bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus
Authors: Kumari Ankita , Mitra Shaila , Tiwari Harish C , Srivastav Reena
Published: February 2017

Background: Hypovitaminosis D has been associated with a number of adverse pregnancy outcomes, and has been recognised as a public health concern. The objective of this study was to determine the impact of Vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM) and preeclampsia (PE) among pregnant women.Methods: This was a case control study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur, Uttar Pradesh, India. Two maternal blood samples, one at <20 weeks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=60), gestational diabetes mellitus (n=35) and control group (n=180) after abstracting past medical records at delivery. Vitamin D was estimated by 25- Hydroxyvitamin D125 RIA kit and categorized according to ACOG criteria. Statistical analysis was done by using chi square test, binary logistic regression and Pearson’s correlation coefficient to compare between two variables. P<0.05 was considered statistically significant.Results: Out of 275 women included in the study, 78% of women were Vitamin D deficient. Mean serum vitamin D was significantly lower among preeclamptic women 11.53±6.22 ng/ml and GDM women 12.62±6.69 ng/ml as compared to controls 24.25±14.44 ng/ml (median=18.2 ng/ml) (P<0.05). Vitamin D deficiency was significantly higher in pregnant women GDM (94.28% vs 68.3%) and preeclampsia (96.67% vs 68.3%) when compared to uncomplicated group.Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is significantly associated with elevated risk for GDM and preeclampsia.
Correlation of PID and multiparity: a case control study
Authors: Pandey Shikha , Pandey Ramesh
Published: February 2017

Background: Pelvic inflammatory disease (PID) has emerged as a silent killer that disturbs women's life. In the rural population of India, most women are usually not aware of symptoms of PID. They do not move for health care unless alarming symptoms develop. The objective of present study is to find out to find out correlation between PID & multiparity.Methods: The present study was conducted at Government Bundelkhand Medical College, Sagar. Study design:  Case control, Participants: Females attending obstetrics & gynecology department OPD, Sample size: Total 150  cases & same number (150) of controls. Statistics: Chi – square test.Results: The odds ratio (OR) was 0.69 with 95% confidence interval (CI) being 0.42-1.09 for PID with multiparity as risk factor. Of 143 cases, multiparity was seen in 63 cases (44.05). In 150 controls, it was seen in 80 (53.33%). The variation was not statistically significant (p = 0.141). The Odds Ratio with in exepertise as a risk factor for PID was 2.41 with 95% CI being 1.78-3.27. Result shows etiological fraction of 58.5% (CI 43.9-69.4%) among inexpert hands. The delivery in untrained hands was significantly higher in cases (p 0.00001).Conclusions: This study does not show multiparity to be a risk factor but delivery conducted by untrained hands was as a risk factor.
Comparative study of post placental cut insertion following vaginal and caesarean delivery
Authors: Lall Jasmine , Nagar Oby
Published: February 2017

Background: The IUCD is a safe and effective contraceptive option for postpartum women who wish to either space or limit subsequent births.Methods: In a hospital based prospective observational, study we compared outcome of post placental IUCD in vaginal and caesarean delivery groups.Results: We found that expulsion rate is significantly higher in vaginal group (10%) as compared to caesarean delivery (2%) group at 3 months of follow up. Excessive bleeding is mostly commonly found complication (18% in both groups at 6weeks of follow up).Conclusions: Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.
Nurse’s knowledge and attitude regarding cervical cancer screening at a tertiary care hospital
Authors: Pegu Bhabani , Dhiman Niharika , Chaturvedi Jaya , Sharma Suresh K.
Published: February 2017

Background: Cervical cancer is one of the commonest cancers among women which cause morbidity and mortality worldwide. Though, it is a preventable disease, most of the women with cervical cancer present in advanced stage due to lack of knowledge about the disease and screening among general population. The objective was to assess the level of knowledge and explore attitude towards cervical cancer screening among female nursing staff.Methods: A cross sectional, questionnaire based study was conducted on 34 female nursing staff in a tertiary care hospital of Uttarakhand, India in the month of January 2015. With the help of predesigned questionnaire, information was collected regarding demographic profile, knowledge about cervical cancer and attitude towards screening techniques.Results: In this study, 79% of the respondents had knowledge about screening methods for cervical cancer and 91% had knowledge about HPV vaccine. Though 82% of them were aware of pap smear and 89% had good attitude towards it, 85.29% respondent knew about colposcopy as one of the screening technique for cervical cancer. None of the respondent had undergone a pap smear themselves.Conclusions: The study showed that, female nursing staff had average knowledge and positive attitude towards cervical cancer screening. They were not aware of the routine screening guidelines and had limited understanding of different types of cervical cancer screening techniques. Hence, it is recommended that routine training should be given on regular basis to all the health care providers.
The influence of menopause on urinary incontinence in the women of the community: a cross-sectional study from North India
Authors: Khan Samreen , Ansari M. Athar , Vasenwala Shaista M. , Mohsin Zehra
Published: February 2017

Background: Urinary incontinence is defined as the complaint of any involuntary loss of urine that is a social or hygienic problem.  Worldwide, over 200 million people are living with urinary incontinence and as the life expectancy of women is increasing, more number of women are bound to suffer from it. The aim of the present study is to find out the effect of menopause on the occurrence of Urinary Incontinence in women and to find out risk factors in post-menopausal women associated with Urinary Incontinence.Methods: It was a community based cross-sectional study involving post-menopausal women living in the urban and rural areas registered under Community Medicine, J.N. Medical College, Aligarh, India. A total of 530 women were taken for this study. Descriptive statistics as well as simple proportion were calculated with SPSS 20.0. Tests of significance and Binary Logistic regression analysis were used for analysis.Results: Significant differences were found in the association of Urinary Incontinence with increasing age groups and consequent years spent in menopause, rural area of residence, illiteracy, lower socio-economic class, inadequate housing standards, obesity, smoking, parity, history of hysterectomy, and co-morbidities such as Urinary Tract Infection and Pelvic organ prolapse.Conclusions: From a public health perspective, there is considerable opportunity to improve women's quality of life by increasing health education about urinary incontinence and its treatment by taking steps for life style modifications.
To study the association of Doppler derived indices of uterine artery resistance with composite of PIH/PET
Authors: Rana Uday Bhanu , Minhas Santosh , Negi Prakash , Pathania Kushla , Kaur Simar Preet
Published: February 2017

Background: Hypertensive disorders of pregnancy (HDP) are among the main public health issues worldwide. They account for an estimated 10-15% of maternal deaths globally. Among the hypertensive disorders of pregnancy, pre-eclampsia is most dangerous, occurring in 10% of first pregnancies, and in 20-25% of women with past history of hypertension. The objective of present study is to investigate the association of Doppler derived Indices of uterine artery resistance with composite of PIH/PET.Methods: A prospective follow up observational study, including pregnant women at 11-13+6 weeks of gestation in whom Uterine Artery Resistance measured using Doppler ultrasound.Results: A total of 100 subjects were enrolled, out of which 11 developed pre-eclampsia/ gestational hypertension. All Doppler indices (Resistance Index, Pulsatility Index and Systolic/Diastolic Index) had high specificities and negative predictive values.Conclusions: The potential advantages of early screening of hypertensive disorders and their associated complications may allow investigations or prophylactic interventions before 20 weeks of gestation.
Evaluation of cases of infertility by diagnostic laparoscopy
Authors: Wankhede Sachin , Thakare Sarika , Goverdhan Nivedita , Shahane Santosh
Published: February 2017

Background: Infertility affects nearly 10-15% of couples and is an important part of clinical practice. Leading causes of infertility include tubal disease, ovulatory disorders, uterine or cervical factors, endometriosis and male factor infertility. The objective of the study was to find out different causes of female infertility with diagnostic laparoscopy.Methods: This was a descriptive study conducted from February 2012 to November 2013. 115 patients with infertility attending the infertility clinic in OPD of Obstetrics and Gynaecology were evaluated clinically with detailed history. The necessary investigations were carried out and the laparoscopic findings were documented.Results: There were 91 cases (79.13%) with primary infertility and 24 (20.87%) with secondary infertility. Laparoscopy revealed normal findings in 14 cases (15.38%) of primary infertility and 1 case (4.17%) of secondary infertility. Pelvic abnormality was found in 100 cases (86.95%). Tubal block was the most common pathology found in 36 cases (31.30%) followed by polycystic ovaries in 32 (27.83%) and adhesions in 24 (20.87%). Uterine anomalies were found in 3 cases (3.30%).Conclusions: Diagnostic laparoscopy is a valuable technique and a mandatory investigation, which, though invasive, is more convenient and more precise for the diagnosis of infertility. Because of its potential diagnostic as well as therapeutic benefits, all patients with infertility should undergo diagnostic laparoscopy as part of their primary workup of infertility.
Lateral location of placenta on ultrasound as a predictive test for preeclampsia
Authors: Kaku Ramya , Shivaraju Pradeep , R. Vimala K. , Lingegowda Krishna
Published: February 2017

Background: Hypertensive disorders represent the most common medical complication of pregnancy Pre-eclampsia complicates approximately 2-7% of pregnancies and is a major cause of maternal and perinatal morbidity This has led to the interest in screening. The placenta is located laterally in majority of patients with abnormal flow velocity waveforms. In the light of these observations, we designed a prospective study to find out whether the lateral location of placenta as seen by ultrasound at II and III trimester of gestation can be used to predict the development of preeclampsia.Methods: A prospective observational study was done in PESIMSR, Kuppam, Andhra Pradesh. The aim of the study was to find out whether placental laterality as determined by ultrasound can be used as a predictor of development of gestational hypertension, development of preeclampsia/eclampsia During the study period of November 2013 to November 2014, all antenatal women attending the OPD in II and III trimester without any medical disorders likeDM, HTN, renal disease, cardiac disease or smoking, who undergo ultrasound in II and III trimester were included. The location of the placenta was determined by real time ultrasound in II and III trimester. The placenta will be classified as central when it is equally distributed between the right and the left side of the uterus irrespective of anterior, posterior or fundal position. When 75% or more of the placental mass is to one side of the midline, it is classified as unilateral right or left placenta. subjects were followed upto delivery for development of gestational hypertension/ preeclampsia/eclampsia as per the ACOG criteria.Results: 66% patients in the lateral placenta group developed preeclampsia. Only 36%in the central group developed preeclampsia. The association of lateral placenta as a predictor of preeclampsia had a P value of <0.001 which is statistically significant. Incidence of preclampsia is more in primigravidas compared to multigravidas. Most of the pre eclamptics had their onset at 29 – 32 weeks of gestation.Conclusions: The study shows that placental position determined by ultrasonogram in II and III trimester of gestation is an excellent screening tool for the prediction of pre-eclampsia. The test is ideal because it is simple, non-invasive, cost effective and convenient to the women.
Clinico–pathological study of hysterectomy in benign lesions: a study of 379 hysterectomies
Authors: Fathepuriya Dharmendra Singh , Verma Leena , Sharma Seema
Published: February 2017

Background: Uterus is a very vital reproductive organ and is subjected to many benign and malignant diseases. Hysterectomy is one of the most frequently performed procedures all over the world. Aims and Objectives of the work was to study the clinical benign indications of hysterectomy specimens and to correlate the findings with the histopathological reports.Methods: A prospective and randomized study was performed in 379 cases of elective hysterectomies for benign lesions.Results: Abdominal hysterectomy was performed in 64.6% cases while vaginal hysterectomy accounted for 35.3% cases. The mean age for hysterectomy was 45 years with a range from 14 to 78 years. Patients mostly presented with menstrual irregularities (34.3%) followed by prolapse uterus (30%). The principle indication of elective hysterectomy was leiomyoma and was present in 197(51.9%) patients, followed by prolapse uterus in 134 (35.3%) and dysfunctional uterine bleeding (DUB) in 26 (6.8%) patients. Maximum numbers of cases of leiomyoma, uterine prolapse and DUB were found in age group of 41-50 yrs.Conclusions: The number of abdominal hysterectomy was more than vaginal hysterectomy. Most common presenting feature was menstrual related symptom followed by prolapsed. The main indication for elective hysterectomy was leiomyoma, prolapsed and DUB.
Liver ailments in pregnancy: our experience
Authors: Kohli Uttara Aiyer , Seth Atul , Singh Sanjay , Mishra Rajesh
Published: February 2017

Background: The spectrum of liver disease is varied and is associated with increased maternal and perinatal morbidity and mortality when pregnancy coexists with the liver disease. This study aims to analyze the incidence, spectrum, clinical presentation and outcome of liver diseases complicating pregnancyMethods: A retrospective cohort study was conducted and data was collected from the hospital records of obstetric cases diagnosed with liver disease complicating pregnancy in a tertiary care hospital, over a period of two years.Results: A total 146 cases of liver diseases complicating pregnancies were recorded out of 5018 deliveries (2.9%). Intrahepatic cholestasis of pregnancy (n=52, 35.62%) and severe preeclampsia (n=47, 32.19%, with HELLP n=8, 5.48%) accounted for majority of cases. The incidence of chronic hepatitis B infection was 20.56% (n=30). There were two maternal deaths (1.37%) attributed to severe post-partum HELLP and severe preeclampsia with multi organ failure.Conclusions: Liver diseases in pregnancy have a non-specific presentation and may be associated with a wide range of conditions, early diagnosis and timely appropriate intervention can help reduce the mortality and morbidity.
Efficacy of anti-thrombotic treatment in thrombophilia patients with adverse pregnancy outcome
Authors: Adhikari Anil Kumar , Dutta Mahuya , Ferdows Sk Samim , Jain Madhu , Shukla Jyoti
Published: February 2017

Background: Thrombophilia is a potentially treatable cause of adverse pregnancy outcome. The objective was to compare the fetomaternal outcome in thrombophilia patients with adverse pregnancy outcome after treating with low-molecular-weight (LMW)/ unfractionated heparin and aspirin.Methods: 54 antenatal women studied who had an earlier or presenting pregnancy complicated by adverse pregnancy outcome were included in this study. In the present pregnancy, therapy consisting of LMW heparin and aspirin was administered who were found to be thrombophilia positive. Patients also received folic acid supplementation throughout their pregnancy. The fetomaternal outcome is compared according to the time of initiation of treatment.Results: Low-molecular-weight heparin and aspirin was well tolerated and none of the women or the newborns developed any hemorrhagic complications.3 thrombophilia negative cases with history of recurrent pregnancy loss aborted even getting treatment from 1 trimester. 1 thrombophilia positive case with history of recurrent pregnancy loss aborted when received treatment from 2nd trimester. There is 25.8% increase in birth weight of neonate if thrombophilia positive cases were treated from 1st trimester. Whereas there was only 10.23% increase in birth weight in thrombophilia negative cases when treated from first trimester. We found, our treatment was significantly effective in preventing IUD, IUGR, abruption, abortion, eclampsia. Though prevention of PIH had no significant correlation with antithrombotic treatment, only 2 cases booked from 1st trimester developed PIH among thrombophilia positive cases. But neither of cases had suffered from any severe complication as compared to 81% of eclampsia cases, 16.67% of DVT cases, 1 case of mortality in cases treated after third trimester.Conclusions: This case control trial suggests that patients with adverse pregnancy outcome and thrombophilia may get benefit from treatment with combined LMW heparin and aspirin in subsequent pregnancies. We suggest all patients with adverse pregnancy outcome should be investigated for thrombophilia markers.
Observational study of scalpel versus electrocautery for subcutaneous incision in elective gynaecological surgeries
Authors: Patil Vaibhav B. , Mule Vidya D. , Raval Ravi M. , Kulkarni Abhishek A.
Published: February 2017

Background: Considering higher rate of postoperative wound complications in Government set up hospitals, this study was an attempt to compare incision time, incisional blood loss, hospital stay, post-operative pain and postoperative wound complications when subcutaneous tissue is opened with either scalpel or electrocautery in elective gynaecological surgeries after keeping all other clinical and surgical variables same i.e. age, BMI, haemoglobin, incision depth and hospital stay.Methods: This was a prospective observational comparative study conducted in one of the tertiary teaching hospital in Western Maharashtra, India over 12 months. All patients (n=100) were divided into 2 groups. Group A in which skin and subcutaneous tissue was dissected by using scalpel and Group B in which after skin, anterior abdominal wall was opened by using electrocautery. Data analyzed for indication, incisional blood loss, incision time, postoperative pain, wound complications and hospital stay.Results: There were no significant association between preoperative diagnosis and the development of a post-operative wound complications. Mean incision blood loss was found to be significantly higher in group A compared to group B patients. Postoperative pain was significantly higher in group A (P value <0.05). Among wound complications, no statistically significant differences were seen regarding wound complications for the two groups.Conclusions: Electrosurgical dissection for abdominal incision is safe, less time consuming and with less blood loss during subcutaneous incision and produces less postoperative pain. We conclude that the method of subcutaneous tissue incision was unrelated to the development of postoperative abdominal incision problems.
Comparison of Doppler findings and neonatal outcome in fetal growth restriction
Authors: B. R. Rekha , A. Pavanaganga , M. P. A. Sai Lakshmi , R. Nagarathnamma
Published: February 2017

Background: Fetal growth restriction (FGR) affects up to 5-10% of pregnancies. It is associated with increased perinatal mortality and morbidity. Doppler studies identify at risk fetuses and help in timing interventions and prognosticate outcomes. The ability of Doppler studies to predict neonatal outcome is studied here.Methods: Prospective study of seventy-two women with singleton pregnancies with gestational age above 28 week and detected to have FGR was done. The patients were subjected to Doppler analysis. Abnormal Doppler indices were compared with neonatal outcomes such as NICU admission, ventilator or CPAP support, sepsis, phototherapy and perinatal mortality.Results: Elevated umbilical artery PI, reduced middle cerebral artery PI and low CP ratio were found in 14, 18 and 36 fetuses. The sensitivity and specificity in predicting neonatal outcome was 25% & 75%, 58.1% and 62% and 17.9% and 75% for umbilical artery PI, MCA PI and CP ratio respectively. None of the Doppler indices showed significant p value. On testing, gestational age at delivery and length of NICU stay, gestational age was a significant determining factor with ‘p’ value of 0.003.Conclusions: Antenatal Doppler analysis of UA and MCA can predict neonatal outcome in FGR fetuses. Though the ‘p’ value was not significant in this study, the sensitivity, specificity, positive predictive value and negative predictive value are comparable to other studies. Gestational age at delivery significantly influences neonatal outcome.
Menstrual hygiene: knowledge and practice among adolescent school girls in rural settings
Authors: Kapoor Gitanjali , Kumar Dinesh
Published: February 2017

Background: Menstrual hygiene is an issue that every girl and women must deal within her life, but there is lack of awareness on the process of menstruation and proper requirements for managing menstruation among adolescent girls. The objectives of present study are to assess the knowledge and the practices of menstrual hygiene among the rural school going adolescent girls and to assess the restrictions practiced by adolescent school going girls during menstruation.Methods: It was a community based cross-sectional study. The present study was undertaken among the adolescent school going girls in the Govt. Higher Secondary School in Marh block of Jammu district. 132 girls of the 8th, 9th, 10th, 11th and 12th standard of the school was selected for the study. A predesigned, pretested and structured questionnaire was used in the study. The data collection technique was a personnel interview of the study subjects.Results: The mean age of menarche in the study subjects was 13.43 years. It was evident that only 65 (49.24%) of the participants were aware about menstruation before menarche and the most important source of the information about menstruation for them was found to be their mothers.  59.09% girls used sanitary pads only, 27.27% used new cloth and 13.64% used old washed cloth.  98.48% of the respondents followed some restriction or taboo during menstruation. 93.18% had daily bath. Regular hand washing was present in 90.91% subjects of which 86.36% subjects used soap and water for hand washing.  Regular cleaning of the external genitalia was present in 65.91% subjects only, of which 66.67% used soap and water and 33.33% used only water.Conclusions: There is a need to educate the girls about menstruation, its importance and hygiene maintenance; to enable them to lead a healthy reproductive life in future.
Prediction of caesarean section for arrest of descent during the second stage of labour
Authors: Samal Sunil Kumar , Rathod Setu
Published: February 2017

Background: Friedman described the normal progress of labor in different curves for nulliparous and multiparous women in 1954. Any deviation from these curves during the second stage of labor is considered as failure to progress in the second stage of labor. The aim of the study is to define obstetrical risk factors for arrest of descent during the second stage of labour.Methods: All singleton, vertex, term deliveries with an unscarred uterus, between December 2013 to November 2016 (3 years) were included. Univariable and multivariable analysis were performed to investigate independent risk factors associated with arrest of descent during the second stage of labor.Results: The study included 7260 deliveries, of these 163 (3.3%) were complicated with arrest of descent during the second stage of labor. Using a multivariable analysis, the following obstetric risk factors were found to be significantly associated with arrest of descent: primigravida (RR=7.8, 95% CI=6.9-8.7, p<0.001), obesity (RR=1.8, 95% CI=1.6-2.0, p<0.001), short stature (RR=2.3, 95% CI=1.9-2.8, p<0.001), hypertensive disorders(RR=1.5, 95% CI=1.3-1.8,p<0.001), gestational diabetes(RR=1.5, 95%  CI=1.2-1.8, p<0.001), free floating head before labour(RR=3.4, 95%CI=2.5-4.1, p<0.001), Occipito-posterior position(RR=3.3, 95% CI=2.1-4.5, p<0.002), Prelabour rupture of membrane (PROM) (RR=1.3, 95% CI=1.0-1.6, p<0.02), induction of labour (RR=2.2, 95% CI=1.0-3.4, p<0.03)  and birth weight>3.5 kg (RR=2.2, 95% CI=2.0-2.4, p<0.001). Deliveries complicated by arrest of descent resulted in cesarean section in 67% and 34% vaginal delivery.Conclusions: In this era of increased public awareness and medicolegal events it is very crucial to assess and evaluate every woman in labor and to identify in advance the possibility of arrest in advanced labor so that a timely obstetric intervention possibly Cesarean section can prevent unnecessary maternal- fetal complications.
Comparison of total laparoscopic hysterectomy and laparoscopic assisted vaginal hysterectomy – a 2-year retrospective study
Authors: Mani Kanmani , Govindarajan Mirudhubashini , Selvaraj Vishranthi
Published: February 2017

Background: Hysterectomy is one of the most commonly performed major surgeries. Recently, increasing number of minimally invasive approaches, such as TLH and LAVH has been applied. People undergoing laparoscopic hysterectomy experience shorter hospitalization, a smaller wound, more rapid recovery, and shorter absence from work compared to patients undergoing abdominal hysterectomy. The objective of present study is to compare the surgical short term results between Laparoscopic assisted vaginal hysterectomy (LAVH) and Total laparoscopic hysterectomy (TLH) in our centre in two years.Methods: This was a retrospective study of 93 women who underwent LAVH and 55 women who underwent TLH. The statistical analysis is done by using Students t-test, Chi-square test, and Mann-Whitney test appropriately.Results: There were no differences between the two groups with respect to age, BMI, Indication of surgery, Uterine size, Previous pelvic surgery, average blood loss and hemoglobin change (P=0.4). The duration of surgery was longer in TLH (124 min vs. 76.9 min) and is found to be extremely significant (P=0.0001). There was significant statistical difference in respect to hospital stay (P=0.0076). There was no significant statistical difference in various complication rates (P=0.22).Conclusions: Both TLH and LAVH are safe methods in performing hysterectomy, but LAVH has advantages over TLH with reduced operating time and less hospital stay even for the patients with history of previous pelvic surgery.
Risk factors for still birth: a hospital based case control study
Authors: Lakshmi Sujatha Thankappan , Thankam Uma , Jagadhamma Preetha , Ushakumari Anuja , Chellamma Nirmala , Hariharan Sankar Vaikam
Published: February 2017

Background: The study of the risk factors contributing to still birth is imperative in our attempts to bring about a decline in the still birth rate.  By identifying the risk factors, we can understand the areas where specific interventions may be applied to bring about a reduction in the still birth rate. The aim of the present study was to identify the risk factors for stillbirth among the mothers attending Sri Avittom Thirunal Hospital, TrivandrumMethods: This was a prospective hospital based case control study conducted from March 2014- September 2015. Sample size was calculated as 100 cases and 200 controls. Odds ratios with 95% confidence interval were calculated using multi variate logistic regression.Results: The major risk factors associated with still births were maternal age, socio economic status, and obesity, sleep position during pregnancy, primi parity, hypertension and febrile illness during pregnancy. The risk of still birth was 3 times higher among mothers with hypertension compared to the control group.  Although the prevalence of diabetes slightly more in the case group it was not statistically significant. By analyzing all the risk factors in preparing a model 42% of the risk for still birth was contributed by these factors.Conclusions: The modifiable risk factors seen in this study to prevent still births are maternal sleep position during pregnancy, diabetes, hypertension and febrile illness especially urinary tract infection. By better antenatal care we can detect complications like diabetes, hypertension and manage appropriately thereby preventing complications. By screening for urinary tract infections in every trimester morbidity can be reduced.
Study of ectopic pregnancy in a tertiary care centre
Authors: Shukla Dhirajkumar B. , Jagtap Sunil V. , Kale Pradnya P. , Thakkar Hardik N.
Published: February 2017

Background: Ectopic pregnancy is a life threatening emergency leading to maternal death. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include abdominal pain, amenorrhoea and/or irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in Department of Pathology, Krishna Institute of Medical Sciences, Karad, Maharashtra, India from January 2010 to June 2014. All the cases of ectopic pregnancy managed surgically were included in the study.Results: Total 102 cases of ectopic pregnancy were studied. Proportion of ectopic pregnancy in the present study is 1 in 205 deliveries. Majority of the cases (37) (36.27%) were noted between 21 to 25 years of age group followed by the age group 26 to 30 years. Ectopic pregnancy was most commonly noted in nulliparous women (44/102) (43.14%). Majority of the cases (50/102) (49.02%) had no risk factors. Abortion was the most common risk factor identified, alone as well as in conjunction with other factors. Ampulla was the most common site for ectopic pregnancy. 55% of the cases were on the right side where as 45% on the left side. We had 2 cases of heterotropic pregnancy with tubal ectopic in both the cases. The typical triad of amenorrhoea, pain in abdomen and bleeding was observed in 21.57% cases.Conclusions: The incidence of ectopic pregnancies is on rise as evident in this study. In order to reduce the morbidity and mortality due to ectopic pregnancies, there is need for early diagnosis especially in high risk cases.
Effect of transcutaneous electrical nerve stimulation on labour pain relief among primigravida and multigravida mothers
Authors: Veyilmuthu Ramamoorthy , Govindan Sumathi , Venugopalan Mahalakshmi , Panicker Seetha
Published: February 2017

Background: TENS by neuro-physiological means seems to help in relieving labour pain. Most of the pregnant women are not aware of the coping strategies for labour pain. As a result they tend to be restless and stress themselves by shouting or screaming due to pain. By using TENS, women in labour can save their energy without stressing themselves and make use of the saved energy for pushing the fetus during the second stage of labour. The objective was to analyze the effect of TENS on relieving labour pain among the postnatal mothers who had used TENS to cope up with the labour pain.Methods: Data collected from 1041 women [Primipara (n=702) and Multipara (n=339)] who used TENS to cope up pain throughout the labour was used for this retrospective study.Results: 88% of women had vaginal delivery and only 12% of women had cesarean section. More than 50% of both primiparous and multiparous women who had normal and vacuum assisted vaginal delivery experienced excellent pain relief using TENS. Almost 40 % of both primiparous and multiparous women who had forceps delivery and lower segment cesarean section experienced excellent pain relief using TENS. Except 2% of women with normal vaginal delivery, none of them stated that there was no relief of pain using TENS.Conclusions: TENS had a very good effect in coping up the labour pain and could be used during the first and second stages of labour.
Obstetrical vacuum extraction practice in Senegal: knowledge, attitude and practices
Authors: Mbaye Magatte , Gueye Mamour , Diaboula Sountou , Gueye Mame Diarra Ndiaye , Diouf Aliou , Wade Mouhamadou , Saheli Brahem , Abdoulaye Mihimit , Moreau Jean Charles
Published: February 2017

Background:Assess knowledge, attitudes and practices of healthcare providers in the three biggest regions in Senegal, appreciate their level of training and determine the frequency of the practice of vacuum extraction in health facilities.Methods: This was a prospective study conducted over 1 year from January 1 to December 31, 2015 with a survey through interviews using a semi-structured questionnaire with open or closed questions, single or multiple-choice. Were included in the study providers practicing vacuum extractor, officiating in Dakar, Thies and Saint-Louis in the private and/or public sector who agreed to participate in the study. Data were captured and analyzed using File Maker Pro version 12 Inc*, then SPSS (Statistical Package for Social Science) version 21.0.Results: Out of 250 healthcare providers, 223 accepted to answer the questionnaire leading to an acceptance rate of 89.2%. 142 healthcare providers (63.7%) were trained in vacuum extraction. A proportion of 62.3% of providers knew the indications of vacuum extraction. For contraindications, only 34.5% of providers were able to cite one of them. Complications of vacuum extraction were known to 58.7% of our providers. There was a statistically significant difference between doctors and the others (midwifes, nurses) in the knowledge of indications, contraindications and complications of vacuum extraction. The only discriminatory parameter leading to this difference was initial and continuous training in vacuum extraction.Conclusions: It is important to introduce obstetric vacuum training in the gynaecology and obstetrics program for medical students and midwifery training schools, reinforce this training using simulators, include the practice of vacuum extraction in the internship objectives of medical students and midwives and evaluate them regularly.
Histopathological study of precursor and neoplastic lesions of endometrium in endometrial samplings
Authors: Patil Nanda J. , Shah Heena P. , Bharti Mamta
Published: February 2017

Background: Endometrial lesion presenting as abnormal uterine bleeding, abdominal pain and menstrual irregularities form most common presenting complaint in women of reproductive age group and in premenopausal women. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding (AUB). The present study was carried out to establish histopathological diagnosis of precursor and neoplastic lesions of endometrial samplings in correlation with clinical details and other investigations.Methods: A two-year prospective study was carried out in the department of pathology in a tertiary care hospital from June 2013-May 2015 which included endometrial samplings of precursor and neoplastic lesions. All cases were analyzed histopathologically.Results: The study included 46 cases comprising 30% of total 153 endometrial samplings. Out of these, precursor lesions were 36 cases (23.6%) and malignant were 10 case (5.8%). The highest incidence of precursor lesions (endometrial hyperplasia) was in the age group of 41- 50 years. Among the precursor lesions, endometrial hyperplasia without atypia (86%) was the commonest observation followed by atypical hyperplasia (14%).Conclusions: For the correct evaluation of cases presenting with AUB, histopathological evaluation of endometrial samplings is the gold standard method.
Study of renal and ophthalmic manifestations in hypertensive disorders of pregnancy and its outcome
Authors: Tharihalli Chandrashekhar , Giraddi Raju V.
Published: February 2017

Background:Hypertensive diseases of pregnancy are commonly manifested in renal and ocular changes. Proper evaluation of findings provided by urine analysis, renal function test, urine output and examination of the optic fundi and visual fields may help in assessing the severity and the need for intervention. The primary objective was to determine the prevalence of retinal and renal manifestations in hypertensive disorders in pregnancy and feto-maternal outcome.Methods: This prospective study was conducted in VIMS, Ballary, Karnataka, India between 1st March 2014 to 28th February 2015. Detailed history and ocular examination with direct fundoscopy and renal parameters were noted on the mothers admitted and their correlation with feto maternal outcome studied.Results: 432 patients were included in the study, 41.7% had retinopathy changes on fundoscopy, 31.3% patients had Grade I hypertensive changes. Grade II, III and IV changes were seen in 4.2%, 2.1% and 4.2% respectively. There was an increase in blood uric acid levels with increase in severity of preeclampsia. The incidence of IUFD (8.3%), still born (8.3%) and need for NICU admission were significantly more with the severity of preeclampsia.Conclusions: Cases of hypertensive disorders in pregnancy with visual disturbances and headache are commonly associated with retinal changes. It is essential to examine every pre-eclampsia patient for ocular manifestations, which is helpful in the management of patient. Maternal urine protein test helps to detect the glomerular insult in the kidney and is a strong predictor of maternal and fetal complications.
Comparative analysis of continuous and interrupted suturing techniques for repair of episiotomy or second degree perineal tear
Authors: Samal Sunil Kumar , Rathod Setu
Published: February 2017

Background: Perineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide and the type of perineal repair may have an impact on pain and healing. The objective of this study was to assess the effects of continuous subcuticular versus interrupted transcutaneous sutures on women following episiotomy or second degree perineal repair following childbirth.Methods: A prospective comparative study comprising 141 women who had undergone vaginal deliveries with episiotomies or second-degree tearing of the perineum between August 2015 and July 2016Two groups were made among which one group was repaired with continuous, nonlocking sutures involving the vagina, perineum, and subcutaneous tissues and the other group had continuous, locking sutures of the vagina, interrupted sutures in the perineal muscles, and interrupted transcutaneous sutures. The threads used for stitching were identical in both groups i.e. rapidly absorbed polyglactin 910 suture material.Results: On the 2nd day after delivery, the perineal pain scores during lying, sitting and walking in the continuous technique(CT) group was less compared to the interrupted technique(IT) group(p value 0.009). On 10th day after delivery the perineal pain score during sitting and walking were statistically less (p value 0.027) in the CT group.  On 42th day there was no difference in pain score between both the groups. The amount of suture materials consumed in CT group was statistically less than IT group(p<0.001). There was no difference in incidence of wound dehiscence (p value 0.301) but superficial dyspareunia is more in IT group which is statistically significant.Conclusions: The episiotomy and perineal tear repairs with continuous suturing associated with lesser incidence of short or long term pain, lesser requirement of suture material without an increase in complication than interrupted suturing.
Comparison of oral and vaginal misoprostol after oral mifepristone in early medical abortion
Authors: J. Nithya , P. Reddi Rani
Published: February 2017

Background: Abortions are still a major problem in developing countries contributing to significant maternal morbidity and mortality. WHO has reported that 53 million unplanned pregnancies result in termination each year. One third of these are performed under unsafe conditions. Deaths related to these accounts for up to about 20% of the maternal deaths that occur each year throughout the world. the main objective of the present study is to compare the efficacy, side effects and acceptability of oral and vaginal misoprostol after single oral dose of mifepristone in induction of abortion in pregnancy up to 63 days.Methods: It was a prospective randomized trial of 100 healthy women opting for termination of pregnancy with ultrasound confirmed intrauterine gestation of less than or equal to 9 weeks who were randomized in to two groups. Mifepristone 200mg was administered on day one followed by 800µg of misoprostol orally or vaginally 48 hours later. They were reviewed on day 7 and day 14 by ultrasound for completeness of abortion. If abortion was incomplete or bleeding was excessive, surgical evacuation was performed.Results: The two groups were comparable with respect to age, parity and gestational age. The mean induction abortion interval was 51.2 hours.98% of the women in both the groups had complete abortion.  Nausea (68%) and vomiting (58%) were more common in oral group. Diarrhoea (60%) was common in vaginal group. None of them had fever. Mean duration of bleeding was 9 days. 92% of the women found the procedure to be highly acceptable and would recommend it to others.Conclusions: Medical abortion with 200mg mifepristone in combination with 800µg of misoprostol either orally or vaginally 48 hours later was found to be safe, simple, effective, inexpensive, noninvasive and acceptable method.
Abdominal hysterectomy: analysis of clinico-histopathological correlation in Western Rajasthan, India
Authors: Yadav Dinesh Pal , Yadav Ramgopal , Bhati Indra
Published: February 2017

Background: Hysterectomy is the most common gynecological surgery done in the females worldwide as it provides definitive cure to a wide range of gynecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and the pathology should be proved histopathologically. Histopathological analysis and review is mandatory to evaluate the appropriateness of the hysterectomy.Methods: A retrospective, longitudinal study was conducted in the Department of Obstetrics and Gynecology, UMAID Hospital, Dr. S.N. M.C. Jodhpur (Raj.) during October 2014 to March 2015.Total 105 cases were studied during this period. The study included all women undergoing planned abdominal hysterectomy. Data was recorded on proformas, including demographic characteristics and clinical features. Hysterectomy specimens were saved in 10% formalin and sent to the Department of Pathology. Histopathology reports were analyzed and compared with the indications of surgery to draw various informative conclusions.Results: Of 105 cases, 55(52.38%) were in the age group of 41 – 50, which comprised the commonest age group undergoing the surgery. Maximum women (95%) those underwent hysterectomy were multiparous. Most common preoperatively clinical diagnosis was leiomyoma uterus which was diagnosed clinically and sonographically in 51(48.57%) cases. On Histopathological examination, the commonest pathology, similar to clinical impression, was found to be Leiomyoma at 50.48% (n = 53). Adenomyosis (21.90%) was detected as Second most common pathology. Histopathological confirmation of pre-operative diagnosis was 89% for malignancy, 96% for fibroids, 100% for adenomyosis, 100% for pelvic inflammatory disease.Conclusions: There was a high correlation when the clinical diagnosis was a fibroid, adenomyosis and ovarian mass. Every hysterectomy specimen should be subjected to histopathological examination because it is mandatory for conforming diagnosis and ensuring optimal management, in particular of malignant disease.
Seroprevalence of Chlamydia trachomatis infection among pregnant women and their outcome
Authors: Pipal Vibha Rani , Pipal Rajendra , Pipal Dharmendra , Yadav Seema , Kamal Manoj , Singariya Geeta
Published: February 2017

Background: Genitourinary infections either sexually transmitted or by other means are a major concern among women, particularly young adults and teens. The objective was to find out seroprevalence of Chlamydia trachomatis infection in pregnant women and its effect on pregnancy outcome.Methods: the present study was carried out in the department of obstetrics and gynaecology, King George Medical University of Lucknow, Uttar Pradesh, India, over a period of September 2003 to July 2004. Total 120 pregnant women were included in the study, these pregnant women were selected according to their will in taking part in the study irrespective of age and parity. 2 ml of blood sample was collected and determination of antichlamydial IgM antibody was done by VIRCELL SL IgM ELISA Kit in microbiology department. Prevalence of chlamydia trachomatis in pregnant women were assessed and correlated with age group, parity, socioeconomic status, previous obstetric outcome, anaemia, PROM, mode of termination according to gestational age, perinatal outcome regards birthweight, and adverse neonatal outcome.Results: Out of 120 cases, total 70 (58.33%) were positive while the remaining 50 cases were negative. 80 cases were followed till delivery in which 66.25% were positive for antichlamydial IgM antibody. There was significant association of previous history of 2-3 abortion and preterm delivery with IgM positive cases. Low birth weight deliveries were 78% and very low birth weight was 100% in positive cases. Caesarean section at <37 weeks of gestation, IUGR and low APGAR score were significantly high in IgM positive group. 100% PROM cases were IgM positive.Conclusions: The prevalence of chlamydia trachomatis infection among pregnant women in our population is high and is strongly associated with premature rupture of membranes, IUGR, LBW, and low APGAR score deliveries.