International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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Menarche, menstruation and reproductive life of women
Get PDFBackground: Reproductive process involves the sexual maturity of male and female. Female bears larger responsibility in a reproduction process with minimum say in India. Therefore, this study was planned in a rural area to investigate the menarche age, menstruation, reproductive life, use of contraceptives and their say in reproductive life in rural areas of Bharatpur district of Rajasthan, India.
Methods: Well defined questionnaire pertaining to the: menarche, age of regular menstrual cycle, age of marriage, fertility, age of first pregnancy, number of children with gap, abortion, and contraceptive methods used was prepared on reproductive matters of women.
Results: Results of study reveals that menarche age of women was 13-15 years, 37% women of study experienced normal menstruation, early marriage, cases of infertility, early age of getting pregnant, 61% had three and more than three children and 42% female did not use birth control methods.
Conclusions: In conclusion women need basic scientific understanding, awareness and say in reproductive and sexual life. Male partner should have basic knowledge of reproductive and sexual health. He should have supportive, caring and sharing attitude toward his spouse
Comparison of labetalol and nifedipine in control of blood pressure in severe pre-eclampsia in Dalhatu Araf Specialist Hospital
Get PDFBackground: Severe preeclampsia and eclampsia are forms of hypertensive disorders of pregnancy that cause significant morbidity and mortality in the mother and foetus globally. The best drug for prompt lowering of blood pressure is required for a desirable outcome. This study was aimed determining the efficacy of intravenous labetalol compared with oral nifedipine in the immediate control of hypertension in severe pre-eclampsia.
Methods: Seventy-four women who fit the criteria for severe preeclampsia were randomly selected and recruited for the prospective comparative study. They were divided into two equal arms, one, receiving intravenous labetalol in precise, timed doses and the other, oral nifedipine in its own timed doses. The doses and time for effective blood pressure control were recorded in both arms and comparatively analyzed.
Results: The time taken to achieve targeted blood pressure of <150/100 mmHg in the intravenous labetalol group was (38.9±17.2 min) and in the oral nifedipine group was (37.1±17.2 min) with p value=0.302. The mean number of doses required to achieve this was (2.6±1.2 doses) and (2.3±1.0 doses) respectively with p value of 0.370. The mean cost of treatment per doses given for labetalol group was (NGN 3259.5±2294.4) and nifedipine group, was (NGN 3254.1±1440.4) with p value=0.990.
Conclusions: Both drugs were found to be equally efficacious in rapidity of controlling blood pressure in severe preeclampsia and both had similar cost effect per dose of drug
Optimizing maternal and neonatal health: a review of anemia at term pregnancy
Get PDFBackground: Anemia in pregnancy remains a critical global health issue, particularly in developing countries, leading to significant maternal and fetal complications. The study aimed to identify factors contributing to anemia at term and its impact on maternal and neonatal outcomes.
Methods: A prospective observational study was conducted at a tertiary hospital in (Mumbai), including 100 pregnant women with hemoglobin <11 gm/dl at term (≥37 weeks) who fulfilled the inclusion and exclusion criteria. Demographics, antenatal care practices, and outcomes were analyzed using a predesigned case record proforma.
Results: The prevalence of mild anemia was 79%, while 21% had moderate anemia. Poor dietary intake, non-compliance with oral iron therapy, and low socioeconomic status were significant contributors. Anemia at term predisposed women to increased risks of labor complications, including prolonged hospital stays and a higher need for parenteral iron therapy or blood transfusions. Neonatal complications, including low APGAR scores and NICU admissions, were higher among moderately anemic mothers.
Conclusions: Anemia at term leads to adverse maternal and neonatal outcomes. Strengthening antenatal care, improving dietary practices, and ensuring adherence to supplementation can mitigate the risks associated with anemia
Polycystic ovary syndrome awareness among patients in a tertiary level teaching hospital: a questionnaire based observational study
Get PDFBackground: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age. Despite its widespread occurrence, awareness remains inconsistent. This study aims to evaluate the awareness, knowledge, and perceptions of PCOS among participants, focusing on risk factors, symptoms, diagnostic modalities, treatment approaches, and sources of information.
Methods: An observational study was conducted among women from diverse educational and occupational backgrounds. Data was collected through structured questionnaires assessing demographic details, awareness levels, knowledge of risk factors and symptoms, diagnostic approaches, treatment-seeking behaviour, and sources of information. Responses were analysed to identify trends, misconceptions, and gaps in knowledge.
Results: The study showed that 40.6% of participants were aware of PCOS, a significant portion (39.6%) reported only partial awareness. The most commonly identified symptom was irregular periods (76.8%). A majority of participants (46.4%) were unsure about seeking medical treatment, reflecting hesitancy and misinformation. Management strategies such as lifestyle changes (32.9%) and medications (29.9%) were known to participants, but awareness of surgical options was low (4.3%). Notably, 30.4% of respondents relied on family and friends as their primary source of information, raising concerns about the accuracy of their knowledge.
Conclusions: The findings highlight significant gaps in PCOS awareness, diagnosis, and management. Healthcare professionals play a crucial role in disseminating accurate information. Targeted educational interventions, enhanced healthcare communication, and community-based awareness programs are necessary to bridge knowledge gaps and promote early diagnosis and effective management of PCOS
Atypical uterine rupture: case report and literature review
Get PDFUterine rupture, defined as a partial or complete disruption of the uterine wall, can occur spontaneously during pregnancy or labor-even without classic symptoms. This report presents an atypical case involving a 34-year-old woman with a history of laparoscopic myomectomy and large loop excision of the transformation zone, who conceived via in vitro fertilization. At 35 weeks, during an elective cesarean section for complications including intrauterine growth restriction and oligohydramnios, dehiscence of a previous uterine scar was incidentally discovered, with the fetal limb partially entrapped. Remarkably, the patient exhibited minimal pain and haemorrhagic signs, deviating from the typical presentation. This case highlights the complex interplay between surgical history, assisted reproductive techniques, and mechanical factors in predisposing patients to uterine rupture. It emphasizes the need for careful monitoring and individualized management strategies for high-risk pregnancies, and calls for further research to refine clinical guidelines
Weaning: a prospective investigation into the reality of USL Umbria 1
Get PDFWeaning represents a critical stage in a child’s development, yet it is frequently surrounded by uncertainty-especially among first-time parents. Such doubts often stem from limited awareness and an abundance of unfiltered information available online. Moreover, informal exchanges among new parents can further complicate matters. To evaluate the real level of parental knowledge on weaning, we conducted a survey at the USL Umbria 1 and the University Hospital of Perugia. Our investigation focused on assessing both the information acquired during antenatal courses and the availability of dedicated resources where parents can seek expert advice on weaning
Evaluating the effects of platelet-rich plasmas plus dehydroepiandrosterone and dehydroepiandrosterone alone in infertile women with diminished ovarian reserve
Get PDFBackground: Diminished ovarian reserve (DOR) is a significant cause of female infertility, often associated with poor response to ovarian stimulation during assisted reproductive techniques. This study aimed to evaluate the effects of a combination therapy using platelet-rich plasma (PRP) and dehydroepiandrosterone (DHEA) compared to DHEA alone in infertile women with DOR.
Methods: This Quasi-experimental study was conducted in the Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2022 to June 2023. In this study, we included 36 women aged 20 to 39 years diagnosed with diminished ovarian reserve (DOR) attending the outpatient Department of Reproductive Endocrinology and Infertility at BSMMU. Participants were assigned to two treatment groups: group A received DHEA plus PRP, and group B received only DHEA.
Results: The mean age in group A was 31.5±5.5 years (range: 25–39), and in group B, it was 31.4±5.2 years (range: 25–39). Baseline characteristics, including age, body mass index (BMI), infertility duration, and hormonal levels, were similar between the groups. Over the 3-month follow-up, both groups showed improvements in ovarian reserve markers. Group A demonstrated slightly greater improvements in AMH (0.36±0.2 ng/ml versus 0.30±0.1 ng/ml), AFC (1.2±1.4 versus 0.82±1.5), and a greater reduction in FSH (-3.1±1.9 mIU/ml versus -2.82±1.7 mIU/ml) compared to group B. However, these differences were not statistically significant.
Conclusions: This study showed that both DHEA alone and in combination with PRP resulted in improved ovarian reserve markers in women with DOR. Although the combination therapy of PRP and DHEA showed slightly better outcomes compared to DHEA alone, the differences were not significant
Cervical heterotopic pregnancy: a rare occurrence
Get PDFEctopic pregnancy is one of the leading causes of first-trimester gestation-related mortality. Cervical ectopic is a rare entity (less than 1% of all ectopic cases), heterotopic cervical pregnancy is a much rarer occurrence. Cervical pregnancy is highly dangerous and demands immediate termination of pregnancy as the chances of haemorrhage are too high, leading to maternal mortality. Although there are various approaches to terminate cervical pregnancy, it is challenging when accompanied by a live intrauterine pregnancy. Ultrasound-guided transcervical aspiration of the products of conception is the most suitable option in these cases. Here we describe a case of cervical heterotopic pregnancy, which we successfully and safely terminated using the above approach
Silent complete uterine dehiscence at repeat caesarean section: a case report
Get PDFUterine scar dehiscence is a rare but potentially life-threatening complication typically associated with prior caesarean deliveries. While most cases present with abdominal pain or abnormal foetal monitoring, silent complete dehiscence is rare and often only detected intraoperatively. Risk factors include multiple prior caesarean sections and short inter-delivery intervals. We report the case of a 32-years-old gravida 4 para 3 female with a history of three previous caesarean sections. She presented for elective repeat caesarean section at term. Antenatal assessments were unremarkable and she reported only minor urinary symptoms. Intraoperatively, a complete uterine dehiscence was identified, characterised by a full-thickness separation of the uterine wall without serosal involvement. This was complicated by a 7 cm bladder laceration. The bladder injury was promptly repaired and the patient received postoperative management including indwelling catheterisation, antibiotic therapy and urology follow-up. Her recovery was uneventful. This case underscores the importance of maintaining a high index of suspicion for uterine dehiscence in patients with multiple prior caesarean deliveries, even in the absence of symptoms. Early recognition and prompt surgical management are crucial to prevent severe maternal morbidity
Early intervention with recombinant factor VIIa in severe postpartum hemorrhage: a retrospective observational study for evaluation of safety and efficacy of recombinant activated factor VII
Get PDFBackground: Postpartum hemorrhage (PPH) is a critical obstetric emergency and leading cause of maternal death worldwide and in India. Despite the availability of several measures to treat PPH, maternal mortality from severe PPH remains high, highlighting the unmet need in the management of PPH. One promising development is the use of recombinant activated factor VII (rFVIIa), which has been recently approved for treatment of severe PPH in India.
Methods: This retrospective observational study compared the requirement of blood products, requirement of invasive procedures, and blood loss before and after rFVIIa administration in patients of severe PPH from two tertiary care centres in Bihar. rFVIIa was given when there was a persistent bleeding (blood loss>1000 ml) post-sequential uterotonics administration.
Results: Only one of 47 patients with severe PPH required an invasive procedure after receiving rFVIIa; the remaining 46 responded without needing further surgical intervention. rFVIIa administration resulted in a significant reduction in blood loss, from 1215 ml pre-administration to only 219 ml post-administration (p<0.001). rFVIIa administration also resulted in a significant reduction in requirement of blood products, from 3.67 units pre-administration to only 1.44 units post-administration (n=34) (p<0.0001). No Thromboembolic events were reported in 30 days of follow-up.
Conclusions: The study demonstrated that early use of rFVIIa in patients with severe PPH significantly reduced blood loss, blood product requirements, and the need for invasive procedures to control bleeding. When administered early in the management of severe PPH, rFVIIa offers a rapid, non-invasive, lifesaving, and fertility-preserving treatment option