Pub Date : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1201
K. Sharma, A. Rana, H. Isher, V. Dadhwal, Abhijeet Kumar
Umbilical vein varix is an uncommon vascular anomaly. The varix may be the initial presentation of an underlying congenital portosystemic shunt adversely affecting the fetus as we demonstrate in this case. To be able to label a varix as an isolated finding necessitates a thorough evaluation of the fetal venous system as well. Serial ultrasound of the fetus can help in detecting changes in the varix, thrombosis, growth restriction, as well as heart failure if there is another underlying venous anomaly. Early postnatal imaging is essential to exclude other associations to optimize the neonatal outcome. The prognosis is good if it is an isolated finding.
{"title":"Lessons from Umbilical Vein Varix","authors":"K. Sharma, A. Rana, H. Isher, V. Dadhwal, Abhijeet Kumar","doi":"10.5005/JP-JOURNALS-10016-1201","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1201","url":null,"abstract":"Umbilical vein varix is an uncommon vascular anomaly. The varix may be the initial presentation of an underlying congenital portosystemic shunt adversely affecting the fetus as we demonstrate in this case. To be able to label a varix as an isolated finding necessitates a thorough evaluation of the fetal venous system as well. Serial ultrasound of the fetus can help in detecting changes in the varix, thrombosis, growth restriction, as well as heart failure if there is another underlying venous anomaly. Early postnatal imaging is essential to exclude other associations to optimize the neonatal outcome. The prognosis is good if it is an isolated finding.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"1 1","pages":"30-32"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89382840","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1200
D. A. Wirasasmita, Gatot Abdurrazak, A. Yani
Choledochal cysts (CCs) are rare congenital anomaly with characterized dilatation of intraor extrahepatic biliary duct or both. Prenatal diagnosis is increasing due to high resolution of ultrasound (US) and ultrafast sequences of magnetic resonance imaging (MRI) showing better delineation of the cyst to the adjacent structure. Considering the additional value of the fetal MRI report is still infrequent to confirm the CC case, we therefore report the type I of CC, which was previously diagnosed as a cystic biliary atresia (CBA) from US result. Postnatal MRI and histopathology prove it.
{"title":"Fetal Magnetic Resonance Imaging of Choledochal Cyst","authors":"D. A. Wirasasmita, Gatot Abdurrazak, A. Yani","doi":"10.5005/JP-JOURNALS-10016-1200","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1200","url":null,"abstract":"Choledochal cysts (CCs) are rare congenital anomaly with characterized dilatation of intraor extrahepatic biliary duct or both. Prenatal diagnosis is increasing due to high resolution of ultrasound (US) and ultrafast sequences of magnetic resonance imaging (MRI) showing better delineation of the cyst to the adjacent structure. Considering the additional value of the fetal MRI report is still infrequent to confirm the CC case, we therefore report the type I of CC, which was previously diagnosed as a cystic biliary atresia (CBA) from US result. Postnatal MRI and histopathology prove it.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"55 1","pages":"27-29"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91144831","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1198
N. Navakumar, R. Vidyalekshmy, Neetha A Paul
Background: To discuss a series of complex non-immune fetal anemia cases, including etiology, investigations, workup, diagnosis, and management. Materials and methods: Five complex non-immune cases of fetal anemia seen in our department are presented. Results: Of the five cases presented, all are live births with follow-up least up to 1.5 years of age. They are cases of hereditary spherocytosis, congenital dyserythropoietic anemia, MCDA twins—twin-twin transfusion syndrome (TTTS) post-laser co-twin demise-fetal anemia, placental chorioangioma, and massive fetomaternal hemorrhage. Conclusion: Non-immune causes of fetal anemia can be difficult to diagnose its etiology and hence complex to manage. Repeated intrauterine transfusions may be the only perinatal management. The perinatal morbidity/mortality and preterm delivery rates are increased, and some cases require long-term treatment including regular transfusions. We present our experience of a series of complex non-immune fetal anemia managed in a tertiary unit, review the literature, and suggest appropriate management. Detailed fetal structural evaluation and placental ultrasound, MCA-PSV Doppler, fetal echocardiogram if hydrops, FBS, blood type, Hb, hematocrit, platelet count, direct Coombs, reticulocyte count and total bilirubin, PCR for CMV and PB 19 with or without syphilis and toxoplasmosis, peripheral smear, nonstress test for sinusoidal fetal heart rate pattern. 2
{"title":"Nonimmune Fetal Anemia: Exploring the Unfathomed! Case Series and Review of Literature","authors":"N. Navakumar, R. Vidyalekshmy, Neetha A Paul","doi":"10.5005/JP-JOURNALS-10016-1198","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1198","url":null,"abstract":"Background: To discuss a series of complex non-immune fetal anemia cases, including etiology, investigations, workup, diagnosis, and management. Materials and methods: Five complex non-immune cases of fetal anemia seen in our department are presented. Results: Of the five cases presented, all are live births with follow-up least up to 1.5 years of age. They are cases of hereditary spherocytosis, congenital dyserythropoietic anemia, MCDA twins—twin-twin transfusion syndrome (TTTS) post-laser co-twin demise-fetal anemia, placental chorioangioma, and massive fetomaternal hemorrhage. Conclusion: Non-immune causes of fetal anemia can be difficult to diagnose its etiology and hence complex to manage. Repeated intrauterine transfusions may be the only perinatal management. The perinatal morbidity/mortality and preterm delivery rates are increased, and some cases require long-term treatment including regular transfusions. We present our experience of a series of complex non-immune fetal anemia managed in a tertiary unit, review the literature, and suggest appropriate management. Detailed fetal structural evaluation and placental ultrasound, MCA-PSV Doppler, fetal echocardiogram if hydrops, FBS, blood type, Hb, hematocrit, platelet count, direct Coombs, reticulocyte count and total bilirubin, PCR for CMV and PB 19 with or without syphilis and toxoplasmosis, peripheral smear, nonstress test for sinusoidal fetal heart rate pattern. 2","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43342786","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1194
A. Vasudeva, Anjali Mundkur, Sanghamitra Paladugu, Srikar Yedlapalli, Roopa Padavagodu Shivananda, N. Hegde
Ab s t r Ac t Background: Fetal growth restriction (FGR) and oligoamnios are one of the major reasons of preterm delivery and low birth weight contributing to almost two-third of neonatal mortality. Fetal kidney, in addition to placenta, acts in controlling and regulating physiology of the fetus. Doppler ultrasound has become a part of routine antenatal care in monitoring such high-risk pregnancies. However, renal artery was the least studied. Aim and objective: To compare the relationship of perinatal outcomes with renal artery Doppler and umbilical artery Doppler indices. Materials and methods: A prospective observational study carried out among women attending an antenatal clinic and who have undergone delivery in Department of Obstetrics and Gynecology, in a tertiary care hospital between August 2016 and May 2018. Regular ultrasonography was done at 28–31 weeks; they were followed up 4 weeks later and Doppler indices were noted. Results: In the 394 patients studied, 13.1% were having FGR, 12.2% were oligoamnios, and 12.2% had preterm delivery. The p values of the pulsatility index and the resistivity index of the renal artery in FGR, oligoamnios, preterm delivery, and low birth weight were more significant than umbilical artery Doppler indices. Conclusion: Renal artery Doppler indices were significantly more reliable in predicting adverse perinatal outcomes in cases of mild uteroplacental insufficiency. Additionally, renal artery Doppler indices were able to pick up these changes earlier than umbilical artery Doppler, hence a potential early indicator, and the pulsatility index being more specific and sensitive. Limitations: Sample size of the study is limited with only mild cases of FGR. Larger studies are required. In addition, patients at a higher risk of FGR in comparison with low-risk cases should be studied with more sample size as this study did not show any significant association with comorbidities.
{"title":"Performance of Fetal Renal Artery Doppler Compared with Umbilical Artery Doppler in Mild and Moderate Fetal Growth Restriction: An Observational Study in a Tertiary Care Hospital","authors":"A. Vasudeva, Anjali Mundkur, Sanghamitra Paladugu, Srikar Yedlapalli, Roopa Padavagodu Shivananda, N. Hegde","doi":"10.5005/JP-JOURNALS-10016-1194","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1194","url":null,"abstract":"Ab s t r Ac t Background: Fetal growth restriction (FGR) and oligoamnios are one of the major reasons of preterm delivery and low birth weight contributing to almost two-third of neonatal mortality. Fetal kidney, in addition to placenta, acts in controlling and regulating physiology of the fetus. Doppler ultrasound has become a part of routine antenatal care in monitoring such high-risk pregnancies. However, renal artery was the least studied. Aim and objective: To compare the relationship of perinatal outcomes with renal artery Doppler and umbilical artery Doppler indices. Materials and methods: A prospective observational study carried out among women attending an antenatal clinic and who have undergone delivery in Department of Obstetrics and Gynecology, in a tertiary care hospital between August 2016 and May 2018. Regular ultrasonography was done at 28–31 weeks; they were followed up 4 weeks later and Doppler indices were noted. Results: In the 394 patients studied, 13.1% were having FGR, 12.2% were oligoamnios, and 12.2% had preterm delivery. The p values of the pulsatility index and the resistivity index of the renal artery in FGR, oligoamnios, preterm delivery, and low birth weight were more significant than umbilical artery Doppler indices. Conclusion: Renal artery Doppler indices were significantly more reliable in predicting adverse perinatal outcomes in cases of mild uteroplacental insufficiency. Additionally, renal artery Doppler indices were able to pick up these changes earlier than umbilical artery Doppler, hence a potential early indicator, and the pulsatility index being more specific and sensitive. Limitations: Sample size of the study is limited with only mild cases of FGR. Larger studies are required. In addition, patients at a higher risk of FGR in comparison with low-risk cases should be studied with more sample size as this study did not show any significant association with comorbidities.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45791007","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1199
N. Viswambharan, Murugan Manavalan
Infertility has been identified as a health issue worldwide and it is of great concern among married couples in our society. Scientifically, it has been established that both males and females can contribute to infertility. However, in most cases, women are held responsible for the same without proper diagnosis. Statistically, female factors contribute to about 40–60% of infertility cases, whereas 20–40% of infertility cases are due to factors contributed by males, of which, deficiency in semen quality is the major cause which accounts for 40–50% of infertility cases. A decrease in semen quality has been reported which can be due to lifestyle changes, occupational exposures to chemicals, heat, and stress. To study the prevalence of infertility, distribution of sperm abnormalities, and the impact of occupation on men visiting a tertiary clinic. Male partners of infertile couples who visited the fertility center were considered for the study. Seminal fluid was analyzed for volume, sperm concentration, motility (progressive motility), and morphology. In this study conducted in our center, we found that 55.8% of the patients had sperm abnormalities, among which teratozoospermia was the commonly observed anomaly. Male factors equally contribute to infertility as female factors. Semen analysis is the crucial diagnostic test for infertility assessment of the male partner. The incidence of male infertility has been increasing recently and the evaluation and prognosis of male subfertility are challenging. Although semen analysis is the primary test for the assessment of infertility in males, it does not recognize the abnormality in idiopathic infertility. Thus, new techniques and methods need to be developed to improve accuracy and reduce variation. Viswambharan N, Manavalan M. Sperm Abnormalities: In the Male Partners of Infertile Couples from Kanyakumari District. Int J Infertil Fetal Med 2020;11(1):16–19.
{"title":"Sperm Abnormalities: In the Male Partners of Infertile Couples from Kanyakumari District","authors":"N. Viswambharan, Murugan Manavalan","doi":"10.5005/JP-JOURNALS-10016-1199","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1199","url":null,"abstract":"Infertility has been identified as a health issue worldwide and it is of great concern among married couples in our society. Scientifically, it has been established that both males and females can contribute to infertility. However, in most cases, women are held responsible for the same without proper diagnosis. Statistically, female factors contribute to about 40–60% of infertility cases, whereas 20–40% of infertility cases are due to factors contributed by males, of which, deficiency in semen quality is the major cause which accounts for 40–50% of infertility cases. A decrease in semen quality has been reported which can be due to lifestyle changes, occupational exposures to chemicals, heat, and stress. To study the prevalence of infertility, distribution of sperm abnormalities, and the impact of occupation on men visiting a tertiary clinic. Male partners of infertile couples who visited the fertility center were considered for the study. Seminal fluid was analyzed for volume, sperm concentration, motility (progressive motility), and morphology. In this study conducted in our center, we found that 55.8% of the patients had sperm abnormalities, among which teratozoospermia was the commonly observed anomaly. Male factors equally contribute to infertility as female factors. Semen analysis is the crucial diagnostic test for infertility assessment of the male partner. The incidence of male infertility has been increasing recently and the evaluation and prognosis of male subfertility are challenging. Although semen analysis is the primary test for the assessment of infertility in males, it does not recognize the abnormality in idiopathic infertility. Thus, new techniques and methods need to be developed to improve accuracy and reduce variation. Viswambharan N, Manavalan M. Sperm Abnormalities: In the Male Partners of Infertile Couples from Kanyakumari District. Int J Infertil Fetal Med 2020;11(1):16–19.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41996684","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 : 2021-01-25DOI: 10.5005/JP-JOURNALS-10016-1196
Jayashree Sambashivaiah, Virupakshi Ajjammanavar, N. D. Hiremath
Hysterolaparoscopy often brings to light the hitherto unexpected pathology. The objective of this study was to evaluate various etiological factors in infertility by hysterolaparoscopy and to evaluate therapeutic interventions done during hysterolaparoscopy. Women posted for hysterolaparoscopy for infertility workup in JSS hospital during the period from November 01, 2014, to October 31, 2016, were included in the study. First hysteroscopy was performed. In hysteroscopy, endocervical canal was visualized for any growth or polyps. Diagnostic laparoscopy was performed using a 30-degree deflection angle telescope powered with a fiber-optic cable for light source. On hysteroscopy, out of 90 cases, 68 (75.6%) had normal findings, 10 (11.1%) had endometrial polyps, 5 (5.6%) had septate uterus, 3 (3.3%) had hyperplastic endometrium, and there was 1 case each of submucous fibroid, atrophic endometrium, intrauterine adhesions, and hypoplastic uterus. Laparoscopic interventions were performed in the form of ovarian cystectomy in 17 (18.8%), paraovarian cystectomy in 3 (3.3%), adhesiolysis in 2 (2.2%) cases, drilling of polycystic ovaries in 26 (28.8%) cases, fulguration or excision of endometriosis nodules in 4 (4.4%), myomectomy in 7 (7.7%) cases), fimbrial cystectomy in 2 (2.22%), and unilateral salpingectomy done in 2 (2.22%). Hysterolaparoscopy is an effective and safe tool in comprehensive evaluation of infertility to diagnose and treat the various pathological conditions in a single sitting. Ajjammanavar V, Hiremath ND, Jayashree S. Role of Hysterolaparoscopy in Infertility. Int J Infertil Fetal Med 2020;11(1):5–10.
{"title":"Role of Hysterolaparoscopy in Infertility","authors":"Jayashree Sambashivaiah, Virupakshi Ajjammanavar, N. D. Hiremath","doi":"10.5005/JP-JOURNALS-10016-1196","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1196","url":null,"abstract":"\u0000\u0000\u0000Hysterolaparoscopy often brings to light the hitherto unexpected pathology. The objective of this study was to evaluate various etiological factors in infertility by hysterolaparoscopy and to evaluate therapeutic interventions done during hysterolaparoscopy.\u0000\u0000\u0000\u0000Women posted for hysterolaparoscopy for infertility workup in JSS hospital during the period from November 01, 2014, to October 31, 2016, were included in the study. First hysteroscopy was performed. In hysteroscopy, endocervical canal was visualized for any growth or polyps. Diagnostic laparoscopy was performed using a 30-degree deflection angle telescope powered with a fiber-optic cable for light source.\u0000\u0000\u0000\u0000On hysteroscopy, out of 90 cases, 68 (75.6%) had normal findings, 10 (11.1%) had endometrial polyps, 5 (5.6%) had septate uterus, 3 (3.3%) had hyperplastic endometrium, and there was 1 case each of submucous fibroid, atrophic endometrium, intrauterine adhesions, and hypoplastic uterus. Laparoscopic interventions were performed in the form of ovarian cystectomy in 17 (18.8%), paraovarian cystectomy in 3 (3.3%), adhesiolysis in 2 (2.2%) cases, drilling of polycystic ovaries in 26 (28.8%) cases, fulguration or excision of endometriosis nodules in 4 (4.4%), myomectomy in 7 (7.7%) cases), fimbrial cystectomy in 2 (2.22%), and unilateral salpingectomy done in 2 (2.22%).\u0000\u0000\u0000\u0000Hysterolaparoscopy is an effective and safe tool in comprehensive evaluation of infertility to diagnose and treat the various pathological conditions in a single sitting.\u0000\u0000Ajjammanavar V, Hiremath ND, Jayashree S. Role of Hysterolaparoscopy in Infertility. Int J Infertil Fetal Med 2020;11(1):5–10.\u0000","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48960769","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 : 2020-12-01DOI: 10.5005/jp-journals-10016-1212
S. Ethirajan, Mangala Lakshmi Pritem
Ab s t r Ac t Background: Neural tube defects (NTDs) are one of the common congenital malformations. Neural tube defects are preventable with folic acid (FA) supplementation periconceptionally. Knowledge about FA and its periconceptional intake among women of reproductive age, pregnant women, and healthcare providers is important for timely supplementation, thereby preventing NTDs. Aim and objective: To assess the knowledge about FA and its benefits and their actual intake of FA periconceptionally among pregnant women at Saveetha Medical College and Hospital. Study design: A cross-sectional descriptive study was conducted at Saveetha Medical College and Hospital in the year 2017. Materials and methods: Two hundred pregnant women attending Antenatal Outpatient Department willing to participate in the study were interviewed with a structured questionnaire and responses were collected and analyzed. Results: Among 200 pregnant women, 153 (76.5%) women had heard about FA and mostly from healthcare providers (94.7%). Sixty-one women (30.5%) and nine women (4.5%) were aware of the benefits of FA in neural development and anemia prevention, respectively. Nine (4.5%) were able to mention a diet rich in FA and 15 (7.5%) women knew the dose of FA. Only 32 women (16%) took FA periconceptionally, whereas 150 women (75%) took FA only after the diagnosis of pregnancy. Among them, 164 women took the tablets regularly. Eighteen women (9%) did not take FA during pregnancy. Out of 131 women (65.5%) who had planned pregnancy, only 48 women (36%) had taken periconceptional FA. Conclusion: Awareness about FA and its importance of periconceptional intake is low among women in this population. The practice of periconceptional intake of FA is less which may be due to a lack of knowledge about the benefits of FA. Health education, awareness programs, planned pregnancy, and preiconceptional counseling can help in optimizing the periconceptional FA intake.
{"title":"Study on Knowledge and Practice of Periconceptional Intake of Folic Acid among Antenatal Mothers at Saveetha Medical College Hospital, Tamil Nadu","authors":"S. Ethirajan, Mangala Lakshmi Pritem","doi":"10.5005/jp-journals-10016-1212","DOIUrl":"https://doi.org/10.5005/jp-journals-10016-1212","url":null,"abstract":"Ab s t r Ac t Background: Neural tube defects (NTDs) are one of the common congenital malformations. Neural tube defects are preventable with folic acid (FA) supplementation periconceptionally. Knowledge about FA and its periconceptional intake among women of reproductive age, pregnant women, and healthcare providers is important for timely supplementation, thereby preventing NTDs. Aim and objective: To assess the knowledge about FA and its benefits and their actual intake of FA periconceptionally among pregnant women at Saveetha Medical College and Hospital. Study design: A cross-sectional descriptive study was conducted at Saveetha Medical College and Hospital in the year 2017. Materials and methods: Two hundred pregnant women attending Antenatal Outpatient Department willing to participate in the study were interviewed with a structured questionnaire and responses were collected and analyzed. Results: Among 200 pregnant women, 153 (76.5%) women had heard about FA and mostly from healthcare providers (94.7%). Sixty-one women (30.5%) and nine women (4.5%) were aware of the benefits of FA in neural development and anemia prevention, respectively. Nine (4.5%) were able to mention a diet rich in FA and 15 (7.5%) women knew the dose of FA. Only 32 women (16%) took FA periconceptionally, whereas 150 women (75%) took FA only after the diagnosis of pregnancy. Among them, 164 women took the tablets regularly. Eighteen women (9%) did not take FA during pregnancy. Out of 131 women (65.5%) who had planned pregnancy, only 48 women (36%) had taken periconceptional FA. Conclusion: Awareness about FA and its importance of periconceptional intake is low among women in this population. The practice of periconceptional intake of FA is less which may be due to a lack of knowledge about the benefits of FA. Health education, awareness programs, planned pregnancy, and preiconceptional counseling can help in optimizing the periconceptional FA intake.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47324119","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 : 2020-12-01DOI: 10.5005/JP-JOURNALS-10016-1209
Gopinathan Kannoli, Parameswara Iyer Ramesh, soumya. K. nair, Asha Menon
Ab s t r Ac t Background: Heterotopic pregnancy (HP) is a rare complication of conceptions following ovarian stimulation. Its incidence is increasing with the use of assisted reproductive techniques (ART). Case description: We are reporting a rare presentation of bilateral ectopic pregnancies together with intrauterine pregnancy which resulted from the transfer of three embryos in a single fresh transfer cycle. The presentation was unique because the pregnancies presented at different times. The intrauterine pregnancy (miscarriage) and the left ectopic pregnancy (EP) presented earlier and the right EP presented late. This is possibly due to the differential implantation and growth potential of the three embryos obtained from a single ART cycle. The patient had to undergo laparoscopy twice in a gap of 12 days. Conclusion: A high index of suspicion will help to decrease the consequences of HP, especially in ART cycles. Elective single embryo transfer would be the best preventive measure. Clinical significance: An early diagnosis of HP will help to prevent the dilemmas associated with it. Meticulous sonography and careful inspection of the contralateral tube should be the dictum in cases of HP.
{"title":"A Rare Presentation of Heterotopic Pregnancy Presenting at Different Periods in the Same Embryo Transfer Cycle","authors":"Gopinathan Kannoli, Parameswara Iyer Ramesh, soumya. K. nair, Asha Menon","doi":"10.5005/JP-JOURNALS-10016-1209","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1209","url":null,"abstract":"Ab s t r Ac t Background: Heterotopic pregnancy (HP) is a rare complication of conceptions following ovarian stimulation. Its incidence is increasing with the use of assisted reproductive techniques (ART). Case description: We are reporting a rare presentation of bilateral ectopic pregnancies together with intrauterine pregnancy which resulted from the transfer of three embryos in a single fresh transfer cycle. The presentation was unique because the pregnancies presented at different times. The intrauterine pregnancy (miscarriage) and the left ectopic pregnancy (EP) presented earlier and the right EP presented late. This is possibly due to the differential implantation and growth potential of the three embryos obtained from a single ART cycle. The patient had to undergo laparoscopy twice in a gap of 12 days. Conclusion: A high index of suspicion will help to decrease the consequences of HP, especially in ART cycles. Elective single embryo transfer would be the best preventive measure. Clinical significance: An early diagnosis of HP will help to prevent the dilemmas associated with it. Meticulous sonography and careful inspection of the contralateral tube should be the dictum in cases of HP.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"41 1","pages":"76-78"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79127075","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 : 2020-12-01DOI: 10.5005/JP-JOURNALS-10016-1211
V. Bansal, M. Chhabra, Boreddi H Bhavani
Ab s t r Ac t Aim and objective: We present three cases of multiple pregnancies associated with hydatidiform mole occurring after in vitro fertilization (IVF)–intracytoplasmic sperm injection (ICSI). Background: The phenomenon of molar pregnancy coexisting with higher-order pregnancies after IVF–ICSI is extremely rare as assisted reproduction techniques allow us to directly assess gametes and ICSI curtails any chances of dispermic fertilization. Case description: Three cases are discussed each of which was managed differently according to gestational age and parity of the patient. Individualization of management along with strict follow-up is necessary in such cases. Conclusion: A high index of suspicion must be kept for the possibility of coexistent molar pregnancy, especially in multiple conceptions occurring after IVF–ICSI. Even though rare, if diagnosed early, appropriate management can help avoid catastrophic complications and preserve future fertility. Clinical significance: No clear guidelines exist at present regarding the management of molar pregnancies coexisting with IVF–ICSI conceptions and many factors unique to these pregnancies need to be addressed. The possibility of severe complications like massive bleeding may necessitate the termination of a precious pregnancy. The high possibility of gestational trophoblastic neoplasia and the need for long-term follow-up may delay further cycles and deny the couple a chance at their own genetic baby. Mole can recur in subsequent pregnancies and this also requires detailed patient counseling with an option for use of preimplantation genetic diagnosis techniques.
{"title":"Does Number Matter: A Case Series of Gestational Trophoblastic Disease with Coexistent Live Pregnancies Post-multiple Embryo Transfer after In vitro Fertilization–intracytoplasmic Sperm Injection","authors":"V. Bansal, M. Chhabra, Boreddi H Bhavani","doi":"10.5005/JP-JOURNALS-10016-1211","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1211","url":null,"abstract":"Ab s t r Ac t Aim and objective: We present three cases of multiple pregnancies associated with hydatidiform mole occurring after in vitro fertilization (IVF)–intracytoplasmic sperm injection (ICSI). Background: The phenomenon of molar pregnancy coexisting with higher-order pregnancies after IVF–ICSI is extremely rare as assisted reproduction techniques allow us to directly assess gametes and ICSI curtails any chances of dispermic fertilization. Case description: Three cases are discussed each of which was managed differently according to gestational age and parity of the patient. Individualization of management along with strict follow-up is necessary in such cases. Conclusion: A high index of suspicion must be kept for the possibility of coexistent molar pregnancy, especially in multiple conceptions occurring after IVF–ICSI. Even though rare, if diagnosed early, appropriate management can help avoid catastrophic complications and preserve future fertility. Clinical significance: No clear guidelines exist at present regarding the management of molar pregnancies coexisting with IVF–ICSI conceptions and many factors unique to these pregnancies need to be addressed. The possibility of severe complications like massive bleeding may necessitate the termination of a precious pregnancy. The high possibility of gestational trophoblastic neoplasia and the need for long-term follow-up may delay further cycles and deny the couple a chance at their own genetic baby. Mole can recur in subsequent pregnancies and this also requires detailed patient counseling with an option for use of preimplantation genetic diagnosis techniques.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"6 1","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89058135","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 : 2020-12-01DOI: 10.5005/JP-JOURNALS-10016-1208
R. Dalal, A. Mishra, Sahil Gupta
Artificial intelligence (AI) has found its way into medicine in the form of robotics, operational and computational tools. We have software to store and recall a patient’s history instantly and algorithms to decide the course of treatment depending on past data. We have robots performing surgeries and witnessing systems to help prevent human errors. There have been significant advancements in the incorporation of AI in the artificial reproduction technology (ART) labs. In vitro fertilization (IVF) at present is a very subjective science, depending on the expertise and experience of the operators, mainly embryologists. Automation and AI are expected to bring about a more calculated, computed, and standardized approach to IVF. Presently, AI is used in the IVF lab for witnessing, data collection, record maintenance, and selecting the best possible embryo for transfer. Continuous research is being undertaken towards bringing more and more automation in the form of robotics. Artificial intelligence in ART is a very exciting upcoming field of research. Our review enlists the present AI in an ART lab and its future prospects.
{"title":"Artificial Intelligence in Assisted Reproductive Technology: Present and Future","authors":"R. Dalal, A. Mishra, Sahil Gupta","doi":"10.5005/JP-JOURNALS-10016-1208","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10016-1208","url":null,"abstract":"Artificial intelligence (AI) has found its way into medicine in the form of robotics, operational and computational tools. We have software to store and recall a patient’s history instantly and algorithms to decide the course of treatment depending on past data. We have robots performing surgeries and witnessing systems to help prevent human errors. There have been significant advancements in the incorporation of AI in the artificial reproduction technology (ART) labs. In vitro fertilization (IVF) at present is a very subjective science, depending on the expertise and experience of the operators, mainly embryologists. Automation and AI are expected to bring about a more calculated, computed, and standardized approach to IVF. Presently, AI is used in the IVF lab for witnessing, data collection, record maintenance, and selecting the best possible embryo for transfer. Continuous research is being undertaken towards bringing more and more automation in the form of robotics. Artificial intelligence in ART is a very exciting upcoming field of research. Our review enlists the present AI in an ART lab and its future prospects.","PeriodicalId":38998,"journal":{"name":"International Journal of Infertility and Fetal Medicine","volume":"23 1","pages":"61-64"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76173801","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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