Search

Background: Thyroid disorders are among the most common endocrine disorders in the world. Thyroid dysfunction can disrupt a variety of metabolic and physiological processes, including the menstrual cycle. The purpose of this study was to discover a pattern of thyroid dysfunction in women with menstrual disorders. Methods: It is a cross-sectional study that includes 116 women. With reproductive age menstrual disorder. Thyroid dysfunction was tested in women who had menstrual problems. Serum free triiodothyronine (T3), free thyroxine (T4), and thyroid stimulating hormone (TSH) levels were used to assess thyroid function. Results: The mean age of study patients was 25.7±6.8 years. The most common menstrual disorder was irregular cycle 72.5%, amenorrhea 21.9%, and menorrhagia 5.6%. The majority of the patients were between the ages of 15 and 24 (51.1%), followed by 25-34 (36.1%) and 35-45 (12.9%). The mean free T3 and T4 levels were 2.911.05 pg/ml and 1.420.57 ng/dl, respectively. TSH was 2.0 mIU/L on average (IQR, 1.0-4.0). Thyroid dysfunction was observed in 25.8% of the women (n=60). Subclinical hypothyroidism (14.2%, n=33) was the most common thyroid dysfunction, followed by subclinical hyperthyroidism (6.9%, n=16), overt hyperthyroidism (3%, n=7), and overt hypothyroidism (1.7%, n=4). Conclusions: The study reveals that women with menstrual disorders frequently have thyroid dysfunction, particularly subclinical hypothyroidism. In order to rule out thyroid disorders as potential etiological agents for menstrual disturbances, it may therefore be advantageous to screen patients with menstrual disorders for thyroid function.

Background: Breech presentation is defined as a fetus in a longitudinal lie with the podalic at the pelvic brim. There are three types of breech presentations: frank breech, complete, incomplete breech. The incidence of breech presentation decreases from about 20% at 28 weeks of gestation to 3-4% at term, as most babies turn spontaneously to the cephalic presentation. Studies have shown that the prevalence of term breech presentation varies globally. In India the incidence was shown to be, 2.1%, and in other Asian countries it was found to be around 2.9 -4.5%. Its incidence is around 25% at 28 weeks of gestation and it reduces to 4% by term. If patients are carefully selected, breech presentation can be delivered vaginally. However, the risk of neonatal complications still persists. sometimes the planned vaginal delivery has to be converted into emergency cesarean section. Such probability varies from 17.4 to 51%. Methods: This was a prospective observational study conducted in department of obstetrics and gynaecology department of SAMC and PGI, Indore, Madhya Pradesh from 1st April, 2021 to 31st October 2022. Ethical approval was taken from the institutional review committee. All term pregnant women (≥37 weeks) aged 18 years and above, admitted to the maternity and labor ward with the diagnosis of singleton breech presentation during the study period were included in the study. The patients were identified as having breech presentation on admission using physical examination and ultrasound. Those women who presented with antepartum hemorrhage, uterine rupture, fetuses with major congenital anomalies and intrauterine deaths were excluded from the study. After through exclusion sample of 70 people were included in study. Results: During the study period, 896 deliveries were conducted in this hospital. Among them, 70 (7.86%) of the deliveries were singleton breech delivery. The age of the participants in the study ranged from 16 to 45 years, with a mean age of 27.07±8.56 years. Most of them had elective cesarean section, and few had emergency cesarean section. The most common indication for emergency cesarean section was footling presentation. Most of the new-borns were males, mean weight of new-borns 2.75±0.5 kg. 21.9% neonates required admission in neonatal intensive care unit, 2.8% mothers developed wound infection and 10% had post-partum haemorrhage. Conclusions: Proper guidance, education and strict adherent to principles and steps of breech delivery, like monitoring taking up call for emergency c-sections, having proper NICU setup, trained doctors will help in reduction of complications. A protocol for the management of breech delivery and a regular training facility for junior health professionals to conduct assisted vaginal breech delivery are highly recommended.

The present study entitled “To evaluate Histopathological changes in Placenta of IUGR” was conducted in the Department of Obstetrics and Gynaecology. A total of 400 patients were studied. Out of them 200 were normal patients without IUGR and 200 with IUGR. These patients were evaluated with the help of semistructured proforma consisting of various socio-demographic and clinical variables.Number of LSCS deliveries in IUGR patients (59) is significantly more than control group (33).The number of syncytial knot formation (>10) in IUGR is 169 compared to 153 of control and hence is statistically insignificant. Cytotrophoblastic proliferation (>10) in IUGR (126) is significantly more than (92) in the control group. Number Of area fibrinoid necrosis in villi > 5 in IUGR group is 57 compared to control group (29) (significantly higher) No. of hylinized areas (> 5) in IUGR (101) is significantly higher than in control group (68). Histopathological findings in low power field like syncytial knot formation, cytotrophoblastic cellular proliferation, calcification and hyalinisation of villi are also found as normal aging changes in placenta but it occur early and more frequently per low power field in IUGR group. To conclude, these morphological & histological findings of placenta are the etiological basis for Intra uterine growth restriction.

The present study was carried out in the Department of Obstetrics and Gynaecology, with an aim to study the role of Serum Lactate Dehydrogenase in prediction of adverse outcomes of pre-eclampsia and eclampsia. The patients were selected from patients who were admitted to as emergency cases in labour room patients were irrespective of age and parity. On a specially designed proforma for this study, the patient particulars like detailed obstetric history, examination and laboratory findings were studied.Among the cases studied 76% preeclampsia and 96% eclampsia patient were unbooked case and most of them resided in rural areas while the remaining were from urban slums. Hyperbilirubinemia was seen in small groups of pre-eclampsia and eclampsia patients. Deranged level of liver enzyme were also found in small group of pre-eclampsia and eclampsia patients. LDH level was found significant higher (more than 600 IU/L) in pre-eclampsia and eclampsia patients. Eclampsia is associated with significant maternal and perinatal morbidity and mortality. The higher mortality is due to high percentage of the patient being unbooked and majority received no therapeutic intervention until admission. Among the cases studied 76% preeclampsia and 96% eclampsia patient were unbooked case and most of them resided in rural areas while the remaining were from urban slums. Hyperbilirubinemia was seen in small groups of pre-eclampsia and eclampsia patients. Deranged level of liver enzyme were also found in small group of pre-eclampsia and eclampsia patients. LDH level was found significant higher (more than 600 IU/L) in pre-eclampsia and eclampsia patients.

Background: The present study of twins was done among the patients admitted in the department of Obstetrics and Gynecology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. Method: Blood sample from the mother was collected for estimation of hemoglobin percentage to diagnose anemia, ABO & Rh typing for blood transfusion if necessary. Urine examination for albumin, sugar & acetone. Special investigations like USG done whenever possible. In maximum cases ultrasonography was done to detect or confirm presence of twins, their lie, maturity, gestational age, rule out congenital anomaly & to note any IUGR, Discordant growth. Amount of liquor also noted. Result: 143 (85.10%) babies were LBW. The main factors responsible for LBW were IUGR and prematurity. Intrauterine growth retardation affected 42 cases (24.41%) while prematurity affected 42 cases (24.41%) and 8 (9.3%) cases aborted. Intrauterine death was more common in first baby, because of malpresentations. Asphyxia was found to be slightly more in second baby in our study. Congenital anomalies were found in total 3 cases (1.78%). In one case, baby-2 was Anencephalic and in the other case baby-2 had fetal ascites. In one case baby-1 had multiple congenital anomalies with imperforate anus. Cord prolapse was present in one case. In one case (Case No. 17) first baby was presented by footling with cord prolapse LSCS was done, baby had SBA and died 1 day after birth. There were 8 abortions. All were second trimester abortions (12 weeks and 22 weeks). Conclusion: In the present study, incidence of various antepartum and intrapartum complications were less in booked cases, which shows that availability of antenatal care to more patients will further reduce their incidence and thus will decrease maternal morbidity. Keywords: Complications, Antepartum, Intrapartum & Postpartum.

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births. Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%). Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care. Conclusion: The rate of cesarean section has increased with time with primary and repeat cesareans both showing an increase. In the primary CS rate, indications like labor arrest disorders & fetal distress show an increase more than the objective indications like malpresentation. In repeat CS, history of 02 or more previous sections & scar tenderness contributed more than the fetal distress. Keywords: Indication, Caesarean

Background: Patients admitted in Gynecological ward in Department of Obstetrics and Gynecology in diagnosed with uterine fibroid and ovarian mass were selected for the study. The Criteria for diagnosis either by clinical features, USG findings and hysterectomy or confirmed by histopathological examination. Result: There are 104 cases of abdominal mass of which 55 cases are of ovarian mass and 46 are of fibroid and 3 are other masses. Conclusion: Management of these giant intraabdominal cysts has traditionally required a full midline laparatomy. Minimally invasive surgical technique has been applied to the management of these giant cysts. Ultrasound is effective in detecting the abdominal mass, size and type of abdominal mass, so that early diagnosis can be done and treatment can be given as soon as possible. Keywords: Surgical, Abdominal Mass & Gynaecological.

Primary pelvic hydatid cyst disease is a zoonotic parasitic disease most frequently caused by Echinococcus granulosus or Echinococcus multilocularis. Primary pelvic hydatid cyst is a rare entity. A 39-year-old, para 3 living 3 presented to casualty with acute pain abdomen and a suprapubic mass. Patient gave history of acute lower abdominal pain since 4 days associated with vomiting. On examination, a palpable mass around 18 weeks size, firm to hard in consistency with ill-defined margins and restricted mobility and suprapubic tenderness. Lower limit could not be reached, extending from right iliac fossa to midline. Per vaginum findings suggestive of mass deviated to right side with fullness in right fornix. No cervical motion tenderness. The pre-operative tumor marker levels were as follows: CA125=12.44 U/mL (normal=0-35), CEA=0.09 ng/mL (normal=0-2.5). CA19.9=16.79 U/mL (normal=1.2-30). Erythrocyte sedimentation rate (ESR) was found to be 82 mm in the first hour. Transabdominal ultrasound suggestive of adnexal mass? ovarian with moderate ascites. Urinary bladder seen separately. Contrast enhanced computed topography (CECT) suggestive of complicated right para-ovarian /ovarian cystic mass like cystadenoma. Exploratory laparotomy was done and specimen (uterus, cervix, omental biopsy and peritoneal washings) was sent for Histopathological report. Histopathological examination of the haematoxylin and eosin-stained section revealed ruptured brood capsule releasing daughter cyst. Post-operative period was uneventful. Patient received full course of anti-helminthic treatment.

Ovarian pregnancy is a rare form of extrauterine ectopic pregnancy. Risk factors such as reproductive treatments and infertility have been identified in recent studies. In this article, we present a case of ovarian ectopic pregnancy occurring following in vitro fertilization treatment and a fresh embryo transfer. The diagnosis of ovarian pregnancy was made during transvaginal sonography performed due to suspected ectopic pregnancy. Ovarian ectopic pregnancy is a rare clinical phenomenon. Late diagnosis and lack of appropriate intervention may have catastrophic results. Several mechanisms and risk factors are proposed, and their acknowledgment may improve early diagnosis and prevention of complications.

Ovarian neoplasms are common tumours in females comprising 23% of all gynecologic tumours and are the most common gynecologic malignancy. Ovarian cancer is primarily a disease of postmenopausal women, the highest number of cases being concentrated in the age group from 50 to 70 years. They are the 5th leading cause of cancer related deaths in women. Primary Mucinuous cystadenocarcinoma of ovary is very rare. Our reported case was 50 years old woman which came in our OPD of Sri Aurobindo Institute of Medical Sciences with vague symptoms of lower abdominal pain and swelling. The data were collected by history-taking, clinical examination, laboratory investigations, ultrasonographic examination, CECT abdomen, CA 125, and by histo-pathological study of the excised surgical specimen. The case was reported as a rare ovarian mucinous cystadenocarcinoma. New and improved screening modalities are required for early diagnosis. And proper diagnostic criteria should be made for better prognosis.

Background: The aim of this study was to evaluate the effectiveness of the condom catheter in treating postpartum hemorrhage refractory to medical treatment.Methods: This prospective study included 21 women with postpartum hemorrhage treated with a condom catheter as a conservative therapeutic option.Results: The condom catheter was successful in controlling hemorrhage in 90.4% of the women. It was effective in all women with vaginal delivery (11 of 12) and highly effective in women with uterine atony who did not respond to medical uterotonic treatment (6 of 7 women).Conclusions: Its ease of use and high effectiveness make the condom catheter a useful approach for the conservative management of acute postpartum hemorrhage. This device reduces bleeding, shortens the hospital stay and avoids the need for surgical management.

Background: Thyroid disease is one of the commonest endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of complications. The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction on maternal and perinatal outcome.Methods: This prospective, observational hospital-based case-control study carried on women coming for antenatal check-up in a Tertiary Care Hospital in INDORE from May 2018-December 2018. 50 known booked antenatal (case) patient with established thyroid disorder, more than 32 week of gestation, and 50-matched euthyroid patients (control) were taken.Results: Women suffering from overt and subclinical hypothyroidism and hyperthyroidism are nulliparous in 72% cases as compared to 32% in euthyroid patient. Increased maternal age was associated with higher incidence of thyroid dysfunction. Normal vaginal delivery by spontaneous labour seen in 56% of euthyroid, while it is reduced with thyroid dysfunction. 38% of altered thyroid profile patient undergo induction of labour and 24% cases undergo caesarean section as compared to control (17%). Adverse fetal outcome like intrauterine growth retardation, preterm birth and ICU admission seen increased with thyroid dysfunction as compared to euthyroid patients.Conclusions: Thyroid dysfunction in pregnancy, although has a low incidence, but is associated with adverse maternal and fetal implications. Thus, thyroid screening should be done in antenatal period to improve fetomaternal outcome.

Dissection of the aorta which is very rare in pregnancy usually occurs in the third trimester when blood volume and cardiac output rise to a maximum. We present here, a case of a 38-year-old pregnant woman with acute aortic dissection Type B. Management was conservative and after stabilization of vitals, obstetric hysterotomy was performed.

Pregnancy in sickle cell disease is associated with increased risk of maternal and fetal morbidity and mortality. Sickle cell disease is very common in tribal populations. The objective of this study was to review the maternal and perinatal outcome in patients with sickle cell disease of tribal populations. This is a retrospective study. The data extracted from the patients' case files included age, gravidity, family history, complications during pregnancy or at time of delivery or postpartum period, mode of delivery, and fetal outcome. There were 25 deliveries to women with sickle cell disease and 54 with sickle cell trait. Preeclampsia and disseminated intravascular coagulation were common problems associated with sickle cell disease as compared to the sickle cell trait and normal groups. No maternal mortality occurred during the period under study. However, a total of five intrauterine fetal deaths and one early neonatal death did occur. The present study confirms the previous reports, the increased risk of fetal death in women with sickle cell disease, however, in contrast to previous studies, no maternal mortality was found.

Objectives To analyze the significant risk associated with obesity and its consequences on obstetrics management and perinatal outcome. Materials and methods A prospective study was carried out in the Department of Obstetric and Gynecology, MGM Medical College and My Hospital, Indore. The study enrolled 200 pregnant women with body mass index (BMI) >25 and equal number of women with normal BMI (18-24.9) as control. Results A total of 76 (38%) out of 200 pregnant women were overweight, 70 (35%) were obese type 1 (BMI: 30-34.9), 44 (22%) had BMI (35-39.9) and 10 (5%) had BMI >40. In comparison to normal BMI pregnant women, women with BMI >25 had significant risk of gestation hypertension (p = 0.004), pre-eclampsia (p = 0.04) gestational diabetes mellitus and shoulder dystocia (p = 0.021), cesarean section (0.0001), induced labor (0.0001) and decreased incidence of VBAC (p = 0.037) with postoperative wound infection. Neonates of these women were mostly macrosomic (p = 0.021) and had high incidence of shoulder dystocia. Conclusion High maternal BMI at booking is associated with increased risk of pregnancy complications. Achieving a normal BMI prior to conception with the institution of healthy eating and exercise regimens may represent an ideal option. How to cite this article Dave A, Maru L, Daksha S, Natu N. Weight does Matter! A Study of Effect of Obesity on Pregnancy and its Outcome. J South Asian Feder Obst Gynae 2013;5(3): 107-110.

Background: Maternal and perinatal mortality and morbidity remains high during pregnancy in the presence of eclampsia, it can have severe adverse effects on mother and the fetus. So, its management should be a top priority. The objective of the present research was to study the effect of magnesium sulphate in control of imminent eclampsia and eclampsia.Methods: 19 cases of eclampsia and 185 cases of imminent eclampsia were treated with standardized magnesium sulphate. The outcome measures in terms of recurrence of convulsions, maternal and neonatal outcome, etc. were seen.Results: Most common age group in both the groups were 21-30 years (i.e. 78.9% with eclampsia and 75.7% with imminent eclampsia). In both the groups, majority of the women were primigravidae. In eclampsia group, 9 (47.4%) women had 1 episode of convulsion, 8 (42.1%) women had two episodes of convulsions, 1 (5.3%) women each had 3 and 4 episodes of convulsions, while there were no convulsions in imminent eclampsia women (‘t’ value = 28.558, df=202, p=0.000). Vomiting and headache (94.7%) were the most common premonitory symptoms in eclampsia group, followed by edema in 68.4% women, while in imminent eclampsia 64.9% women had headache, 57.8% women had edema and 43.2% had vomiting. Recurrence of convulsions were seen in 4 (21.1%) women of the eclampsia group even after giving maintenance dose and additional dose of magnesium sulphate. 1 (5.3%) death was seen in eclampsia group and none in the imminent eclampsia group. Neonatal mortality in eclampsia group (47.4%) was higher than imminent eclampsia group (11.7%), which was statistically significant (Z value = 3.05, p=0.002).Conclusions: Magnesium sulphate regimen was effective in control of convulsions in eclampsia and as prophylaxis in imminent eclampsia.

To determine the diagnostic value of risk factor analysis (age, duration of menopause, body mass index and physical activities) and radiological imaging (Singh index and cortical index of the femoral neck) in diagnosing osteoporosis in post-menopausal women, this study was cross sectional on 200 menopausal women without secondary risk factor for osteoporosis. They were classified proportionally using the Singh index. The Singh index and cortical index of the femoral neck were evaluated using femoral neck anterio-posterior X-ray. Physical activities were measured using a Historical leisure activity questionnaire. 14% women were found osteoporotic whereas osteopenia was observed in 62.5% women. The score system algorithm was the best method for determining osteoporosis in post-menopausal women. If there is osteopenia, evaluation using DEXA is then required. However score system algorithm cannot be used to follow up the therapy. Keywords: Postmenopausal; Singh's index; Osteoporosis

Background: Preterm birth remains a significant problem in obstetric care, affecting women and babies world-wide. Progesterone has an essential role in maintaining pregnancy by suppression of the calcium–calmodulin–myosin light chain kinase system. This study reflects the use of progesterone in preventing preterm birth.Methods: The data were collected as a retrospective study from SAMC and PGI Obstetric and Gynaecology Department.Results: With the use of Oral micronized progesterone out of 15 cases, term delivery 9 cases i.e. 60% and preterm delivery 6 cases i.e 40% and, with the use of vaginal progesterone suppository out of 15 cases, term delivery 11 cases i.e.73.3%, preterm delivery only 4 cases i.e 26.7%.Conclusions: Progesterone appears to be safe and efficacious in reducing the risk of preterm birth as well as NICU admissions, and neonatal morbidity and mortality in high risk patients. However, there is limited information available relating to longer-term infant and childhood outcomes, the assessment of which remains a priority. Further, trials are required to assess the optimal timing, mode of administration and dose of administration of progesterone therapy when given to women considered to be at increased risk of early birth.

Urogenital myiasis is an extremely rare condition seen in immunocompromised individuals, elderly, and persons with poor personal hygiene. It commonly occurs in tropical, subtropical countries, and areas with warm climate. The most common species associated with urogenital myiasis is phorids. Both diagnosis and management are equally simple.

Placenta accreta is one of the most serious complications of pregnancy and is frequently associated with severe obstetric hemorrhage, usually necessitating hysterectomy. Here, we are appending a case in the literature one with placenta accreta with previa. Uterine artery embolization was performed for the management of postpartum hemorrhage after subtotal hysterectomy.

In this paper, we are reporting a case of heterotopic pregnancy, which occurs as complications of clomiphene citrate.