International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Study of the effect of vitamin D supplementation on the clinical, metabolic, and hormonal profile of women with polycystic ovary syndrome in walled city of Delhi
Full text linkBackground: Polycystic ovary syndrome (PCOS) is a ubiquitous endocrine disorder often associated with vitamin D deficiency, which may contribute to reproductive and metabolic disturbances. This work gauged the influence of vitamin D supplementation on the clinical, metabolic, hormonal, and sonographic profiles of women having PCOS.
Methods: A hospital-based case control study initially included 60 women diagnosed with PCOS. The final sample size was 56, as two participants in the case group conceived, one in the control group conceived, and another control participant was lost to follow-up. The remaining 56 women were equally divided into two groups: cases (receiving metformin 500 mg BD for 12 weeks + vitamin D 60,000 IU once weekly for 12 weeks with advice for lifestyle and dietary modification) and controls (receiving metformin 500 mg BD for 12 weeks with advice for lifestyle and dietary modification). Clinical symptoms, menstrual patterns, and metabolic, hormonal, and sonographic parameters were evaluated before and after the intervention.
Results: Vitamin D supplementation significantly improved infrequent menses (78.6% to 46.4%, p=0.027) and scanty menses (50% to 21.4%, p=0.048) compared to controls. Weight gain reduced markedly in cases (71.4% to 25%, p=0.0013). Significant reductions were observed in fasting glucose (p=0.001) and postprandial glucose (p=0.022), with high density lipoprotein (HDL) showing a significant rise (p<0.001). Hormonal parameters showed no significant changes. Right ovarian volume decreased modestly (p=0.046).
Conclusion: Vitamin D supplementation in PCOS women improved menstrual regularity, weight-related symptoms, glycaemic control, HDL cholesterol, and ovarian morphology, but had limited effects on hormonal parameters
Retained and forgotten intrauterine contraceptive devices: a case series from Kasturba Hospital, Delhi
Full text linkIntrauterine contraceptive devices (IUCDs) are widely used for long-acting reversible contraception. Rarely, devices may be retained, forgotten, or only discovered incidentally years later, presenting diagnostic and management challenges. We report four women who presented to the outpatient department of Kasturba Hospital, Delhi with retained or missing IUCDs. Presentations ranged from symptomatic postmenopausal bleeding and pelvic pain to incidental discovery in surgical specimens. Imaging and removal strategies varied according to clinical scenario. These cases underscore the importance of thorough history, targeted imaging, documentation of IUCD insertion, and patient education to prevent prolonged unnoticed retention. They highlight diagnostic pitfalls and management dilemmas in both symptomatic and asymptomatic retained devices
Awareness and practices related to preconception health among women of reproductive age attending a tertiary care hospital in Eastern India
Full text linkBackground: Preconception health refers to the health status of women during their reproductive years before conception occurs. Optimal preconception health improves maternal and neonatal outcomes and reduces adverse pregnancy outcomes. Objectives were to assess the level of awareness regarding preconception health and to identify factors associated with adequate awareness among women of reproductive age.
Methods: A hospital-based cross-sectional study was conducted among women aged 18-45 years attending outpatient departments of a tertiary care hospital in eastern India from November 2024 to April 2025. Data were collected using a pre-tested structured questionnaire.
Results: Among 220 women studied, 41.8% had adequate awareness regarding preconception health. Higher education, previous antenatal care exposure, and planned pregnancy were significantly associated with adequate awareness.Conclusions: Awareness regarding preconception health was suboptimal. Strengthening preconception counselling through routine health services is essential
Gestational weight gain and its association with birth outcomes among pregnant women attending a tertiary care hospital in Eastern India
Full text linkBackground: Gestational weight gain (GWG) is an important determinant of maternal and neonatal outcomes. Both inadequate and excessive GWG are associated with adverse birth outcomes. Objectives were to assess GWG and examine its association with selected birth outcomes.
Methods: A hospital-based prospective observational study was conducted among 220 pregnant women attending a tertiary care hospital in Eastern India. GWG was classified as per institute of medicine guidelines and birth outcomes were analyzed.
Results: Inadequate GWG was significantly associated with low birth weight and preterm delivery, while excessive GWG was associated with macrosomia and increased caesarean section rates.
Conclusions: Suboptimal GWG is significantly associated with adverse birth outcomes
A study on prevalence of endometrial tuberculosis in unexplained infertility using cartridge-based nucleic acid amplification test
Full text linkBackground: Infertility is clinically defined as the inability to achieve pregnancy following one year of regular, unprotected intercourse. Its prevalence exhibits considerable variation across different regions, ranging between 5% and 20%. Extensive research has identified multiple etiological factors contributing to female infertility, including ovulatory dysfunction, infections of the genital tract, tubal obstruction, uterine abnormalities, endometriosis, endocrine disorders, and pelvic inflammatory diseases.
Methods: The study was conducted in the Department of Obstetrics and Gynaecology at RNT Medical College and Allied Hospitals, Udaipur from January 2024 to December 2024, in collaboration with the Department of Microbiology.
Result: Study finding shows that cartridge-based nucleic acid amplification test (CBNAAT) performed on endometrial samples. CBNAAT positivity was observed in 2 out of 70 women (2.86%), while 97.14% tested negative. The detected prevalence aligns closely with global estimates of genital tuberculosis in infertility, reinforcing the value of CBNAAT as a sensitive diagnostic tool in detecting paucibacillary forms of endometrial tuberculosis that might otherwise go undiagnosed through conventional methods.
Conclusion: Study concludes a low prevalence, underscoring that genital tuberculosis may not be a frequent cause in cases labelled as unexplained infertility. While CBNAAT demonstrated high specificity (approaching 100%), its sensitivity remains low (around 22–25%), indicating that although a positive result strongly confirms disease, a negative result does not reliably exclude it
Prevalence of various types of congenital malformations: a hospital based descriptive cross-sectional study
Full text linkBackground: World Health Organization (WHO) defines birth defect as structural or functional anomalies during intrauterine life which are identified during prenatal, at birth and sometime later in the infancy. The international statistical classification of diseases includes birth defects in chapter XVII as congenital malformations, deformations and chromosomal abnormalities.
Methods: This was a descriptive cross sectional observational hospital-based study conducted on prevalence of various types of congenital malformations at Department of Obstetrics and Gynecology, RNT Medical College, Udaipur. Study period from February 2024 to February 2025.
Results: Among the 250 mothers, the majority were primigravida (G-1) at 39.6%, followed by G-2 at 27.9%, G-3 at 20.1%, G-4 at 8.5%, and multigravida beyond four pregnancies (>G-4) at 4%. 211 mothers (86.2%) had no previous history of abortion, while 39 (13.8%) reported prior abortions. Among these, 19 cases (7.6%) were induced and 20 cases (8%) were spontaneous, indicating a slightly higher prevalence of spontaneous abortions. majority of congenital anomalies were seen in mothers aged 20-30 years (58.8%), with central nervous system (CNS) defects being the most common across all age groups.
Conclusions: This study highlights that congenital malformations, CNS defects were the leading anomalies, followed by cardiovascular and genito-urinary (GU) malformations. Most cases occurred among mothers aged 20-30 years, and first and second pregnancy, with a higher prevalence in rural populations
Iniencephaly apertus: a rare case with early first-trimester diagnosis by ultrasonography and fetoscopic correlation
Full text linkIniencephaly (IE) is a neural tube defect (NTD) of infrequent occurrence caused by developmental arrest of neural tube formation. It is usually complemented with other congenital malformations carrying lethal prognosis. Hysteroscopy(fetoscopy) can be used as an add-on tool for confirmation of lethal malformations such as iniencephaly, along with ultrasonography in very early first trimester pregnancy. Our patient was diagnosed on ultrasonography, with a fetus possibly carrying Iniencephaly apertus variant (with encephalocele) with cardiovascular and spinal cord malformations, at 8 weeks 5 days period of gestation. The ultrasound findings suggested IE, which were confirmed by fetoscopy before termination. The objective of this case report is to reinstate the importance of early ultrasound scan in first trimester of pregnancy to diagnose and intervene timely in case of relatively rare neural tube defects with grave outcome, also delineate the role of fetoscopy (hysteroscopy) as a diagnostic and therapeutic tool.
Puerperal uterine inversion-a near miss: case series
Full text linkUterine inversion occurs when the uterine fundus collapses into the endometrial cavity, turning the uterus partially or completely inside out. It is a rare and severe complication with an incidence of 1:2000 to 1:50000 reflecting the quality of third stage of Labour. We studied case series of 4 cases on postpartum uterine inversion. We studied case series of 4 cases on postpartum uterine inversion in our hospital (MMIMSR), who were referred to us, from local hospitals with postpartum collapse in shock. Patient resuscitated with colloids and crystalloids, blood and blood products. Methods such as manual reposition of uterus have aided to reduce maternal morbidity and mortality in our cases. Hence early recognition and timely referral to a tertiary care hospital with ICU and blood bank facilities, helps to manage obstetrical emergencies. Acute uterine inversion is an obstetric emergency and can lead to the maternal mortality. Proper training of health care workers to conduct labour, institutional deliveries and active management of third stage of labour should be encouraged. Early diagnosis and appropriate management is the key to reduce maternal morbidity and mortality
Adverse maternal and fetal outcomes associated with traditional herbal medicine use in Sub-Saharan Africa: a systematic review
Full text linkTraditional herbal medicine use is widespread during pregnancy in Sub-Saharan Africa (SSA), driven by cultural beliefs, limited access to healthcare, and affordability. Despite this, concerns persist about its safety, especially its impact on maternal and fetal outcomes. This systematic review synthesizes evidence on the adverse outcomes associated with herbal medicine use during pregnancy across SSA. A systematic literature search was conducted using PubMed, Google Scholar, African Journals Online (AJOL), and Scopus for studies published up to May 2025. Inclusion criteria comprised studies conducted in SSA involving pregnant women using herbal medicines with reported maternal and/or fetal outcomes. Observational studies, qualitative research, ethnobotanical surveys, and case reports were included. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. A total of 23 studies met inclusion criteria and underwent narrative synthesis. Findings revealed a high prevalence of unsupervised herbal use across SSA. Reported adverse maternal outcomes included uterine rupture, preterm labor, postpartum hemorrhage, and increased cesarean delivery rates. Gastrointestinal and psychological side effects were also noted. Adverse fetal outcomes included stillbirth, early neonatal death, low birth weight, congenital anomalies, and low APGAR scores. Utero-tonic herbs such as Mwanamphepo and Kaligu-tim were commonly implicated. The majority of studies were of high methodological quality but often lacked precise herb identification and dosage standardization. This review highlights the significant health risks associated with traditional herbal medicine use during pregnancy in SSA. There is an urgent need for targeted public health education, clinician training, and stricter herbal medicine regulation to safeguard maternal and neonatal health
Prevalence of abnormal Pap smear in pregnant women
Full text linkBackground: Cervical cancer is a leading cause of morbidity and mortality among women, particularly in low-resource settings. Pregnancy presents an opportunity for early cervical screening, yet routine screening programs remain inadequate. This study aims to determine the prevalence of abnormal Pap smears in pregnant women and assess the association of abnormal findings with age and clinicodemographic characteristics.
Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, F.H. Medical College and Hospital, Agra. A total of 197 pregnant women undergoing routine antenatal Pap smear screening were enrolled. Cytological evaluation was performed using the Bethesda classification system. Statistical analysis was conducted using SPSS version 26, with chi-square tests applied to determine associations between variables.
Results: Among 197 participants, 73.1% had normal or inflammatory smears, while 26.9% had varying degrees of epithelial abnormalities. The prevalence of ASCUS, Low SIL and High SIL were 10.7%, 8.6% and 7.6%, respectively. No cases of squamous cell carcinoma were identified. Women aged 30-40 years exhibited the highest proportion of abnormal Pap smears (49%). Rural residence, lower socioeconomic status and multiparity were associated with increased prevalence of abnormal cytology, though age was not statistically significant as a risk factor.
Conclusions: The study highlights a significant proportion of abnormal Pap smears among pregnant women, underscoring the importance of integrating cervical cancer screening into routine antenatal care. Awareness programs, early HPV vaccination and improved access to gynecological services are essential strategies for reducing the burden of cervical cancer in pregnant populations