International Journal of Reproduction, Contraception, Obstetrics and Gynecology
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A study on feto-maternal outcome in instrument assisted vaginal deliveries
Full text linkBackground: Operative Vaginal delivery (OVD) is performed with either forceps or vacuum used in second stage labour when there is maternal or fetal distress. A successful instrument assisted vaginal delivery can reduce the incidence the incidence of caesarean rates and its associated morbidity and mortality. It can be effective and safe when applied according to the individual patients indications.
Methods: A retrospective study was carried out in patients who has undergone instruments assisted vaginal delivery in SVMCH&RC during the year 2021-2023 and their data was obtained from medical record and delivery register at the hospital. The data obtained from Sri Venkateshwaraa Medical College Hospital and Research Centre Puducherry is compared with previously published studies.
Results: Out of 2022 deliveries 67 were instrument assisted vaginal deliveries in which majority of participants were primigravida aged between 21-30 years. The most common maternal indication was maternal exhaustion with inadequate expulsive efforts. Around 97% of newborn delivered by assisted vaginal delivery had an apgar score >6 at 1 minute. The complications have been reported in both vacuum and forceps assisted vaginal deliveries with slight increase in numbers on forceps assisted vaginal deliveries.
Conclusions: In this study after reviewing current various articles, it is proposed that surgeons prefer vacuum over forceps assisted vaginal delivery as it can provide better outcome in both mother and fetus in terms of both complications and its associated maternal and newborn morbidity and mortality. However, it should be applied according to individual patients indications, to reduce the caesarean section delivery rates
Estimation of serum uric acid levels as adverse prognostic indicator of perinatal outcome in pregnant women with pre-eclampsia: a prospective observational study
Full text linkBackground: Preeclampsia, a spectrum of hypertensive disorders of pregnancy, continues to have a significant impact in developing nations like India. Predicting the development of severe pregnancy-induced hypertension would be beneficial because all treatment protocols include some degree of expectant management. Hence, in this prospective observational study we aimed to estimate serum uric acid level and evaluated serum uric acid level as an indicator of adverse perinatal outcome in pregnant women with preeclampsia.
Methods: This is a prospective observational study conducted with total of 200 pregnant women at Department of Obstetrics and Gynaecology, S.S. Institute of Medical Science and Research Centre (SSIMRC) Davangere, Karnataka. The study subjects were divided in to two groups viz. Cases (n=100) and Control (n=100) groups. In Case group pregnant women diagnosed with preeclampsia were included and control group consist of normotensive pregnant women. All selected women were subjected to clinical examination and blood pressure was recorded. Blood samples were collected and serum was separated for serum uric acid estimation.
Results: The mean (±SD) age of the study subjects was found to be 25.56 (±3.56) and 24.75 (±2.48) in cases and control group respectively (p=0.214). There was a significant difference (p<0.05) in gestational age of delivery between cases (34.98±1.58) and control group (38.54±2.01). The mean (±SD) serum uric acid level between cases and control was found to be 7.36 (±0.21) and 3.30 (±0.13) which is statistically significant (p<0.001). There was a significant (p<0.001) positive correlation exists between SBP and serum uric acid (ρ=0.718) and DBP and serum uric acid (ρ=0.534).
Conclusions: This study clearly established association between serum uric acid levels and adverse perinatal outcome in pregnant women with preeclampsia. Hence, serum uric acid level >7 mg/dl in pregnant women with mean gestational age of 35 weeks either in primigravida or multigravida could be used as a prognostic marker of adverse perinatal outcome in pregnant women with preeclampsia
Awareness about Janani Suraksha Yojana among women: a community-based study
Full text linkBackground: Janani Suraksha Yojana (JSY), a maternity-benefit scheme launched by GOI (Government of India) in April 2005 under the national health mission aims to lessen maternal and neonatal deaths by promoting institutional birth among underprivileged pregnant women. The current research aimed to assess pregnant and post-partum women’s awareness about JSY scheme and to examine how the various components of the scheme were utilized by them.
Methods: The study followed a cross- sectional approach to collect data through in-person interviews after obtaining informed consent, using a pre-tested predesigned questionnaire. Women who were pregnant or delivered baby after the implementation of JSY were included in the study.
Results: Out of the total 85 women interviewed, it was seen that more than half of the women (63.5%) had heard about the JSY programme and their source of information was from auxiliary nurse midwives (ANMs) and anganwadi workers (AWWs) (35.8%) followed by radio/ T. V. (30.6%). Less than half of the respondents (35.3%) were unaware about cash incentives offered to pregnant women in rural areas. The study also revealed that a high correlation exists between family income and respondent’s awareness about the JSY scheme.
Conclusions: It was concluded from the findings that there is a dire need to improve the awareness about the utilization of JSY scheme among the urban population. Efforts should be enhanced to educate the health staff, AWWs and ASHA about the scheme as they are the agents of delivery and social change
Caesarean sections at full cervical dilation: a case series on outcomes and proactive measures in an Indian teaching hospital
Full text linkThis case series examines 20 cesarean sections performed at full cervical dilation at Khaja Banda Nawaz Teaching and General Hospital, India, from January to December 2024. Among 852 deliveries, 548 were cesarean sections, with 20 (3.65%) occurring at full dilation. Maternal complications included postpartum hemorrhage in 35% of cases, sepsis in 12%, blood transfusion in 15%, and one peripartum hysterectomy. Neonatal outcomes showed 10% NICU admissions, primarily for respiratory distress and sepsis. Deep transverse arrest was the leading indication in 66.15% of cases. The findings highlight the high morbidity associated with second-stage cesarean sections and propose proactive measures such as team training, standardized protocols, and enhanced monitoring to improve outcomes. These results emphasize the need for specialized care and further research in resource-constrained settings
Comparison between anti-Müllerian hormone and antral follicle count for assessment of ovarian reserve
Full text linkBackground: In general, anti-müllerian hormone (AMH) is positively associated with antral follicle count (AFC). AMH and AFC are correlated with the ovarian response, but their reliability and reproducibility are questionable.
Methods: This is a prospective observational study. A total of 50 patients were selected who visited the hospital for infertility treatment. It was conducted in SKIMS MCH Srinagar over a period of 4 months from January 2023 to April 2023. Karl Pearson’s correlation coefficient was employed for assessing correlation between AMH levels and Total AFC. A P value of less than 0.05 was considered statistically significant.
Results: Total of 50 patients were included in the study with mean age of patients being 34.1. The mean BMI of patients was 27.1 and mean duration of infertility was 3.6years. Mean±SD of AFC between age group 26 to 30 was 6.41±9.65 between 31 to 35 was 5.60±4.42 and between 36 to40 was 2.76±2.34, with a p value of 0.012 (statistically significant). Mean±SD of AMH between age 26 to30 was 2.10±1.98 between age 31to35 was 1.83±2.19 and between age 36 to40 was 0.49±0.72.
Conclusion: AMH is considered as most reliable investigation for ovarian reserve testing. However, AFC can be used in place of AMH in poor patients as the cost of AMH is more as they have a strong corelation
Clinical audit on period of gestation at induction of labor in singleton low risk women at a tertiary care centre in South India: M. O. S. C. Medical College, Kolenchery
Full text linkThis audit evaluates the period of gestation at which labor induction was performed in singleton low-risk women at MOSC medical college, Kolenchery. The objective was to identify inadequacies in the process and indications for labor induction to ensure compliance with recognized guidelines, improve patient care, and raise the standard of labor induction practices. Over a two-month period, 376 deliveries were recorded, of which 137 were singleton uncomplicated pregnancies. Among these, 77 women (56%) were induced at or after 39 weeks, while 60 women (44%) were induced before 39 weeks. This report presents a statistical analysis of the induction practices and recommends modifications to enhance adherence to established criteria for labor induction
Successful management of a young patient with endometroid ovarian carcinoma with positive immuno-histochemistry
Full text linkOvarian cancer is overall a disease of postmenopausal women although, in about 12% of cases, it may develop during child bearing age. This estimate includes numerous women with borderline and non-epithelial tumours typically presenting during child bearing age group. Although there are several case reports of Endometriosis-associated ovarian cancer (EAOC) at a young age, the exact age distribution of EAOC diagnosis is still not well- expounded. Presenting here with a young patient with ovarian malignancy with positive immuno-histochemistry for both oestrogen and progesterone receptor
Effect of negative suction drain on abdominal wounds after obstetric and gynecological surgery
Full text linkBackground: Wound complications are common after gynecological surgery. The purpose of the study was to find out whether use of negative suction reduces wound complications in gynecological surgery
Methods: Patients undergoing obstetric and gynecological surgeries were taken into the study. The study group had negative suction drain in the subcutaneous plane. The control group had conventional layered closure of abdominal wound. Wound complications were noted in each group and compared.
Results: We found significant reduction in surgical site infections in the negative suction group. In patients who are obese and BMI>25 there were less delayed wound healing, surgical site infections and gaping in negative suction group.
Conclusions: The use of negative suction drain significantly reduced surgical site infections. In patients with BMI>25 there was significant reduction in the incidence of delayed wound healing, gaping and surgical site infections
Recurrent transverse vaginal septum presenting as lactational amenorrhea: a rare presentation of a rare anomaly
Full text linkTransverse vaginal septum is a rare congenital Mullerian duct developmental anomaly with varied presentations in different age groups. Depending on its location in vagina, it can be a high, middle or low transverse vaginal septum, thus causing hematometra with or without hematocolpos. Diagnosis of transverse vaginal septum in female with symptoms of obstructive vaginal pathology is usually made with a careful gynaecological examination and USG. MRI may also be considered particularly in women with recurrence to know septal thickness and any distortion in anatomy from previous surgery. We report case of a 22-year-old lactating mother presenting as lactation amenorrhea and lower abdominal pain. She was diagnosed as a case of recurrent low transverse vaginal septum with hematocolpos and hematometra. She underwent Y-V plasty with drainage of hematometra and hematocolpos with mould with drainage placement. On follow-up she resumed her menses and able to cohabitate normally after 3 months of surgery. In females with primary amenorrhea, differentiating imperforate hymen and transverse vaginal septum is important. Transverse vaginal septum is known for its high rate of recurrences after surgery and will require postop dilators and regular postop follow-up. Using Mould with drainage is suggested for allowing longer intervals for mould change particularly in patients with hematometra and hematosalpinx
Perceptions, choices and experiences of contraceptive use among rural women aged 35–50 years: a case series from Jammu
Full text linkMidlife women often face unique reproductive health challenges, yet contraceptive practices and perceptions in this group remain under-researched, especially in rural India. This qualitative case series explored contraceptive perceptions, choices and experiences among six rural women aged 35–50 years in Chak Bhalwal Village, Jammu. Data were collected through in-depth interviews and analyzed using thematic content analysis. Most participants preferred male condoms due to ease of use and safety. Perceptions were shaped by partner influence, cultural beliefs and misinformation. Themes identified included contraceptive perceptions, method choices, personal experiences, sources of information and unintended pregnancy. Healthcare workers and media were the main information sources. Despite moderate awareness, myths about contraceptives persisted, limiting autonomous contraceptive decisions. Rural midlife women demonstrate moderate awareness but remain influenced by misconceptions and social dynamics. Community-based education involving both women and men is essential to improve contraceptive practice