Journal of Obstetrics and Gynecology of India最新文献

Adoption refers to legally taking a child to be taken care of as your own. Adoption and maintenance act guides the process of adoption in our country. CARA is one such body which streamlines the adoption process. Gynaecologists play a crucial role in guiding the couples with infertility visiting the outpatinet department for adoption after ruling out their eligibility.

Introduction: High-risk pregnancies refer to conditions that pose significant health risks to the mother, the foetus, or both. These pregnancies are linked to a higher incidence of maternal complications, such as antepartum haemorrhage, postpartum haemorrhage, infections, and an increased need for operative deliveries. Additionally, infants born to high-risk mothers have an increased likelihood of low birth weight, preterm birth, respiratory distress, and a higher risk of neonatal mortality.

Materials and methods: This hospital-based prospective observational study was conducted in the Department of Obstetrics and Gynecology at AIIMS Mangalagiri, a tertiary carte institute in South India over a period of two years from January 2023 to January 2025 after obtaining IEC approval. A total of 432 pregnant women were enrolled in study. Each participant was stratified into low, moderate, or high-risk categories using a risk scoring system. The maternal and foetal outcomes of each group were analysed.

Results: Among the 432 participants, 97 (22.5%) were classified as high-risk. Higher Coopland's scores were significantly associated with unfavourable maternal outcomes, including increased hospitalizations, labour inductions, operative deliveries, and intrapartum complications such as prolonged or difficult labour. The high-risk group also experienced a significantly higher incidence of postpartum haemorrhage, puerperal fever, and extended hospital stays. Additionally, adverse foetal outcomes, including preterm birth, low birth weight, low APGAR scores, the need for neonatal resuscitation, NICU admission, and prolonged NICU stays, were significantly more frequent in this group.

Conclusion: The high-risk group constituted 97 (22.5%) of pregnant women delivering at our institute, as determined by the risk scoring system. Higher risk scores were significantly associated with adverse maternal and perinatal outcomes, including complications during labour, postpartum, and neonatal care. The early detection of high-risk pregnancies using reliable risk assessment tools enables timely interventions and specialized care, ultimately enhancing the health and well-being of both mother and baby. This study highlights the significance of integrating risk evaluation methods into routine prenatal care to achieve better pregnancy outcomes.

Introduction: Swyer syndrome is a rare condition of complete gonadal dysgenesis due to mutations in the Y chromosome SRY gene, leading to testicular underdevelopment. In this condition individuals present with a female phenotype despite having a male karyotype (46, XY).

Method and materials: This retrospective review of five cases of Swyer Syndrome at our centre since 2013.

Results: All five patients, raised as girls, presented at 18-31 years with primary amenorrhea; one had hyposmia. Breast development ranged from Tanner stage 1-4 with varying axillary hair. Internal exams showed an infantile uterus and cervix. Imaging revealed small to normal uterus and streak gonads. Elevated serum FSH and low testosterone confirmed the diagnosis (46, XY karyotype). Three patients underwent laparoscopic gonadectomy due to gonadoblastona risk; two were lost to follow-up. All received Estrogens and Progesterone replacement therapy development of secondary sexual characters.

Conclusions: Swyer syndrome requires high clinical suspicion for diagnosis. Early identification allows timely hormone therapy and consideration of gonadectomy to prevent gonadoblastona.

Background: The WHO classification of contraceptive effectiveness placed IUCD in the most effective first tier. The family welfare program, in India, has recently emphasized postpartum IUCD insertion to space childbirth, resulting in reducing childbirth-related complications and a small family norm. However, evidence suggests that the acceptability of PPIUCD is still a challenge in developing countries, though in fully informed woman, PPIUCD is a satisfactory method of contraception. Therefore, the present study will try to find out the factors associated with the acceptance and refusal of PPIUCD which is available free of cost, under the National Family Planning Program in India.

Methods: This is a cross-sectional study conducted in the Gynecology and Obstetrics Department, over a period of 1 year, from February 2023 to January 2024. Women who delivered, either vaginally or by cesarean section were included in the present study. The categorical variables were expressed as frequencies and percentages. A P value of 0.05 was considered significant.

Results: Out of 1127 women who delivered and were counseled for PPIUCD as contraception, 32.7% (368) accepted and 67.3% (759) refused it. Of all, 42.5% were from the 20-30 years age group, but acceptance of PPIUCD was seen higher (36.2%) in the 30-40 years age group. The odds of acceptance of PPIUCD were 4.2 times higher in housewives compared to working women [OR = 4.2; 95% CI: 3.2-5.6]. Women with ≥ 4 ANC checkups in recent pregnancy accepted PPIUCD use by 47.2%. 53.2% of women (404/759) cited unawareness of the method as the main cause of refusal.

Conclusion: More antenatal checkups resulted in higher acceptance of PPIUCD. Preference for another method of contraception and not being aware of PPIUCD are the major contributing factors to its refusal.

Background: Workplace violence against women in healthcare is a pervasive and alarming issue with far-reaching consequences for individuals, institutions, and society.

Objective: This article aims to highlight the need for a comprehensive approach to address workplace violence, ensuring safer workplaces and promoting women's well-being.

Methods: A multi-faceted strategy is proposed, encompassing enhanced legislation, institutional accountability, gender-sensitive workplaces, education, and community outreach to dismantle the culture of silence.

Conclusion: By adopting a comprehensive approach, we can dismantle the culture of silence, promote a culture of respect and accountability, and create safer workplaces, ultimately upholding the fundamental right to safety and well-being for women in healthcare.

Background: Hypertensive disorders in pregnancy are responsible for 14% of maternal deaths. Maternal mortality is not only due to medical disorder but also due to underlying social-cultural factors lead to delays in getting timely and appropriate intervention. This study aimed to analyse three delays, to identify socio-cultural, demographic and accessibility factors that contributed to maternal deaths due to hypertension in pregnancy.

Method: It was a prospective observational study. Verbal autopsy was done for each maternal death that occurred due to hypertensive disorder. The "3 delay model" concept was used in collection and analysis of data for each maternal death. The Chi-square test (χ ²) and multivariable logistic regression model were used to accomplish the study objectives.

Results: Out of 326 maternal deaths, 52 deaths were due to hypertensive disorders. Pulmonary oedema, eclamptic encephalopathy, sepsis and cerebrovascular accident were the major causes of maternal mortality. In thirty-nine (75%) type I delay was the most significant contributor of maternal death. Twenty-four (46.15%) and 14 (26.9%) had Type II/III delay. The reasons for level I delay were failure to recognize the danger signs, delay in decision-making, no ANC registration, Type II delay being lack of timely transport facility, type III delay being lack of adequate monitoring, delay in initiating treatment and substandard care in hospital were observed.

Conclusions: Socio-cultural and demographic factors significantly contribute to the direct or indirect medical cause of maternal death. Analysing these factors provide deep insight into the maternal death and will provide useful information for guiding the policy makers to take corrective actions and direct their programmes and policies such as strengthening referral networking, widespread coverage of healthcare facility and raising awareness of danger signs of pregnancy by reaching at grass root levels.

Objective: To investigate the accuracy of a non-invasive device to measure haemoglobin and compare it with the laboratory gold standard in pregnant women, and to assess if the results vary by skin pigmentation.

Material and methods: Women attending pre-operative assessment before a scheduled caesarean section were invited, and informed consent was taken. Haemoglobin (Hb) estimation was performed using a non-invasive point-of-care device (Masimo Pronto pulse co-oximeter). Venous blood sample was collected for full blood count. The skin pigmentation was classified using the Fitzpatrick scale. Bias and 95% limits of agreement were examined for haemoglobin estimation. Accuracy of the pulse co-oximeter device was assessed in the six Fitzpatrick scales of skin tone.

Results: A total of 122 women were recruited. Twelve of these women (9.8%) had their haemoglobin values < 105 g/L. The Pronto device showed a significant positive bias. The mean difference was 23.4 (SD: 11.97) g/L. The 95% limits of agreement were - 0.06 to 46.9 g/L. The difference between the two methods was unrelated to the skin pigmentation. The area under the ROC curve was 0.705 (95% CI: 0.817-0.593, p = 0.013) for the detection of anaemia.

Conclusions: The point-of-care device (Masimo Pronto pulse co-oximeter) overestimates the Hb readings in pregnant women, and a correction is needed to estimate the real Hb value. The accuracy is unaffected by skin pigmentation. The device may be a potentially useful screening tool in the detection of anaemia in pregnancy in limited resource setting, but the 95% limits of agreements are relatively wide.

In the last decade, social media has evolved from a casual communication tool to a powerful platform for professional engagement, education, and advocacy -particularly in the field of Obstetrics and Gynaecology (Ob Gyn). As maternal health, reproductive rights, and gynaecologic care continue to occupy central roles in public discourse, social media offers Ob Gyn professionals a unique opportunity to amplify evidence-based information, foster community, and shape the future of women's health. Ob Gyn professionals have increasingly embraced platforms like Twitter, LinkedIn, Instagram, and YouTube to share research findings, clinical insights, and public health messages. This shift is not merely cosmetic, but it reflects a deeper transformation in how knowledge is disseminated and consumed. Despite its promise, social media in Ob Gyn is not without pitfalls. This article explores the multifaceted impact of social media in Ob Gyn, from academic visibility and patient education to ethical considerations and institutional strategy.

Background/purpose: Polycystic ovarian syndrome (PCOS) is the most frequent cause of anovulatory infertility. Due to the high rates of ovulation and pregnancies, Letrozole (LE) has recently been considered the first-line ovulation induction medication administered to PCOS patients. Nowadays, different clinical trials have examined various LE protocol methods to reach the best strategy for infertility therapy in PCOS patients.

Methods: This study was designed as a single-center, parallel randomized [1:1] clinical trial. It was registered on the World Health Organization trial registry of IRAN with registration number IRCT20110908007513N19. Eligible participants with PCOS resistant to conventional treatment were assigned to receive extended LE treatment for 7 days (group A) and 10 days (group B). Primary endpoints included ovulation rate and follicle measurements, while secondary endpoints assessed pregnancy rates and complications. A per-protocol analysis was considered.

Results: Among 55 participants, the mean age was 29.27, with a BMI of 25.51. In group A, 27/27 patients were ovulated, and lastly, 10 indicated clinical pregnancy. In group B, 27/28 patients were ovulated, and only 5 indicated clinical pregnancy. While the variation in clinical pregnancy rates between the groups in our study did not achieve statistical significance, the observed trend indicates a potentially significant clinical implication. Hormone profiles, follicle sizes, and endometrial thickness did not significantly differ between clinically pregnant and non-pregnant females in both groups. No complications were observed.

Conclusion: Although several conventional treatment-resistant females eventually became pregnant in a 7- or 10-day course of treatment, there are no notable differences between LE therapy in 7-day and 10-day groups. Further extensive studies are needed to validate the findings. Healthcare professionals should take this trend into account when assessing treatment alternatives, particularly within the framework of personalized patient care, as even slight enhancements in pregnancy rates can have significant effects.

World health organization trial registry of iran registration number: IRCT20110908007513N19.

Aim: To discover out the impact of Kinesio Taping (KT) in reduction of pain and disability experienced by pregnant females.

Method: Total 30 pregnant females in second trimester were recruited after fulfilling inclusion and exclusion criteria. They were randomized into 2 group. Experimental (A) received KT and Control group (B) sham KT. KT or sham KT was applied on day 1 and removed on day 5. Pain and disability were the results measures of the study. The pain levels were assessed by utilizing Visual Analogue Scale (VAS) on 1st day before treatment (BF) and after treatment (AF), 3rd day, 5th day and 7th day. Disability was evaluated using Oswestry Disability Index in Hindi Version, on day 1 and day 7.

Results: Preintervention both the groups were comparable regarding Pain and Oswestry Disability Index (ODI) scores. Post intervention experimental group had markedly decreased VAS and ODI from day 1 to day 7 (VAS Day 1 BF: 43.66 ± 17.31 Vs VAS Day 7: 26.13 ± 13.74; ODI Day 1: 31.80 ± 12.36 Vs ODI Day 7: 17.66 ± 7.30; p < 0.05). In control group VAS and ODI remained same between Day 1 & 7 (VAS Day 1 BF 31.93 ± 14.08, Vs VAS Day 7 32.46 ± 13.68;, ODI Day 1 22.13 ± 15.35 Vs ODI Day 7 22.00 ± 11.73).

Conclusions: KT can significantly reduce PGP and disability in pregnant females as compared to sham taping, measured by VAS and ODI scale respectively.