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The coronavirus disease (COVID-19) has affected the health-care system worldwide. The effect of COVID-19 on obstetric and perinatal outcomes is yet to be completely ascertained. A hospital-based prospective observational study was conducted at the Department of Obstetrics & Gynecology, AIIMS Rishikesh from July to December 2020. A total of 60 COVID-positive pregnant women were included. Obstetric and perinatal outcomes were compared with 60 COVID-negative pregnant women. A subgroup comparison was also performed between symptomatic and asymptomatic pregnant women with COVID-19. Majority of COVID-positive pregnant women were asymptomatic (81.7%). Eleven patients were symptomatic, out of which 9 (15%) had mild disease and only 2 (3.3%) had severe pneumonia. There was an increased likelihood of early pregnancy loss (5%), oligohydramnios (21.7%), preterm birth (31.7%), and cesarean section (53.3%). The occurrence of preterm birth was significantly higher in symptomatic women than asymptomatic women (p =.01). Oligohydramnios was significantly more frequent in COVID-positive than COVID-negative pregnant women (p =.048). Preterm birth and cesarean rate were slightly higher in COVID-positive group but the difference was not statistically significant. Other obstetric outcomes were comparable in both groups. The majority of women with COVID-19 infection in pregnancy remain asymptomatic or have mild symptoms. Still, it may lead to maternal death and poor fetal outcomes in form of early pregnancy loss, prematurity, oligohydramnios, intrapartum fetal distress, and increased cesarean rate. Therefore, COVID-19 preventive measures should be strictly implemented and followed. [ABSTRACT FROM AUTHOR]

Background: Pelvic Organ Prolapse (POP) negatively affects the health of a woman in terms of physical, social and emotional wellbeing. Objective: The aim of this study was to elucidate the experience of living with prolapse and its impact on daily life. Methods: Women undergoing surgery for pelvic organ prolapse were interviewed to evaluate their sociodemographic profile with subsequent impact on their daily life. Results: Among the 45 cases with POP, 80% belonged to rural areas. Mean age of study group was 53.68 years. Young age at marriage (mean age 17.31), early first child birth (mean age being 20.5 years) and increased parity (86.66% had parity 3 and above) with majority of children born at home under supervision of untrained dais (77.78%) could probably attribute to their prolapse. Approximately 51% thought that prolapse occurs as a result of hard manual work and 64% cases considered it non treatable. POP was associated with poor quality of life in terms of physical, social and sexual life. Decreased sexual frequency was seen in 86.67% cases. 50% cases reported bladder problems. Sense of incomplete evacuation was seen in nearly 35% and constipation was reported by 37%. Conclusion: Though there exists a social stigma associated with pelvic organ prolapse, this study showed that in majority, it was the woman herself who delayed medical help. Health care providers should take initiative in educating women regarding prolapse and to make them aware that it is a treatable condition which can improve their quality of life. [ABSTRACT FROM AUTHOR]

Objective: In complicated mono-chorionic twin pregnancies, vaso-occlusive techniques like bipolar cord coagulation (BPCC), radiofrequency ablation (RFA), interstitial laser ablation (ILA) of cord and fetoscopy guided cord coagulation with lasers are the methods proposed for selective fetal reduction. This study brings forth preliminary data of selective fetal reduction procedures at a tertiary care center in India. Material and Methods: This was a prospective observational study of 31 patients with complicated mono-chorionic twin pregnancies. Methods used were ILA, RFA and BPCC. Outcome measures included overall co-twin survival after selective feticide, survival rates with each method, miscarriage (defined as all fetal loss before 24 weeks), early fetal death (<24 hours after procedure) and late fetal death (>24 hours after the procedure) of co-twin. Results: Technical success was achieved in 30/31 (96.8%) of pregnancies. Over all take home baby rate was 63.3%. Live birth rates were 50%, 71.4% and 75% with ILA, RFA and BPCC respectively. Conclusion: Data from initial cases of selective fetal reduction in complicated mono-chorionic twins suggests that these procedures are feasible but are associated with high adverse perinatal outcome. [ABSTRACT FROM AUTHOR]

Uterine adenofibroma is an extremely rare benign mixed mullerian tumor, most often presenting as vaginal mass with pain and abnormal uterine bleeding in postmenopausal females. Nonpuerperal uterine inversion is also an uncommon entity. We present a rare case of nonpuerperal uterine inversion due to a uterine adenofibroma. A 56-year-old postmenopausal female presented to us with bleeding and discharge per vaginum. Examination showed a polyp. Due to associated comorbidities, polypectomy was chosen as management modality failing which laparotomy was done, and the uterus was found to be inverted through the cervix, hysterectomy was done. Histopathological evaluation showed uterine adenofibroma. This is the first case of inversion reported due to uterine adenofibroma. [ABSTRACT FROM AUTHOR]

The article presents a review to summarize the epidemiology, etiology and risk factors, latest approach towards investigating an intrauterine death (IUD), and management options. It discusses the definition of IUD, causes of stillbirth, and the diagnosis of stillbirth. It attempts to give further understanding on intrauterine death to better manage such cases in clinical practice and to prevent similar cases in future.

Primary ovarian leiomyoma is an extremely rare form of extrauterine leiomyomas. The incidence of primary ovarian leiomyoma is 0.5%–1% of all benign ovarian smooth muscle tumors. We present a case of primary ovarian leiomyoma managed laparoscopically with ovarian preservation. [ABSTRACT FROM AUTHOR]

The article discusses the study on the comparison of the efficacy of glyceryl trinitrate, a nitric oxide donor, and misoprostol, a prostaglandin E1 analogue, in pre-abortion cervical priming before first trimester surgical abortion. Topics discussed include the difference in the cervical dilatation, its side effects, and the operative blood loss.

Purpose: The purpose of the study was to compare the choroidal thickness (CT) in pre-eclamptic (PE), healthy pregnant, and age-matched healthy non-pregnant females by spectral-domain optical coherence tomography (SD-OCT) and to investigate any possible correlation between subfoveal CT (SFCT) and mean arterial pressure (MAP) in PE., Methods: This was a hospital-based, comparative study. A total of 90 females (30 in each group) aged 20-40 years were recruited prospectively over 1 year. Females with refractive error beyond ±3 D, intraocular pressure >21 mmHg, prior ocular trauma or surgeries, systemic diseases, pregnancy-related complications (except PE), and poor OCT scans were excluded. Following comprehensive ophthalmic evaluation, CT was measured bilaterally using SD-OCT (EDI) at the subfoveal region and at 1500 μm nasal and temporal to fovea. Systolic and diastolic blood pressures were recorded in all., Results: The PE group had significantly thinner choroid (SFCT: 337.5 ± 49.8 OD, 333.0 ± 50.8 OS) as compared to the healthy non-pregnant group (SFCT: 351.6 ± 34.4 OD, 365.3 ± 33.6 OS) and healthy pregnant group (SFCT: 374.2 ± 44.1 OD, 377.2 ± 49.5 OS) (P < 0.05) in all locations (nasal, temporal, and subfoveal) in both eyes (except for OD nasal CT). However, there was no significant correlation between SFCT and MAP in the PE group., Conclusion: Significantly lower CT in PE without any direct correlation between SFCT and MAP may implicate that choroidal thinning in PE is governed by multifactorial choroidal vasospasm and endothelial dysfunction, instead of MAP solely., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Background This pilot study compared the intrauterine enabler device technique with the conventional method for inserting the copper 380 mm² intrauterine device (Cu-IUD), focusing on the fundal placement achieved by both methods. Methods This randomized controlled trial compared the provider and client experiences as well as the technique for inserting the Cu-IUD using the intrauterine enabler device and the conventional no-touch technique. A total of 100 clients underwent Cu-IUD insertion: 50 participants (Group A) received the conventional no-touch technique, while 50 participants (Group B) were treated with the intrauterine enabler device. Results Pain experienced during sounding with the Esa (plastic sound provided with an inserter device) was significantly lower compared to the metallic sound (p < 0.0001). Providers in Group B reported that loading the arms of the Cu-IUD was easy 94% of the time, compared to only 26% in Group A (p < 0.0001). Setting the measurement of uterine depth on the inserter tube was achieved easily every time in Group B and 90% of the time in Group A (p = 0.054). The placement technique for the device was easy every time in Group B, while it was reported as easy 86% of the time in Group A (p = 0.012). Overhandling of the device was significantly easier with the intrauterine enabler (98%) compared to the conventional method (64%) (p < 0.0001). Additionally, the time taken for insertion was significantly shorter with the intrauterine enabler compared to the conventional method (p < 0.0001). Conclusions The insertion of the Cu-IUD using a novel intrauterine enabler device is as safe and effective as the conventional method. The overall experience of insertion is more comfortable for the provider and less painful for the client., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of All India Institute of Medical Sciences, Rishikesh issued approval AIIMS/IEC/19/1284 and AIIMS/IEC/20/810. The trial was registered with the Clinical Trials Registry - India (CTRI/2020/06/025578). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chawla et al.)

Background: Robot-assisted surgeries are increasingly used for the treatment of benign gynaecological conditions. However, their impact in cases of significantly enlarged uteruses remains uncertain. This study aims to investigate whether the weight of the uterus influences the surgical results of robotic hysterectomy., Patients and Methods: Ambispective analysis of 306 cases was performed, of which 265 cases were analysed retrospectively. The outcome measures included total operative time, including docking time, console time and vault closure time, complication rates and quality of life (World Health Organization Quality of Life Brief questionnaire) stratified based on uterine sizes into three groups by every 250 g., Results: Of the 306 cases, 76.47% of cases (n = 234) had uterine weight <250 g, 18.30% of cases (n = 56) had uterine weight between 250 and 500 g, while 5.23% of cases (n = 16) had a weight of uterine specimen >500 g. The total operative time was significantly lower in the <250 g group compared to >500 g (81.92 ± 22.81 vs. 111.88 ± 40.27 min; P = 0.003), contributed primarily by the console time. Although the need for post-operative blood transfusion was higher in the >500 g group, the overall complication rate between the three groups was similar. The three groups had comparable QOL through all four domains., Conclusion: The present study underscores the influence of uterine weight on robotic hysterectomy outcomes, revealing increased operative times and post-operative haemoglobin drop for uteri over 500 g. Despite these challenges, complications were not significantly affected by uterine size., (Copyright © 2024 Copyright: © 2024 Journal of Minimal Access Surgery.)

Objective: In complicated mono-chorionic twin pregnancies, vaso-occlusive techniques like bipolar cord coagulation (BPCC), radiofrequency ablation (RFA), interstitial laser ablation (ILA) of cord and fetoscopy guided cord coagulation with lasers are the methods proposed for selective fetal reduction. This study brings forth preliminary data of selective fetal reduction procedures at a tertiary care center in India., Material and Methods: This was a prospective observational study of 31 patients with complicated mono-chorionic twin pregnancies. Methods used were ILA, RFA and BPCC. Outcome measures included overall co-twin survival after selective feticide, survival rates with each method, miscarriage (defined as all fetal loss before 24 weeks), early fetal death (<24 hours after procedure) and late fetal death (>24 hours after the procedure) of co-twin., Results: Technical success was achieved in 30/31 (96.8%) of pregnancies. Over all take home baby rate was 63.3%. Live birth rates were 50%, 71.4% and 75% with ILA, RFA and BPCC respectively., Conclusion: Data from initial cases of selective fetal reduction in complicated mono-chorionic twins suggests that these procedures are feasible but are associated with high adverse perinatal outcome.

Study Objective: To evaluate the outcomes of total laparoscopic hysterectomy using 3D vision in comparison with 2D vision in women with large uteri (≥500g)., Design: Retrospective analytical study Design Classification: Canadian Task Force II-1 Setting: Tertiary referral center for advanced gynecological surgery., Patients: Five hundred forty six women who underwent total laparoscopic hysterectomy over a period of 13 years were studied: 301 under 2D vision and 245 under 3D vision., Interventions: Total laparoscopic hysterectomy Measurements: Surgical time, blood loss and complications were recorded for every case in both groups., Main Results: The duration of surgery for hysterectomy in the 3D laparoscopy group (88.01?36.95 min) was significantly shorter than that in the 2D group (112.61?42.59 min, p=.0001). Blood loss in the 500-1000g group was significantly less in the 3D group (p=.005). The total complication rates for 3D surgery (3.37 %) and 2D surgery (6.64%) were comparable (p=.25)., Conclusion: Three-dimensional laparoscopy provides stereoscopic vision and increases precision and safety. The availability of depth perception adds to the ease of surgery, especially in cases of large uteri, leading to reductions in both the duration of surgery and blood loss, which improves patient outcomes.