mifepristone and misoprostol and higher doses of misoprostol.
Pregnancy complicated by previous cesarean section: a retrospective study
Authors: M. Poornima
Published: October 2018

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.
The effect of placenta previa on fetal weight and feto-maternal blood flow: a prospective cohort study
Authors: Ali Mohammed K. , Mahfouz Islam S. , Abbas Ahmed M. , Sayed Ezzat H.
Published: October 2018

Background: The current study aims to evaluate the effect of placenta previa on the fetal weight and to explore its effect on the uterine and umbilical arteries blood flow.Methods: The current study was a prospective cohort study conducted at Assiut Women’s Health Hospital, Egypt from 1st of October 2016 to 30th of September 2017 including placenta previa and non-placenta previa women. They were followed up by two-dimensional ultrasound and Doppler blood flow in the uterine and umbilical arteries. The main study outcome was the number of low birth weight (LBW) babies delivered at or beyond 37 weeks and blood flow changes in uterine and umbilical arteries.Results: Two hundred twelve women were divided into two groups; group I included 106 placenta previa women (PP group) and 106 non-placenta previa women (NPP group). The number of LBW babies were comparable in both groups without statistically significant difference (P value= 0.555). Neither; uterine artery nor umbilical artery blood flow had any significant differences between the groups.  Preterm delivery was significantly higher in the PP group (p value=0.000).Conclusions: Although there is no agreement, in the literature, on the association between placenta previa and LBW, authors suggest that placenta previa is not a reason for LBW babies. In addition, placenta previa shows no effect on uterine artery or umbilical artery blood flow.
Preterm premature rupture of membranes: maternal and perinatal outcome
Authors: Khade Shweta Avinash , Bava Amarjeet Kaur
Published: October 2018

Background: This is an observational analytical study carried out in department of obstetrics and Gynecology, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis and complications in preterm premature rupture of membrane cases.Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 2837 weeks gestation with singleton pregnancy, from 1st March 2013 to 28th February 2014. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.Results: In this study maternal morbidity was 16%. Perinatal morbidity was 33% and most common causes were hyperbilirubinemia (23%), RDS (21%).  Perinatal mortality was seen in 15% and mainly due to RDS (53%). Twenty-five (25%) neonates were delivered by cesarean. The main indications for cesarean being malpresentation (36%) followed by fetal distress (24%).Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.
Incidence and maternal outcome of twin pregnancy
Authors: Sahu Bharti , Jain Pooja Jain
Published: October 2018

Background: Twin pregnancy is a high-risk pregnancy with different prevalences in different regions of world which is on the rise due to growing use of assisted reproductive technology. The objective of this study is to determine the incidence and maternal complication and outcome of twin pregnancies.Methods: This is a prospective observational study conducted in 2016-2017 in NSCB medical college and hospital, Jabalpur on 67 twin deliveries. Final outcome was given in terms of percentage and ratio.Results: After assessment of 5995 deliveries during the period 2016-2017 the incidence of twin pregnancy was 1.12 percent. In present study 83.6% of patients were in the age group of 21-30 years. Majority 56.7% were unbooked. 50.7% were primipara. Family history of twin pregnancy was found in 31.3% cases and 17.9% cases have history of ovulation inducing agent. Maximum 65.7% delivered between the gestational age 29-37weeks. Mostly 59.7% were dichorionic-diamniotic twins. Preterm delivery occurred 72.5% in Diamniotic Dichorionic and 85.7% in Monoamniotic Monochorionic. 49.3% cases were having both babies with cephalic presentation. 29.9% twins delivered by cesarean section. most common indication for LSCS in twin pregnancy was malpresentation. Most common complication was preterm labour (52.2%) followed by anaemia and preeclampsia.Conclusions: Twin pregnancy had higher likelihood of maternal adverse effect. The higher morbidity and mortality is due to high percentage of patient being unbooked and majority receive no therapeutic intervention until admission. So all efforts should directed towards better quality antenatal care of twin carrying mother.
Abnormal uterine bleeding in relation to thyroid dysfunction
Authors: Sudha H. C. , Sunanda K. M. , G. S. Anitha
Published: October 2018

Background: Abnormal uterine bleeding is an abnormal bleeding from the uterus in absence of any organic disease of genital tract and demonstrable extra genital causes. Thyroid dysfunction is marked by large number of menstrual abnormalities. This study is aimed at detecting thyroid dysfunction in patients with provisional diagnosis of AUB (abnormal uterine bleeding).and refer positive cases to physician for further management.Methods: All patients from are from puberty to pre-menopausal age groups, presenting as menoraghia, metrorragia, polymenorrhoea, polymenorragia, hypomenorrhoea, and acyclical bleeding. Onset, duration, amount of bleeding, complaints related to thyroid dysfunction was noted in detail. A thorough clinical examination including general physical examination, neck examination, systemic and gynecological examination was carried out, with special reference to thyroid dysfunction. A provisional clinical diagnosis of DUB was made. Patients with clinical signs and symptoms of thyroid disease were excluded. All these patients were subjected to routine investigations like Hb%, blood counts, urine routine, and bleeding and clotting time to rule out coagulation defects. Then all were subjected for serum T3, T4, and TSH estimation. Patients were then grouped into 4 categories: euthyroid, subclinical lhypothyroid, hypothyroid, and hyperthyroid. Patients who had thyroid disease, on hormonal treatment, IUCD users, and bleeding disorders were excluded.Results: Among 100 patients studied with abnormal uterine bleeding, patients were distributed according to age groups from puberty to perimenopause age. Majority of patients belongs to 31-40 years of age about 40% and the least age group were between 41-45 years of age.(7%).Among different parity status AUB was more common among para three patients(26%). Out of 100 patients, 32% of patients had thyroid dysfunction of which 16% of patients had subclinical hypothyroidism. 15% of patients had hypothyroidism and only 2% of patients had hyperthyroidism. The commonest bleeding abnormality in AUB were polymenorrhoea (30%) and menorrhagia (35%). All hyperthyroid cases were oligomenorrhoeic.Conclusions: This study concludes that thyroid dysfunction should be considered as an important etiological factor for menstrual abnormality. The biochemical evaluation of T3, T4, and TSH estimations should be made mandatory in AUB cases to detect apparent and occult thyroid dysfunction.
Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion
Authors: Fonseca Michelle N. , Sah Vernica
Published: October 2018

Background: Abortions are one of the most commonly performed procedures in gynaecological departments worldwide. They are still a major problem in developing countries contributing to a significant percentage of maternal morbidity and mortality. The main objective of this study is to compare the efficacy, side effects and acceptability of intracervical Foley and oral Mifepristone both followed with sequential administration of vaginal misoprostol for second trimester medical abortion.Methods: This was a prospective randomized trial of 36 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation between 12 to 20 completed weeks. Intracervical Foley catheter with administration of misoprostol (200µg) vaginally was done for Group A. Mifepristone 200mg was administered on day one followed by misoprostol (200µg) vaginally, 48 hours later, to Group B. Both groups received misoprostol (200µg) vaginally at 4 hourly intervals. Completeness of abortion was assessed, and surgical evacuation was performed, if abortion was found to be incomplete.Results: The two groups were comparable with respect to age, parity and gestational age. 83-89% of the women in both the groups had complete abortion. The mean induction abortion interval was 20.11 hours in Group A and 54.77 hours in Group B, which was statistically significant. Side effect profile was comparable in both groups however the intensity and the duration of persistence of pain was greater among patients from Group A.Conclusions: Authors conclude that medical abortions with both methods were found to be safe, effective, inexpensive and acceptable methods. Whereas a shorter induction abortion interval was observed in the Foley induction group, induction with mifepristone was the preferred regimen in second trimester abortion because of its high efficacy, low incidence of side effects, better tolerance by the patients and due to lower dose of misoprostol required following mifepristone administration.
Evaluation of high risk screening protocol for detection of overt hypothyroidism in pregnancy
Authors: Goel Bharti , Singh Anju , Goel Poonam , Kaur Jasbinder , Singla Seema , Singla Mandeep
Published: October 2018

Background: Overt hypothyroidism is a known cause of feto-maternal morbidity. Many large-scale studies do not support the identification and treatment of sub-clinical hypothyroidism. Hence, we need a screening protocol that will identify all cases of overt hypothyroidism. The present study aimed to evaluate the high-risk screening protocol for detection of overt hypothyroidism during pregnancy.Methods: Authors performed a prospective observational study for detection of thyroid dysfunction in 604 pregnant women in a tertiary care hospital setting. Detailed demographic, medical and obstetric history was noted and baseline serum thyrotropin (TSH) level and urinary iodine levels were checked. Reflex testing for thyroid peroxidase antibody was done in women diagnosed to have hypothyroidism. The enrolled women were then grouped as high risk if any of the high-risk criteria provided by ATA was positive.Results: The study population was iodine sufficient with median urinary iodine (MUI) level of 255µg/l. Overall 32.2% women (n=201) were found to be hypothyroid (TSH >2.5mIU/L), 0.8% women (n=5) were hyperthyroid. Overt hypothyroidism was seen in 3.8% women (n=23), all of whom were in the high-risk group as per the ATA guidelines. This co-relation was highly significant (likelihood ratio 24.94; P <0.001). Sensitivity of targeted screening for detection of overt hypothyroidism was 100%. On the other hand, logistic regression analysis showed poor co-relation of high-risk factors with sub-clinical hypothyroidism (TSH levels between 2.5 mIU/L- 10.0 mIU/L), likelihood ratio being 0.534; P>0.05.Conclusions: High risk screening protocol is highly sensitive for detection of overt hypothyroidism and provides the best therapeutic payoff.
Study of feto-maternal outcome in patients with intra uterine fetal death
Authors: Thaker Rajal V. , Munshi Kavina S. , Patel Vivek A. , Vasava Dipti C. , Makwana Nilesh M.
Published: October 2018

Background: Intra Uterine Fetal Death (IUFD) is an important issue in modern obstetrics. This study has been undertaken to find out the incidence of IUFD, socio-demographic factors, probable etiological factors, mode of delivery, its outcome and complications if any.Methods: This retrospective observational study was carried out at a tertiary care hospital. Data was collected from case papers of patients who have delivered beyond 20 weeks and/or baby weighing more than 500 grams and having IUFD prior to onset of labor or during labor with singleton pregnancy.Results: Incidence of IUFD was 17.2 per 1000 births. Majority of the patients 93 (48.1%) were in age group of 26-30 years, 115 (59.5%) came as an emergency and 94 (48.7%) were primi gravida. Majority 89 (46.1%) patients had not taken any antenatal visit. IUFD occurred due to unexplained etiology, pre-eclampsia-eclampsia, anemia, uncontrolled diabetes, jaundice, antepartum haemorrhage and congenital malformation in 77 (39.9%), 51 (26.4%), 10 (5.1%), 7 (3.6%), 4 (2%), 29 (15%) and 2 (1%) respectively. Vaginal delivery occurred in 151 (78.2%). Majority of dead babies 111 (57.5%) were male, 71 (36.7%) were weighing 1kg or less and 92 (47.6%) were macerated. Emotional upset, DIC, PPH and ARF occurred in 193 (100%), 21 (10.8%), 15 (7.7%) and 1 (0.5%) respectively.Conclusions: Majority of patients were unregistered and had not taken antenatal care or had inadequate antenatal care. Pre-eclampsia-eclampsia, APH, anemia and diabetes were the leading cause of IUFD along with unknown causes. A significant proportion of IUFD can be prevented by health education regarding adequate antenatal care, warning signs and institutional deliveries.
Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation
Authors: Chiniwar Mahantappa A. , M. Joe Kaushik , Menasinkai Sharada B.
Published: October 2018

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.
Maternal serum selenium as a predictor of preeclampsia
Authors: Kaveri Vismaya , S. K. Manjula , C. N. Sheela , Kurpad Anura , Dwarkanath Pratibha
Published: October 2018

Background: Preeclampsia (PE) is a hypertension disorder condition occurring in 7-10% of all pregnancies. Preeclampsia if unidentified and left untreated is associated with poor maternal and fetal adverse outcomes. The objective of the present study was to characterize maternal serum selenium levels as a predictor of preeclampsia and to correlate dietary selenium intake with serum selenium levels in first trimester of pregnancyMethods: A retrospective case-control study of 107 pregnant women was conducted over 1.5 years at St. John’s Medical College Hospital. On screening for inclusion criteria, at baseline, information on maternal socio-demography, anthropometry, dietary intake and clinical examination was collected. A venous blood sample at baseline and 2nd or 3rdtrimester of pregnancy was collected for estimation of selenium concentrations. Blood pressure was measured at baseline and followed up during pregnancy to select cases and controls. Pregnant women were termed ‘cases’ based on NHBPEP (National High Blood Pressure Education Program) classification and subsequent 22 women with normal blood pressure controlled for age were termed as ‘controls.Results: No statistically significant differences were observed for baseline characteristics, biochemical parameters and blood pressure at recruitment among cases and controls. Cases had significant lower levels of energy (P=0.032) and micronutrients like zinc (P=0.027), selenium (P=0.022), magnesium (P=0.047) at first trimester. The serum selenium levels were significantly higher in cases as compared to the controls (69.2±13.7 vs. 59.6±12.9; P=0.021) at baseline.Conclusions: Our findings suggest that serum selenium levels may not be an independent predictor of preeclampsia. Assessment of other micronutrients, oxidative stress markers and other complementary elements may be useful in predicting preeclampsia.
Study of maternal and fetal outcome in various types of placenta previa
Authors: Bhuyar Sonal , Dharmale Neha
Published: October 2018

Background: Placenta previa is one of the life-threatening complications in obstetrics which affects maternal and neonatal outcome. Now-a-days its incidence is increasing due to previous operative procedures. The objective of the present study was to study out maternal and fetal outcome in various types of placenta previa.Methods: A prospective study was conducted in our tertiary care hospital on 78 patients in order to know the cause and outcome of placenta previa.Results: Early termination was carried out in major PP group due to APH. 13 out of 17 patients presenting with APH had major degree of PP. Abnormal lie and presentation are commonly seen in cases of PP however cephalic constituted 83.3% cases of fetal presentations in present study followed by breech 10.2%, oblique 3.9%, face 1.3% and transverse 1.3%. In this study, 92.2% neonates were born alive while neonatal death and intrauterine death (IUD) was observed in 5.2% and 2.6% neonates respectively.Conclusions: Combined efforts for prevention of risk factors for PP, timely diagnosis and planned institutional deliveries can only reduce the morbidity and mortality associated with PP.
A retrospective analysis of maternal deaths over a period of five years at a tertiary care hospital of central India
Authors: Yadav Kalpana , Rajput Neelu , Tiwari Arti , Yadav Gunjan
Published: October 2018

Background: Maternal mortality is one of the important indicators used for the measurement of maternal health. The present study was conducted to analyse the maternal deaths over a period of five years in a tertiary care centre, GMH Rewa, Madhya Pradesh.Methods: A retrospective observational   study was conducted in department of Obstetrics and Gynaecology, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa. The case records of all maternal deaths between January 3013 to December 2017 were collected from hospital medical records and studied. Data were analyzed statistically.Results: There were 214 maternal deaths from January 3013 to December 2017.The average maternal mortality ratio over a period of five years was 471.5 per one lac live births. Majority of maternal deaths were from toxaemia 33.2%, haemorrhage 26.2%, anaemia 16.3% and sepsis 12.6%.Conclusions: The present study highlights the importance of early antenatal registration of all pregnancies and regular follow up of cases by trained staff. Active management of high-risk groups by frequent antenatal visits, fluid and component transfusions, aggressive management of infection and closer monitoring of women in labor. Higher fertility and unwanted pregnancies should be reduced through family welfare services and easy availability of Medical termination of pregnancy services to be ensured. Analysis of every maternal death through maternal death audit should be carried out.
Biochemical parameter and feto-maternal outcome in preeclampsia: a hospital based observational study
Authors: Nagar Teena , Nagar Rajendra P. , Gupta Manisha
Published: October 2018

Background: Preeclampsia is one of the maternal diseases that cause detrimental effects on to the maternal, fetal, and neonatal health. The objective of the present study was to analyse maternal, perinatal outcome and investigation parameter in preeclampsia.Methods: This is an observational study and total of 90 consecutive patients were enrolled who has blood pressure ≥ 140/90 mmHg after 20 weeks of gestation with proteinuria (1+ by dipstick).Results: Among enrolled patients, 52 (58%) were in age group of 25-35 year and 51 (57%) were primigravida. Mean systolic and diastolic blood pressure of patients was 148±3.8 mm of Hg and 95±1.4 mm of Hg respectively. Most common presenting symptom was labor pain in 65 (72%) patients followed by edema in 61 (68%) patients. Most common complication was CNS symptom including seizure (Eclampsia) in 13 (15%) patients followed by vaginal bleeding (including abruption) in 12 (13%) patients. Mean hemoglobin level was 9.12±0.9 gm/dl. Mean urea and creatinine values were 34±4.6 mg/dl and 1.5±1.1 mg/dl respectively. Out of total 90 patients, 18 (20%) had elevated liver enzymes. Most common neonatal outcome was low birth weight 63 (70%) and 40 (44%) were preterm. APGAR score was less than 7 in 11 (12%) patients and more than 7 in 79 (88%) patients. Five (5.5%) newborn were still born.Conclusions: Preeclampsia is associated with multiple maternal and neonatal complications. Hence, there is a need for regular antenatal checkup to detect early and strengthening of neonatal intensive care units.
Clinical profile of patients with pelvic adnexal masses
Authors: Sharma Suksham , Wakhloo Ajay , Singh Gagan
Published: October 2018

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. Aim was to study the clinical profile of women in reproductive age group presented with adnexal masses.Methods: The study comprised of 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done.A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. Out of these, majority i.e.66.67% had chronic pelvic pain and 23% had pain of less than 1-month duration which were cases of ectopic pregnancy. 41.67% cases were suspected to have endometriosis,33.33% were suspected to have ovarian cyst, followed by ectopic pregnancy in 16.67% cases and tubo-ovarian mass in 8.33% cases.Conclusions: The present study shows that if proper preoperative evaluation is done, we can select the appropriate patients for laparoscopic approach.
A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college
Authors: Mandi Dipak , Sen Sayantan , Goswami Vasundhara
Published: October 2018

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.
Comparison of maternal and neonatal outcome of IVF/ICSI conceived pregnancies with spontaneous conceived pregnancies
Authors: Patil Preeti , Karthik Gayathri
Published: October 2018

Background: Conception by IVF has been associated with an increased incidence of several obstetrical and perinatal complications. IVF is associated with increased complications like OHSS (Ovarian Hyper Stimulation Syndrome), multiple pregnancies and thromboembolism, ectopic pregnancy, congenital malformations, and small for gestational age, low birth weight etc. This study is done to evaluate and compare the obstetric and perinatal complications between assisted reproduction and spontaneous conception. The objective of the present study was to evaluate and compare the maternal and neonatal outcome of IVF/ICSI conceived pregnancies with spontaneous conceived pregnancies.Methods: In this study 62 patients conceived with IVF/ICSI were taken as cases and 62 patients conceived spontaneously were taken as controls. The categorical data was analyzed using chi square test and results expressed by p value.Results: The incidence of multiple pregnancies among IVF/ICSI group is 33.8% and 1.6% in controls. IVF/ICSI conception when compared to spontaneous conception is associated with increased incidence of miscarriage (18% versus 1.6%), first trimester bleeding (18% versus 1.6%), cervical insufficiency (22.5% versus 0), PROM (11.3% versus 1.6%), preterm birth (33.8% verss 14.5%), caesarean section rates (71% vs 53%), low birth weight babies (44% vs 10.7%) and NICU admissions(33.3% vs 10.7%). The male: female ratio is higher in IVF/ICSI group.Conclusions: IVF/ICSI conceptions are associated with a significantly higher incidence of multiple pregnancies, miscarriage, prematurity, increased caesarean section rates, and increased male: female ratio.