International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Knowledge, perception and the utilization of immediate postpartum family planning among pregnant and postpartum women in Ogbomoso, southwest Nigeria
Get PDFBackground: The postpartum period is frequently characterised by a heightened risk of unintended pregnancies and unmet contraceptive needs, and women who wish to delay or avoid subsequent pregnancies soon after childbirth often lack access to timely and effective family planning information and services. This study aimed to determine the knowledge, perception, and utilisation of immediate postpartum family planning (IPPFP) amongst pregnant and postpartum women in Ogbomosho, Oyo State.
Methods: A cross-sectional, descriptive multi-stage study design was conducted in selected hospitals in Ogbomoso, southwest Nigeria. Data obtained using a self-administered structured questionnaire were analysed using IBM SPSS version 26, and the results obtained were presented in tables. The level of significance was set at 0.05.
Results: The findings in this study revealed that a larger number of respondents had good knowledge of postpartum family planning (83.30%), while a smaller number (16.70%) had poor knowledge. Regarding utilisation, despite the high level of knowledge demonstrated in this study, only 43.60% of respondents had used any method of IPPFP, while 56.4% had not.
Conclusions: The high level of knowledge demonstrated by the participants in this study did not translate into the uptake of postpartum contraceptives. The study emphasises the need for improved access to diverse IPPFP options to enhance utilisation
A rare case of incidental chronic ovarian ectopic encountered in a case of ruptured ectopic pregnancy
Get PDFChronic ectopic pregnancy has mild clinical presentation with absent or subtle symptoms. The high incidence of negative pregnancy tests and a poor specificity of ultrasonography can be misleading, and the correct diagnosis is sometimes established only at the time surgery with its nature or even histopathologically after the operation. Here is the case of chronic ovarian ectopic diagnosed accidentally during the case of ruptured tubal ectopic. 34 years G4P2+1L2 underwent laparoscopic salpingectomy for ruptured tubal ectopic left side. She had a regular menstrual cycle of 24 days and complained of chronic dull aching lower abdomen pain off and on during cycle. Ultrasonography echogenic hemoperitoneum with an anechoic area measuring 19×24.3×23.1 mm with embryo-like echo (18.8 mm in length) amidst the echogenic region. On doing laparoscopy the left ruptured tubal ectopic removed with clearing of hemoperitoneum revealed right bluish black color cyst adherent to adjacent structure forming tubo-ovarian mass. A chronic ectopic pregnancy is often difficult to diagnose due to its subtle symptoms and varied echogencity in ultrasound. It is often mistaken with chronic PID with tubo-ovarian mass or endometrioma
Effect of COVID-19 on pregnant women and its relation to pregnancy outcomes
Get PDFBackground: To evaluate the pregnancy outcomes and clinical characteristics of pregnant women infected with SARS-CoV-2 and their neonates, highlighting COVID-19’s potential impact on maternal and neonatal health.
Methods: A retrospective cohort study was conducted which included 50 pregnant women, aged 18-40 years, hospitalized with strongly suspected or confirmed COVID-19 based on RT-PCR or clinical/imaging findings. Data on maternal symptoms, delivery mode, laboratory findings, and neonatal outcomes were collected and then analyzed. Pregnancies complicated by cancers or inflammatory diseases were excluded. Neonatal health was assessed using the Apgar score, NICU admissions, and SARS-CoV-2 testing.
Results: The mean gestational age at diagnosis was 35.85±4 weeks, with 50% vaginal deliveries and 50% cesarean sections (30% elective, 20% emergency). Adverse outcomes included 2 preterm births (4%) and 5 cases of premature rupture of membranes (10%). Three neonates (6%) tested positive for SARS-CoV-2, with a mean birth weight of 3506 gm, and Apgar scores of 4±2.1 (1 minute) and 8±1.2 (5 minutes). NICU admission was required for 14% of newborns, with no reported neonatal deaths. The majority of women experienced mild symptoms, and no severe maternal illness or death occurred.
Conclusions: In pregnant women, COVID-19 infection was associated with mild maternal symptoms and favorable neonatal outcomes, although vertical transmission of SARS-CoV-2 was observed in 6% of cases. Further research is required in order to assess long-term effects and better understand the mechanisms behind vertical transmission
Study on the knowledge, attitude and practice of contraception in Kerala, centered around a tertiary care centre
Get PDFBackground: Family planning is a public health cornerstone. In Kerala, India, despite high literacy, contraceptive use is dominated by female sterilization, with low uptake of spacing methods and minimal male participation. This suggests significant gaps in knowledge and attitudes. This study aimed to assess the awareness, specific knowledge and attitudes towards contraceptive methods in a mixed population of Kerala.
Methods: A cross-sectional, questionnaire-based study was conducted from May 2024 to September 2025 among 500 individuals (84.2% female; 48% healthcare workers) residing in Kerala, aged above 18 years. The sample size was justified using a 71.6% anticipated prevalence from a parent study. Data was collected via an online survey distributed at a tertiary maternity hospital and the wider community. Main outcome measures were awareness levels, specific knowledge, lifetime usage and attitudes towards intrauterine devices (IUDs) and male sterilization, analyzed using t-tests and Chi-Square tests.
Results: General awareness of contraception was nearly universal, but lifetime usage was low (22.8%). A significant knowledge-practice gap was identified. Participants who had used contraception had significantly higher mean awareness scores (7.35) than non-users (6.22) (t=3.90, p<0.001). Healthcare workers (Mean Score: 7.67) were significantly more knowledgeable than non-healthcare workers (Mean Score: 5.37) (t=10.19, p<0.001), but this did not correlate with higher personal use (p=0.492). Education level was highly associated with willingness to accept an IUD (p<0.001), but economic status was not associated with contraceptive use (p=0.373).
Conclusions: Despite high general awareness, significant gaps in detailed knowledge and low practical adoption persist. Misconceptions and reluctance, particularly towards male sterilization and long-acting reversible contraceptives (LARC), are prevalent. Targeted educational interventions addressing specific procedural fears-and specifically sensitizing healthcare providers to their own biases-are necessary to bridge this knowledge-practice gap
A rare case of advanced cervical cancer in pregnancy: clinical presentation, diagnostic challenges, and multidisciplinary management
Get PDFAdvanced cervical cancer diagnosed during pregnancy is an exceptionally rare occurrence. We present a case of stage IIIC cervical squamous cell carcinoma identified during pregnancy. A woman in her early thirties in her fourth pregnancy attended maternity triage with unprovoked antepartum haemorrhage at 23+2 weeks of gestation with an irregular mass on her cervix. Colposcopic biopsy confirmed a moderately to poorly differentiated invasive squamous cell carcinoma. MRI pelvis showed parametrial invasion and pelvic lymphadenopathy, consistent with FIGO stage IIIC1 disease. Following multidisciplinary team discussion, the management plan included early delivery with steroid cover, followed by definitive chemoradiotherapy. At 32 weeks’ gestation, a caesarean section with sterilisation was performed due to severe fetal growth restriction (estimated fetal weight <3rd centile). Postnatally, the patient commenced neoadjuvant chemotherapy with paclitaxel and carboplatin, followed by definitive chemoradiotherapy consisting of external beam radiation and intracavitary brachytherapy. Post-treatment MRI demonstrated an excellent therapeutic response. Management of cervical cancer in pregnancy depends on gestational age and disease stage. This case illustrates the multidisciplinary management of advanced cervical cancer in pregnancy, balancing maternal treatment needs with fetal well-being to achieve optimal outcomes for both. This case also underscores the importance of regular cervical screening, patient education regarding its value, and careful speculum examination by experienced clinicians in pregnant women presenting with vaginal bleeding, as pregnancy can obscure critical symptoms.
Hypertensive disorders of pregnancy-pre-conception and inter-conception care
Get PDFWomen with hypertensive disorders during pregnancy face short- term and long-term complications which can impact both maternal as well as neonatal health. It is still a leading cause of maternal mortality despite aggressive treatment methods available. In the present article, effort has been made to address the potential threats and how and when to take certain preventive steps to improve the overall health of the woman before and after conceiving. It focuses on prenatal counselling, goals, lifestyle modifications and anti-hypertensive treatment
An observational study of postoperative surgical site infection in abdominal obstetrics and gynecological surgeries in tertiary care set up of south Gujarat
Get PDFBackground: Surgical site infections (SSIs) represent a significant type of healthcare-associated infection, especially following major obstetric and gynecological surgeries. The incidence of SSI varies widely depending on patient health and type of surgery, that impacts hospital resources and patient recovery time. Despite advances in surgical techniques, SSIs remain a major cause of morbidity. This study aimed to investigate risk factors, bacterial patterns, and outcomes associated with postoperative SSIs in obstetric and gynecological surgeries.
Methods: Conducted as a prospective observational study over 10 months in the OG department of a tertiary healthcare center in south Gujarat, 50 patients with post-operative SSIs were consecutively recruited using purposive sampling. Inclusion criteria included major abdominal surgery patients with post-operative SSIs, with exclusions for non-consenting patients, laparoscopic procedures, and surgeries conducted outside the institution.
Results: Among 50 patients, the highest SSI incidence was found in cesarean sections (74%), with abdominal hysterectomies and laparotomies accounting for 16% and 10%, respectively. Most patients (60%) were aged 19-29 years, and 44% had a BMI of 30-39.9. About 52% showed bacterial growth in wound cultures, with E. coli (14%) and Staphylococcus aureus (10%) as predominant organisms. Notable infection-related outcomes included deep skin gaps in 40% of cases and slough formation in 22%.
Conclusions: This study highlighted the risk factors associated with SSIs in abdominal obstetric and gynecological surgeries, emphasizing high infection rates in cesarean deliveries. The findings underscore the importance of targeted infection control & effective postoperative care protocols to improve patient outcomes in this population
Fertility-preserving management of post-adenomyomectomy enterocutaneous fistula with GnRH analogue
Get PDFUterocutaneous fistula is a rare pathological communication between the uterine cavity and the anterior abdominal wall, typically presenting with cyclical menstrual discharge through a cutaneous opening. While most cases occur following Caesarean sections or open myomectomy, this case describes an unusual presentation following adenomyomectomy in a 32-year-old nulligravida. The patient initially presented with symptoms suggestive of uterine fibroids but was intraoperatively found to have adenomyosis, for which adenomyomectomy with uterine reconstruction was performed. Four weeks postoperatively, she developed a localized swelling on the lower abdominal wall, which ruptured with the onset of menstruation, discharging blood through both the skin and vagina. Ultrasonography confirmed a hypoechoic tract connecting the uterus to the cutaneous swelling, consistent with uterocutaneous fistula. The patient was successfully managed non-surgically using monthly subcutaneous Goserelin injections for three months, resulting in spontaneous closure of the fistulous tract and resolution of symptoms. This case highlights the diagnostic challenges of differentiating adenomyosis from fibroids using 2D ultrasonography, as well as the importance of considering rare postoperative complications such as uterocutaneous fistula. It underscores the potential role of medical therapy with GnRH analogues as a fertility-preserving alternative to surgery in select cases, contributing to improved clinical outcomes and patient quality of life
Low-grade appendiceal mucinous adenocarcinoma with peritoneal and ovarian spread: a case report and literature review
Get PDFAppendiceal mucinous neoplasms are rare and often present with nonspecific symptoms, leading to diagnostic challenges. This case report describes an atypical presentation of a low-grade mucinous appendiceal adenocarcinoma initially misdiagnosed as an ovarian mass, highlighting the importance of a multidisciplinary diagnostic approach. This case report involves a 57-year-old postmenopausal woman presented with persistent gastroesophageal reflux disease (GERD) and was found to have a large abdominopelvic cystic mass on imaging, suggestive of ovarian origin. Further evaluation, including computed tomography (CT), magnetic resonance imaging (MRI), and histopathological analysis after exploratory laparotomy, revealed a metastatic low-grade mucinous appendiceal adenocarcinoma with peritoneal dissemination (pseudomyxoma peritonei). The patient was referred for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). This case illustrates the diagnostic complexity of appendiceal mucinous neoplasms, particularly when mimicking gynaecological pathology. A high index of suspicion, comprehensive imaging, and histopathological confirmation are crucial for accurate diagnosis. CRS and HIPEC remain the standard of care for advanced disease, emphasizing the need for early multidisciplinary involvement in management
Polycystic ovary syndrome: a comprehensive review of pathophysiology, diagnosis, and emerging management strategies
Get PDFPolycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting 6-20% of women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Its pathophysiology involves intricate interactions among genetic, epigenetic, metabolic, and environmental factors, with insulin resistance, gut microbiota dysbiosis, and novel biomarkers like anti-Müllerian hormone (AMH) playing pivotal roles. This review provides an in-depth exploration of PCOS etiology, diagnostic challenges, and management strategies, including lifestyle interventions, pharmacological therapies, and emerging approaches like microbiota modulation and microRNA therapies. We also address long-term health risks, such as cardiovascular disease, type 2 diabetes mellitus (T2DM), and mental health challenges, emphasizing personalized and multidisciplinary treatment strategies.