Pub Date : 2023-11-15DOI: 10.18231/j.ijogr.2023.096
Anjani Dixit
Total laparoscopic hysterectomy (TLH) is a common procedure in gynecology, often performed to treat various gynecologic conditions. This case report presents a patient who underwent TLH with bilateral salpingectomy and subsequently developed a pulmonary embolism (PE) postoperatively. The patient, a 49-year-old woman with a history of adenomyosis and abnormal uterine bleeding (AUB) associated with endometrial hyperplasia – AUB-M, developed difficulty breathing and chest pain two days after surgery. Diagnostic tests revealed acute PE affecting both main pulmonary arteries. The patient received prompt medical treatment in the intensive care unit (ICU), including anticoagulation therapy, diuretics, oxygen support, and antibiotics. Her condition gradually improved, and she was discharged on oral anticoagulation medication after five days. The case highlights the importance of considering venous thromboembolism (VTE) as a potential complication, even in low-risk patients, and the need for further research to identify additional risk factors and improve preoperative care to prevent such life-threatening complications.
{"title":"Management of venous thromboembolism as a complication after Total laparoscopic hysterectomy with bilateral salpingectomy: A case report","authors":"Anjani Dixit","doi":"10.18231/j.ijogr.2023.096","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.096","url":null,"abstract":"Total laparoscopic hysterectomy (TLH) is a common procedure in gynecology, often performed to treat various gynecologic conditions. This case report presents a patient who underwent TLH with bilateral salpingectomy and subsequently developed a pulmonary embolism (PE) postoperatively. The patient, a 49-year-old woman with a history of adenomyosis and abnormal uterine bleeding (AUB) associated with endometrial hyperplasia – AUB-M, developed difficulty breathing and chest pain two days after surgery. Diagnostic tests revealed acute PE affecting both main pulmonary arteries. The patient received prompt medical treatment in the intensive care unit (ICU), including anticoagulation therapy, diuretics, oxygen support, and antibiotics. Her condition gradually improved, and she was discharged on oral anticoagulation medication after five days. The case highlights the importance of considering venous thromboembolism (VTE) as a potential complication, even in low-risk patients, and the need for further research to identify additional risk factors and improve preoperative care to prevent such life-threatening complications.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275347","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.2023.097
Sarah Quraishi, Arathy Raj, Swati Rathore
Cervical laceration (CL) after vaginal delivery is one of the uncommon side effects with significant morbidity if undetected and unattended to promptly. This is however one of the common causes for postpartum haemorrhage. There are several documented risk factors for CL such as previous interventions on the cervix, induction of labour, use of Prostaglandins for induction, precipitate labour, operative vaginal deliveries and birth weight of more than 3500gm.In this article we have described a series of eleven women who were detected to have CL following vaginal delivery. One of whom had delivery of the baby through a bucket handle cervical tear with a non-dilated cervical os. Almost all of them needed multiple blood and product transfusions in view of postpartum haemorrhage with one of them developing acute kidney injury subsequently. This necessitates the need for prompt identification of CL and its needed intervention.
{"title":"Cervical lacerations: A case series","authors":"Sarah Quraishi, Arathy Raj, Swati Rathore","doi":"10.18231/j.ijogr.2023.097","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.097","url":null,"abstract":"Cervical laceration (CL) after vaginal delivery is one of the uncommon side effects with significant morbidity if undetected and unattended to promptly. This is however one of the common causes for postpartum haemorrhage. There are several documented risk factors for CL such as previous interventions on the cervix, induction of labour, use of Prostaglandins for induction, precipitate labour, operative vaginal deliveries and birth weight of more than 3500gm.In this article we have described a series of eleven women who were detected to have CL following vaginal delivery. One of whom had delivery of the baby through a bucket handle cervical tear with a non-dilated cervical os. Almost all of them needed multiple blood and product transfusions in view of postpartum haemorrhage with one of them developing acute kidney injury subsequently. This necessitates the need for prompt identification of CL and its needed intervention.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"34 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272990","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.2023.083
Ashish Zarariya, Arya Chaubey, Dr D Harikanth
Obstetric haemorrhage is the leading cause of maternal mortality and morbidity worldwide. A prospective observational study was conducted among 132 women admitted, booked/referred, at tertiary care centre with Obstetric Haemorrhage for 2 years period. Of these 71 patients had received Non-pneumatic antishock garment and / or Uterine Balloon Tamponade (Group 1) and 61 didn’t receive any (Group 2). Both groups were observed for its outcome. The socio-demographic parameters and obstetric characteristics among both groups were comparable. However, there were differences in their outcomes and complications. Surgical interventions were more among group 2 as compared to group 1, B-lynch/Modified B-lynch (8.4% vs. 1.6%), Stepwise devascularisation (2.8% vs. 1.6%) and Obstetric hysterectomy (7.0% vs. 3.2%). There was significantly more blood loss in Group 2 than group 1. Duration of hospital stay was significantly shorter (9.8±2.7 days) in Group 1 as compared to Group 2 (12.7±3.6). The shock index after intervention was significantly smaller (0.7±0.1) in Group 1 in comparison to Group 2 (0.8±0.1) and Group 1 required significantly less number of blood and blood products as compared to group 2. 19.7% required ICU admission in group 1 and 24.6% in Group 2. There was no mortality in group 1 and 3 patients died in group 2. NASG and UBT is both life-saving and cost effective and can become the first defence against Obstetric Haemorrhage.
{"title":"Non-pneumatic anti-shock garment (NASG) and balloon tamponade decrease maternal mortality and morbidity from Obstetrics Haemorrhage: A prospective observational study","authors":"Ashish Zarariya, Arya Chaubey, Dr D Harikanth","doi":"10.18231/j.ijogr.2023.083","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.083","url":null,"abstract":"Obstetric haemorrhage is the leading cause of maternal mortality and morbidity worldwide. A prospective observational study was conducted among 132 women admitted, booked/referred, at tertiary care centre with Obstetric Haemorrhage for 2 years period. Of these 71 patients had received Non-pneumatic antishock garment and / or Uterine Balloon Tamponade (Group 1) and 61 didn’t receive any (Group 2). Both groups were observed for its outcome. The socio-demographic parameters and obstetric characteristics among both groups were comparable. However, there were differences in their outcomes and complications. Surgical interventions were more among group 2 as compared to group 1, B-lynch/Modified B-lynch (8.4% vs. 1.6%), Stepwise devascularisation (2.8% vs. 1.6%) and Obstetric hysterectomy (7.0% vs. 3.2%). There was significantly more blood loss in Group 2 than group 1. Duration of hospital stay was significantly shorter (9.8±2.7 days) in Group 1 as compared to Group 2 (12.7±3.6). The shock index after intervention was significantly smaller (0.7±0.1) in Group 1 in comparison to Group 2 (0.8±0.1) and Group 1 required significantly less number of blood and blood products as compared to group 2. 19.7% required ICU admission in group 1 and 24.6% in Group 2. There was no mortality in group 1 and 3 patients died in group 2. NASG and UBT is both life-saving and cost effective and can become the first defence against Obstetric Haemorrhage.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273518","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.065
Aman Tiwari, Aayushi Mathur
One of the most prevalent metabolic disorders among women of reproductive age is polycystic ovarian syndrome (PCOS).Menstrual dysfunction and androgen excess symptoms, such as hirsutism and acne, are common in women with PCOS. Additionally, there may be an increased risk of other morbidities such as obesity, insulin resistance, type 2 diabetes mellitus, cardiovascular diseases, infertility, cancer, and psychological disorders.This study is an attempt to summarise the prevalence of polycystic ovarian syndrome(PCOS) in adolescent girls and young women residing in the National Capital Region belonging to the age group of 11-30 years.The study was questionnaire-based and carried out for a duration of 6 months with 267 participants. The BMI of the participants was calculated using the formula: BMI= weight in kgs/ height in m2. PCOS was diagnosed using a questionnaire with Rotterdam’s criteria.The prevalence of PCOS was found to be 77.1%. The mean age group at which maximum number of participants were diagnosed with PCOS was 18-20 years. The BMI (BMI=kg/m2) of all the participants was calculated and 8% participants came under the obese category. 90% of the participants were aware of PCOS, 79.2% participants agreed PCOS is increasing rapidly while 19.3% participants had no idea about PCOS.The study concludes that respondents were less aware of the actual prevalence of PCOS and also associate the disorder’s manifestation with lifestyle variations. Even at this young age adolescent girls and women are at a high risk of metabolic syndrome because of the increased prevalence of sedentary lifestyles and lack of physical activity. A good diet, regular exercise, early diagnosis, and treatment modalities available are all critical components of raising awareness about PCOS and the risk factors associated with it.
{"title":"Prevalence of polycystic ovary syndromes (PCOS) in adolescent girls and young women: A questionnaire-based study","authors":"Aman Tiwari, Aayushi Mathur","doi":"10.18231/j.ijogr.2023.065","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.065","url":null,"abstract":"One of the most prevalent metabolic disorders among women of reproductive age is polycystic ovarian syndrome (PCOS).Menstrual dysfunction and androgen excess symptoms, such as hirsutism and acne, are common in women with PCOS. Additionally, there may be an increased risk of other morbidities such as obesity, insulin resistance, type 2 diabetes mellitus, cardiovascular diseases, infertility, cancer, and psychological disorders.This study is an attempt to summarise the prevalence of polycystic ovarian syndrome(PCOS) in adolescent girls and young women residing in the National Capital Region belonging to the age group of 11-30 years.The study was questionnaire-based and carried out for a duration of 6 months with 267 participants. The BMI of the participants was calculated using the formula: BMI= weight in kgs/ height in m2. PCOS was diagnosed using a questionnaire with Rotterdam’s criteria.The prevalence of PCOS was found to be 77.1%. The mean age group at which maximum number of participants were diagnosed with PCOS was 18-20 years. The BMI (BMI=kg/m2) of all the participants was calculated and 8% participants came under the obese category. 90% of the participants were aware of PCOS, 79.2% participants agreed PCOS is increasing rapidly while 19.3% participants had no idea about PCOS.The study concludes that respondents were less aware of the actual prevalence of PCOS and also associate the disorder’s manifestation with lifestyle variations. Even at this young age adolescent girls and women are at a high risk of metabolic syndrome because of the increased prevalence of sedentary lifestyles and lack of physical activity. A good diet, regular exercise, early diagnosis, and treatment modalities available are all critical components of raising awareness about PCOS and the risk factors associated with it.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"195 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74426204","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.052
Mahin Fatima Faridi Khan, B. Gupta, M. Srivastava, Kusum Lata, Vibha Singh, Dr Twinkle
Cervical cancer poses a major public health challenge, particularly in developing nations, where around 80% of cases are diagnosed. Despite being a preventable disease, it remains highly prevalent, with over 600,000 new cases and 340,000 deaths reported worldwide in 2020. According to the GLOBOCAN 2020 data, cervical cancer represented 9.4% of all cancer cases and 18.3% of new cancer cases in India. However cervical cancer is now considered preventable through cervical screening and curable, particularly if detected early, which emphasizes the importance of "prevention is better than cure". The current research utilized Pap smear, VIA, and colposcopy to identify abnormal cervical appearances indicative of carcinoma.: During a span of 18 months, a study was carried out on 329 women who were attending the OPD clinic at Integral Institute Of Medical Sciences and Research hospital. With the participants' consent, the women underwent VIA, Pap smear and colposcopy tests as part of the study. In the study 61 (18.5%) cases were found positive in VIA findings and 268 (81.5%) were VIA negative. In this study 85.7% of Pap smears were normal, out of 18.5% VIA positive, 77% of pap smears were abnormal 23 (37.5%) ASC (NOS/US), 8 (13.1%) AGC and AGC NOS, 6 (9.1%) AEC, 5 (8.2%) LSIL, 5 (8.2%) HSIL and out of 268 VIA negative all Pap were normal (100%). 61 colposcopies were done, out of 18.5% VIA positive, 73.6% colposcopies were positive 29 were CIN I (47.5%), 10 were CIN III (16.3), 6 were CIN II (9.8%) and 13.2% were normal and 13.2% were cervicitis. Biopsy was done in all colposcopy patients, 49.2% were CIN I, 27% were chronic cervicitis, 10% were CIN I, 3.2% were squamous cell carcinoma and 1.6% were adenocarcinoma in situ and 1.6% were cx show no atypia. VIA offers a promising alternative to cytology for detecting premalignant lesions of the uterine cervix, with its cost-effectiveness, on-the-spot results, and high sensitivity and specificity. In low-resource settings like India, where a substantial number of women lack access to screening tests, VIA is especially well-suited. This screening method allows for immediate counseling and referral for treatment, helping to reduce delays in diagnosis and treatment which can help to minimize delays in diagnosis and treatment.
宫颈癌是一项重大的公共卫生挑战，特别是在发展中国家，那里约有80%的病例得到诊断。尽管是一种可预防的疾病，但它仍然非常普遍，2020年全球报告了60多万新病例和34万例死亡。根据GLOBOCAN 2020的数据，宫颈癌占印度所有癌症病例的9.4%，占新发癌症病例的18.3%。然而，宫颈癌现在被认为是可以通过子宫颈检查预防和治愈的，特别是如果及早发现，这强调了"预防胜于治疗"的重要性。目前的研究使用巴氏涂片，VIA和阴道镜检查来识别指示癌的异常宫颈外观。在18个月的时间里，对329名在Integral Institute of Medical Sciences and Research医院门诊就诊的妇女进行了一项研究。在参与者的同意下，作为研究的一部分，这些女性接受了VIA、巴氏涂片和阴道镜检查。本研究中，经检阳性61例(18.5%)，经检阴性268例(81.5%)。在本研究中，85.7%的子宫颈抹片检查正常，18.5%的子宫颈抹片检查阳性，77%的子宫颈抹片检查异常，23例(37.5%)ASC (NOS/US)， 8例(13.1%)AGC和AGC NOS, 6例(9.1%)AEC, 5例(8.2%)LSIL, 5例(8.2%)HSIL, 268例(100%)VIA阴性，所有子宫颈抹片检查正常。共行阴道镜检查61例，其中VIA阳性18.5%，阳性73.6%，ⅰ期29例(47.5%)，ⅲ期10例(16.3%)，ⅱ期6例(9.8%)，正常13.2%，宫颈炎13.2%。所有阴道镜患者均行活检，其中CIN为49.2%，慢性宫颈炎为27%，CIN为10%，鳞状细胞癌为3.2%，原位腺癌为1.6%，无异型性的为1.6%。VIA是细胞学检测子宫颈癌前病变的一种很有前途的替代方法，具有成本效益、现场结果、高灵敏度和特异性。在印度等资源匮乏的地区，大量妇女无法获得筛查测试，VIA尤其适合。这种筛查方法允许立即咨询和转诊治疗，有助于减少诊断和治疗的延误，从而有助于最大限度地减少诊断和治疗的延误。
{"title":"To compare the effectiveness of pap smear, via and colposcopy for screening of premalignant lesions of cervix","authors":"Mahin Fatima Faridi Khan, B. Gupta, M. Srivastava, Kusum Lata, Vibha Singh, Dr Twinkle","doi":"10.18231/j.ijogr.2023.052","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.052","url":null,"abstract":"Cervical cancer poses a major public health challenge, particularly in developing nations, where around 80% of cases are diagnosed. Despite being a preventable disease, it remains highly prevalent, with over 600,000 new cases and 340,000 deaths reported worldwide in 2020. According to the GLOBOCAN 2020 data, cervical cancer represented 9.4% of all cancer cases and 18.3% of new cancer cases in India. However cervical cancer is now considered preventable through cervical screening and curable, particularly if detected early, which emphasizes the importance of \"prevention is better than cure\". The current research utilized Pap smear, VIA, and colposcopy to identify abnormal cervical appearances indicative of carcinoma.: During a span of 18 months, a study was carried out on 329 women who were attending the OPD clinic at Integral Institute Of Medical Sciences and Research hospital. With the participants' consent, the women underwent VIA, Pap smear and colposcopy tests as part of the study. In the study 61 (18.5%) cases were found positive in VIA findings and 268 (81.5%) were VIA negative. In this study 85.7% of Pap smears were normal, out of 18.5% VIA positive, 77% of pap smears were abnormal 23 (37.5%) ASC (NOS/US), 8 (13.1%) AGC and AGC NOS, 6 (9.1%) AEC, 5 (8.2%) LSIL, 5 (8.2%) HSIL and out of 268 VIA negative all Pap were normal (100%). 61 colposcopies were done, out of 18.5% VIA positive, 73.6% colposcopies were positive 29 were CIN I (47.5%), 10 were CIN III (16.3), 6 were CIN II (9.8%) and 13.2% were normal and 13.2% were cervicitis. Biopsy was done in all colposcopy patients, 49.2% were CIN I, 27% were chronic cervicitis, 10% were CIN I, 3.2% were squamous cell carcinoma and 1.6% were adenocarcinoma in situ and 1.6% were cx show no atypia. VIA offers a promising alternative to cytology for detecting premalignant lesions of the uterine cervix, with its cost-effectiveness, on-the-spot results, and high sensitivity and specificity. In low-resource settings like India, where a substantial number of women lack access to screening tests, VIA is especially well-suited. This screening method allows for immediate counseling and referral for treatment, helping to reduce delays in diagnosis and treatment which can help to minimize delays in diagnosis and treatment.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84807085","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.069
Zuha Ahmed, S. Gupta, Ifrah Ahmed, Syed Saif Ahmad
To report rare case of pregnancy in Mullerian Anomaly of the uterus and to understand the concept of precise diagnosis for rare cases. This is a case report at CIMS, Lucknow of patient who came to our hospital at first trimester with history of recurrent abortions and preterm delivery. She was diagnosed to have cervical incompetence initially until her abdomen was opened for LSCS when rare Mullerian Anomaly was seen to be the cause of previous obstetric history.Rare congenital anomaly was reported and the bad obstetric outcomes were known to be the symptoms of the rare cause.We need to broad our diagnosis with the fact that rare cases can also be the cause of worst conditions or some initial primary conditions.
{"title":"Pregnancy in Mullerian anomaly – A diagnostic dilemma","authors":"Zuha Ahmed, S. Gupta, Ifrah Ahmed, Syed Saif Ahmad","doi":"10.18231/j.ijogr.2023.069","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.069","url":null,"abstract":"To report rare case of pregnancy in Mullerian Anomaly of the uterus and to understand the concept of precise diagnosis for rare cases. This is a case report at CIMS, Lucknow of patient who came to our hospital at first trimester with history of recurrent abortions and preterm delivery. She was diagnosed to have cervical incompetence initially until her abdomen was opened for LSCS when rare Mullerian Anomaly was seen to be the cause of previous obstetric history.Rare congenital anomaly was reported and the bad obstetric outcomes were known to be the symptoms of the rare cause.We need to broad our diagnosis with the fact that rare cases can also be the cause of worst conditions or some initial primary conditions.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85325833","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.070
Arti Gautam, Neeru Malik, Sandhya Jain
: To know the risk and management of postabortal haemorrhage in patients with previous caesarean delivery to prevent maternal mortality. : Placenta accreta is an emergency life threatening obstetric situation may also complicate first trimester and midtrimester abortion and encountered as profuse vaginal bleeding and difficulty in placenta removal at delivery. The incidence of placenta accreta increased from 1 in 30,000 pregnancies in 1960 to 1 in 533 pregnancies in 2000. Placenta accreta developed in 55 of 590 women with placenta previa and 7 of 156080 without placenta previa. Increased incidence of caesarean increases the incidence of placenta accreta. Multiple caesarean deliveries are largest risk factor for placenta accreta. On the basis of a high risk factor, suspected case of placenta accreta spectrum, must be diagnose and be in charge of a multidisciplinary team with better maternal and fetal outcome. A 36 years old patient, P3L3A1 had prior 3 LSCS with retained placenta with profuse bleeding per vaginum with history of expulsion of fetus (18 week) on the way to hospital, presented to labor room. Patient was unbooked and uninvestigated. Initial resuscitation done along with oxytocic given but no sign of placental separation was there and bleeding was continued. On the basis of torrential bleeding and history of previous three caesarean deliveries, patient is immediately shifted to the operation theatre for exploratory laparotomy in view or provisional diagnosis of a morbidly adherent placenta with torrential haemorrhage. On laparotomy, the anterior surface of lower uterine segment of uterus accompanied by numbers of engorged blood vessels. Bladder was spared. Decision of exploratory laparotomy taken into consideration of morbidly adherent placenta, and procedure was ended with Subtotal hysterectomy, haemostasis achieved. 2 units PCV transfused intraoperatively and patient was shifted to intensive care unit for observation postoperatively. Her postoperative duration was uneventful; she got discharged on postoperative day6 under satisfactory condition. The specimen was sent for histopathological examination. Vigilant monitoring and timely intervention in obstetric emergencies can avoid maternal mortality. We wish to highlight the vigilant monitoring and timely decision, active collaboration by multidisciplinary team improve outcomes in patient of postabortal haemorrhage in midtrimester with previous caesarean delivery with placenta accreta spectrum.
{"title":"Early diagnosis of placenta accreta in case of mid trimester postabortal haemorrhage with previous 3 cesarean sections","authors":"Arti Gautam, Neeru Malik, Sandhya Jain","doi":"10.18231/j.ijogr.2023.070","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.070","url":null,"abstract":": To know the risk and management of postabortal haemorrhage in patients with previous caesarean delivery to prevent maternal mortality. : Placenta accreta is an emergency life threatening obstetric situation may also complicate first trimester and midtrimester abortion and encountered as profuse vaginal bleeding and difficulty in placenta removal at delivery. The incidence of placenta accreta increased from 1 in 30,000 pregnancies in 1960 to 1 in 533 pregnancies in 2000. Placenta accreta developed in 55 of 590 women with placenta previa and 7 of 156080 without placenta previa. Increased incidence of caesarean increases the incidence of placenta accreta. Multiple caesarean deliveries are largest risk factor for placenta accreta. On the basis of a high risk factor, suspected case of placenta accreta spectrum, must be diagnose and be in charge of a multidisciplinary team with better maternal and fetal outcome. A 36 years old patient, P3L3A1 had prior 3 LSCS with retained placenta with profuse bleeding per vaginum with history of expulsion of fetus (18 week) on the way to hospital, presented to labor room. Patient was unbooked and uninvestigated. Initial resuscitation done along with oxytocic given but no sign of placental separation was there and bleeding was continued. On the basis of torrential bleeding and history of previous three caesarean deliveries, patient is immediately shifted to the operation theatre for exploratory laparotomy in view or provisional diagnosis of a morbidly adherent placenta with torrential haemorrhage. On laparotomy, the anterior surface of lower uterine segment of uterus accompanied by numbers of engorged blood vessels. Bladder was spared. Decision of exploratory laparotomy taken into consideration of morbidly adherent placenta, and procedure was ended with Subtotal hysterectomy, haemostasis achieved. 2 units PCV transfused intraoperatively and patient was shifted to intensive care unit for observation postoperatively. Her postoperative duration was uneventful; she got discharged on postoperative day6 under satisfactory condition. The specimen was sent for histopathological examination. Vigilant monitoring and timely intervention in obstetric emergencies can avoid maternal mortality. We wish to highlight the vigilant monitoring and timely decision, active collaboration by multidisciplinary team improve outcomes in patient of postabortal haemorrhage in midtrimester with previous caesarean delivery with placenta accreta spectrum.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"102 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72717810","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.059
Ankita Chonla, Sangeeta Gupta
: Maternal mortality is an indicator of the quality of maternal health services provided in the country. Despite the therapeutic advances in obstetric care and growing perception of the safety of childbirth over the past few decades, maternal morbidity and mortality remain to be a challenge in developing countries like ours where little attention has been given to the near miss obstetric events. : To study the prevalence and clinical profile of Maternal near miss in a tertiary care center.: To evaluate the underlying disorders, contributory factors and socio-demographic variables among maternal near miss cases.: This observational study was undertaken at the Department of Obstetrics and Gynecology, Maulana Azad Medical College (MAMC) & associated Lok Nayak Hospital (LNH), New Delhi for a period of one year. The study population was the patients attending OPD or casualty or admitted in the Department of Obstetrics and Gynecology at LNH, MAMC, who fulfilled the MoHFW maternal near miss identifying criteria and whose case records were available. The data for the study was collected both retrospectively and prospectively from January 2019 to December 2021. Detailed history of patients like name, age, date of admission and presenting complaints were recorded. Obstetric history including history of previous pregnancy and labor, complications during present pregnancy, past and present medical problems were also recorded. For each case of MNM, the primary obstetric complication leading to near miss was evaluated.: There were 7064 live births during the study period. The study reveals a near miss ratio of 3.25 per 1000 live births. The near miss to mortality ratio was found to be 0.38:1 and the mortality index was 71.95%. Hemorrhage followed by hypertensive disorders of pregnancy were the most common disorders seen in near miss cases. All near miss cases required either HDU and/or ICU stay. The total requirement of blood and blood products by all near miss cases in the study was six whole blood, 61 packed red blood cells, 62 platelets and 42 fresh frozen plasma. The neonatal and perinatal mortality rate of our study was 38.8%.: A near-miss tool that is more generalizable, especially in a low-resource setting where many deliveries occur at home, needs to be developed. It should also be simple enough to be used by accredited social health workers, auxiliary nurse and midwife and other health care workers.
{"title":"Maternal near miss in a tertiary care hospital: A retrospective and prospective observational study","authors":"Ankita Chonla, Sangeeta Gupta","doi":"10.18231/j.ijogr.2023.059","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.059","url":null,"abstract":": Maternal mortality is an indicator of the quality of maternal health services provided in the country. Despite the therapeutic advances in obstetric care and growing perception of the safety of childbirth over the past few decades, maternal morbidity and mortality remain to be a challenge in developing countries like ours where little attention has been given to the near miss obstetric events. : To study the prevalence and clinical profile of Maternal near miss in a tertiary care center.: To evaluate the underlying disorders, contributory factors and socio-demographic variables among maternal near miss cases.: This observational study was undertaken at the Department of Obstetrics and Gynecology, Maulana Azad Medical College (MAMC) & associated Lok Nayak Hospital (LNH), New Delhi for a period of one year. The study population was the patients attending OPD or casualty or admitted in the Department of Obstetrics and Gynecology at LNH, MAMC, who fulfilled the MoHFW maternal near miss identifying criteria and whose case records were available. The data for the study was collected both retrospectively and prospectively from January 2019 to December 2021. Detailed history of patients like name, age, date of admission and presenting complaints were recorded. Obstetric history including history of previous pregnancy and labor, complications during present pregnancy, past and present medical problems were also recorded. For each case of MNM, the primary obstetric complication leading to near miss was evaluated.: There were 7064 live births during the study period. The study reveals a near miss ratio of 3.25 per 1000 live births. The near miss to mortality ratio was found to be 0.38:1 and the mortality index was 71.95%. Hemorrhage followed by hypertensive disorders of pregnancy were the most common disorders seen in near miss cases. All near miss cases required either HDU and/or ICU stay. The total requirement of blood and blood products by all near miss cases in the study was six whole blood, 61 packed red blood cells, 62 platelets and 42 fresh frozen plasma. The neonatal and perinatal mortality rate of our study was 38.8%.: A near-miss tool that is more generalizable, especially in a low-resource setting where many deliveries occur at home, needs to be developed. It should also be simple enough to be used by accredited social health workers, auxiliary nurse and midwife and other health care workers.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88338717","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.049
R. Mondal, Mouli Nandi, Priyadarshi Mandal
Loss of normal ovarian function before the age of 40 characterizes primary ovarian insufficiency (POI), sometimes called premature ovarian failure or early menopause. Many women all around the globe deal with this serious reproductive health issue. The purpose of this study is to provide a broad perspective on how to identify and treat primary ovarian insufficiency. Symptoms, hormone profiles, and ovarian imaging help diagnose POI. Genetics, autoimmune illness, and medical intervention may cause it. After a proper diagnosis, affected women might get counselling and therapy.This review article covers primary ovarian insufficiency diagnosis and treatment. Affected women should be diagnosed early, counselled, and treated individually. Understanding POI and developing better drugs may improve these people's reproductive and general health.
{"title":"Primary ovarian insufficiency- an overview: Part 1 definition, arteriology, clinical relevance","authors":"R. Mondal, Mouli Nandi, Priyadarshi Mandal","doi":"10.18231/j.ijogr.2023.049","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.049","url":null,"abstract":"Loss of normal ovarian function before the age of 40 characterizes primary ovarian insufficiency (POI), sometimes called premature ovarian failure or early menopause. Many women all around the globe deal with this serious reproductive health issue. The purpose of this study is to provide a broad perspective on how to identify and treat primary ovarian insufficiency. Symptoms, hormone profiles, and ovarian imaging help diagnose POI. Genetics, autoimmune illness, and medical intervention may cause it. After a proper diagnosis, affected women might get counselling and therapy.This review article covers primary ovarian insufficiency diagnosis and treatment. Affected women should be diagnosed early, counselled, and treated individually. Understanding POI and developing better drugs may improve these people's reproductive and general health.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79338859","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 : 2023-08-15DOI: 10.18231/j.ijogr.2023.067
S. Sinha, S. Sharma, Mudit Sharma, Vishal Bankawar
: Contraceptive prevalence rate serves as a proxy measure of access to reproductive health services. It is an indicator of health, population, development and women’s empowerment. : To determine the prevalence and pattern of contraceptive usage and also the factors affecting among the married women of reproductive age in an urban field practice area of the Department of Community Medicine, JNU Institute of Medical Sciences, Jaipur; Rajasthan.: A community based cross-sectional study was conducted in urban field practice area of JNU medical college, Rajasthan among women aged 15-49 years with calculated sample size of 402. A predesigned and pretested semi-structured questionnaire was used and data was collected with interview technique. The questionnaire consisted of socio-demographic details, reproductive history and current contraceptive usage. Data was entered in Ms Excel, analyzed using SPPS v.22 and represented in tables and figures. Chi square test was used to show the association and p-value <0.005 was considered statistically significant. : Currently 50.47% of the women were not using any contraceptive method. Maximum usage was of male condom 36.26%. Majority of the participants stated as it was husband’s disapproval (31.28%) for current non-usage of any contraceptive. Socio-economic status was not significantly associated with the contraceptive use.: In our study, male condom was the most common temporary contraceptive used. Misconception and fear of side effects related to the contraceptive usage was a major reason for non-utilization of contraceptives.
{"title":"Prevalence of contraceptive practices and its associated factors among women in an urban slum area of North India: An observational study","authors":"S. Sinha, S. Sharma, Mudit Sharma, Vishal Bankawar","doi":"10.18231/j.ijogr.2023.067","DOIUrl":"https://doi.org/10.18231/j.ijogr.2023.067","url":null,"abstract":": Contraceptive prevalence rate serves as a proxy measure of access to reproductive health services. It is an indicator of health, population, development and women’s empowerment. : To determine the prevalence and pattern of contraceptive usage and also the factors affecting among the married women of reproductive age in an urban field practice area of the Department of Community Medicine, JNU Institute of Medical Sciences, Jaipur; Rajasthan.: A community based cross-sectional study was conducted in urban field practice area of JNU medical college, Rajasthan among women aged 15-49 years with calculated sample size of 402. A predesigned and pretested semi-structured questionnaire was used and data was collected with interview technique. The questionnaire consisted of socio-demographic details, reproductive history and current contraceptive usage. Data was entered in Ms Excel, analyzed using SPPS v.22 and represented in tables and figures. Chi square test was used to show the association and p-value <0.005 was considered statistically significant. : Currently 50.47% of the women were not using any contraceptive method. Maximum usage was of male condom 36.26%. Majority of the participants stated as it was husband’s disapproval (31.28%) for current non-usage of any contraceptive. Socio-economic status was not significantly associated with the contraceptive use.: In our study, male condom was the most common temporary contraceptive used. Misconception and fear of side effects related to the contraceptive usage was a major reason for non-utilization of contraceptives.","PeriodicalId":13288,"journal":{"name":"Indian Journal of Obstetrics and Gynecology Research","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73713535","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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