Pub Date : 2020-07-05DOI: 10.3329/bjog.v33i2.43564
N. Nargis, F. Dewan
Background: Postpartum haemorrhage (PPH) is a major cause of maternal mortality, accounting for one-quarter of all maternal deaths worldwide. Tranexamic acid (TXA), an antifibrinolytic agent, has therefore been investigated as a potentially useful complement to prevention and treatment of PPH. It has been proved to reduce blood loss in elective surgery, bleeding in trauma patients, and menstrual blood loss. Aims: To evaluate the effectiveness of TXA in reducing blood loss given just immediately after delivery of baby in women undergoing cesarean section. Methods: This was a prospective, randomized, double blind, placebo controlled study conducted in the Department of Gynaecology and Obstetrics unit of IBN SINA Medical College Dhaka, Bangladesh from June 2016 to May 2017. Participants were randomly assigned to TXA group or group A (n=60) and placebo group or group B (n=60). Randomization was done by residents using computer generated random numbers. Group A received 1 gram (10ml) of intravenous bolus dose of TXA just after delivery of the baby, Group B received 10 ml of sterile distilled water for injection intravenously at the same time. Statistical analysis has been done by SPSS. Results: The subjective characteristics in the two groups were similar with respect to their age, BMI, gestational age and gravidity. The duration of surgery was 40-50 minutes. There was no statistically significant difference in the heart rates (p>0.05) and blood pressures between the two groups, after 2 hours of delivery. Blood losses from both placental deliveries to the end of cesarean section and from end of CS to 2 hours postpartum were significantly lower in the study group (p<0.05). Change in hemoglobin concentration in study group was also significantly less than in the control group. Total amount of oxytocin required was significantly less in TXA group (p<0.05) also the number of women requiring other oxytocics (inj. Methyl ergometrine, inj carboprost and tab misoprostol per rectally) was significantly less in TXA group (p< 0.05). The amount of intra-operative fluid required were significantly less in TXA group (p<0.005); however post – operative fluid requirement and minor side effects in the form of nausea and vomiting were similar in both the groups. Conclusion: Tranexamic acid can effectively reduce blood loss in patients undergoing LSCS and its use was not associated with any side effects and or complications like thrombosis. The adoption of WHO guidelines for using uterotonic agents and prophylactically administering TXA may significantly reduce the number of PPH incidents.
{"title":"Prophylactic use of Tranexamic Acid during Caesarean Section in Preventing Postpartum haemorrhage– a Prospective Randomised Double Blind Placebo Controlled Study","authors":"N. Nargis, F. Dewan","doi":"10.3329/bjog.v33i2.43564","DOIUrl":"https://doi.org/10.3329/bjog.v33i2.43564","url":null,"abstract":"Background: Postpartum haemorrhage (PPH) is a major cause of maternal mortality, accounting for one-quarter of all maternal deaths worldwide. Tranexamic acid (TXA), an antifibrinolytic agent, has therefore been investigated as a potentially useful complement to prevention and treatment of PPH. It has been proved to reduce blood loss in elective surgery, bleeding in trauma patients, and menstrual blood loss. Aims: To evaluate the effectiveness of TXA in reducing blood loss given just immediately after delivery of baby in women undergoing cesarean section. Methods: This was a prospective, randomized, double blind, placebo controlled study conducted in the Department of Gynaecology and Obstetrics unit of IBN SINA Medical College Dhaka, Bangladesh from June 2016 to May 2017. Participants were randomly assigned to TXA group or group A (n=60) and placebo group or group B (n=60). Randomization was done by residents using computer generated random numbers. Group A received 1 gram (10ml) of intravenous bolus dose of TXA just after delivery of the baby, Group B received 10 ml of sterile distilled water for injection intravenously at the same time. Statistical analysis has been done by SPSS. Results: The subjective characteristics in the two groups were similar with respect to their age, BMI, gestational age and gravidity. The duration of surgery was 40-50 minutes. There was no statistically significant difference in the heart rates (p>0.05) and blood pressures between the two groups, after 2 hours of delivery. Blood losses from both placental deliveries to the end of cesarean section and from end of CS to 2 hours postpartum were significantly lower in the study group (p<0.05). Change in hemoglobin concentration in study group was also significantly less than in the control group. Total amount of oxytocin required was significantly less in TXA group (p<0.05) also the number of women requiring other oxytocics (inj. Methyl ergometrine, inj carboprost and tab misoprostol per rectally) was significantly less in TXA group (p< 0.05). The amount of intra-operative fluid required were significantly less in TXA group (p<0.005); however post – operative fluid requirement and minor side effects in the form of nausea and vomiting were similar in both the groups. Conclusion: Tranexamic acid can effectively reduce blood loss in patients undergoing LSCS and its use was not associated with any side effects and or complications like thrombosis. The adoption of WHO guidelines for using uterotonic agents and prophylactically administering TXA may significantly reduce the number of PPH incidents.","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"125-130"},"PeriodicalIF":0.0,"publicationDate":"2020-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43401233","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 : 2020-07-05DOI: 10.3329/bjog.v33i2.43555
M. Amir, S. Rouf, S. B. Chowdhury
Objective:The study is aimed to describe the grave maternal outcomes encountered in patients having morbidly adherent placenta along with history of previous caesarean section. Materials and Methods: This was a cross-sectional study from September 2014 to August 2015. All the patients attended in the in-patient department of obstetrics & gynaecology in DMCH during the study period having morbid adhesion of placenta (diagnosed antenatally by USG or diagnosed preoperatively) along with history of previous caesarean section. Result: Total 10,805 obstetric patients delivered during the study period, of which 6,337 patients had caesarean sections. Out of them 37 pregnant patients were found to have morbid adhesion of placenta along with history of previous C/S. The incidence is 1 in 292 deliveries. All of the 37 patients needed hysterectomy for intractable per operative haemorrhage. All the patients needed transfusion of more than 04 units of blood. Nineteen patients needed ICU supports Ten (27%) patients died. Other grave complications were hypovolemic shock (19 patients), bladder injury (16patients), renal failure (07 patients), multiorgan failure (07 patients) and DIC (06 patients). Conclusion: All the patients of morbidity adherant placenta with previous Caesarean Section needed caesarian hysterectomy and ten patients died.
{"title":"Catastrophic Maternal Complications of Morbidly Adherent Placenta in Patients with History of Previous Caesarean Delivery","authors":"M. Amir, S. Rouf, S. B. Chowdhury","doi":"10.3329/bjog.v33i2.43555","DOIUrl":"https://doi.org/10.3329/bjog.v33i2.43555","url":null,"abstract":"Objective:The study is aimed to describe the grave maternal outcomes encountered in patients having morbidly adherent placenta along with history of previous caesarean section. Materials and Methods: This was a cross-sectional study from September 2014 to August 2015. All the patients attended in the in-patient department of obstetrics & gynaecology in DMCH during the study period having morbid adhesion of placenta (diagnosed antenatally by USG or diagnosed preoperatively) along with history of previous caesarean section. Result: Total 10,805 obstetric patients delivered during the study period, of which 6,337 patients had caesarean sections. Out of them 37 pregnant patients were found to have morbid adhesion of placenta along with history of previous C/S. The incidence is 1 in 292 deliveries. All of the 37 patients needed hysterectomy for intractable per operative haemorrhage. All the patients needed transfusion of more than 04 units of blood. Nineteen patients needed ICU supports Ten (27%) patients died. Other grave complications were hypovolemic shock (19 patients), bladder injury (16patients), renal failure (07 patients), multiorgan failure (07 patients) and DIC (06 patients). Conclusion: All the patients of morbidity adherant placenta with previous Caesarean Section needed caesarian hysterectomy and ten patients died.","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2020-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/bjog.v33i2.43555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46212218","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 : 2020-07-05DOI: 10.3329/bjog.v33i2.43568
Shakeela Ishrat, F. Deeba, P. Fatima
Background: Endometriosis is frequently associated with gastrointestinal symptoms, in addition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not always involved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics & Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile women with surgical diagnosis of endometriosis with the objective to determine the frequency of gastrointestinal symptoms in our population of women with endometriosis and to find out whether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women with endometriosis. Bloating was the most frequent gastrointestinal symptom. Among the women with severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing with the women with endometriosis. Further evaluation of gastrointestinal tract involvement is necessary for counseling and comprehensive management of the women with endometriosis.
{"title":"Gastrointestinal Symptoms in Endometriosis","authors":"Shakeela Ishrat, F. Deeba, P. Fatima","doi":"10.3329/bjog.v33i2.43568","DOIUrl":"https://doi.org/10.3329/bjog.v33i2.43568","url":null,"abstract":"Background: Endometriosis is frequently associated with gastrointestinal symptoms, in addition to dysmenorrhoea, dyspareunia and infertility. Gastrointestinal tract is not always involved when gastrointestinal symptoms are present. Method: A cross sectional study was conducted in the department of Obstetrics & Gynaecology of Bangladesh Sheikh Mujib Medical University (BSMMU) on 55 infertile women with surgical diagnosis of endometriosis with the objective to determine the frequency of gastrointestinal symptoms in our population of women with endometriosis and to find out whether they were relevant to severity of endometriosis. Results: There was a high prevalence (37.5%) of gastrointestinal symptoms in women with endometriosis. Bloating was the most frequent gastrointestinal symptom. Among the women with severe stage IV endometriosis, 57.6% had gastrointestinal symptoms. Conclusion: A gynecologist must consider the gastrointestinal symptoms while dealing with the women with endometriosis. Further evaluation of gastrointestinal tract involvement is necessary for counseling and comprehensive management of the women with endometriosis.","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"140-142"},"PeriodicalIF":0.0,"publicationDate":"2020-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417982","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 : 2020-07-05DOI: 10.3329/bjog.v33i2.43562
Mk Nahaer, Akm Nurunnobi, S. Talukder, H. Ferdousy, F. Sharmin, G. Islam, R. Parvin
Background: Postpartum hemorrhage is the leading cause of maternal mortality; uterine atony is the most important cause. Uterotonics are used to prevent uterine atony. Carbetocin, a synthetic anallague of oxytocin seems to be an effective and safe new drug for prevention of PPH after caesarean The Aim of Study: To find out the efficacy and safety of carbetocin over oxytocin for the prevention of PPH during caesarean section. Patients and Methods: A randomized-controlled trial was conducted in the Dept. of Obs & Gyane, Rangpur Medical College and Hospital, Rangpur, Bangladesh over a period of twelve months from June 2016 to June 2017. One hundred admitted patients undergoing cesarean section at term were randomized into two groups receiving either 10 IU oxytocin or 100 μg carbetocin after caesarean section. Outcome measures such as primary PPH, massive blood loss, need for additional uterotonic drug, additional blood transfusion as well as adverse effects were all documented. Results: Massive blood loss occurred in 6% patients, blood transfusion needed in 20% patients and additional uterotonic needed for 36% patients in Oxytocin group but in Carbetocin group no massive blood lossoccurred, only 2%patients needed immediate blood transfusion and 4% patients were required additional uterotonics. There were no major adverse effects observed in both the groups. No patients had developed PPH in carbetocin group. But 8%(4) patients had developed PPH in oxytocin group. Conclusion: Carbetocin appears to be an effective new drug than Oxytocin for the prevention of postpartum hemorrhage following caesarean section.
{"title":"Carbetocin Versus Oxytocin for Prophylaxis of PPH Used During Caesarean Section: An Open Label Randomized Control Trial","authors":"Mk Nahaer, Akm Nurunnobi, S. Talukder, H. Ferdousy, F. Sharmin, G. Islam, R. Parvin","doi":"10.3329/bjog.v33i2.43562","DOIUrl":"https://doi.org/10.3329/bjog.v33i2.43562","url":null,"abstract":"Background: Postpartum hemorrhage is the leading cause of maternal mortality; uterine atony is the most important cause. Uterotonics are used to prevent uterine atony. Carbetocin, a synthetic anallague of oxytocin seems to be an effective and safe new drug for prevention of PPH after caesarean The Aim of Study: To find out the efficacy and safety of carbetocin over oxytocin for the prevention of PPH during caesarean section. Patients and Methods: A randomized-controlled trial was conducted in the Dept. of Obs & Gyane, Rangpur Medical College and Hospital, Rangpur, Bangladesh over a period of twelve months from June 2016 to June 2017. One hundred admitted patients undergoing cesarean section at term were randomized into two groups receiving either 10 IU oxytocin or 100 μg carbetocin after caesarean section. Outcome measures such as primary PPH, massive blood loss, need for additional uterotonic drug, additional blood transfusion as well as adverse effects were all documented. Results: Massive blood loss occurred in 6% patients, blood transfusion needed in 20% patients and additional uterotonic needed for 36% patients in Oxytocin group but in Carbetocin group no massive blood lossoccurred, only 2%patients needed immediate blood transfusion and 4% patients were required additional uterotonics. There were no major adverse effects observed in both the groups. No patients had developed PPH in carbetocin group. But 8%(4) patients had developed PPH in oxytocin group. Conclusion: Carbetocin appears to be an effective new drug than Oxytocin for the prevention of postpartum hemorrhage following caesarean section.","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"113-118"},"PeriodicalIF":0.0,"publicationDate":"2020-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44087870","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 : 2020-07-05DOI: 10.3329/bjog.v33i2.43572
Ahreen Akhtar, N. Dorji, T. Parveen, Yeshey Dorjey, F. Begum, Samira Hayee, S. Karim
A 30 year old, G2P1, pregnancy complicated with moderate anaemia, preeclampsia andgestational diabetes mellitus was admitted at 37+ week pregnancy with less fetal movementand premature rupture of membrane. A healthy baby was delivered by caesarean sectionwith uneventful perioperative period. On 4th post operative day, she developed severe acutepulmonary edema where intubation was done instantly and ventilated in the intensive careunit. Patient recovered and extubation done on 6th postoperative day. A healthy mother anda healthy baby were discharged on 10th postoperative day. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 157-159
{"title":"Acute Postpartum Pulmonary edema: A Case Report","authors":"Ahreen Akhtar, N. Dorji, T. Parveen, Yeshey Dorjey, F. Begum, Samira Hayee, S. Karim","doi":"10.3329/bjog.v33i2.43572","DOIUrl":"https://doi.org/10.3329/bjog.v33i2.43572","url":null,"abstract":"A 30 year old, G2P1, pregnancy complicated with moderate anaemia, preeclampsia andgestational diabetes mellitus was admitted at 37+ week pregnancy with less fetal movementand premature rupture of membrane. A healthy baby was delivered by caesarean sectionwith uneventful perioperative period. On 4th post operative day, she developed severe acutepulmonary edema where intubation was done instantly and ventilated in the intensive careunit. Patient recovered and extubation done on 6th postoperative day. A healthy mother anda healthy baby were discharged on 10th postoperative day. \u0000Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 157-159","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/bjog.v33i2.43572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48692155","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 : 2020-07-03DOI: 10.3329/bjog.v33i1.43548
L. Yasmin, F. Begum
Objective: The objectives of the study were to find out the prevalence of urinary incontinence in women. Materials and Methods: A cross sectional study was conducted on five hundred one (501) women older than 18 years of age who were admitted in department of obstetrics and gynaecology of Shaheed Suhrawardi Medical College and Hospital from April to December 2009, answered a questionnaire about urinary incontinence. They were grouped according to presence or absence of urinary incontinence (incontinent and continent) and type of incontinence present (urge, stress and mixed). Results: Urinary incontinence was found in 104(20.8%) women, out of which 25 (24%) suffered from stress incontinence only, 21 (20.2%) suffered from urge incontinence and 58(55.8%) suffered mixed incontinence. Conclusions: One in five women older than 18 years of age suffer from one or other form of urinary Incontinence. Key word: Urinary Incontinence in female, Prevalence of Urinary Incontinence in woman 1. Jr. Consultant, OSD, DGHS, Mohakhali, Dhaka. E-mail: ylubna03@gmail.com, Mobile: 01711388688. 2. Professor, Department of Obstetrics and Gynaecology, Ibrahim Medical College and BIRDEM Hospital, Dhaka. Emai: fbegum9@gmail.com, Mobile: 01714008166 Address of Correspondence: Dr. Lubna Yasmin, MBBS, FCPS (Gynae & Obs.), Jr. Consultant, OSD, DGHS, Mohakhali, Dhaka. E-mail: ylubna03@gmail.com, Mobile: 01711388688. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1): 59-62
{"title":"Prevalence of Urinary Incontinence in Women","authors":"L. Yasmin, F. Begum","doi":"10.3329/bjog.v33i1.43548","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43548","url":null,"abstract":"Objective: The objectives of the study were to find out the prevalence of urinary incontinence in women. Materials and Methods: A cross sectional study was conducted on five hundred one (501) women older than 18 years of age who were admitted in department of obstetrics and gynaecology of Shaheed Suhrawardi Medical College and Hospital from April to December 2009, answered a questionnaire about urinary incontinence. They were grouped according to presence or absence of urinary incontinence (incontinent and continent) and type of incontinence present (urge, stress and mixed). Results: Urinary incontinence was found in 104(20.8%) women, out of which 25 (24%) suffered from stress incontinence only, 21 (20.2%) suffered from urge incontinence and 58(55.8%) suffered mixed incontinence. Conclusions: One in five women older than 18 years of age suffer from one or other form of urinary Incontinence. Key word: Urinary Incontinence in female, Prevalence of Urinary Incontinence in woman 1. Jr. Consultant, OSD, DGHS, Mohakhali, Dhaka. E-mail: ylubna03@gmail.com, Mobile: 01711388688. 2. Professor, Department of Obstetrics and Gynaecology, Ibrahim Medical College and BIRDEM Hospital, Dhaka. Emai: fbegum9@gmail.com, Mobile: 01714008166 Address of Correspondence: Dr. Lubna Yasmin, MBBS, FCPS (Gynae & Obs.), Jr. Consultant, OSD, DGHS, Mohakhali, Dhaka. E-mail: ylubna03@gmail.com, Mobile: 01711388688. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1): 59-62","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"59-62"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3329/bjog.v33i1.43548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44866869","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 : 2020-07-03DOI: 10.3329/bjog.v33i1.43542
N. Mahjabeen, Sk. Nasreen, Faryl Mustary
Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to 18% of women. It has been suggested that this condition occurs in as many as 4-10% of women of reproductive age. PCOS is associated with significant reproductive morbidity, including infertility, abnormal uterine bleeding, miscarriage and other complications of pregnancy. Method: This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January, 2013 to December, 2016 over a period of 4 years with the objective to find out various clinical presentations, endocrine status, the menstrual abnormalities and sonographic findings of the patients with PCOS. During the study period a total number of 1600 patients were examined for infertility in the Outpatient and in Inpatient Department. Out of these 1600 infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailed information about the patients were collected in a predesigned data collection sheet. Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%) had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration of infertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in 78.0 percent of PCOS patients, of which & 90 (18.0%) had amenorrhoea, 250 (50.0%) had oligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normal menstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normal BMI and 60 (12.0%) were under weight. Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients. Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalence of menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% had amenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding.
{"title":"Clinical profile of 500 cases of Polycystic Ovary Syndrome in a Tertiary Hospital","authors":"N. Mahjabeen, Sk. Nasreen, Faryl Mustary","doi":"10.3329/bjog.v33i1.43542","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43542","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to 18% of women. It has been suggested that this condition occurs in as many as 4-10% of women of reproductive age. PCOS is associated with significant reproductive morbidity, including infertility, abnormal uterine bleeding, miscarriage and other complications of pregnancy. Method: This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January, 2013 to December, 2016 over a period of 4 years with the objective to find out various clinical presentations, endocrine status, the menstrual abnormalities and sonographic findings of the patients with PCOS. During the study period a total number of 1600 patients were examined for infertility in the Outpatient and in Inpatient Department. Out of these 1600 infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailed information about the patients were collected in a predesigned data collection sheet. Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%) had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration of infertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in 78.0 percent of PCOS patients, of which & 90 (18.0%) had amenorrhoea, 250 (50.0%) had oligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normal menstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normal BMI and 60 (12.0%) were under weight. Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients. Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalence of menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% had amenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding.","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"33 1","pages":"45-48"},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48544151","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 : 2020-07-03DOI: 10.3329/bjog.v33i1.43552
F. Sharmin
Urinary tract aspergillosis is uncommon even in the era of increased frequency of invasivemycoses. Experience is largely from isolated case reports and few case series or reviews.The majority of cases involve transplant recipients predominantly following renaltransplantation but is also reported in other immunocompromised states such as AIDS anduncontrolled diabetes mellitus. Most cases represent haematogenous spread to renalparenchyma, often in the absence of recognized focus of infection, presenting as small orlarge abscesses, infarcts, renal insufficiency or urinary drainage system fungal balls withobstructive uropathy. Diagnosis is usually made on the basis of renal tissue aspiration, urinecultures or by histopathology of the suspicious mass passed through urinary tract. Theeffective management of invasive aspergillosis includes strategies to optimize preventionand early antifungal treatment, immunomodulation, and, in some cases, surgery. Neweranti-Aspergillus drugs notably voriconazole offer less toxic therapeutic options and are quitesuccessful in combination with drainage measures to relieve urinary stasis. This reportdescribes a case of primary urinary tract aspergillosis with fungal bezoars formation in a 37years old female, diabetic, hypertensive, who presented with intermittent urinary tractobstruction and was successfully managed by oral voriconazole for six weeks as itraconazolewas found refractory. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 74-77
{"title":"Urinary Tract Aspergillosis in a Patient With Diabetes Who Underwent Total Abdominal Hysterectomy","authors":"F. Sharmin","doi":"10.3329/bjog.v33i1.43552","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43552","url":null,"abstract":"Urinary tract aspergillosis is uncommon even in the era of increased frequency of invasivemycoses. Experience is largely from isolated case reports and few case series or reviews.The majority of cases involve transplant recipients predominantly following renaltransplantation but is also reported in other immunocompromised states such as AIDS anduncontrolled diabetes mellitus. Most cases represent haematogenous spread to renalparenchyma, often in the absence of recognized focus of infection, presenting as small orlarge abscesses, infarcts, renal insufficiency or urinary drainage system fungal balls withobstructive uropathy. Diagnosis is usually made on the basis of renal tissue aspiration, urinecultures or by histopathology of the suspicious mass passed through urinary tract. Theeffective management of invasive aspergillosis includes strategies to optimize preventionand early antifungal treatment, immunomodulation, and, in some cases, surgery. Neweranti-Aspergillus drugs notably voriconazole offer less toxic therapeutic options and are quitesuccessful in combination with drainage measures to relieve urinary stasis. This reportdescribes a case of primary urinary tract aspergillosis with fungal bezoars formation in a 37years old female, diabetic, hypertensive, who presented with intermittent urinary tractobstruction and was successfully managed by oral voriconazole for six weeks as itraconazolewas found refractory. \u0000Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 74-77","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48978182","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 : 2020-07-03DOI: 10.3329/bjog.v33i1.43540
S. Shimul, S. Chowdhury, M. Jabeen, U. Salma, M. Akter, A. Sarkar
Background: Breastfeeding is widely known to be beneficial for infants and the mothers and also economically advantageous for the community. Objective: The principal purpose of this study was to explore the common problems encountered during lactation and their management in a lactation management center. Method: A cross sectional study was conducted at lactation management center of Institute of Child and Maternal Health (ICMH), Dhaka. A total of 100 lactating mothers were recruited consecutively during the period of August 2008 to October 2008. Data was collected by history taking and required examination. Result: In this study, 46.0% mothers complained of poor milk secretion, 13.0% had breast engorgement, 9.0% had cracked nipple, 3.0% had inverted nipple, 2.0% had nipple infection, 2.0% had flat nipple, 1.0% had sore nipple, 1.0% had breast abscess and in 23% cases there was no reasonable cause. During interview twenty seven percent of the mothers were advised to start nursing as soon as possible; 45.0% mothers breast fed on demand, 75.0% mothers demonstrated proper breast feeding technique, 36.0% mothers avoided use of artificial milk, 10.0% mothers applied last part of milk on nipple, then dry by exposing to air, 12.0% mothers manually express milk from the areola before breast feed if it is engorged and 1.0% advised to slip the index or little finger into the infant’s mouth between his/her gums before the infant is taken off of the breast, to break suction. Conclusion: Almost half of the mothers complained of less milk production. Apart from this 13.0% mothers had breast engorgement, 9.0% mothers had cracked nipple and no reasonable cause for lactation problem was found in 23.0% cases. More than half of the mothers had incorrect knowledge and skill of breast feeding.
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