International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Population study for awareness about medical termination of pregnancy pills in population in India
Get PDFBackground: The present study was conducted as a home-based survey of 505 females in reproductive age group mainly in rural, semi urban and urban areas around Ahmedabad to identify the awareness about medical termination of pregnancy (MTP) pills in the population.
Methods: A home-based survey of 505 females in reproductive age group mainly in rural, semi urban and urban areas around Ahmedabad was done. Home visit was carried out by MBBS interns accompanied by ASHA workers.
Results: Among the population studied it was observed that termination of pregnancy by MTP pills was most commonly seen among women with previous 2 live children. Most of the women confirmed their pregnancy with a home based urine pregnancy kit. Majority of women have taken the pills as self-medication without any consultation with a qualified obstetrician, increasing not only the risk of complications like incomplete abortion and haemorrhage but also showing the poor status of drug regulations in the country.
Conclusions: Majority of women, have taken the pills as self-medication without any consultation with a qualified obstetrician. Out of the women who had taken the pills after prescription, most of them had gotten the prescription from a doctor while others women got the pills prescribed from a known medical professional. The study shows the easy availability of MTP pills in the market, however the knowledge about the use and side effects of these pills is not well understood
The transient effect of dexamethasone on foetal cardiotocography in antenatal period
Get PDFBackground: Preterm birth is a major contributor to neonatal morbidity and mortality worldwide. This study aimed to evaluate the impact of antenatal dexamethasone on CTG patterns, specifically FHR variability, accelerations, and foetal movements, in women at high risk of preterm labour.
Methods: A cross-sectional, comparative observational study was conducted in a Kamla Nehru hospital Shimla from June 23 to June 24. The study included 102 women aged 18-35 years, with a gestational age of 28-34 weeks, at risk for preterm delivery. Participants received a full course of dexamethasone (24 mg in divided doses 12 hours apart). CTG was recorded before administration and at 48- and 96-hours post-dexamethasone. Statistical analysis was performed using Chi-square tests with significance set at p<0.05.
Results: Before dexamethasone administration, all participants reported normal foetal movement, but 48 hours later, 53.9% reported decreased foetal movement (p<0.001). By 96 hours, the perception of foetal movement returned to normal in 98% of participants (p=0.498). FHR variability significantly decreased with moderate variability observed in 74.5% of cases at 48 hours (p<0.001). FHR accelerations decreased significantly from 94.1% before administration to 79.4% at 48 hours (p=0.002), but returned to baseline by 96 hours (p=0.774).
Conclusions: Dexamethasone administration resulted in transient changes in FHR patterns, including decreased accelerations, decreased moderate variability, and reduced foetal movement within the first 48 hours. However, these effects were short-lived, with normalization occurring by 96 hours
Correlation between clinical presentation with USG findings and per-operative findings of ovarian tumor
Get PDFBackground: Ovarian tumors present with diverse clinical symptoms and accurate diagnosis is essential for effective management. Ultrasound (USG) is a key diagnostic tool, providing insights into tumor characteristics such as size, location and morphology. However, variations may exist between clinical presentation, USG findings and intraoperative findings. This study aimed to correlate clinical, USG and preoperative findings of ovarian tumors.
Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University, Dhaka, between March and August 2014. A total of 50 women with provisional diagnoses of ovarian tumors, admitted during this period, were included. A purposive consecutive sampling technique was applied and data analysis was performed using MS Office tools.
Results: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University, Dhaka, between March and August 2014. A total of 50 women with provisional diagnoses of ovarian tumors, admitted during this period, were included. A purposive consecutive sampling technique was applied and data analysis was performed using MS Office tools.
Conclusions: Common clinical presentations of ovarian tumors include lower abdominal lump, distension, vague discomfort, occasional pain, severe pain, appetite loss, dyspepsia and weight loss. Histopathological patterns include serous and mucinous cyst adenomas, mature teratomas, mucinous cyst adenocarcinomas and serous. Pelvic exams and transvaginal ultrasounds help detect ovarian neoplasms
Atypical polypoid adenomyoma: insights into recurrence, malignant transformation and management: a case report
Get PDFAtypical polypoid adenomyoma (APAM) is a rare, benign mixed epithelial-mesenchymal tumor of the uterus. It is characterized by its polypoid growth pattern and atypical histological features. This study aims to consolidate current knowledge regarding its clinical presentation, diagnostic criteria, treatment options, and potential for malignancy. There is a significant rate of recurrence associated with this tumor. It consists of unusual endometrial glands interspersed with bundles of smooth muscle fibers. It is frequently diagnosed in young women and may coexist with or progress to atypical endometrial hyperplasia or endometrioid endometrial carcinoma. We report a case of a 35-year-old woman affected by APAM treated with hysteroscopic resection. Given the risk of recurrence and progression, APAM might be treated via hysterectomy in patients with no desire for pregnancy
Profile of intrauterine fetal demise in Central India: is it preventable?
Get PDFBackground: Intrauterine fetal demise (IUFD) refers to the death of a fetus after 20 weeks of gestation but before or during labor, and it remains a significant obstetric concern worldwide. This study investigates the profile of IUFD in Central India, focusing on its causes, associated maternal factors, and the potential for prevention. Globally, unexplained stillbirth is reported in 76% of cases. The study aims to find the causes of IUFD in this area to help in achieving the goal of less than 12 neonatal deaths.
Methods: A retrospective observational study was conducted over two years from April 2022 to April 2024 at the Department of Obstetrics and Gynecology, R. D. Gardi Medical College, Ujjain, Madhya Pradesh. We included diagnosed cases of pregnancies with IUFD that presented at our hospital. Women before delivery and those who came in emergency with IUFD were included.
Results: 151 cases of IUFD were diagnosed out of 4492 deliveries in the study period of two years; rate of 3.36%. The most common cause of IUFD was preeclampsia (24%) followed by unexplained causes (12%), obstructed and prolonged labor (9.9%). Inspite of tertiary care level of health facility most of these intrauterine deaths were not prevented due to poor antenatal care, late reporting and callous attitude of relatives.
Conclusions: Certain causes of IUFD, such as congenital anomalies, are unavoidable, a significant proportion of cases could be prevented through enhanced maternal health management, improved prenatal screening, and better healthcare access across Central India
Impact of nutrition education on maternal hemoglobin and calcium levels during pregnancy and their association with birthweight in an Indian cohort
Get PDFBackground: Maternal nutrition during pregnancy is pivotal for fetal growth, neonatal health, iron stores across infancy and adolescence, and future adult disease risk. In India, this role is especially important because anemia, micronutrient deficiencies, and protein-energy malnutrition remain widespread despite national supplementation programmes. Many women still experience suboptimal outcomes due to poor dietary diversity and inconsistent adherence to iron, calcium, and protein recommendations. This study examined the effect of trimester-specific nutrition education on maternal hemoglobin and calcium levels during pregnancy. It examined whether these changes were associated with birth weight in an Indian cohort.
Methods: A prospective quasi-experimental cohort study was conducted at a tertiary care hospital in New Delhi among 200 pregnant women, systematically allocated to an intervention group receiving structured nutrition education or a control group receiving standard antenatal care. Maternal anthropometry, hemoglobin, calcium, and protein intake were assessed at baseline and in the third trimester, and maternal biomarkers at delivery and birth outcomes were analysed using regression methods.
Results: Of 200 women, 173 (88 in the intervention group, 85 in the control group) completed follow-up. At baseline, 45.7% were anemic; after the intervention, normal hemoglobin levels rose to 73.9% in the intervention group, compared with 35.3% in the control group. Hypocalcemia at delivery was 1.1% in the intervention group compared with 22.4% in controls. Protein intake and BMI improved significantly with education. Hemoglobin and calcium at birth were positively correlated in the intervention group (r=0.372, p<0.05), but not in the control group. Neonatal birthweight was marginally higher, and low birthweight was less frequent in the intervention group, though the differences were not statistically significant.
Conclusions: Trimester-specific nutrition education substantially improved maternal hemoglobin levels, calcium status, and dietary practices and is feasible for integration into routine antenatal care to support better perinatal outcomes in India
Rising trends of peripartum cardiomyopathy: insights from the COVID-19 pandemic
Get PDFPeripartum cardiomyopathy (PPCM) is a rare, life-threatening condition of unknown etiology occurring in late pregnancy or early postpartum. The COVID-19 pandemic has introduced new diagnostic challenges, particularly in distinguishing PPCM from COVID-19-related cardiomyopathy, both of which may share overlapping clinical features. This study was done to investigate the temporal relationship between SARS-CoV-2 infection and the onset of PPCM, highlighting possible implications for maternal health in the post-COVID-19 era. A prospective observational case series was conducted at a tertiary care center in South India. Four postpartum women with recent or past COVID-19 infection were diagnosed with PPCM over a six-month period. Three of the four patients succumbed despite intensive care and multidisciplinary interventions. The clustering of these cases in a short time frame and their shared history of COVID-19 infection raises questions regarding a potential pathogenic link. Future studies are needed to elucidate the pathophysiological mechanisms linking COVID-19 and PPCM
Carbetocin versus oxytocin in the prevention of postpartum hemorrhage in cesarean section: a prospective randomised comparative study
Get PDFBackground: Postpartum hemorrhage is the leading cause of maternal mortality. The prevention of PPH can be best done by active management of the third stage of labour. Oxytocin is currently the uterotonic of choice. The study compared the efficacy of Carbetocin 100 µg intravenous bolus and oxytocin 10 IU intravenous infusion over 2 hours by measuring total blood loss, the need for additional uterotonic agents, and the need for blood transfusion. It is important to evaluate the efficacy of Carbetocin compared to oxytocin in low-income countries, especially where patient affordability is a major concern.
Methods: A prospective randomised comparative single-blinded study was conducted in the department of obstetrics and gynecology, Kurji Holy Family Hospital, Patna, Bihar. 100 patients undergoing elective cesarean section fitting in the inclusion criteria were randomly allocated by a sealed envelope system to either case study group A receiving Carbetocin 100 µg intravenous and control study group B receiving oxytocin 10 IU intravenous infusion. Three specific outcomes were measured: total blood loss, additional uterotonic use and the need for blood transfusion.
Results: In this study, Carbetocin was found to significantly reduce total blood loss in comparison to oxytocin (p<0.0001), the use of additional uterotonics was significantly less in the Carbetocin group (p=0.023), the need for blood transfusion was less in Carbetocin group but not significantly (p=0.538).
Conclusions: Carbetocin has better efficacy in comparison to oxytocin in reducing total blood loss, hence preventing PPH. The need for additional uterotonic agents is less with Carbetocin use. The need for blood transfusion was also less with Carbetocin use but needs larger studies to be proved. Carbetocin may be cost-effective
A case series of scar endometriosis: a mysterious painful scar
Get PDFEndometriosis is the presence of endometrial tissue outside the uterine cavity. Scar endometriosis, one of its rare variants, is the study of interest since most of the patients present to the general surgeon rather than to a gynaecologist due to its quite often non-specific symptoms. In this case series of 5 patients, 2 of the patients had presented to the general surgery department, one presented with non-specific symptom. Prior history of any obstetric (caesarean section in particular) and gynaecological surgeries must be elicited which may help in clinching towards the diagnosis. This report is about a case series of 5 patients who had variable presentations and were offered wide local excision. Diagnosis was confirmed with post-operative histopathology. The pathogenesis, treatment and prevention have been discussed
Fetomaternal outcomes in antenatal women with sickle cell hemoglobinopathies: an observational study from central India
Get PDFBackground: Sickle cell hemoglobinopathies, especially prevalent in tribal populations of central India, pose significant obstetric and neonatal risks. Early recognition and high-risk pregnancy management are essential in minimizing complications. Objective was to analyze fetomaternal and labor outcomes in antenatal mothers with sickle cell hemoglobinopathies (SCD and SCT) attending a tertiary care center in Chhattisgarh.
Methods: A hospital-based prospective observational study was conducted at RIMS, Raipur, over 18 months. A total of 75 antenatal women in the third trimester diagnosed with sickle cell hemoglobinopathies were enrolled. Clinical data on maternal (anemia, PIH, ICU stay), fetal (birth weight, NICU admission, Apgar scores), and labor outcomes (gestational age, delivery mode) were collected and analyzed using SPSS v28.0.
Results: Out of 75 participants, 93.3% had sickle cell trait (HbAS) and 6.6% had sickle cell disease (HbSS). Anemia was present in 65.3% (mild in 40%, moderate in 18.7%, severe in 6.6%). PIH occurred in 13.3%, and 2.7% required ICU admission. No postpartum hemorrhage or maternal mortality was noted. LBW was observed in 45.3%, NICU admission in 17.3%, Apgar<7 at 1 minute in 18.7%. Cesarean section was performed in 77.3% of cases, and preterm birth occurred in 22.7%.
Conclusions: Sickle cell hemoglobinopathies are associated with a high burden of maternal anemia, hypertensive disorders, and adverse neonatal outcomes. Enhanced antenatal surveillance, multidisciplinary care, and community-based screening are recommended to improve outcomes in high-prevalence regions