Advanced abdominal pregnancy is an uncommon and potentially precarious variant of ectopic pregnancy in which the fetus develops in the abdominal cavity. A 30-year-old multigravida presented at 33+5 weeks of gestation with abdominal pain. Ultrasonography revealed a single live fetus lying in the abdominal cavity, with the uterus seen separately. Previous ultrasonography done at 15 weeks of gestation was suggestive of intrauterine pregnancy. She underwent emergency laparotomy at 33+6 weeks, which confirmed secondary abdominal pregnancy with the placenta deriving its blood supply from the left uterine artery and omental vessels. A peripartum hysterectomy was performed. The postoperative period was uneventful, and both mother and baby were discharged after one week. Despite notable advancements in prenatal care and medical imaging technologies, abdominal pregnancies, even if advanced, may remain undiagnosed, emphasizing the necessity for healthcare professionals to maintain a heightened level of suspicion regarding this condition. If conservative management has to be sought, the case selection should be done carefully due to the high risk to both the mother’s and fetus’s life. There is a pressing need for the standardisation of treatment protocols in order to optimise maternal and fetal outcomes in abdominal pregnancy.
{"title":"A rare case of advanced abdominal pregnancy with good maternal and fetal outcome","authors":"Akanksha Agarwal, Ramandeep Bansal, Pooja Sikka, Tanvi Katoch, Nalini Gupta","doi":"10.18203/2320-1770.ijrcog20240814","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240814","url":null,"abstract":"Advanced abdominal pregnancy is an uncommon and potentially precarious variant of ectopic pregnancy in which the fetus develops in the abdominal cavity. A 30-year-old multigravida presented at 33+5 weeks of gestation with abdominal pain. Ultrasonography revealed a single live fetus lying in the abdominal cavity, with the uterus seen separately. Previous ultrasonography done at 15 weeks of gestation was suggestive of intrauterine pregnancy. She underwent emergency laparotomy at 33+6 weeks, which confirmed secondary abdominal pregnancy with the placenta deriving its blood supply from the left uterine artery and omental vessels. A peripartum hysterectomy was performed. The postoperative period was uneventful, and both mother and baby were discharged after one week. Despite notable advancements in prenatal care and medical imaging technologies, abdominal pregnancies, even if advanced, may remain undiagnosed, emphasizing the necessity for healthcare professionals to maintain a heightened level of suspicion regarding this condition. If conservative management has to be sought, the case selection should be done carefully due to the high risk to both the mother’s and fetus’s life. There is a pressing need for the standardisation of treatment protocols in order to optimise maternal and fetal outcomes in abdominal pregnancy.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"134 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369688","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}
Compression of myometrium and occlusion of uterine artery by Dr. Mahesh Gupta (COMOC-MG) technique is an improved B-lynch stitch technique used to control postpartum hemorrhage (PPH). Objective was to study clinical perspective of the COMOC-MG technique on the effect of PPH in Indian women. Data of 10 patients with PPH who were managed by using the COMOC-MG technique in a tertiary care center in Gujarat from April 2022 to December 2022 were retrieved. Baseline characteristics, medical problems and history of women were recorded. Decision to perform COMOC-MG stitch was taken based on the indications such as PPH, per vaginal bleeding and degree of uterine contractility. Out of 10 women, four women had medical problems such as pregnancy-induced hypertension, dysfunctional uterine bleeding and using psychiatric medicines; two women had uterine surgery/ Laparotomy; four women were diagnosed with ailments such as pregnancy induced hypertension (PIH) and hypertension during the third trimester of pregnancy. Indications such as twins during a previous pregnancy, deflexed head, previous lower segment caesarean section (LSCS) with intrauterine growth restriction (IUGR), breech, prim parity, severe oligohydramnios, placental insufficiency and second baby were considered to carry out the CS delivery. Women were managed by COMOC-MG stitch followed by Misoprostol tablets; Carbetocin, Oxytocin, Methylergometrine and Carboprost injections to control PPH. Mean time between uterine closure to COMOC-MG was 10 min. COMOC-MG stitch resulted in good outcomes in seven patients except one patient had atonic PPH. Out of ten patients, one patient required a hysterectomy and three patients required blood transfusion. COMOC-MG stitch is an easy, simple method to control PPH.
{"title":"The compression of myometrium and occlusion of uterine artery by COMOC-MG technique for the management of postpartum haemorrhage: clinical perspective from ten cases","authors":"Jitendra Prajapati, Abhishek Oza, Mahesh Gupta, Ketan Kulkarni","doi":"10.18203/2320-1770.ijrcog20240806","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240806","url":null,"abstract":"Compression of myometrium and occlusion of uterine artery by Dr. Mahesh Gupta (COMOC-MG) technique is an improved B-lynch stitch technique used to control postpartum hemorrhage (PPH). Objective was to study clinical perspective of the COMOC-MG technique on the effect of PPH in Indian women. Data of 10 patients with PPH who were managed by using the COMOC-MG technique in a tertiary care center in Gujarat from April 2022 to December 2022 were retrieved. Baseline characteristics, medical problems and history of women were recorded. Decision to perform COMOC-MG stitch was taken based on the indications such as PPH, per vaginal bleeding and degree of uterine contractility. Out of 10 women, four women had medical problems such as pregnancy-induced hypertension, dysfunctional uterine bleeding and using psychiatric medicines; two women had uterine surgery/ Laparotomy; four women were diagnosed with ailments such as pregnancy induced hypertension (PIH) and hypertension during the third trimester of pregnancy. Indications such as twins during a previous pregnancy, deflexed head, previous lower segment caesarean section (LSCS) with intrauterine growth restriction (IUGR), breech, prim parity, severe oligohydramnios, placental insufficiency and second baby were considered to carry out the CS delivery. Women were managed by COMOC-MG stitch followed by Misoprostol tablets; Carbetocin, Oxytocin, Methylergometrine and Carboprost injections to control PPH. Mean time between uterine closure to COMOC-MG was 10 min. COMOC-MG stitch resulted in good outcomes in seven patients except one patient had atonic PPH. Out of ten patients, one patient required a hysterectomy and three patients required blood transfusion. COMOC-MG stitch is an easy, simple method to control PPH.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"124 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369960","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240780
Nowsheen Khan, Syed Basit, Danish Ahmed
Background: Metabolic syndrome is a group of clinical, metabolic and biochemical abnormalities with negative impact on global health. The aim of the study was to determine the association between metabolic syndrome and pregnancy induced hypertension, and incidence and effects of metabolic syndrome in pregnant patients. Methods: Prospective observational study, performed in the Department of Obstetrics and Gynecology, Holy Family Hospital, New Delhi. Antenatal women before 20 weeks of gestation were enrolled in the study. Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy to observe their progression into hypertensive disorders of pregnancy i.e. gestational hypertension, pre-eclampsia and eclampsia. Results: Out of 100 cases with metabolic syndrome 37% developed PIH, 21 developed pre-eclampsia and 14 developed gestational hypertension, 2 patients developed eclampsia as compared to controls in which only 10% developed PIH among which only 3% developed pre-eclampsia. Conclusions: Our study demonstrates a higher rate of complicated pregnancy with higher incidence of PIH in association with metabolic syndrome compared to control group. Each component of metabolic syndrome increases the probability of PIH. The addition of components of metabolic syndrome exacerbates this probability, especially the combination of increased BMI, increased blood sugar levels and increased triglycerides.
{"title":"Association of metabolic syndrome with gestational hypertension","authors":"Nowsheen Khan, Syed Basit, Danish Ahmed","doi":"10.18203/2320-1770.ijrcog20240780","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240780","url":null,"abstract":"Background: Metabolic syndrome is a group of clinical, metabolic and biochemical abnormalities with negative impact on global health. The aim of the study was to determine the association between metabolic syndrome and pregnancy induced hypertension, and incidence and effects of metabolic syndrome in pregnant patients.\u0000Methods: Prospective observational study, performed in the Department of Obstetrics and Gynecology, Holy Family Hospital, New Delhi. Antenatal women before 20 weeks of gestation were enrolled in the study. Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy to observe their progression into hypertensive disorders of pregnancy i.e. gestational hypertension, pre-eclampsia and eclampsia.\u0000Results: Out of 100 cases with metabolic syndrome 37% developed PIH, 21 developed pre-eclampsia and 14 developed gestational hypertension, 2 patients developed eclampsia as compared to controls in which only 10% developed PIH among which only 3% developed pre-eclampsia.\u0000Conclusions: Our study demonstrates a higher rate of complicated pregnancy with higher incidence of PIH in association with metabolic syndrome compared to control group. Each component of metabolic syndrome increases the probability of PIH. The addition of components of metabolic syndrome exacerbates this probability, especially the combination of increased BMI, increased blood sugar levels and increased triglycerides.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"98 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371166","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240794
Gunjan Yadav, Meenal Verma
Background: Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications. Methods: A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay. Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p<0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p<0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p<0.05). Conclusions: TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.
{"title":"Study to analyse the intraoperative and post-operative complications of total abdominal hysterectomy and total laparoscopic hysterectomy","authors":"Gunjan Yadav, Meenal Verma","doi":"10.18203/2320-1770.ijrcog20240794","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240794","url":null,"abstract":"Background: Laparoscopic hysterectomy is preferable due to faster recovery, decreased morbidity and absence of an abdominal incision. The aim of the study was to compare the risks and complications of total laparoscopy hysterectomy and total abdominal hysterectomy in terms of intra-operative and post-operative complications.\u0000Methods: A retrospective observational study was conducted in the Gynaecology department at Department of Obstetrics and Gynecology, Central Railway Hospital, Jabalpur, Madhya Pradesh, India. The data for the past 2-year record was taken for analysis. A total of 72 subjects were included in the study and were divided into two groups with 36 patients under TAH (total abdominal hysterectomy) group and 36 under TLH (Total Laproscopic hysterectomy) group. The primary outcome of the present analysis were incidence of perioperative complications like blood loss and the secondary outcomes were operating time, blood loss, urinary tract injury, rate of conversion to laparotomy, postoperative pain, and length of post operative stay.\u0000Results: The mean intra-operative blood loss was measured among both the groups and it was found to be very high among TAH group (215 ml) compared to TLH group (124 ml) and the difference was found to be statistically significant (p<0.05). Similarly, the duration of operative procedure was found to be less in TLH group (46.5 mins) compared to TAH group (76.8 mins) and the difference was found to be statistically significant (p<0.05). Post-operative wound infection (14 vs 0) was found to be more among the patients in TAH group than that of the TLH group and the difference was found to be statistically significant (p<0.05).\u0000Conclusions: TLH is a safe and effective surgical treatment for benign gynaecological diseases and should be offered whenever possible, taking into account the low rate of complications and cost-effectiveness.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"57 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371341","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}
Background: Bacterial vaginosis is a condition characterized by alteration in the vaginal flora. It is a common occurrence during pregnancy and is one of the established risk factors for preterm delivery, premature rupture of membranes and chorioamnionitis. The objective of the study was to study the prevalence and effects of bacterial vaginosis during pregnancy. Methods: : The study was a hospital based prospective study conducted in the department of obstetrics and gynaecology, RIMS, Imphal from January to December, 2021. 250 women between 20-28 weeks of gestation underwent examination and testing for bacterial vaginosis and were followed up till delivery. Pregnancy outcomes like pre-term labour, premature rupture of membrane; fetal outcomes like birth-weight, APGAR score, NICU admission, or any other complications were noted. Results: Out of the 250 singleton pregnancies, 48 women (19.2%) were found to have bacterial vaginosis. Pregnancies associated with bacterial vaginosis had more chances of premature rupture of membranes, low birth weight babies. But, there was no significant association of the same to preterm labor and to the rate of NICU admission of the newborns. Conclusions: Vaginal infection during pregnancy should also be entertained seriously and treated well since bacterial vaginosis may directly or indirectly be related to preterm delivery and low birth weight babies.
{"title":"Pregnancy outcome in women with bacterial vaginosis","authors":"Snehangshu Das, Namoijam Basanti, Ajitkumar Singh, Neiketouzo Kulnu","doi":"10.18203/2320-1770.ijrcog20240788","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240788","url":null,"abstract":"Background: Bacterial vaginosis is a condition characterized by alteration in the vaginal flora. It is a common occurrence during pregnancy and is one of the established risk factors for preterm delivery, premature rupture of membranes and chorioamnionitis. The objective of the study was to study the prevalence and effects of bacterial vaginosis during pregnancy.\u0000Methods: : The study was a hospital based prospective study conducted in the department of obstetrics and gynaecology, RIMS, Imphal from January to December, 2021. 250 women between 20-28 weeks of gestation underwent examination and testing for bacterial vaginosis and were followed up till delivery. Pregnancy outcomes like pre-term labour, premature rupture of membrane; fetal outcomes like birth-weight, APGAR score, NICU admission, or any other complications were noted.\u0000Results: Out of the 250 singleton pregnancies, 48 women (19.2%) were found to have bacterial vaginosis. Pregnancies associated with bacterial vaginosis had more chances of premature rupture of membranes, low birth weight babies. But, there was no significant association of the same to preterm labor and to the rate of NICU admission of the newborns.\u0000Conclusions: Vaginal infection during pregnancy should also be entertained seriously and treated well since bacterial vaginosis may directly or indirectly be related to preterm delivery and low birth weight babies.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"45 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371585","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}
Tokophobia is a mental disorder that affects women of all ages and varies from a mild to severe dread of delivery. Knauer first reported in the literature in 1897 that between 20% to 78% of pregnant women experience dread connected to pregnancy and delivery. The International Journal of Reproduction, Contraception, Obstetrics and Gynaecology published a study that found that the prevalence of tokophobia was 30.7% on Levin's scale and 55.3% on Areskog's score. Tokophobia is a multifaceted fear of labor that can be further classified into primary tokophobia and secondary tokophobia. People who have tokophobia may have extreme anxiety that manifests as nightmares, insomnia, panic attacks, and avoidance of situations involving pregnancy or childbirth. The most prevalent type of tokophobia is called secondary tokophobia, and it usually affects women who have already given birth and have experienced a traumatic delivery previously. A 20-item questionnaire called the fear of childbirth questionnaire (FCQ) is used to scale people's fear of giving birth. Cognitive-behavioral therapy (CBT) is mostly used as a non-pharmacological treatment.
{"title":"Tokophobia: a fear of childbirth and pregnancy - an overview","authors":"Mudit Bhardwaj, Aashutosh Sinwal, Vishv Sagar Sharma, Smrithimol Baby, Shagun Singh","doi":"10.18203/2320-1770.ijrcog20240823","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240823","url":null,"abstract":"Tokophobia is a mental disorder that affects women of all ages and varies from a mild to severe dread of delivery. Knauer first reported in the literature in 1897 that between 20% to 78% of pregnant women experience dread connected to pregnancy and delivery. The International Journal of Reproduction, Contraception, Obstetrics and Gynaecology published a study that found that the prevalence of tokophobia was 30.7% on Levin's scale and 55.3% on Areskog's score. Tokophobia is a multifaceted fear of labor that can be further classified into primary tokophobia and secondary tokophobia. People who have tokophobia may have extreme anxiety that manifests as nightmares, insomnia, panic attacks, and avoidance of situations involving pregnancy or childbirth. The most prevalent type of tokophobia is called secondary tokophobia, and it usually affects women who have already given birth and have experienced a traumatic delivery previously. A 20-item questionnaire called the fear of childbirth questionnaire (FCQ) is used to scale people's fear of giving birth. Cognitive-behavioral therapy (CBT) is mostly used as a non-pharmacological treatment.\u0000 ","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372201","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240803
Priya T. Singh, Karishma Salana, Meetali Nehate
Background: Caesarean delivery is a complex multidisciplinary procedure. Decision to delivery interval is supposed to play a significant role in maternal and neonatal outcomes. The present study was undertaken to determine the incidence of DDI delay among pregnant women undergoing Emergency LSCS in tertiary care centres. Methods: This study was conducted on 400 subjects who underwent emergency LSCS in category I and category II during a period from November 2020 to August 2021. Results: The maximum patients were from the age group of 25-29 years (43%), primigravida (59.1%), gestational age between 37-40 weeks (78%). 29% have undergone category-1 LCSC and 71.2% have undergone category-2 LSCS. Out of 116 patients underwent category-1 LSCS, 11 (9.5%) patient delay was present whereas in category-2 LSCS out of 284,12 (4.2%) patient delay was present. Among Category-I LSCS the most common indication was Fetal distress and among Category-II LSCS the major indication was non reassuring CTG. Maximum babies have APGAR scores between 7-10 at 1 (N=369) and 5 min (N=398). The mean cord PH was 7.31, ranged from 6.9-7.47. 98 babies required NICU admission and most of them admitted for respiratory distress. 11 patients required blood transfusion. There was no significant association found between various parameters and DDI delay, (p>0.05). Conclusions: In the present study, the interval between the decision to delivery interval has no significant impact on feto-maternal outcome in Category-I LSCS. Among Category-II LSCS there was a delay in 12 cases, among them 7 babies required NICU admission, the complications among neonates were significantly more when DDI was >75 minutes.
{"title":"Incidence of decision to delivery interval delay in emergency LSCS and its impact on fetal and maternal outcome: a prospective observational study","authors":"Priya T. Singh, Karishma Salana, Meetali Nehate","doi":"10.18203/2320-1770.ijrcog20240803","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240803","url":null,"abstract":"Background: Caesarean delivery is a complex multidisciplinary procedure. Decision to delivery interval is supposed to play a significant role in maternal and neonatal outcomes. The present study was undertaken to determine the incidence of DDI delay among pregnant women undergoing Emergency LSCS in tertiary care centres.\u0000Methods: This study was conducted on 400 subjects who underwent emergency LSCS in category I and category II during a period from November 2020 to August 2021.\u0000Results: The maximum patients were from the age group of 25-29 years (43%), primigravida (59.1%), gestational age between 37-40 weeks (78%). 29% have undergone category-1 LCSC and 71.2% have undergone category-2 LSCS. Out of 116 patients underwent category-1 LSCS, 11 (9.5%) patient delay was present whereas in category-2 LSCS out of 284,12 (4.2%) patient delay was present. Among Category-I LSCS the most common indication was Fetal distress and among Category-II LSCS the major indication was non reassuring CTG. Maximum babies have APGAR scores between 7-10 at 1 (N=369) and 5 min (N=398). The mean cord PH was 7.31, ranged from 6.9-7.47. 98 babies required NICU admission and most of them admitted for respiratory distress. 11 patients required blood transfusion. There was no significant association found between various parameters and DDI delay, (p>0.05).\u0000Conclusions: In the present study, the interval between the decision to delivery interval has no significant impact on feto-maternal outcome in Category-I LSCS. Among Category-II LSCS there was a delay in 12 cases, among them 7 babies required NICU admission, the complications among neonates were significantly more when DDI was >75 minutes.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"36 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372274","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240769
Assefa A. Jegora, Ephrem H. Ahmed, Menbeu S. Mohamed, A. Laytin, Ayida T. Negussie
Background: Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two-thirds of these deaths occurred in sub-Saharan Africa. This study aims to assess the utility of the obstetric high dependency unit and intensive care unit and maternal outcome in a tertiary medical center in Ethiopia. Methods: A comparative cross-sectional study was conducted on critically ill obstetric clients admitted to St. Paul's Hospital Millennium medical college obstetric HDU from October 2020 to September 2022 and before the establishment of the obstetric HDU (who were admitted to the medical ICU). Binary and multivariate logistic regression was conducted to identify factors associated with maternal mortality before the establishment of the maternal HDU. Results: The minimum duration in both units was one day. The maximum duration was 14 days for HDU and 26 days for ICU. Following the establishment of the maternity HDU, the ICU admission rate decreased to 1.2 per 1000 deliveries. Obstetric patients diagnosed with DIC and HELLP syndrome upon admission to the ICU had a 4.9 times higher risk of mortality compared to their counterparts. Obstetric women admitted to the ICU and treated with inotropic agents or vasopressors had a 33.8 times higher risk of mortality compared to their counterparts. Conclusions: Obstetric admissions to the ICU significantly decreased following the establishment of the maternity HDU. Obstetric patients diagnosed with DIC and HELLP syndrome are more likely to develop unfavorably outcome.
{"title":"Utility in the obstetric high dependency unit and intensive care unit in tertiary medical center in Ethiopia: a comparative cross-sectional study","authors":"Assefa A. Jegora, Ephrem H. Ahmed, Menbeu S. Mohamed, A. Laytin, Ayida T. Negussie","doi":"10.18203/2320-1770.ijrcog20240769","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240769","url":null,"abstract":"\u0000Background: Globally, an estimated 10.7 million women have died due to obstetric complications in the last two decades, and two-thirds of these deaths occurred in sub-Saharan Africa. This study aims to assess the utility of the obstetric high dependency unit and intensive care unit and maternal outcome in a tertiary medical center in Ethiopia.\u0000Methods: A comparative cross-sectional study was conducted on critically ill obstetric clients admitted to St. Paul's Hospital Millennium medical college obstetric HDU from October 2020 to September 2022 and before the establishment of the obstetric HDU (who were admitted to the medical ICU). Binary and multivariate logistic regression was conducted to identify factors associated with maternal mortality before the establishment of the maternal HDU.\u0000Results: The minimum duration in both units was one day. The maximum duration was 14 days for HDU and 26 days for ICU. Following the establishment of the maternity HDU, the ICU admission rate decreased to 1.2 per 1000 deliveries. Obstetric patients diagnosed with DIC and HELLP syndrome upon admission to the ICU had a 4.9 times higher risk of mortality compared to their counterparts. Obstetric women admitted to the ICU and treated with inotropic agents or vasopressors had a 33.8 times higher risk of mortality compared to their counterparts.\u0000Conclusions: Obstetric admissions to the ICU significantly decreased following the establishment of the maternity HDU. Obstetric patients diagnosed with DIC and HELLP syndrome are more likely to develop unfavorably outcome.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"31 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372864","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240792
Geethalakshmi A., Saraswathi S., Kalaivani K., Anjalakshi C., Rajesh Jain, Seshiah V.
Background: The present study aimed to evaluate if postpartum gestational diabetes mellitus (GDM) screening can be performed during immediate post-delivery 72 hrs instead of six weeks postpartum for follow-up. Methods: Total 150 GDM patients were included. The sample size was calculated as 150 with Nimaster2.0 software. GDM patients are enrolled after meeting the exclusion criteria for the study. The GDM diagnosis was made by DIPSI test and treated as per guidelines. After delivery, the Dipsi test was done on PND-3 (PP1). Furthermore, all were kept on LSM irrespective of the glycaemic level DIPSI test was repeated in all Patients after 45 days (PP2). Results: All 150 patients had a DIPSI test on 3rd day post-partum (PP1) and repeat test at 45 days (PP2)., Of these, 60 patients (40%) showed negative DIPSI test on P1 and all remained in Group 1, with 63 patients having negative DIPSI test on PP2. 50 patients (33.3%) had blood glucose between 140-199 mg (Group 2) on PP1 and increased to 53 patients in PP2 in 45 days. 40 patients had diabetic (26.6%) value (Group 3) in PP1, and out of them 34 (22.6%) remained in group 3 in PP2 after 45 days post-partum. Conclusions: This pilot study shows that nearly 60% of the GDM patient have either IGT or diabetic value following delivery on 3rd day of PP1 and almost similar results in PP2. Hence, we can do the postpartum screening on the postpartum 3rd day and need not wait for 6 wks when more than 50% is lost for follow-up. This study shows among GDM 60% of them have underlying beta cell dysfunction.
{"title":"Efficacy of early versus late postpartum DIPSI test in gestational diabetes mellitus women for follow up","authors":"Geethalakshmi A., Saraswathi S., Kalaivani K., Anjalakshi C., Rajesh Jain, Seshiah V.","doi":"10.18203/2320-1770.ijrcog20240792","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240792","url":null,"abstract":"Background: The present study aimed to evaluate if postpartum gestational diabetes mellitus (GDM) screening can be performed during immediate post-delivery 72 hrs instead of six weeks postpartum for follow-up.\u0000Methods: Total 150 GDM patients were included. The sample size was calculated as 150 with Nimaster2.0 software. GDM patients are enrolled after meeting the exclusion criteria for the study. The GDM diagnosis was made by DIPSI test and treated as per guidelines. After delivery, the Dipsi test was done on PND-3 (PP1). Furthermore, all were kept on LSM irrespective of the glycaemic level DIPSI test was repeated in all Patients after 45 days (PP2).\u0000Results: All 150 patients had a DIPSI test on 3rd day post-partum (PP1) and repeat test at 45 days (PP2)., Of these, 60 patients (40%) showed negative DIPSI test on P1 and all remained in Group 1, with 63 patients having negative DIPSI test on PP2. 50 patients (33.3%) had blood glucose between 140-199 mg (Group 2) on PP1 and increased to 53 patients in PP2 in 45 days. 40 patients had diabetic (26.6%) value (Group 3) in PP1, and out of them 34 (22.6%) remained in group 3 in PP2 after 45 days post-partum.\u0000Conclusions: This pilot study shows that nearly 60% of the GDM patient have either IGT or diabetic value following delivery on 3rd day of PP1 and almost similar results in PP2. Hence, we can do the postpartum screening on the postpartum 3rd day and need not wait for 6 wks when more than 50% is lost for follow-up. This study shows among GDM 60% of them have underlying beta cell dysfunction.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372997","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 : 2024-03-28DOI: 10.18203/2320-1770.ijrcog20240816
Mahendra Gangadharaiah, Sunil Chikkatharahalli Vykuntegowda, Vijayalaxmi, Tejashwini A. Neelavani
Adnexal torsion is defined as twisting of the ovary and/or tube around usually the utero-ovarian ligament and in case of the ovary the infundibulopelvic ligament. Ovarian torsion is seen in reproductive age group, mainly due to enlongated ovarian ligament. Recurrence is more uncommon. This article presents a case of young 23-year-old women presenting with acute pain abdomen, with scan showing ovarian torsion, an emergency laparoscopy was performed, 1 turn of left infundibulopelvic ligament was noted and detorsion performed along with plication of round and ovarian ligament and utero-ovarian ligament plication. This helps in preventing recurrent ovarian torsion, though there is no standard management to prevent recurrent ovarian torsion, plications to some extent prevents recurrent torsion and thus also preserving fertility of women.
{"title":"Case of ovarian torsion-detorsion-ovarian and round ligament plication to save the ovary","authors":"Mahendra Gangadharaiah, Sunil Chikkatharahalli Vykuntegowda, Vijayalaxmi, Tejashwini A. Neelavani","doi":"10.18203/2320-1770.ijrcog20240816","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240816","url":null,"abstract":"Adnexal torsion is defined as twisting of the ovary and/or tube around usually the utero-ovarian ligament and in case of the ovary the infundibulopelvic ligament. Ovarian torsion is seen in reproductive age group, mainly due to enlongated ovarian ligament. Recurrence is more uncommon. This article presents a case of young 23-year-old women presenting with acute pain abdomen, with scan showing ovarian torsion, an emergency laparoscopy was performed, 1 turn of left infundibulopelvic ligament was noted and detorsion performed along with plication of round and ovarian ligament and utero-ovarian ligament plication. This helps in preventing recurrent ovarian torsion, though there is no standard management to prevent recurrent ovarian torsion, plications to some extent prevents recurrent torsion and thus also preserving fertility of women.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"28 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373029","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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