International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Not a member yet
9909 research outputs found
Sort by
Complication trends in gynecologic endoscopy: a global registry review
Get PDFMinimally invasive gynecologic surgery (MIGS) has expanded substantially over the past decade, supported by technological advances, structured surgical training, and enhanced perioperative care pathways. Although MIGS offers clear benefits over laparotomy, clinically significant complications—including vascular, bowel, and urinary tract injuries in laparoscopy and uterine perforation, fluid overload, and gas embolism in hysteroscopy—remain important contributors to morbidity. Earlier literature, primarily derived from single-centre retrospective studies, was limited by inconsistent definitions and incomplete reporting, prompting greater reliance on national and multinational registries to capture real-world outcomes. This narrative review synthesises evidence from registry analyses, large administrative databases, and institutional audits published between 2015 and 2025 to evaluate complication patterns, risk factors, and prevention strategies in gynecologic laparoscopy and hysteroscopy. Across datasets, advanced age, elevated BMI, prior abdominal surgery, high ASA class, prolonged operative duration, and increased procedural complexity consistently emerged as risk factors. Preventive measures—including structured skills training, simulation-based crisis preparation, intraoperative monitoring standards, device- and technique-specific safeguards, and ERAS-based perioperative protocols—were associated with improved safety. Despite these gains, substantial heterogeneity persists in complication definitions, follow-up intervals, coding standards, and case-mix adjustment across registries, contributing to under-reporting and limiting meaningful international benchmarking. Harmonised reporting frameworks, unified definitions, minimum dataset requirements, and integrated cross-disciplinary reporting structures are essential to improving surveillance, guiding training and credentialing, and strengthening global quality-improvement efforts in gynecologic endoscopy
Evaluating the efficacy of anti-Müllerian hormone as a predictor of ovarian reserve and fertility treatment success
Get PDFBackground: Ovarian reserve assessment is crucial for predicting fertility treatment outcomes, with Anti-Müllerian Hormone (AMH) emerging as a key biomarker. This study aimed to evaluate the efficacy of AMH as a predictor of ovarian reserve and its correlation with fertility treatment success among women in Bangladesh.
Methods: This retrospective study analyzed medical records of 100 women aged 20-40 years who underwent fertility treatment at a specialized clinic in Bangladesh over five years. AMH levels were measured using VIDAS and ovarian reserve was assessed via antral follicle count (AFC) using transvaginal ultrasound. The correlation between AMH levels, AFC, oocytes retrieved and clinical pregnancy rates was analyzed using Pearson's correlation coefficient with statistical software SPSS 26.
Results: The study found a significant positive correlation between AMH levels and AFC, with 80% of women with high AMH levels also having a high AFC. Additionally, women with high AMH levels had higher oocyte retrieval rates and clinical pregnancy rates (70%) compared to those with medium (50%) and low AMH levels (29.4%). The nearly equal distribution of clinical pregnancy outcomes (49% achieving pregnancy) highlighted the varied success of fertility treatments in this population.
Conclusions: AMH is a valuable predictor of ovarian reserve and fertility treatment outcomes, particularly when combined with AFC and other patient-specific factors. This study supports the use of AMH in clinical settings to enhance individualized fertility treatment strategies, potentially improving success rates
Insights into endometrial cancer profiles and its pattern of recurrences: a study from a leading health center in eastern Morocco
Get PDFBackground: Endometrial cancer (EC) is a rising gynecological malignancy, particularly in low- and middle-income countries. This study explored the demographic, clinical, and pathological features of women with EC in eastern Morocco.Methods: A retrospective review of 60 cases of histologically confirmed EC was conducted at Mohammed VI University Hospital, Oujda, from January 2016 to January 2024. Data included demographics, clinical symptoms, diagnostics, treatments, and risk factors. Results: The mean age was 56 years, with 80% aged 50-70. Most patients (60%) resided in urban areas, and 90% were nonsedentary housewives. Vaginal bleeding was the main symptom (87%). Early-stage disease (stage I) was predominant (70%), with endometrioid carcinoma accounting for 65% of cases. Tumor grades were 40% grade I, 45% grade II, and 15% grade III, with >50% myometrial invasion in 45%. Risk factors included postmenopausal status (80%), nulliparity (43%), and overweight (46%), while hypertension and diabetes affected 30% and 20%, respectively. Treatment involved total hysterectomy with bilateral salpingo-oophorectomy (45%) or radical hysterectomy (18.3%). Adjuvant therapy was administered to 76.7%, with 11.7% receiving combined chemo-radiotherapy. Based on ESMO-ESGO-ESTRO risk classification, 60% were low-risk, while high-risk cases showed higher recurrence and poorer outcomes.Conclusions: EC in Morocco is often detected at an early stage, predominantly affecting postmenopausal women. Efforts should focus on early diagnosis and customized treatment strategies for high-risk patients to improve outcomes
Diagnostic office hysteroscopy in a tertiary care centre: a retrospective analysis
Get PDFBackground: Office hysteroscopy is the standard technique for evaluation of intrauterine pathologies in abnormal uterine bleeding, infertility, recurrent pregnancy loss, secondary amenorrhea, post-menopausal bleeding. It is easy to perform, well tolerated by patients and has less complication rates with availability of adequate expertise and equipment. Our aim was to assess the role of diagnostic office hysteroscopy in gynaecology in a referral centre.
Methods: A retrospective descriptive study based on hospital records conducted in a government tertiary care centre. Data collected from hospital registers were analysed for common indications, pathology, complications, safety and efficacy of the procedure.
Results: Diagnostic office hysteroscopy done on 1624 patients from January 2018 to January 2023 were analysed. Most common indication was infertility. Common pathology seen were intrauterine adhesions, mullerian anomalies and endometrial polyps. Procedure was successful in 94.4% of patients. No major complication observed in any patient.
Conclusions: Our findings show that office hysteroscopy is effective, feasible, convenient and safe; in diagnosing various intrauterine pathologies and it is well tolerated by patients. There is no requirement for admission or anesthesia
Various presentations of gestational trophoblastic disease and its outcomes in a tertiary hospital
Get PDFBackground: Gestational trophoblastic disease encompasses a heterogeneous group of lesions arising from abnormal placental trophoblast proliferation. While molar pregnancy is the most common form, gestational trophoblastic neoplasia, though rare and often curable even with widespread dissemination, can follow any gestational event, including abortion, ectopic pregnancy, or term pregnancy. The aim of the study was to evaluate the various presentations and outcomes of gestational trophoblastic disease (GTD) in a tertiary hospital setting.
Methods: This retrospective study, conducted in the department of gynecological oncology at BSMMU from June 2023 to July 2024, included 173 patients with GTD. Diagnoses were confirmed using ultrasonography, serum beta-hCG, and histopathology. Data were retrospectively collected from medical records, documenting key demographic and clinical information. Ethical approval and informed consent were obtained. Data analysis was performed using SPSS version 22.
Results: Most participants were between 25-34 years (91.91%). The majority of GTD cases (54.91%) occurred in the 20-25 years age group, with bleeding per vagina being the most common clinical presentation (91.91%). Histopathology classified 72.83% of cases as complete moles. Treatment resulted in complete resolution for 85.55% of cases. Pre-evacuation beta hCG levels were above 100,000 IU/l in 72.83% of cases.
Conclusions: This study highlights the diverse presentations and favorable outcomes of gestational trophoblastic disease (GTD) in a tertiary hospital, emphasizing the importance of tailored management and monitoring strategies
Pain relief by paracervical block during manual vacuum aspiration for early miscarriage
Get PDFBackground: Early miscarriage is a common clinical problem that requires safe and effective management. Manual vacuum aspiration (MVA) under paracervical block is a minimally invasive procedure that helps to minimize pain during the procedure. This study aims to determine the safety and effectiveness of paracervical block in reducing pain during MVA for early miscarriage.
Methods: A cross-sectional prospective observational study was conducted at the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital, Bangladesh from January to June 2019. A total of 52 women with early miscarriages undergoing MVA were included. The procedure was done with a paracervical block given beforehand. Visual analog scale (VAS) was used to assess pain levels immediately after the procedure and 30 minutes later following the procedure.
Results: The average age of the patients (57%) was 20-30 years. The mean gestational age was 6-10 weeks, and 65.4 percent of patients had incomplete abortion. Immediately after MVA, 69.23% of patients had mild pain severity (VAS 0 to 3), though this rose to 80.77% at 30 minutes post procedure. The mean VAS scores was 2.92±1.38 immediately after procedure and 2.57±1.44 after 30 minutes of the procedure. The procedure was considered acceptable by most patients (86.54%) with few adverse effects.
Conclusions: During paracervical block for early miscarriage, MVA is a safe, effective and well tolerated means for pain relief and patient satisfaction
Intraovarian platelet-rich plasma injection: a potential path to genetic parenthood for women with low ovarian reserve
Get PDFBackground: The incidence of women with low ovarian reserve (LOR) presenting for ART is increasing. Infertility management is challenging since oocyte numbers are related to IVF success. The use of intraovarian platelet rich plasma (IOPRP) is emerging as a promising technique for ovarian rejuvenation. This study evaluates role of IOPRP in improving ovarian reserve markers, ovarian response and reproductive outcomes in women with LOR keen to achieve genetic parenthood.
Methods: This prospective observational cohort study was done on 85 women of Indian ethnicity 25-50 years, Poseidon group 3 and 4, infertility >3 years wih at least 1 previous IVF failure. One ml of PRP prepared by double centrifugation technique was injected into each ovary transvaginally. AMH, AFC, FSH, ovarian response measured pre and post IOPRP.
Results: At 8 weeks post PRP a statistically significant increase in AMH (0.57±0.33 ng/ml vs 0.96±0.49 ng/ml p<0.001), AFC (4.11±1.81 vs 7.81±3.35 p<0.001), number of oocytes retrieved (3.29±2.22 vs 5.52±3.66 p<0.001) and number of usable embryos (1.11±1.21 vs 2.33±2.12, p<0.001) was seen. Of women who underwent IVF 57.1% achieved clinical pregnancy. Overall Live birth rate was 38.09%, 8 women conceived without IVF with a live birth rate of 40%. Poseidon group 3 showed a greater improvement.
Conclusions: The study suggests that IOPRP treatment increases ovarian reserve markers and response and may be a viable alternative to donor oocytes in women with LOR wanting genetic parenthood
Prospective study to analyse effectiveness of Samartharam suction canula as a preventive strategy for postpartum haemorrhage in high-risk mothers at a teaching hospital over a period of one year
Get PDFBackground: To analyse the effectiveness of Samartharam suction canula as a preventive strategy along with routine Active management of third stage of labour (AMTSL) in women who are high risk for pph. Incorporating SR canula along with routine AMSL might help in reducing the incidence of postpartum haemorrhage (PPH).
Methods: This is a hospital based comparative prospective cross-sectional study, carried out among 150 high risk women for PPH who delivered vaginally in department of obstetrics and gynaecology, govt. Theni medical college and hospital, Theni between October 2020 to October 2021. All the women received 10 units of oxytocin IM at the appearance of anterior shoulder, or uterine massage and controlled cord traction. SR cannula was applied in 75women and in another 75 women all other uterotonics (oxytocin, misoprostol and tranexamic acid) for preventing PPH were used.
Results: Mean age of the patients was observed in the age group of 21-30 years (SR suction canula=49, medical management=50). Comparison between SR suction canula and medical methods. In this study it was observed, in higher number of cases the bleeding stopped immediately and there was a significant reduction in the amount of blood loss and the need for blood transfusion. Whereas, bleeding stopped immediately only in lower numbers, in whom medical management alone was used.
Conclusions: This study provides a promising insight, as a prophylactic strategy for prevention of atonic PPH for high-risk mothers
Comparison of effect of autologous platelet rich plasma and estrogen replacement vs estrogen replacement alone on implantation and pregnancy outcome in IUI cycles in infertility patients
Get PDFBackground: Successful embryo implantation requires an appropriate embryonic development coincident with a receptive endometrium. Thin endometrium, non-responsive to standard treatments is still a challenge in assisted reproductive technique, which usually results either in cycle cancellation or failed ART cycle. The minimal endometrial thickness required for implantation is now considered about 7 mm at the end of natural or medically induced follicular phase. The aim of this study is to detect any significant effect of platelet rich plasma (PRP) intrauterine infusion on endometrial proliferation, implantation and pregnancy rates.
Methods: This study was carried out for a period of 12 months in a tertiary care post graduate teaching hospital. 50 patients fulfilling the inclusion criteria were divided into two groups based on randomisation. One group received PRP plus estradiol (Group P) and other group received only estradiol (Group E). All patients underwent ovulation induction with letrozole and serial monitoring of endometrial thickness was done by USG (TVS) and results were compared.
Results: The mean endometrial thickness on the day of IUI in Group P was 9.1 mm+0.67 mm and in Group E was 7.56 mm+0.62 mm. The mean increase in endometrial thickness after PRP instillation was 3.4 mm+0.60 mm which is significantly higher than the Group E with mean increase of 1.5 mm+0.9 mm, which was statistically significant. However, there was no statistically significant increase in positive pregnancy rate and pregnancy outcome.
Conclusions: Our study concluded that PRP instillation increased the endometrial thickness in the patients with thin endometrium. However, there was no effect on the positive pregnancy rates and outcome
A retrospective analysis of vaginal birth after caesarian-predictors of success and its outcomes
Get PDFBackground: A repeat caesarian delivery (C-section) after a previous C-section increases maternal and foetal complication and poses an enormous burden on the economy of nations and individuals. The success of vaginal birth after C-section (VBAC) is affected by various antepartum, intrapartum factors as well as the difference in the obstetric population. This study aims to analyse the maternal and neonatal outcomes and factors associated with successful VBAC.
Methods: The study is a retrospective analysis of 12 months hospital data conducted at BloomLife hospital, a private multispeciality hospital at Chennai during September 2022 to September 2023. The inclusion criteria were pregnant women with gestational age of 37±40 weeks who had intention for vaginal delivery, previous non recurrent indicating pregnancy, inter-delivery interval of at least 2 years, cephalic presentation, low risk pregnancies. High risk maternal and fetal factors were excluded from the study.
Results: Among 204 women who had previous history of LSCS, 124 women were offered a trial of labour after caesarean (TOLAC) among which 56 (45%) of them successfully delivered through VBAC. Out of 124 women, 44 women out of 124, had opted for holistic approach during antenatal and intrapartum period among which n=27 (67.5%), had a statistically significant successful VBAC (Chi-square statistic is 6.25 p=0.012, significant at p<0.05). The most common reason for repeat C-section after TOLAC were labor dysfunction and fetal distress (n=2, 3.5%). Incidence of maternal complications in the study was atonic postpartum hemorrhage (n=7, 12.5%) that was well managed medically. All the babies had an Apgar >7 at 5 minutes. There was no maternal or neonatal mortality.
Conclusions: Statistically significant rate of success was found in women who went into spontaneous labor and had antenatal and intrapartum holistic interventions. The study results demonstrates that an integrated approach with qualified birth support team will improve the success rate as well as reduce the maternal and fetal morbidity