Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.093
F. Wani, Yoga Nagendhar, Rani Reddy
Ovarian torsion in childhood and adolescence is rare gynecological emergency. We report a case of ovarian torsion in eleven-year-old pre-menarcheal girl who presented with acute lower left abdominal pain and vomiting. On examination her vital signs were stable, secondary sexual characters were absent, abdomen was scaphoid with tenderness in left iliac fossa. Ultrasonography with doppler study showed a heterogenous mass measuring about 58x31mm in left adnexal region close to uterus with minimal vascularity. MRI findings were consistent with ovarian torsion. Patient underwent emergency laparoscopy and left ovary was found to be enlarged, blue-black with hemorrhagic cyst with two twists along Infundibulo-pelvic ligament. Ovarian Sparing Surgery involving de-torsion of torsed ovary with drainage of hemorrhagic cyst was performed. Right ovary was found to be normal in size with multicystic appearance. Bilateral oophoropexy using sandwich technique was done in order to prevent future recurrences. This case report emphasizes on importance of immediate diagnosis with ultrasound and MRI. Surgical management in form of laparoscopy with ovarian sparing surgery in young patients is important to preserve their fertility.
{"title":"A rare case of ovarian torsion in premenarcheal age- Case report and review of literature","authors":"F. Wani, Yoga Nagendhar, Rani Reddy","doi":"10.18231/j.ijogr.2023.093","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.093","url":null,"abstract":"Ovarian torsion in childhood and adolescence is rare gynecological emergency. We report a case of ovarian torsion in eleven-year-old pre-menarcheal girl who presented with acute lower left abdominal pain and vomiting. On examination her vital signs were stable, secondary sexual characters were absent, abdomen was scaphoid with tenderness in left iliac fossa. Ultrasonography with doppler study showed a heterogenous mass measuring about 58x31mm in left adnexal region close to uterus with minimal vascularity. MRI findings were consistent with ovarian torsion. Patient underwent emergency laparoscopy and left ovary was found to be enlarged, blue-black with hemorrhagic cyst with two twists along Infundibulo-pelvic ligament. Ovarian Sparing Surgery involving de-torsion of torsed ovary with drainage of hemorrhagic cyst was performed. Right ovary was found to be normal in size with multicystic appearance. Bilateral oophoropexy using sandwich technique was done in order to prevent future recurrences. This case report emphasizes on importance of immediate diagnosis with ultrasound and MRI. Surgical management in form of laparoscopy with ovarian sparing surgery in young patients is important to preserve their fertility.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.086
Balaji Vijayam, Manoranjani K, Anandhi A, Shanmugam A, T. Balaji, M. Balaji, Seshiah Veerasamy, Vinothapooshan Ganesan
Gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT), which are growing health concerns globally, are the most common metabolic and endocrine perinatal issues. It is a contentious entity with competing policies and procedures. Most physicians in the United States employ a two-step procedure, starting with a 50-g non-fasting oral glucose challenge test at 24 to 28 weeks and moving on to a 100-g fasting test for women who receive a positive screening result. Instead, doctors use the Diabetes in Pregnancy Study Group India (DIPSI) technique and conduct just a 75-g, two-hour fasting oral glucose tolerance test. The prospective observational study was approved by the hospital's institutional ethics committee and was conducted from April 2020 to September 2021 at the department of obstetrics and gynecology at Stanley Medical College Hospital in Chennai, Tamil Nadu, India. The patients were chosen in accordance with the inclusion criteria, which called for first-trimester pregnant women without diabetes mellitus. Both oral and written consent were also obtained. DIPSI performed the screening. The WHO standards have been updated to be a one-step process with a single glycemic value. According to the results of this study, GDM is linked to harmful consequences that might affect both the mother and the foetus. The short- and long-term consequences in both the mother and the newborn can be greatly reduced with early detection and timely therapy of this illness. In this study, birth weights ranging from 2.5 to 3.5 kg were the same for GDM and IGT moms. IGT mothers should also be followed up on, and we should be more watchful at birth, even though we monitor GDM mothers.
{"title":"A comparison study of maternal and perinatal outcomes with gestational diabetes mellitus, impaired glucose tolerance, and normal glucose tolerance","authors":"Balaji Vijayam, Manoranjani K, Anandhi A, Shanmugam A, T. Balaji, M. Balaji, Seshiah Veerasamy, Vinothapooshan Ganesan","doi":"10.18231/j.ijogr.2023.086","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.086","url":null,"abstract":"Gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT), which are growing health concerns globally, are the most common metabolic and endocrine perinatal issues. It is a contentious entity with competing policies and procedures. Most physicians in the United States employ a two-step procedure, starting with a 50-g non-fasting oral glucose challenge test at 24 to 28 weeks and moving on to a 100-g fasting test for women who receive a positive screening result. Instead, doctors use the Diabetes in Pregnancy Study Group India (DIPSI) technique and conduct just a 75-g, two-hour fasting oral glucose tolerance test. The prospective observational study was approved by the hospital's institutional ethics committee and was conducted from April 2020 to September 2021 at the department of obstetrics and gynecology at Stanley Medical College Hospital in Chennai, Tamil Nadu, India. The patients were chosen in accordance with the inclusion criteria, which called for first-trimester pregnant women without diabetes mellitus. Both oral and written consent were also obtained. DIPSI performed the screening. The WHO standards have been updated to be a one-step process with a single glycemic value. According to the results of this study, GDM is linked to harmful consequences that might affect both the mother and the foetus. The short- and long-term consequences in both the mother and the newborn can be greatly reduced with early detection and timely therapy of this illness. In this study, birth weights ranging from 2.5 to 3.5 kg were the same for GDM and IGT moms. IGT mothers should also be followed up on, and we should be more watchful at birth, even though we monitor GDM mothers.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abnormal uterine bleeding (AUB) refers to bleeding that occurs outside of normal menstrual cycles and includes changes in the regularity, frequency, duration, or amount of bleeding during or between periods. AUB is a condition that causes significant impairment in women's health, impacting a substantial proportion of women in different stages of their reproductive life with 14-25% of women of reproductive age and up to 50% of women in the perimenopausal phase experience the effects of this condition. The present study was analytical observational study conducted in the Department of Obstetrics and Gynaecology for the period of 18 months. Prior to commencement, the study obtained approval from the ethics committee at the hospital, and 63 women aged 35 or above, who were experiencing abnormal uterine bleeding, willingly participated in the study by providing written consent.. Each patient underwent a thorough medical history and general systemic examination. They were also subjected to baseline investigations, transvaginal sonography, diagnostic hysteroscopy, and endometrial biopsy. The overall diagnostic accuracy of our study came out to be 90.48%. The correlation between Histopathological and Hysteroscopic findings of the endometrium and was found to be statistically significant (p<0.05). Hysteroscopy is a valuable diagnostic tool for identifying the underlying cause of AUB. Proper management of AUB will depend on several factors including the patient's age, fertility goals, and the results of the final histopathology. While hysteroscopy is a valuable tool for visualizing abnormalities in the uterine cavity, it is important to note that it is not a substitute for tissue diagnosis, which is considered the gold standard. Rather, hysteroscopy complements other diagnostic procedures by offering the advantage of direct visualization of any abnormalities within the uterine cavity.
{"title":"An analytical study of hysteroscopic evaluation in patients with abnormal uterine bleeding, and its correlation with histopathology","authors":"Twinkle, Arshiya Khan, Asma Nigar, Keerti Singh, Bhavana Gupta, Mahin Fatima Faridi Khan","doi":"10.18231/j.ijogr.2023.082","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.082","url":null,"abstract":"Abnormal uterine bleeding (AUB) refers to bleeding that occurs outside of normal menstrual cycles and includes changes in the regularity, frequency, duration, or amount of bleeding during or between periods. AUB is a condition that causes significant impairment in women's health, impacting a substantial proportion of women in different stages of their reproductive life with 14-25% of women of reproductive age and up to 50% of women in the perimenopausal phase experience the effects of this condition. The present study was analytical observational study conducted in the Department of Obstetrics and Gynaecology for the period of 18 months. Prior to commencement, the study obtained approval from the ethics committee at the hospital, and 63 women aged 35 or above, who were experiencing abnormal uterine bleeding, willingly participated in the study by providing written consent.. Each patient underwent a thorough medical history and general systemic examination. They were also subjected to baseline investigations, transvaginal sonography, diagnostic hysteroscopy, and endometrial biopsy. The overall diagnostic accuracy of our study came out to be 90.48%. The correlation between Histopathological and Hysteroscopic findings of the endometrium and was found to be statistically significant (p<0.05). Hysteroscopy is a valuable diagnostic tool for identifying the underlying cause of AUB. Proper management of AUB will depend on several factors including the patient's age, fertility goals, and the results of the final histopathology. While hysteroscopy is a valuable tool for visualizing abnormalities in the uterine cavity, it is important to note that it is not a substitute for tissue diagnosis, which is considered the gold standard. Rather, hysteroscopy complements other diagnostic procedures by offering the advantage of direct visualization of any abnormalities within the uterine cavity.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.100
Sweta Nayak
Contrary to well-established guidelines in developed countries, awareness regarding red cell alloantibodies in antenatal period are lacking in India. Investigating for indirect antiglobulin test (IAT) is mostly limited to the Rh D negative antenatal cases. This case series revisits this vital aspect of maternal and fetal safety. Instances of alloantibody other than anti-D are reported.Study was done in Transfusion Medicine department of a tertiary care hospital in North India during 2019-2020. IAT was performed not during the 1st or 2nd trimesters of pregnancy but as a routine compatibility test during delivery. Patients with positive IAT were further evaluated for the detection of alloantibody by using identification panel red cells. Result: Eight antenatal cases with irregular antibodies other than anti-D during 2019-2020 are described. Antibodies detected per patient were single (three cases of anti-E, one of anti-Fya, one of anti-M) or multiple (two cases of anti-E plus anti-c, one of anti-E plus anti-K). Direct antiglobulin test of four babies born to these mothers was found to be positive, one of whom was still born and rest recovered with medical management. Two other babies had DAT negative and two mothers presented late after still birth. Alloantibody titer indicated in patient with anti-E during mid-pregnancy had titer was undetectable by standard tube technique.Non anti-D alloantibodies can potentially affect fetus, asserting equal attention as anti-D. IAT should not be missed in pregnancy as it is common to investigations for compatibility as well as for fetal wellbeing assessment.
与发达国家完善的指导方针相反，印度对产前红细胞异体抗体缺乏认识。对间接抗球蛋白试验（IAT）的调查大多仅限于 Rh D 阴性的产前病例。本系列病例重新审视了母体和胎儿安全的这一重要方面。研究于 2019-2020 年期间在北印度一家三级医院的输血医学科进行。IAT 并非在妊娠的前三个月或后三个月进行，而是作为分娩时的常规相容性检测。对 IAT 呈阳性的患者进行了进一步评估，以使用鉴定板红细胞检测异体抗体。结果本报告描述了 2019-2020 年期间出现抗 D 以外不规则抗体的 8 例产前病例。每位患者检测到的抗体均为单一抗体（3 例抗-E、1 例抗-Fya、1 例抗-M）或多重抗体（2 例抗-E 加抗、1 例抗-E 加抗-K）。这些母亲所生的四名婴儿的直接抗球蛋白试验呈阳性，其中一名婴儿仍在出生，其余婴儿经药物治疗后痊愈。另外两名婴儿的直接抗球蛋白试验呈阴性，两名母亲在死产后很晚才出现症状。非抗 D 型异体抗体可能会影响胎儿，因此需要与抗 D 型异体抗体同等重视。妊娠期不应该错过 IAT，因为它是检查相容性和评估胎儿健康的常用方法。
{"title":"Significance of red cell alloantibodies other than anti-D during pregnancy and their effect on the newborn: A case series","authors":"Sweta Nayak","doi":"10.18231/j.ijogr.2023.100","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.100","url":null,"abstract":"Contrary to well-established guidelines in developed countries, awareness regarding red cell alloantibodies in antenatal period are lacking in India. Investigating for indirect antiglobulin test (IAT) is mostly limited to the Rh D negative antenatal cases. This case series revisits this vital aspect of maternal and fetal safety. Instances of alloantibody other than anti-D are reported.Study was done in Transfusion Medicine department of a tertiary care hospital in North India during 2019-2020. IAT was performed not during the 1st or 2nd trimesters of pregnancy but as a routine compatibility test during delivery. Patients with positive IAT were further evaluated for the detection of alloantibody by using identification panel red cells. Result: Eight antenatal cases with irregular antibodies other than anti-D during 2019-2020 are described. Antibodies detected per patient were single (three cases of anti-E, one of anti-Fya, one of anti-M) or multiple (two cases of anti-E plus anti-c, one of anti-E plus anti-K). Direct antiglobulin test of four babies born to these mothers was found to be positive, one of whom was still born and rest recovered with medical management. Two other babies had DAT negative and two mothers presented late after still birth. Alloantibody titer indicated in patient with anti-E during mid-pregnancy had titer was undetectable by standard tube technique.Non anti-D alloantibodies can potentially affect fetus, asserting equal attention as anti-D. IAT should not be missed in pregnancy as it is common to investigations for compatibility as well as for fetal wellbeing assessment.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.088
Sunil K S, Shalini Bhat, Apoorva Jain
Preterm labour is the leading cause of perinatal morbidity and mortality worldwide. Preterm birth accounts for 75% of neonatal deaths and 50% of long-term morbidity including respiratory disease and neuro-developmental impairment. The use of tocolysis in women in preterm labour aims to inhibit uterine contractions and reduce perinatal morbidity and mortality associated with early delivery.To study the effect and compare the efficacy of Nifedipine and Magnesium sulphate in management of preterm labour.: This randomized controlled trial was performed on 80 women with preterm labor between 28 and 37 weeks of gestation who were randomly assigned to receive either MgSO4 or nifedipine. All patients were checked for successful prolongation of pregnancy who had not been delivered at 48 hours [primary tocolytics effects] and more than 7 days [secondary tocolytics effects] after beginning the treatment and side effects of tocolysis.: From 80 patients, 40 received nifedipine and 40 received MgSO4. There were no differences in suppression of labor pain in 24 hours, 48 hours and 7 days between the two groups. Even though there were no statistically significant differences in one-minute and five-minute Apgar scores, neonatal respiratory distress syndrome between the groups neonates of MgSO4 group had more NICU admission which is significant (p value 0.049).: Oral nifedipine is as effective as magnesium sulfate with regard to inhibition of preterm labor.
{"title":"Nifedipine versus magnesium sulfate in the management of preterm labour- A randomised controlled trial","authors":"Sunil K S, Shalini Bhat, Apoorva Jain","doi":"10.18231/j.ijogr.2023.088","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.088","url":null,"abstract":"Preterm labour is the leading cause of perinatal morbidity and mortality worldwide. Preterm birth accounts for 75% of neonatal deaths and 50% of long-term morbidity including respiratory disease and neuro-developmental impairment. The use of tocolysis in women in preterm labour aims to inhibit uterine contractions and reduce perinatal morbidity and mortality associated with early delivery.To study the effect and compare the efficacy of Nifedipine and Magnesium sulphate in management of preterm labour.: This randomized controlled trial was performed on 80 women with preterm labor between 28 and 37 weeks of gestation who were randomly assigned to receive either MgSO4 or nifedipine. All patients were checked for successful prolongation of pregnancy who had not been delivered at 48 hours [primary tocolytics effects] and more than 7 days [secondary tocolytics effects] after beginning the treatment and side effects of tocolysis.: From 80 patients, 40 received nifedipine and 40 received MgSO4. There were no differences in suppression of labor pain in 24 hours, 48 hours and 7 days between the two groups. Even though there were no statistically significant differences in one-minute and five-minute Apgar scores, neonatal respiratory distress syndrome between the groups neonates of MgSO4 group had more NICU admission which is significant (p value 0.049).: Oral nifedipine is as effective as magnesium sulfate with regard to inhibition of preterm labor.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.084
S. Hebbar, Sonam Agarwal
Preeclampsia is one of the most common disorders of pregnancy known to complicate 5-10% of all the pregnancies, and it is a component of the deadly triad (along with haemorrhage and infection), that contributes greatly to maternal morbidity and mortality rates. The prevalence of preeclampsia in twin pregnancy is 3-4 fold compared to singleton pregnancy. Timely diagnosis and prevention of this condition is therefore critical. Multiple maternal factors and placental biomarkers have shown to predict preeclampsia in singleton pregnancies. Previous Studies have shown that the proposed algorithms for preeclampsia screening in singletons can also be applied in twins, but with slight modifications and lower accuracy. To study the various parameters included in FMF screening algorithm in first trimester for preeclampsia in singleton and twin pregnancies. To find diagnostic accuracy of screening parameters to predict preeclampsia later in second and third trimester. To study sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) in singleton and twin pregnancy. This prospective observational cohort study conducted in department of Obstetrics and Gynecology, Kasturba Medial College, Hospital, Manipal. Patients were recruited from August 2021 to November 2022. A total of 295 pregnant women were included of which 255 were singleton gestation and 40 were twin gestation. All parameters mentioned in FMF algorithm were obtained between 11week to 13+6 weeks. Patients were followed until delivery for occurrence of pre-eclampsia. Individual parameters of first trimester FMF algorithm of pre-eclampsia screening were analyzed in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) in both singleton and twin study subjects and results were then compared among the groups. In this study a total of 295 pregnant women were recruited. 255 were single gestation of which 47 had preeclampsia and 40 were twin gestation of which 4 had preeclampsia. In the cohort of singleton pregnant women with pre-eclampsia, mean age was noted to be higher (32.77±4.27). They had higher BMI (mean 27.61±3.74) and first trimester MAP was also higher. Similarly, cohort of twin pregnancy with preeclampsia had higher mean of maternal age, BMI and MAP (30.33 ±4.46, 22.83 ± 2.93 and 90.40 ± 1.45 respectively). The Preeclampsia group in both singleton and twin subjects had lower serum concentration and lower MoM values of PAPP-A and PlGF while higher values of free beta HCG and uterine artery PI. Therefore the FMF algorithm for first trimester screening of preeclampsia was found to be a good predictor in both singleton and twin pregnancy. The first trimester FMF algorithm for preeclampsia screening had similar utility in the prediction of preeclampsia in both singleton and twin pregnancy with its individual parameters and combined risk model. However, its accuracy was slightly lesser among twins. Therefore, same screening
{"title":"A comparative study of performance of first trimester FMF algorithm for prediction of preeclampsia in singleton and twin pregnancies in coastal Karnataka","authors":"S. Hebbar, Sonam Agarwal","doi":"10.18231/j.ijogr.2023.084","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.084","url":null,"abstract":"Preeclampsia is one of the most common disorders of pregnancy known to complicate 5-10% of all the pregnancies, and it is a component of the deadly triad (along with haemorrhage and infection), that contributes greatly to maternal morbidity and mortality rates. The prevalence of preeclampsia in twin pregnancy is 3-4 fold compared to singleton pregnancy. Timely diagnosis and prevention of this condition is therefore critical. Multiple maternal factors and placental biomarkers have shown to predict preeclampsia in singleton pregnancies. Previous Studies have shown that the proposed algorithms for preeclampsia screening in singletons can also be applied in twins, but with slight modifications and lower accuracy. To study the various parameters included in FMF screening algorithm in first trimester for preeclampsia in singleton and twin pregnancies. To find diagnostic accuracy of screening parameters to predict preeclampsia later in second and third trimester. To study sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) in singleton and twin pregnancy. This prospective observational cohort study conducted in department of Obstetrics and Gynecology, Kasturba Medial College, Hospital, Manipal. Patients were recruited from August 2021 to November 2022. A total of 295 pregnant women were included of which 255 were singleton gestation and 40 were twin gestation. All parameters mentioned in FMF algorithm were obtained between 11week to 13+6 weeks. Patients were followed until delivery for occurrence of pre-eclampsia. Individual parameters of first trimester FMF algorithm of pre-eclampsia screening were analyzed in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) in both singleton and twin study subjects and results were then compared among the groups. In this study a total of 295 pregnant women were recruited. 255 were single gestation of which 47 had preeclampsia and 40 were twin gestation of which 4 had preeclampsia. In the cohort of singleton pregnant women with pre-eclampsia, mean age was noted to be higher (32.77±4.27). They had higher BMI (mean 27.61±3.74) and first trimester MAP was also higher. Similarly, cohort of twin pregnancy with preeclampsia had higher mean of maternal age, BMI and MAP (30.33 ±4.46, 22.83 ± 2.93 and 90.40 ± 1.45 respectively). The Preeclampsia group in both singleton and twin subjects had lower serum concentration and lower MoM values of PAPP-A and PlGF while higher values of free beta HCG and uterine artery PI. Therefore the FMF algorithm for first trimester screening of preeclampsia was found to be a good predictor in both singleton and twin pregnancy. The first trimester FMF algorithm for preeclampsia screening had similar utility in the prediction of preeclampsia in both singleton and twin pregnancy with its individual parameters and combined risk model. However, its accuracy was slightly lesser among twins. Therefore, same screening","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.099
Yesha Thakker, Salomi Singh, Devdatta M Dabholkar, Sameeksha Gabhane
The aim of this study is to review the various modalities used for management of non-tubal ectopic pregnancies. Ectopic pregnancy is a rare occurrence comprising 1-2% of all pregnancies. However, the most common site for ectopic implantation is fallopian tube. Tubal ectopic pregnancies 95% of all ectopic pregnancies while rest 5% are non-tubal pregnancies. Common sites for non-tubal ectopic pregnancy are cervical, cornual, interstitial, caesarean scar, ovarian and abdominal. Often misdiagnosed, however, detailed history taking, clinical examination and ultrasound helps to establish diagnosis. In this article, we discuss various cases of non-tubal ectopic pregnancy managed with medical treatment using methotrexate or surgical intervention or a combination of both. This study is a retrospective study carried out at MGM Medical College, Navi Mumbai, India between the years 2020-2022A total of 10 patients were diagnosed using clinical, laboratory and radiological methods and were then managed using medical and surgical management modalities ranging from methotrexate therapy to obstetric hysterectomy.There should be a clear protocol for management of non-tubal ectopic pregnancies in hospitals since there is an anticipated rise in the near future because of an increased rate of risk factors.
{"title":"Management of non-tubal ectopic pregnancy: A case series","authors":"Yesha Thakker, Salomi Singh, Devdatta M Dabholkar, Sameeksha Gabhane","doi":"10.18231/j.ijogr.2023.099","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.099","url":null,"abstract":"The aim of this study is to review the various modalities used for management of non-tubal ectopic pregnancies. Ectopic pregnancy is a rare occurrence comprising 1-2% of all pregnancies. However, the most common site for ectopic implantation is fallopian tube. Tubal ectopic pregnancies 95% of all ectopic pregnancies while rest 5% are non-tubal pregnancies. Common sites for non-tubal ectopic pregnancy are cervical, cornual, interstitial, caesarean scar, ovarian and abdominal. Often misdiagnosed, however, detailed history taking, clinical examination and ultrasound helps to establish diagnosis. In this article, we discuss various cases of non-tubal ectopic pregnancy managed with medical treatment using methotrexate or surgical intervention or a combination of both. This study is a retrospective study carried out at MGM Medical College, Navi Mumbai, India between the years 2020-2022A total of 10 patients were diagnosed using clinical, laboratory and radiological methods and were then managed using medical and surgical management modalities ranging from methotrexate therapy to obstetric hysterectomy.There should be a clear protocol for management of non-tubal ectopic pregnancies in hospitals since there is an anticipated rise in the near future because of an increased rate of risk factors.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.075
Janaki Vellanki, Velpula Sushma Sri
: Pain management during labour is an essential part of good obstetric care. Though this severe pain during labour is not life-threatening, it can have physiological and neuropsychological consequences. Adequate analgesia during labour is a benefit for the mother, has a positive influence on the course of labour and the state of the new born child. The ideal analgesic in obstetrics should have potent opiate-like analgesic efficacy with minimal side effects. Tramadol can be used as a basic analgesic for the treatment of patients with moderate to severe pain. Parenteral tramadol during labour was proven to have no negative effects on the baby or the process of labour.The study was conducted for a period of one year from April 2022 to March 2023 in the Department of obstetrics and Gynaecology, Gandhi Medical College and Hospital, Hyderabad after approval from Institutional Ethics Committee. Total of 500 parturient of age group 18 to 35 years were divided into 2 groups, control and study groups 250 participants each. The drug utilized was Intramuscular Tramadol Hydrochloride at a dosage of 1 ampule containing 2 ml, where 1 ml is equivalent to 50 mg. It is observed that there was a significant decrease in the degree of pain when compared to control group after giving Intramuscular Tramadol injection. And the majority of the patients had good neonatal outcomes and no maternal complications and reduced the duration of labour. In the study group 10% and 43.2% of patients, whereas 13.2% and 54.4% of patient in control group had Grade III and Grade IV pain, which was statistically significant.Intramuscular Tramadol Injection is safe for both mother and baby, effective and shortens the duration of labour period.
{"title":"Tramadol – A wonder drug in women with labour pain","authors":"Janaki Vellanki, Velpula Sushma Sri","doi":"10.18231/j.ijogr.2023.075","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.075","url":null,"abstract":": Pain management during labour is an essential part of good obstetric care. Though this severe pain during labour is not life-threatening, it can have physiological and neuropsychological consequences. Adequate analgesia during labour is a benefit for the mother, has a positive influence on the course of labour and the state of the new born child. The ideal analgesic in obstetrics should have potent opiate-like analgesic efficacy with minimal side effects. Tramadol can be used as a basic analgesic for the treatment of patients with moderate to severe pain. Parenteral tramadol during labour was proven to have no negative effects on the baby or the process of labour.The study was conducted for a period of one year from April 2022 to March 2023 in the Department of obstetrics and Gynaecology, Gandhi Medical College and Hospital, Hyderabad after approval from Institutional Ethics Committee. Total of 500 parturient of age group 18 to 35 years were divided into 2 groups, control and study groups 250 participants each. The drug utilized was Intramuscular Tramadol Hydrochloride at a dosage of 1 ampule containing 2 ml, where 1 ml is equivalent to 50 mg. It is observed that there was a significant decrease in the degree of pain when compared to control group after giving Intramuscular Tramadol injection. And the majority of the patients had good neonatal outcomes and no maternal complications and reduced the duration of labour. In the study group 10% and 43.2% of patients, whereas 13.2% and 54.4% of patient in control group had Grade III and Grade IV pain, which was statistically significant.Intramuscular Tramadol Injection is safe for both mother and baby, effective and shortens the duration of labour period.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139276096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.091
Sarojini, A. T. Rathod, G. Shivamurthy, Raksha R Nayak, Kavyashree Kavyashree D
: Corona virus disease 2019 (COVID -19) is caused by the Severe acute respiratory syndrome corona virus (SARS-COV-2). In the absence of an effective treatment, vaccination becomes the main modality to control the incidence of infectious diseases. Hence, there is a need to estimate the attitudes and willingness among pregnant women for COVID 19 Vaccine.To estimate the frequency of COVID 19 Vaccine acceptance and non acceptance in pregnant women attending antenatal OPD. To describe the factors associated with non acceptance of COVID 19 Vaccine in pregnant women attending antenatal OPDThis is an observational cross-sectional study where 500 pregnant women attending antenatal care were counseled about the COVID-19 vaccine. Women who refused the vaccine were asked about the reasons for refusal and the same was noted. 95.6% accepted the vaccine and 4.4% did not accept. Majority belonged to 21 to 25 years(45% acceptors and 72% non acceptors), were second gravidas (38.7% acceptors and 54.5% non acceptors) and were between 25 to 36 weeks gestation(52.7% acceptors and 50% non acceptors). 13.8% of acceptors and 4.5% of non acceptors had previous history of abortions. Commonest concern was fear of vaccine related complications and fear of harming the fetus. Vaccine reactions followed by fear of harming the baby were the commonest reasons for non acceptance. Vaccine acceptance was high in this study (95.6%). Vaccine induced reactions followed by fear of harming the baby were the commonest reasons for non acceptance.
{"title":"Acceptance for coronavirus disease 19 vaccines among pregnant women seeking antenatal care in tertiary care hospital","authors":"Sarojini, A. T. Rathod, G. Shivamurthy, Raksha R Nayak, Kavyashree Kavyashree D","doi":"10.18231/j.ijogr.2023.091","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.091","url":null,"abstract":": Corona virus disease 2019 (COVID -19) is caused by the Severe acute respiratory syndrome corona virus (SARS-COV-2). In the absence of an effective treatment, vaccination becomes the main modality to control the incidence of infectious diseases. Hence, there is a need to estimate the attitudes and willingness among pregnant women for COVID 19 Vaccine.To estimate the frequency of COVID 19 Vaccine acceptance and non acceptance in pregnant women attending antenatal OPD. To describe the factors associated with non acceptance of COVID 19 Vaccine in pregnant women attending antenatal OPDThis is an observational cross-sectional study where 500 pregnant women attending antenatal care were counseled about the COVID-19 vaccine. Women who refused the vaccine were asked about the reasons for refusal and the same was noted. 95.6% accepted the vaccine and 4.4% did not accept. Majority belonged to 21 to 25 years(45% acceptors and 72% non acceptors), were second gravidas (38.7% acceptors and 54.5% non acceptors) and were between 25 to 36 weeks gestation(52.7% acceptors and 50% non acceptors). 13.8% of acceptors and 4.5% of non acceptors had previous history of abortions. Commonest concern was fear of vaccine related complications and fear of harming the fetus. Vaccine reactions followed by fear of harming the baby were the commonest reasons for non acceptance. Vaccine acceptance was high in this study (95.6%). Vaccine induced reactions followed by fear of harming the baby were the commonest reasons for non acceptance.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.078
Subha Bansal, K. Mandrelle, Varughese P V
Early detection of abnormal progress of labour and prevention of prolonged labour significantly improves pregnancy outcomes. Partograph is a simple and important tool which can provide a continuous pictorial overview of labour on a single sheet of paper and is essential to monitor labour. (1) To study the progress of labour using WHO modified partograph in terms of alert line and action line and using paperless partograph in terms of alert and action estimated time of delivery and detect any deviation from normal progress of labour. (2) To evaluate the duration of labour, mode of delivery and perinatal outcome in both the groups.It was a prospective observational study which was conducted over a period of 18months on 200 antenatal patients admitted to the Department of Obstetrics and Gynaecology at Christian Medical College and Hospital, Ludhiana. Antenatal patients with singleton term pregnancy with cephalic presentation in active phase of labour were included in the study. The WHO modified partograph was plotted for 100 cases (Group I) and the paperless partograph was recorded for the other group of 100 patients (Group II) and their outcomes were compared. The p value <0.05 was considered to be significant.In our study we noted that the findings were similar in the WHO modified partograph group and the paperless partograph group in terms of duration of labour, progress of labour, mode of delivery and neonatal outcomes with no statistically significant difference between both the groups.Our study concluded that the paperless partograph is as good as the WHO modified partograph in predicting the labour outcomes and identifying labour abnormalities. The paperless partograph does not need graphical representation and therefore can be adopted as an alternative to the WHO modified partograph in busy labour room settings.
{"title":"To study the clinical utility of WHO modified and paperless partograph in the management of labour and its outcome","authors":"Subha Bansal, K. Mandrelle, Varughese P V","doi":"10.18231/j.ijogr.2023.078","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.078","url":null,"abstract":"Early detection of abnormal progress of labour and prevention of prolonged labour significantly improves pregnancy outcomes. Partograph is a simple and important tool which can provide a continuous pictorial overview of labour on a single sheet of paper and is essential to monitor labour. (1) To study the progress of labour using WHO modified partograph in terms of alert line and action line and using paperless partograph in terms of alert and action estimated time of delivery and detect any deviation from normal progress of labour. (2) To evaluate the duration of labour, mode of delivery and perinatal outcome in both the groups.It was a prospective observational study which was conducted over a period of 18months on 200 antenatal patients admitted to the Department of Obstetrics and Gynaecology at Christian Medical College and Hospital, Ludhiana. Antenatal patients with singleton term pregnancy with cephalic presentation in active phase of labour were included in the study. The WHO modified partograph was plotted for 100 cases (Group I) and the paperless partograph was recorded for the other group of 100 patients (Group II) and their outcomes were compared. The p value <0.05 was considered to be significant.In our study we noted that the findings were similar in the WHO modified partograph group and the paperless partograph group in terms of duration of labour, progress of labour, mode of delivery and neonatal outcomes with no statistically significant difference between both the groups.Our study concluded that the paperless partograph is as good as the WHO modified partograph in predicting the labour outcomes and identifying labour abnormalities. The paperless partograph does not need graphical representation and therefore can be adopted as an alternative to the WHO modified partograph in busy labour room settings.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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