International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Not a member yet
9909 research outputs found
Sort by
Assessment of satisfaction level among postnatal women delivered in a government hospital in urban Bengaluru: a cross-sectional study
Get PDFBackground: Postnatal care (PNC) satisfaction has been defined as the level at which mothers’ immediate postnatal health care needs are met, in regard to their expectations, giving them a sense of happiness and it is considered one of the desired outcomes of health care. To assess the level of satisfaction among postnatal women delivered in a Government Hospital in Urban Bengaluru by using a semi-structured interview-based questionnaire.
Method: It was an analytical cross-sectional study which was done among postnatal mothers who delivered in Government health facilities. The sample size estimated was 178.
Results: The mean age of the postnatal mothers was 27.75 (SD=4.4). Nearly 40% belong to the age category of 25-29 years. More than a third, had graduate degree whereas, only 14% were employed. Only 42% were satisfied overall in all the four domains of healthcare. The level of satisfaction was poor in informative aspects of healthcare (10.6%). The antenatal features like birth weight and early initiation of breastfeeding practices were significantly associated with level of satisfaction.
Conclusion: The level of satisfaction was higher in interpersonal and technical aspects of care than in informative aspects and health facility-related statements. The higher the education level, the lower the level of maternal satisfaction, and multiparous are more likely to be satisfied with delivery service than primiparous
Surgical challenges: total laparoscopic hysterectomy of a bulky uterus weighing 4.4 kg
Get PDFWith the advancements in minimally invasive surgeries, the main concern while operating huge fibroids is to avoid laparo-conversion. Performing safe and effective total laparoscopic hysterectomy for large uterus hinges largely on modifications in pre-operative preparation and modifications in surgical techniques. The procedure was done at Indigo women Centre, Chennai, Tamil Nadu, India. This procedure was performed on a 44-year-old woman with complaints of abdominal discomfort and a rapidly growing pelvic mass. Imaging suggested massive fibroid of 34 weeks size. Operative challenges included port placement, manipulation, positioning, vascularity, dissection in altered anatomy and specimen retrieval. The same was accordingly overcome by cephalad port entry, Trendelenburg and air-planning position, “two myoma screw” technique, vasopressin, appropriate energy sources use and manual morcellation. Laparoscopic approach to huge fibroids can be made feasible, provided there is sufficient preoperative preparation and surgical expertise, thereby rendering the entire benefits of minimally invasive surgery
Evaluation of the synergistic application of bone marrow aspirate concentrate and platelet-rich plasma therapy in women experiencing premature ovarian failure and poor ovarian reserve: a case series
Get PDFAutologous bone marrow-derived stem cells (BMSCs) and platelet-rich plasma (PRP) separately were found to be effective in restoring ovarian function in infertile women. The present study aims to study the synergistic effect of bone marrow-derived aspirate concentrate (BMAC) and PRP in women diagnosed with poor ovarian response (POR) and premature ovarian failure (POF) undergoing in vitro fertilization (IVF). A total of 10 patients participated in the study. Eight patients were diagnosed with POR, while two patients had POF. Intraovarian BMAC-PRP injection was given to all the patients via the laparoscopic or transvaginal route. Group 1 before starting the IVF cycle, group 2-intracycle-post ovum pick-up and group 3-POF patients. Outcomes assessed include improvement in antral follicular count (AFC), Anti-Mullerian hormone (AMH), response to ovarian stimulation at subsequent IVF cycle and clinical pregnancy. In group I POR patients (n=4) post-instillation, an increase in AFC count was observed and subsequently, these patients underwent IVF, however, no clinical pregnancies were achieved. Group II POR patients (n=4), who received BMAC-PRP instillation intracycle post-OPU there was improvement in AFC and better response with more oocytes and embryos in the subsequent IVF cycle, leading to three pregnancies in this group. In group III-POF patients (n=2) who received BMAC-PRP instillation, one of them spontaneously conceived post 3 months of instillation. The synergistic application of BMAC-PRP was found to be effective in improving ovarian function in POR and POF patients.
Comparative study between Reid’s colposcopic index score and Swede’s score in women with cervical precancerous lesions
Get PDFBackground: Colposcopic indexes including Reid’s index and Swede’s score were developed to make the colposcopy more objective. The aim of this study was to compare two widely used colposcopic indices Reid’s index and Swede’s score for the detection of premalignant lesions of the cervix.
Methods: This prospective observational study was conducted on 125 women who attended gynecology OPD with gynecological complaints in June-2018 to July-2019 in the department of obstetrics and gynecology at Hindu Rao Medical College New Delhi over a period of one year. Colposcopic examination was done in all patients RCI score and Swede’s score were calculated from the colposcopic findings. Biopsy was taken and histopathology results were recorded.
Results: Majority of women enrolled in the study were between 41-50 years (36%), 88.00% were married staying with husband. Around 41.60% were illiterate, it was observed that majority of women 70.40% had first sexual inter course at ≤18 years. There was an excellent correlation between RCI and Swede’s score p value was <0.001. Larger size of lesions was associated with malignant cases.
Conclusions: Swede’s score and RCI score have good correlation in detecting cervical cancer. However, Swede’s score is better than RCI score for predicting cervical intraepithelial neoplasia 1 (CIN 1)
Effect of myoinositol plus metformin versus metformin alone on high serum AMH level in infertile PCOS women: clinical and biochemical response
Get PDFBackground: Polycystic ovary syndrome (PCOS), a common endocrine disorder in reproductive-age women, is characterized by insulin resistance, hyperandrogenism, and elevated serum AMH levels. Both metformin and myoinositol improve insulin sensitivity through different mechanisms, potentially enhancing reproductive outcomes. This study aimed to compare the clinical and biochemical effects of combined myoinositol and metformin therapy versus metformin alone in reducing high serum AMH levels in infertile PCOS women.
Methods: This randomized controlled trial at BSMMU’s department of reproductive endocrinology and infertility (July 2022-June 2023) randomized 80 PCOS women (18-35 years) to myoinositol+metformin (n=40) or metformin alone (n=40) for 3 months. We assessed AMH (primary outcome), BMI, waist-hip ratio, menstrual regularity, hormones (LH/testosterone), glucose metabolism, and pregnancy rates, analyzed via SPSS 23 (t-tests; p<0.05 significant).
Results: In 80 subfertile PCOS women (40/group), myoinositol+metformin (group A) outperformed metformin alone (group B): greater reductions in BMI (27.1 to 24.5 versus 27.4 to 25.3), waist-hip ratio (0.91 to 0.86 versus 0.90 to 0.88), AMH (12.2 to 9.5 versus 12.3 to 8.6 ng/ml), LH (10.1 to 6.4 versus 9.9 to 6.9 mIU/ml), and testosterone (2.1 to 1.4 versus 2.3 to 1.7 ng/ml). Group A showed higher menstrual regularity (95% versus 87.2%) and pregnancy rates (10% versus 5.1%).
Conclusions: Combination therapy of myoinositol and metformin is more effective than metformin alone in improving clinical and biochemical outcomes in infertile PCOS women
Prospective observational study of inside-out versus outside-in transobturator tapes for female stress urinary incontinence at a tertiary care hospital of South Western railway
Get PDFBackground: To compare outcomes of transobturator tension-free vaginal tape using outside-in and inside-out approaches in women with stress urinary incontinence (SUI), and to identify risk factors for treatment failure.
Methods: A prospective observational study was conducted at Central Hospital, Hubli, from July 2007 to June 2022. A total of 223 women with SUI refractory to conservative management were enrolled; 129 underwent the inside-out (TVT-O) procedure and 94 underwent the outside-in (TOT) procedure. Patients were followed annually for at least 3 years (maximum 10 years). Subjective and objective cure rates, complications, quality of life (QoL), and psychological outcomes were assessed.
Results: At 5 years, subjective cure rates were 87% for TVT-O and 83% for TOT, while objective cure rates were 95.3% and 90%, respectively. Both techniques demonstrated significant improvements in QoL and Beck depression inventory scores. Dyspareunia was higher in the TVT-O group (p=0.02), but other complication rates were comparable. In 75 patients with 10-year follow-up, long-term success was maintained at 97%.
Conclusions: Both TVT-O and TOT techniques are safe and effective for treating female SUI, with durable long-term results. The choice of procedure should be guided by surgeon expertise and patient preference
Acute pancreatitis in the third trimester of pregnancy: a rare case report and management challenges
Get PDFAcute pancreatitis during pregnancy is a rare but potentially life-threatening condition for both mother and fetus, with an estimated incidence ranging from 1 in 1,000 to 1 in 10,000 pregnancies. The third trimester is the most commonly affected period, often due to hormonal and anatomical changes that predispose to gallstone formation and biliary stasis. Clinical presentation is frequently nonspecific and may mimic other obstetric or gastrointestinal conditions, making timely diagnosis challenging. Common etiologies include gallstones, hypertriglyceridemia, and, less frequently, alcohol use or idiopathic causes. Diagnosis relies heavily on biochemical markers such as serum amylase and lipase, supported by imaging modalities. Management typically involves conservative treatment; however, obstetric complications may necessitate early delivery. This case highlights a rare instance of acute pancreatitis at 35+5 weeks gestation, complicated by fetal distress, requiring an emergency cesarean section. A multidisciplinary approach involving obstetrics, gastroenterology, and critical care ensured a favorable maternal and neonatal outcome
Thyroid dysfunction and hypertensive disorders in pregnancy: a retrospective study stratified by gestational age and maternal thyroid profile
Get PDFBackground: Thyroid dysfunction has been increasingly implicated in the development of hypertensive disorders in pregnancy (HDP), though its influence on gestational age of onset, fetal outcomes, and disease severity remains underexplored. The roles of maternal parity, intrauterine growth restriction (IUGR), and antihypertensive management strategies in this context are also not well established.
Methods: A retrospective study was conducted at a tertiary care center in North India over 3 years (2022–2025), including pregnant women diagnosed with HDP after 20 weeks of gestation. Thyroid function tests (TSH, FT4) were correlated with HDP type, gestational age at onset, parity, presence of IUGR, and antihypertensive therapy used.
Results: Among 384 women with HDP, 114 (29.7%) had thyroid dysfunction 96 (25%) with subclinical and 18 (4.7%) with overt hypothyroidism. Thyroid abnormalities were more prevalent in women with early-onset HDP (<34 weeks) and in primigravidae. IUGR was observed in 41.2% of patients with thyroid dysfunction compared to 22.9% in euthyroid women (p<0.01). Subclinical hypothyroidism was strongly associated with preeclampsia and eclampsia. The most commonly prescribed antihypertensive agents were labetalol (74.1%) and nifedipine (62.5%), with higher use of dual therapy in patients with overt hypothyroidism.
Conclusions: Thyroid dysfunction, particularly subclinical hypothyroidism, is significantly associated with early-onset and severe hypertensive disorders, higher incidence of IUGR, and increased need for combination antihypertensive therapy. Routine thyroid screening in antenatal care, especially in primigravidae, may facilitate early risk identification and targeted management
Contraceptive conversations: an observational pilot study to understand, ‘what women prefer and why’
Get PDFBackground: Contraceptive use is a vital aspect of reproductive health and women's empowerment. Despite national progress in family planning, regional disparities persist, especially in Uttar Pradesh (UP), where contraceptive prevalence remains below the national average. This study explores the preferences and factors influencing contraceptive choices among women in Aligarh, UP. To identify the most commonly preferred contraceptive methods among women aged 18–60 years attending a government hospital in Aligarh and to examine the socio-demographic factors influencing their choices.
Methods: A retrospective cross-sectional study was conducted using hospital records from Mohan Lal Gautam Rajkiya Mahila Chikitsalaya, Aligarh, covering a six-month period (January–June 2024). A total of 3,776 women who sought contraceptive services were included. Data on age, socioeconomic status and contraceptive method used were collected and analyzed using descriptive statistics.
Results: The majority of women preferred short-term, non-invasive contraceptive methods. Nirodh (condoms) and Mala N (oral contraceptive pills) were the most commonly used, accounting for 40.88% and 39.43% of usage, respectively. Long-term methods such as IUDs and female sterilization were significantly less utilized (<10%). Preference was influenced by factors such as accessibility, cultural acceptability, ease of use and government promotion. Middle and lower-middle socioeconomic groups formed the largest segments of users and women aged 29–39 represented the highest age group seeking contraception.
Conclusions: The study highlights a clear preference for reversible, user-controlled contraceptives among women in UP, shaped by ease of access, affordability and minimal side effects. Government initiatives have played a pivotal role in promoting these methods. However, low uptake of long-term options indicates the need for enhanced education, counselling and culturally sensitive awareness programs to broaden contraceptive choices and support informed decision-making
Evaluation of thyroid disorders in pregnancy: prevalence and its varieties
Get PDFBackground: Thyroid disorders represent one of the most common endocrine problems in pregnancy, with maternal hypothyroidism being the most frequent. Global prevalence of hypothyroidism during pregnancy varies widely, from 2.5% to 11%, and is reported to be higher in Asian countries compared to global estimates. The overall prevalence of thyroid disorder in pregnancy is estimated at up to 33.9% comprising hypothyroidism (31.6%) and hyperthyroidism (2.3%). Although hyperthyroidism is relatively uncommon, affecting only 0.1-0.4% of pregnancies, it is associated with greater maternal and fetal complications. Despite the higher prevalence of thyroid disorders in India, data on their distribution and adverse outcomes remain limited. Further research is therefore necessary to improve understanding and guide clinical practice in this population.
Methods: A cross-sectional study was carried out at MGM Medical College and LSK Hospital over an 18-month period. The study population included pregnant women attending the antenatal clinic. Based on the estimated prevalence of thyroid disorders in India (33.9%), the minimum required sample size was calculated as 344 participants.
Results: During the study, 344 antenatal women underwent thyroid evaluation. Of these, 112 were diagnosed with some form of thyroid disorder. The prevalence of thyroid dysfunction in pregnancy was calculated 32.56%.
Conclusions: Given this high prevalence, universal thyroid function testing at the first antenatal visit is strongly recommended. Women of higher maternal age are particularly prone to developing thyroid dysfunction. The mean TSH, FT3 and FT4 values in euthyroid participants (n=232) may serve as useful reference values for this region in future studies